Transarterial embolization of nonvariceal gastrointestinal bleeding: Our experience

Abstract

Objective: To analyze the technical and clinical outcomes of transarterial embolization in patients with nonvariceal gastrointestinal (GI) bleeding in our institute. Materials and Methods: From July 2009 to June 2013, retrospective data of all patients with nonvariceal GI bleeding who underwent catheter-directed angiography with or without Transarterial Embolization (TAE) were collected and included in the study. All were inpatients at the time of the procedures, and they were followed up till discharge or demise. Results: Out of 152 patients, 127 cases (age - 12-94 years; median age - 47 years) of GI bleeding were included in the study. Male to female ratio was ~4:1. Catheter-directed angiography was tried in all 127 patients. Out of 37 patients (29%) who had a normal angiogram, 26 (70%) improved spontaneously without embolization whereas in 11 (30%) the bleeding source could not be identified even with a repeat angiogram and clinical evidence of haemorrhage requiring surgery. Out of 90 patients (71%) with angiographically visible bleeding; 88 (69.3%) had successful, catheter directed trans-arterial embolization (TAE) whereas in 2 patients (2.2%), the bleeding vessel could not be cannulated (technical failure). Complications were encountered in 11 patients (8.7%) and rebleeding occurred in 3 patients (3.4%). Angiography related mortality was 4.7% (6/127). Conclusion: Endovascular treatment can be performed safely in sick patients. It is technically demanding, and it is not always possible for anatomic reasons or because of distorted anatomy due to previous surgeries.