scholarly journals Evaluation of Superselective Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate in Treating Lower Gastrointestinal Bleeding: A Retrospective Study on Seven Cases

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Yuan Zhao ◽  
Gang Li ◽  
Xiang Yu ◽  
Ping Xie
Keyword(s):  
Retrospective Study ◽  
Gastrointestinal Bleeding ◽  
Transcatheter Arterial Embolization ◽  
Alternative Therapy ◽  
Clinical Signs ◽  
Arterial Embolization ◽  
Lower Gastrointestinal Bleeding ◽  
Lower Gastrointestinal Hemorrhage ◽  
Intestinal Necrosis ◽  
Long Run

Background. To investigate the safety and efficacy of superselective transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) in treating lower gastrointestinal bleeding caused by angiodysplasia.Methods. A retrospective study was performed to evaluate the clinical data of the patients with lower gastrointestinal bleeding caused by angiodysplasia. The patients were treated with superselective TAE with NBCA between September 2013 and March 2015. Angiography was performed after the embolization. The clinical signs including melena, anemia, and blood transfusion treatment were evaluated. The complications including abdominal pain and intestinal ischemia necrosis were recorded. The patients were followed up to evaluate the efficacy in the long run.Results. Seven cases (2 males, 5 females; age of69.55±2.25) were evaluated in the study. The embolization was successfully performed in all cases. About 0.2–0.8 mL (mean0.48±0.19 mL) NCBA was used. Immediate angiography after the embolization operation showed that the abnormal symptoms disappeared. The patients were followed up for a range of 2–19 months and six patients did not reoccur. No serious complications, such as femoral artery puncture point anomaly, vascular injury, and intestinal necrosis perforation were observed.Conclusion. For the patients with refractory and repeated lower gastrointestinal hemorrhage due to angiodysplasia, superselective TAE with NBCA seem to be a safe and effective alternative therapy when endoscopy examination and treatment do not work.

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

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Mitsuhiro Kinoshita ◽  
Hiroshi Kondo ◽  
Suguru Hitomi ◽  
Takuya Hara ◽  
Ryusei Zako ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Transcatheter Arterial Embolization ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Arterial Embolization ◽  
Lower Gastrointestinal Bleeding ◽  
Recurrent Bleeding ◽  
Major Complications ◽  
Vasa Recta

Abstract Purpose To evaluate the clinical outcome of ultraselective transcatheter arterial embolization (TAE) with small-sized microcoils for acute lower gastrointestinal bleeding (LGIB). Materials and methods 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. Results 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. Conclusion Ultraselective TAE with small-sized microcoils is a highly effective and safe treatment modality for LGIB.

scholarly journals Validation and modification of existing mortality prediction model for lower gastrointestinal bleeding: A retrospective study

2021 ◽  
Author(s):  
Hyun Suk Lee ◽  
Hee Seok Moon ◽  
In Sun Kwon ◽  
Hyun Yong Jeong ◽  
Byung Seok Lee ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Confidence Interval ◽  
Gastrointestinal Bleeding ◽  
Scoring System ◽  
Vital Signs ◽  
International Normalized Ratio ◽  
Mortality Prediction ◽  
Lower Gastrointestinal Bleeding ◽  
Operating Characteristics ◽  
Related Mortality

Abstract Background Lower gastrointestinal bleeding (LGIB) often subsides by itself; however, in some cases, the bleeding does not stop and the patient’s condition worsens. Therefore, if the occurrence of severe lower gastrointestinal bleeding can be predicted in advance, it can be helpful for treatment. This study aimed to evaluate variables related to mortality from LGIB and to propose a scoring system. Methods This retrospective study reviewed the medical records of patients who visited the emergency room with hematochezia between January 2016 and December 2020. Through regression analysis of vital signs, laboratory investigations, and hospital stay, variables related to LGIB-related mortality were evaluated. A scoring system was developed, and the appropriateness with an area under the receiver operating characteristics curve (AUROC) was evaluated and compared with other existing models. Results A total of 932 patients were hospitalized for LGIB. Variables associated with LGIB-related mortality were the presence of cancer, heart rate of > 100 beats/min, blood urea nitrogen level of ≥ 30 mg/dL, an international normalized ratio of > 1.50, and albumin level of ≤ 3.0 g/dL. The AUROCs of CNUH-4 and CNUH-5 were 0.890 (p < 0.001; cutoff, 2.5; 95% confidence interval, 0.0851 − 0.929) and 0.901 (p < 0.001; cutoff, 3.5; 95% confidence interval, 0.869 − 0.933), respectively. Conclusions The model developed for predicting the risk of LGIB-related mortality is simple and easy to apply clinically. The AUROC of the model was better than that of the existing models.

scholarly journals Acute Lower Gastrointestinal Bleeding: Part II

2001 ◽  
Vol 15 (8) ◽  
pp. 517-521 ◽  
Author(s):  
Robert Enns
Keyword(s):  
Gastrointestinal Bleeding ◽  
Surgical Intervention ◽  
Lower Gastrointestinal Bleeding ◽  
Lower Gastrointestinal Hemorrhage ◽  
Nuclear Scintigraphy ◽  
Diagnostic Strategies ◽  
Advantages And Disadvantages ◽  
Therapeutic Value ◽  
The Face ◽  
Acute Lower Gastrointestinal Hemorrhage

Diagnostic strategies for lower gastrointestinal bleeding include nuclear scintigraphy, mesenteric angiography and endoscopic evaluation of the lower gastrointestinal tract. Each method has inherent advantages and disadvantages. Nuclear scintigraphy is simple and noninvasive, but high rates of false localization have led most clinicians to insist on confirmation of the bleeding site by another method before considering surgical intervention. Angiography is very specific, but is invasive and not as sensitive as nuclear scintigraphy. Colonoscopy is sensitive and specific, and can offer therapeutic value but can be technically challenging in the face of acute lower gastrointestinal hemorrhage. These strategies and the evidence behind them are discussed.

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