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CC BY 4.0 · Journal of Clinical Interventional Radiology ISVIR 2025; 09(01): 007-015
DOI: 10.1055/s-0045-1801888
Original Article

Clinical Outcome of Superselective Transarterial Embolization for Acute Colonic Gastrointestinal Bleeding: A Retrospective Single-Center Experience

Rajendra Kumar Behera
1   Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
,
Mohak Narang
1   Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
,
Shivam Pandey
2   Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
,
Kumble Seetharama Madhusudhan
1   Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations Funding None.
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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

Ethical Approval

Ethical approval was obtained from our institute's ethics committee board and the requirement for informed consent was waived. Care has been taken not to disclose the patient's identity directly or indirectly in any form.




Publication History

Article published online:
03 February 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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