Efficacy of emergency transarterial embolization in acute lower gastrointestinal bleeding: A single-center experience.
OBJECTIVE
The purpose of this study was to assess the safety and efficacy of transcatheter arterial embolization (TAE) in the treatment of acute lower gastrointestinal bleeding (LGIB) and to determine the potential factors that influence treatment outcome.


METHODS
A total of 38 patients with acute LGIB who were treated by TAE were retrospectively included. There were 24 men and 14 women, with a mean age of 61 years (range: 9-84 years). Patient characteristics, laboratory findings, treatments, causes of bleeding, angiographic findings, and outcomes were reviewed.


RESULTS
Active contrast extravasation was observed in 26/38 patients (68.4%) and was the most frequent angiographic finding, followed by abnormal mucosal staining (8/38; 21.1%) and tumor staining (4/38; 10.5%). Technical success of TAE was obtained in 35/38 patients (92%) whereas technical failure was observed in 3/38 patients (8%). Clinical success rate following TAE was 63%. Bowel ischemia occurred in 5/38 patients (13%) following TAE; mild ischemia without sequelae was observed in 3 patients and severe ischemias with bowel perforation requiring surgery in 2 patients. No variables were identified as significant predictive factors of failed TAE.


CONCLUSIONS
TAE is a safe and effective treatment to control massive acute LGIB, especially in the emergency setting with a clinical success rate of 63%.
Vascular and body interventional radiology unit, department of diagnostic and therapeutic radiology, faculty of medicine, Ramathibodi hospital, Mahidol university, 270, Rama VI Road, 10400 Ratchathewi, Bangkok, Thailand. Electronic address: pap191@hotmail.com.
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Bua-Ngam
Vascular and body interventional radiology unit, department of diagnostic and therapeutic radiology, faculty of medicine, Ramathibodi hospital, Mahidol university, 270, Rama VI Road, 10400 Ratchathewi, Bangkok, Thailand. Electronic address: sand_oic@hotmail.com.
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Norasetsingh
Vascular and body interventional radiology unit, department of diagnostic and therapeutic radiology, faculty of medicine, Ramathibodi hospital, Mahidol university, 270, Rama VI Road, 10400 Ratchathewi, Bangkok, Thailand. Electronic address: nong2204@yahoo.com.
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Treesit
Vascular and body interventional radiology unit, department of diagnostic and therapeutic radiology, faculty of medicine, Ramathibodi hospital, Mahidol university, 270, Rama VI Road, 10400 Ratchathewi, Bangkok, Thailand. Electronic address: tonmail2004@yahoo.com.
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Wedsart
Vascular and body interventional radiology unit, department of diagnostic and therapeutic radiology, faculty of medicine, Ramathibodi hospital, Mahidol university, 270, Rama VI Road, 10400 Ratchathewi, Bangkok, Thailand. Electronic address: jernychan@hotmail.com.
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Chansanti
Vascular and body interventional radiology unit, department of diagnostic and therapeutic radiology, faculty of medicine, Ramathibodi hospital, Mahidol university, 270, Rama VI Road, 10400 Ratchathewi, Bangkok, Thailand. Electronic address: jiemjit.tap@mahidol.ac.th.
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Tapaneeyakorn
Vascular and body interventional radiology unit, department of diagnostic and therapeutic radiology, faculty of medicine, Ramathibodi hospital, Mahidol university, 270, Rama VI Road, 10400 Ratchathewi, Bangkok, Thailand. Electronic address: loveuteng@hotmail.com.
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Panpikoon
Section of clinical epidemiology and biostatistics, faculty of medicine, Ramathibodi hospital, Mahidol university, Bangkok, Thailand. Electronic address: dr.sakda@gmail.com.
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Vallibhakara
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D002445:Celiac Artery / Q000000981:diagnostic imaging; D002648:Child; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D004630:Emergencies; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007416:Intestinal Perforation / Q000209:etiology; D007422:Intestines / Q000098:blood supply; D007511:Ischemia / Q000209:etiology; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D055815:Young Adult
Angiography; Gastrointestinal bleeding; Interventional imaging; Percutaneous arterial embolization