Digestive Disease Interventions 2023; 07(02): 089-094
DOI: 10.1055/s-0042-1760427
Review Article

Complications of Arterial Transcatheter Embolization for Treatment of Gastrointestinal Hemorrhage

1   Division of Interventional Radiology and Image-Guided Medicine, Emory University School of Medicine, Atlanta, Georgia
› Author Affiliations
Funding No funding was obtained for this article.


Transcatheter embolization is an effective minimally invasive treatment for nonvariceal gastrointestinal (GI) hemorrhage. While many patients with GI bleeding can be treated endoscopically, transcatheter embolization is an important therapy in patients with bleeding refractory to endoscopic management and serves as an alternative to surgery. Despite having lower morbidity than surgical management of GI bleeding, transcatheter embolization has its own set of risks and complications. Moreover, embolization can be performed with a variety of embolic agents, each with their own advantages and disadvantages. Knowledge of complications specific to transcatheter embolization is essential for interventional radiologists as well as all physicians involved in managing patients with GI hemorrhage.

Publication History

Received: 01 July 2022

Accepted: 07 December 2022

Article published online:
10 January 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

  • References

  • 1 Penugoda N, Jones J, Spears R, Schreiber T. Incidence and predictors of vascular complications after invasive coronary procedures: a prospective analysis. Vasc Dis Manag 2008; 5: 6-9
  • 2 Ben-Dor I, Sharma A, Rogers T. et al. Micropuncture technique for femoral access is associated with lower vascular complications compared to standard needle. Catheter Cardiovasc Interv 2021; 97 (07) 1379-1385
  • 3 Seto AH, Abu-Fadel MS, Sparling JM. et al. Real-time ultrasound guidance facilitates femoral arterial access and reduces vascular complications: FAUST (Femoral Arterial Access With Ultrasound Trial). JACC Cardiovasc Interv 2010; 3 (07) 751-758
  • 4 Taylor BS, Rhee RY, Muluk S. et al. Thrombin injection versus compression of femoral artery pseudoaneurysms. J Vasc Surg 1999; 30 (06) 1052-1059
  • 5 Zilinyi RS, Sethi SS, Parikh MA, Parikh SA. Iatrogenic arteriovenous fistula following femoral access precipitating high-output heart failure. JACC Case Rep 2021; 3 (03) 421-424
  • 6 Kelm M, Perings SM, Jax T. et al. Incidence and clinical outcome of iatrogenic femoral arteriovenous fistulas: implications for risk stratification and treatment. J Am Coll Cardiol 2002; 40 (02) 291-297
  • 7 Tsetis D. Endovascular treatment of complications of femoral arterial access. Cardiovasc Intervent Radiol 2010; 33 (03) 457-468
  • 8 Joyal D, Bertrand OF, Rinfret S, Shimony A, Eisenberg MJ. Meta-analysis of ten trials on the effectiveness of the radial versus the femoral approach in primary percutaneous coronary intervention. Am J Cardiol 2012; 109 (06) 813-818
  • 9 Rashid M, Kwok CS, Pancholy S. et al. Radial artery occlusion after transradial interventions: a systematic review and meta-analysis. J Am Heart Assoc 2016; 5 (01) e002686
  • 10 DeCarlo C, Latz CA, Boitano LT. et al. Percutaneous brachial access associated with increased incidence of complications compared with open exposure for peripheral vascular interventions in a contemporary series. J Vasc Surg 2021; 73 (05) 1723-1730
  • 11 Yu Q, Funaki B, Navuluri R. et al. Empiric transcatheter embolization for acute arterial upper gastrointestinal bleeding: a meta-analysis. AJR Am J Roentgenol 2021; 216 (04) 880-893
  • 12 Kim PH, Tsauo J, Shin JH, Yun SC. Transcatheter arterial embolization of gastrointestinal bleeding with N-butyl cyanoacrylate: a systematic review and meta-analysis of safety and efficacy. J Vasc Interv Radiol 2017; 28 (04) 522-531.e5
  • 13 Hur S, Jae HJ, Lee M, Kim HC, Chung JW. Safety and efficacy of transcatheter arterial embolization for lower gastrointestinal bleeding: a single-center experience with 112 patients. J Vasc Interv Radiol 2014; 25 (01) 10-19
  • 14 Kodani M, Yata S, Ohuchi Y, Ihaya T, Kaminou T, Ogawa T. Safety and risk of superselective transcatheter arterial embolization for acute lower gastrointestinal hemorrhage with N-butyl cyanoacrylate: angiographic and colonoscopic evaluation. J Vasc Interv Radiol 2016; 27 (06) 824-830
  • 15 Loffroy R, Guiu B, D'Athis P. et al. Arterial embolotherapy for endoscopically unmanageable acute gastroduodenal hemorrhage: predictors of early rebleeding. Clin Gastroenterol Hepatol 2009; 7 (05) 515-523
  • 16 Padia SA, Geisinger MA, Newman JS, Pierce G, Obuchowski NA, Sands MJ. Effectiveness of coil embolization in angiographically detectable versus non-detectable sources of upper gastrointestinal hemorrhage. J Vasc Interv Radiol 2009; 20 (04) 461-466
  • 17 Aina R, Oliva VL, Therasse E. et al. Arterial embolotherapy for upper gastrointestinal hemorrhage: outcome assessment. J Vasc Interv Radiol 2001; 12 (02) 195-200
  • 18 Guy GE, Shetty PC, Sharma RP, Burke MW, Burke TH. Acute lower gastrointestinal hemorrhage: treatment by superselective embolization with polyvinyl alcohol particles. AJR Am J Roentgenol 1992; 159 (03) 521-526
  • 19 Tandberg DJ, Smith TP, Suhocki PV. et al. Early outcomes of empiric embolization of tumor-related gastrointestinal hemorrhage in patients with advanced malignancy. J Vasc Interv Radiol 2012; 23 (11) 1445-1452
  • 20 Lin YM, Lin EY, Tseng HS. et al. Preventive covered stent placement at the gastroduodenal artery stump in angiogram-negative sentinel hemorrhage after pancreaticoduodenectomy. Abdom Radiol (NY) 2021; 46 (10) 4995-5006