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20.06.2018 | Vascular-Interventional

Transcatheter arterial embolisation for acute lower gastrointestinal haemorrhage: a single-centre study

verfasst von: Joon Ho Kwon, Man-Deuk Kim, Kichang Han, Woosun Choi, Yong Seek Kim, Junhyung Lee, Gyoung Min Kim, Jong Yun Won, Do Yun Lee

Erschienen in: European Radiology | Ausgabe 1/2019

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Abstract

Objective

To investigate the safety and efficacy of transcatheter arterial embolisation (TAE) in the management of lower gastrointestinal bleeding (LGIB) and to identify predictors of clinical outcomes.

Methods

Between December 2005 and April 2017, 274 patients underwent diagnostic angiography for signs and symptoms of LGIB; 134 patients with positive angiographic findings were retrospectively analysed. The technical success of TAE and clinical outcomes, including recurrent bleeding, major complications, and in-hospital mortality were evaluated. The associations of various clinical and technical factors with clinical outcomes were analysed. Predictors for clinical outcomes were evaluated using univariate and multivariate logistic regression analyses.

Results

A total of 134 patients (mean age, 59.7 years; range, 14–82 years) underwent TAE for LGIB. The bleeding foci were in the small bowel in 74 patients (55.2%), colon in 35 (26.1%), and rectum in 25 (18.7%). Technical success was achieved in 127 patients (94.8%). The clinical success rate was 63% (80/127). The rates of recurrent bleeding, major complications, and in-hospital mortality were 27.9% (31/111), 18.5% (23/124), and 23.6% (33/127), respectively. Superselective embolisation and the use of N-butyl cyanoacrylate (NBCA) were significant prognostic factors associated with reduced recurrent bleeding (OR, 0.258; p = 0.004 for superselective embolisation, OR, 0.313; p = 0.01 for NBCA) and fewer major complications (OR, 0.087; p ˂ 0.001 for superselective embolisation, OR, 0.272; p = 0.007 for NBCA).

Conclusions

TAE is an effective treatment modality for LGIB. Superselective embolisation is essential to reduce recurrent bleeding and avoid major complications. NBCA appears to be a preferred embolic agent.

Key Points

• Transcatheter arterial Embolisation (TAE) is a safe and effective treatment for lower gastrointestinal tract haemorrhage.

• Superselective embolisation is essential to improve outcomes.

• N-butyl cyanoacrylate (NBCA) appears to be a preferred embolic agent with better clinical outcomes.

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Titel: Transcatheter arterial embolisation for acute lower gastrointestinal haemorrhage: a single-centre study
verfasst von: Joon Ho Kwon
Man-Deuk Kim
Kichang Han
Woosun Choi
Yong Seek Kim
Junhyung Lee
Gyoung Min Kim
Jong Yun Won
Do Yun Lee
Publikationsdatum: 20.06.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 1/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5587-8

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Transcatheter arterial embolisation for acute lower gastrointestinal haemorrhage: a single-centre study

Abstract

Objective

Methods

Results

Conclusions

Key Points

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Abstract

Objective

Methods

Results

Conclusions

Key Points

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