Literature DB >> 25927678

Long-term results of microcoil embolization for colonic haemorrhage: how common is rebleeding?

O Ahmed1, D Jilani1, S Sheth1, M Giger1, B Funaki1.   

Abstract

OBJECTIVE: To determine the long-term results of patients undergoing transcatheter coil embolization for the treatment of acute colonic haemorrhage.
METHODS: Patients undergoing angiography for suspected colonic bleeding between January 2002 and December 2012 were reviewed (average age, 60 years; 38.4% male). Baseline, procedural and outcome parameters were recorded following the Society of Interventional Radiology guidelines. Primary outcome measures included early (<30 days) and delayed (>30 days) rebleeding events and adverse procedure-related complication. Average follow-up time was 996 days (median, 232 days; range, 30-3663 days).
RESULTS: One or multiple sites of bleeding were identified in 40 cases. Coil embolization was performed in 39 patients, 26 (66.7%, 26/39) of whom were treated successfully without technical/clinical failure (n = 12) or loss to follow-up (n = 1). Three patients (11.5%, 3/26) rebled in the early period within 30 days; one patient went on to hemicolectomy. Four patients (15.3%, 4/26) experienced delayed rebleeding after 30 days; two of whom also underwent hemicolectomy. No major complication occurred. One minor complication of short segment arterial dissection was seen in the clinical failure group. One case of asymptomatic ischaemia was identified on a patient undergoing pre-operative colonoscopy for elective bowel resection. No instances of ischaemic stricture were seen. All-cause mortality of successfully treated and all patients at 1 year was 31% (8/26) and 30% (12/40), respectively.
CONCLUSION: Transcatheter coil embolization is a durable treatment option with a technical and clinical success rate of 67% in the setting of acute colonic haemorrhage. A modest level of rebleeding was seen among successfully treated patients in both the early and delayed periods; in the majority of patients, embolization proved to be definitive therapy. ADVANCES IN KNOWLEDGE: Transcatheter coil embolization is a durable and potentially definitive therapy in the management of acute colonic haemorrhage.

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Year:  2015        PMID: 25927678      PMCID: PMC4628543          DOI: 10.1259/bjr.20150203

Source DB:  PubMed          Journal:  Br J Radiol        ISSN: 0007-1285            Impact factor:   3.039


  27 in total

1.  Colonic stricture after transcatheter embolization for diverticular bleeding.

Authors:  H A Mitty; S Efremidis; R J Keller
Journal:  AJR Am J Roentgenol       Date:  1979-09       Impact factor: 3.959

2.  Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage.

Authors:  D M Jensen; G A Machicado; R Jutabha; T O Kovacs
Journal:  N Engl J Med       Date:  2000-01-13       Impact factor: 91.245

3.  Quality improvement guidelines for percutaneous transcatheter embolization. SCVIR Standards of Practice Committee. Society of Cardiovascular & Interventional Radiology.

Authors:  A T Drooz; C A Lewis; T E Allen; S J Citron; P E Cole; N J Freeman; J W Husted; P C Malloy; L G Martin; A Van Moore; C D Neithamer; A C Roberts; D Sacks; O Sanchez; A C Venbrux; C W Bakal
Journal:  J Vasc Interv Radiol       Date:  1997 Sep-Oct       Impact factor: 3.464

4.  Transmural coil extrusion after embolization for colonic hemorrhage.

Authors:  Richard Duszak; John W Fowler
Journal:  J Radiol Case Rep       Date:  2010-09-01

5.  Superselective arterial embolization for the treatment of lower gastrointestinal hemorrhage.

Authors:  R Bandi; P C Shetty; R P Sharma; T H Burke; M W Burke; D Kastan
Journal:  J Vasc Interv Radiol       Date:  2001-12       Impact factor: 3.464

Review 6.  Review article: the management of lower gastrointestinal bleeding.

Authors:  J J Farrell; L S Friedman
Journal:  Aliment Pharmacol Ther       Date:  2005-06-01       Impact factor: 8.171

7.  Superselective microcoil embolization for the treatment of lower gastrointestinal hemorrhage.

Authors:  William T Kuo; David E Lee; Wael E A Saad; Nikhil Patel; Lawrence G Sahler; David L Waldman
Journal:  J Vasc Interv Radiol       Date:  2003-12       Impact factor: 3.464

8.  Can superselective embolization be definitive for colonic diverticular hemorrhage? An institution's experience over 9 years.

Authors:  Ker-Kan Tan; Vigneswaran Nallathamby; Daniel Wong; Richard Sim
Journal:  J Gastrointest Surg       Date:  2009-10-20       Impact factor: 3.452

Review 9.  Treatment of lower gastrointestinal bleeding: vasopressin infusion versus embolization.

Authors:  Michael Darcy
Journal:  J Vasc Interv Radiol       Date:  2003-05       Impact factor: 3.464

10.  Angiographic treatment of gastrointestinal hemorrhage: comparison of vasopressin infusion and embolization.

Authors:  A S Gomes; J F Lois; R D McCoy
Journal:  AJR Am J Roentgenol       Date:  1986-05       Impact factor: 3.959

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  1 in total

Review 1.  The Indications for and Timing of Surgery for Diverticular Disease.

Authors:  Johan Friso Lock; Christian Galata; Christoph Reißfelder; Jörg-Peter Ritz; Thomas Schiedeck; Christoph-Thomas Germer
Journal:  Dtsch Arztebl Int       Date:  2020-08-31       Impact factor: 5.594

  1 in total

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