Superselective Transarterial Embolization for Lower Gastrointestinal Bleeding: An Analysis of its Effectiveness and Safety

Abstract

Background: Superselective transarterial embolization (TAE) is the most commonly used treatment for lower gastrointestinal (LGI) bleeding when endoscopic management is impossible or fails. Its effectiveness and safety are increased using advanced techniques, instruments, and embolic materials. Objectives: To evaluate the outcome and safety of TAE for LGI bleeding and to analyze various influencing factors, including embolic material, embolization site, and anticoagulant or antiplatelet medication. Patients and Methods: Fifty-two patients who underwent superselective TAE for LGI bleeding between 2003 and 2011 were included, and their clinical and imaging information were retrospectively reviewed. Outcome and safety measures, including technical and clinical success, early and delayed rebleeding, and complications, were evaluated. Logistic regression analysis was used to determine whether the clinical success rate was associated with specific variables. Results: Technical and clinical success was achieved in 52 (100%) and 43 (83%) patients, respectively. The prior embolization site was the point of rebleeding in five of the nine patients with early rebleeding. Delayed rebleeding was documented in four patients, including two patients with angiodysplasia. Logistic regression analysis showed that embolization site, embolic material, and anticoagulant or antiplatelet medication were not statistically significant factors affecting the clinical success rate of TAE for LGI bleeding. A major complication, ischemic colitis, occurred in one patient. Conclusion: Superselective TAE for LGI bleeding has a high success and low complication rate. There are no statistical correlations between the clinical success rate and several variables, including embolic material, embolization site, and anticoagulant or antiplatelet medication.