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Microcoil Embolization for Acute Lower Gastrointestinal Bleeding

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An Erratum to this article was published on 18 October 2007

Abstract

Purpose

To assess outcomes after microcoil embolization for active lower gastrointestinal (GI) bleeding.

Methods

We retrospectively studied all consecutive patients in whom microcoil embolization was attempted to treat acute lower GI bleeding over 88 months. Baseline, procedural, and outcome parameters were recorded following current Society of Interventional Radiology guidelines. Outcomes included technical success, clinical success (rebleeding within 30 days), delayed rebleeding (>30 days), and major and minor complication rates. Follow-up consisted of clinical, endoscopic, and pathologic data.

Results

Nineteen patients (13 men, 6 women; mean age ± 95% confidence interval = 70 ± 6 years) requiring blood transfusion (10 ± 3 units) had angiography-proven bleeding distal to the marginal artery. Main comorbidities were malignancy (42%), coagulopathy (28%), and renal failure (26%). Bleeding was located in the small bowel (n = 5), colon (n = 13) or rectum (n = 1). Technical success was obtained in 17 patients (89%); 2 patients could not be embolized due to vessel tortuosity and stenoses. Clinical follow-up length was 145 ± 75 days. Clinical success was complete in 13 (68%), partial in 3 (16%), and failed in 2 patients (11%). Delayed rebleeding (3 patients, 27%) was always due to a different lesion in another bowel segment (0 late rebleeding in embolized area). Two patients experienced colonic ischemia (11%) and underwent uneventful colectomy. Two minor complications were noted.

Conclusion

Microcoil embolization for active lower GI bleeding is safe and effective in most patients, with high technical and clinical success rates, no procedure-related mortality, and a low risk of bowel ischemia and late rebleeding.

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Authors and Affiliations

  1. Department of Radiology, Beth Israel Deaconess Medical Center – Harvard Medical School, 330 Brookline Avenue – W/CC 335, Boston, MA, 02215-5400, USA

    Bertrand Janne d’Othée, Padmaja Surapaneni, Dmitry Rabkin & Melvin Clouse

  2. Department of Pathology, Beth Israel Deaconess Medical Center – Harvard Medical School, 330 Brookline Avenue – W/CC 335, Boston, MA, 02215-5400, USA

    Imad Nasser

Authors
  1. Bertrand Janne d’Othée
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  2. Padmaja Surapaneni
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  3. Dmitry Rabkin
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  4. Imad Nasser
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  5. Melvin Clouse
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Correspondence to Bertrand Janne d’Othée.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s00270-007-9183-6.

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d’Othée, B.J., Surapaneni, P., Rabkin, D. et al. Microcoil Embolization for Acute Lower Gastrointestinal Bleeding. Cardiovasc Intervent Radiol 29, 49–58 (2006). https://doi.org/10.1007/s00270-004-0301-4

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