Abstract
Purpose The aim of the study was to assess the safety and efficacy of transarterial embolization
in the treatment of acute lower gastrointestinal hemorrhage (LGIH) from colonic origin
and to determine factors that influence the treatment outcome.
Methods This retrospective study included 32 patients (mean age: 37.5 years; 24 males) of
acute LGIH with a colonic source diagnosed on conventional angiography between March
2014 and May 2023. The clinical characteristics at presentation, laboratory findings,
etiology of bleeding, angiographic findings, and embolization details were assessed
and correlated with outcomes comprising success rates of embolization, complications,
recurrence (immediate and late), and mortality.
Results Embolization was technically successful in 27 patients (84.4%) and clinically successful
in 24 patients (75%). Embolic agents used were coils (n = 12), n-butyl cyanoacrylate glue (n = 8), Gelfoam (n = 4), polyvinyl alcohol (PVA) particles (n = 2), and a combination of coils and glue (n = 1). Major complications were seen in five patients (15.6%) including artery dissection
(n = 3) and catheter impaction and fracture (n = 2). Sixteen patients (50%) died after a mean period of 8.3 ± 8.8 days mostly due
to septic shock related to the underlying cause. Immediate recurrence was observed
in five patients (15.6%) after 3.8 ± 1.6 days of embolization and late recurrence
in one patient (3.1%) after 76 days. Both univariate and multivariate analyses showed
that acute pancreatitis as etiology was significantly associated with mortality (p < 0.05). No other parameters showed any significant association with outcomes.
Conclusion Transarterial embolization is safe and effective in the treatment of acute LGIH due
to a colonic source. The etiology of acute pancreatitis is significantly associated
with increased mortality.
Keywords
lower GI bleed - transarterial intervention
