Yosuke Nozawa1, Kenkichi Michimoto2, Hirokazu Ashida2, Akira Baba2, Takeshi Fukuda2, Hiroya Ojiri2. 1. Department of Radiology, Jikei University Hospital, Jikei University, 3-19-18, Nishishinbashi, Minato-ku, Tokyo, Japan. nozawaivr@gmail.com. 2. Department of Radiology, Jikei University Hospital, Jikei University, 3-19-18, Nishishinbashi, Minato-ku, Tokyo, Japan.
Abstract
PURPOSE: Transcatheter arterial embolization (TAE) for colonic diverticular bleeding (CDB), an established procedure for hemostasis, is sometimes complicated by spontaneous hemostasis and unclear bleeding site on angiography despite active arterial bleeding on preoperative computed tomography angiography (CTA). Therefore, to investigate and increase the feasibility of TAE, this retrospective study evaluates the clinical and radiological features related to positive extravasation on angiography. MATERIAL AND METHODS: Sixty CDB patients with extravasation on CTA underwent TAE between January 2011 and February 2021 and were divided into extravasation-positive (P-group; n = 25) and -negative groups (N-group; n = 35) based on the superior or inferior mesenteric angiography. Patient characteristics, laboratory findings, the diameter of the inferior vena cava (IVCD), the diameter of superior and inferior mesenteric veins, and technical outcomes were evaluated. RESULTS: TAE was successful in 24 patients in the P-group (96%) and 14 in the N-group (40%) (p < 0.001). Univariate analysis revealed "usage of anticoagulant" (p < 0.05) and "larger IVCD (p < 0.05) on preoperative CTA" to be significant predictors of positive extravasation. In the multivariate analysis, IVCD remained significant with an adjusted odds ratio of 1.17. The IVCD cutoff value was 13.6 mm (area under the curve = 0.72, sensitivity = 84.0%, specificity = 54.3%). There were no significant differences in other parameters. CONCLUSION: Measurement of IVCD in CDB with the cutoff value of 13.6 mm can be a simple and useful indicator to predict the detectability of extravasation following TAE procedures.
PURPOSE: Transcatheter arterial embolization (TAE) for colonic diverticular bleeding (CDB), an established procedure for hemostasis, is sometimes complicated by spontaneous hemostasis and unclear bleeding site on angiography despite active arterial bleeding on preoperative computed tomography angiography (CTA). Therefore, to investigate and increase the feasibility of TAE, this retrospective study evaluates the clinical and radiological features related to positive extravasation on angiography. MATERIAL AND METHODS: Sixty CDB patients with extravasation on CTA underwent TAE between January 2011 and February 2021 and were divided into extravasation-positive (P-group; n = 25) and -negative groups (N-group; n = 35) based on the superior or inferior mesenteric angiography. Patient characteristics, laboratory findings, the diameter of the inferior vena cava (IVCD), the diameter of superior and inferior mesenteric veins, and technical outcomes were evaluated. RESULTS: TAE was successful in 24 patients in the P-group (96%) and 14 in the N-group (40%) (p < 0.001). Univariate analysis revealed "usage of anticoagulant" (p < 0.05) and "larger IVCD (p < 0.05) on preoperative CTA" to be significant predictors of positive extravasation. In the multivariate analysis, IVCD remained significant with an adjusted odds ratio of 1.17. The IVCD cutoff value was 13.6 mm (area under the curve = 0.72, sensitivity = 84.0%, specificity = 54.3%). There were no significant differences in other parameters. CONCLUSION: Measurement of IVCD in CDB with the cutoff value of 13.6 mm can be a simple and useful indicator to predict the detectability of extravasation following TAE procedures.
Authors: A Lanas; L A García-Rodríguez; M Polo-Tomás; M Ponce; E Quintero; M A Perez-Aisa; J P Gisbert; L Bujanda; M Castro; M Muñoz; M D Del-Pino; S Garcia; X Calvet Journal: Aliment Pharmacol Ther Date: 2011-01-05 Impact factor: 8.171
Authors: Angel Lanas; Luis A García-Rodríguez; Mónica Polo-Tomás; Marta Ponce; Inmaculada Alonso-Abreu; Maria Angeles Perez-Aisa; Javier Perez-Gisbert; Luis Bujanda; Manuel Castro; Maria Muñoz; Luis Rodrigo; Xavier Calvet; Dolores Del-Pino; Santiago Garcia Journal: Am J Gastroenterol Date: 2009-05-05 Impact factor: 10.864
Authors: Laurens Hermie; Elisabeth Dhondt; Peter Vanlangenhove; Jan De Waele; Helena Degroote; Luc Defreyne Journal: Eur Radiol Date: 2020-09-22 Impact factor: 5.315
Authors: V García-Blázquez; A Vicente-Bártulos; A Olavarria-Delgado; M N Plana; D van der Winden; J Zamora Journal: Eur Radiol Date: 2012-11-29 Impact factor: 5.315