Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2019; 7(22): 3728-3733
Published online Nov 26, 2019. doi: 10.12998/wjcc.v7.i22.3728
Super-selective arterial embolization in the control of acute lower gastrointestinal hemorrhage
Liang-Shan Lv, Jing-Tao Gu
Liang-Shan Lv, Department of Gastroenterology and Interventional Radiography, Xi’an Gaoxin Hospital, Xi’an Jiaotong University, Xi’an 710075, Shaanxi Province, China
Jing-Tao Gu, Department of Vascular Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Author contributions: Lv LS and Gu JT contributed equally to this work and were considered as co-first authors; Lv LS and Gu JT designed the research, collected and analyzed the data, and wrote the paper.
Institutional review board statement: This research was approved by the Medical Ethics Committee of Xi’an Gaoxin Hospital.
Informed consent statement: Due to the retrospective nature of the study, informed consent was waived.
Conflict-of-interest statement: This research did not use any statistical method to analyze the data.
Data sharing statement: The authors have no conflict of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Liang-Shan LV, MD, Doctor, Department of Gastroenterology and Interventional Radiography, Xi’an Gaoxin Hospital, Xi’an Jiaotong University, Xi’an 710075, Shaanxi Province, China. 1603014227@st.nuc.edu.cn
Received: September 8, 2019
Peer-review started: September 8, 2019
First decision: October 24, 2019
Revised: November 14, 2019
Accepted: November 15, 2019
Article in press: November 15, 2019
Published online: November 26, 2019
Processing time: 79 Days and 2.9 Hours
Abstract
BACKGROUND

Acute gastrointestinal bleeding is an emergency condition that can lead to significant morbidity and mortality. Embolization is considered the preferred therapy in the treatment of lower gastrointestinal bleeding when it is unrealistic to perform the surgery or vasopressin infusion in this population. Treatment of acute lower gastrointestinal (GI) bleeding (any site below the ligament of Treitz) using this technique has not reached a consensus, because of the belief that the risk of intestinal infarction in this condition is extremely high. The purpose of the study is to evaluate the effectiveness and safety of this technique in a retrospective group of patients who underwent embolization for acute lower GI bleeding.

AIM

To evaluate the efficacy and safety of super-selective arterial embolization in the management of acute lower GI bleeding.

METHODS

A series of 31 consecutive patients with angiographically demonstrated small intestinal or colonic bleeding was retrospectively reviewed. The success rate and complication rate of super-selective embolization were recorded.

RESULTS

Five out of thirty-one patients (16.1%) could not achieve sufficiently selective catheterization to permit embolization. Initial control of bleeding was achieved in 26 patients (100%), and relapsed GI bleeding occurred in 1 of them at 1 wk after the operation. No clinically apparent bowel infarctions were observed in patients undergoing embolization.

CONCLUSION

Super-selective embolization is a safe therapeutic method for acute lower GI bleeding, and it is suitable and effective for many patients suffering this disease. Importantly, careful technique and suitable embolic agent are essential to the successful operation.

Keywords: Lower gastrointestinal bleeding; Embolization; Infarction; Bowel; Hemorrhage; Selective arterial embolization

Core tip: Transcatheter embolization has been accepted as an effective and safe method for treating acute upper gastrointestinal (GI) bleeding. Treatment of acute lower GI bleeding (any site below the ligament of Treitz) using this technique has not reached a consensus, because of the belief that the risk of intestinal infarction in this condition is extremely high. The purpose of the study is to evaluate the effectiveness and safety of this technique in a retrospective group of patients who underwent embolization for acute lower GI bleeding.