Ultraselective transcatheter arterial embolization with small-sized microcoils for acute lower gastrointestinal bleeding

CVIR Endovascular

article

Kinoshita, Mitsuhiro¹  Matsunaga, Naoki²  Takechi, Katsuya¹  Shirono, Ryozo³  Akagawa, Yoko¹  Osaki, Kyosuke¹  Ohnishi, Norio¹  Tani, Hayato¹  Kondo, Hiroshi⁴  Hitomi, Suguru⁴  Hara, Takuya⁴  Zako, Ryusei⁴  Yamamoto, Masayoshi⁴  Hiraoka, Junichiro¹  Takaoka, Yukiko⁵  Enomoto, Hideaki⁵ 

[1] Department of Radiology, Tokushima Red Cross Hospital;Department of Emergency & Clinical Care Medicine, Tokushima Red Cross Hospital;Department of Radiology, Kawashima-kai Kawashima Hospital;Department of Radiology, Teikyo University School of Medicine;Department of Radiology (Diagnostic Radiology), Tokushima University Hospital

关键词: Acute lower gastrointestinal bleeding;    Microcoils;    Recurrent bleeding;    Ultraselective transcatheter arterial embolization;    Vasa recta;   

DOI  :  10.1186/s42155-021-00215-9

学科分类：计算机科学（综合）

来源: Springer

【 摘 要 】

To evaluate the clinical outcome of ultraselective transcatheter arterial embolization (TAE) with small-sized microcoils for acute lower gastrointestinal bleeding (LGIB). The subjects were 17 consecutive patients (mean age, 69 years) with LGIB who were treated with ultraselective TAE using small-sized microcoils between December 2013 and December 2019. Ultraselective TAE was defined as embolization of one or both of the long or short branches of the vasa recta. The etiologies of bleeding were colonic diverticulosis in 16 patients (94%) and malignancy in one patient (6%). The bleeding foci were in the ascending colon in 11 patients (65%), transverse colon in 2 patients (12%), and sigmoid colon in 4 patients (23%). A total of 18 branches (diameter: range 0.5–1.5 mm, mean 1.1 mm) of the vasa recta in 17 patients were embolized with small-sized microcoils (size range 1–3 mm, mean combined lengths of all microcoils 7.6 cm). The mean follow-up period was 19 months (range 1–80 months). The technical and clinical success rate, recurrent bleeding rate, major complications and long-term clinical outcomes were retrospectively evaluated. Technical and clinical success was achieved in all patients (17/17). The rates of early recurrent bleeding (within 30 days of TAE) and major complications were 0% (0/17). Recurrent bleeding occurred in one patient at 2 months after TAE, but was stopped with conservative treatment. There were no other bleeding episodes or complications in the follow-up period. Ultraselective TAE with small-sized microcoils is a highly effective and safe treatment modality for LGIB.

【 授权许可】

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