Transcatheter Arterial Embolization in Acute Non-Variceal Gastrointestinal Bleedings: A Ten-Year Single-Center Experience in 91 Patients and Review of the Literature.

Federico Fontana,Giulio Carcano,Sergio Segato,Marco Curti,Edoardo Macchi,Anna Maria Ierardi,Gianpaolo Carrafiello,Massimo Venturini,Christian Ossola,Andrea Coppola,Chiara Floridi,Filippo Piacentino,Giuseppe De Marchi

doi:10.3390/jcm10214979

Abstract

Objective: To report the safety and efficacy of trans-arterial embolization (TAE) for upper gastrointestinal bleeding (UGIB) and lower gastrointestinal bleeding (LGIB) due to different etiologies in 91 patients for ten years. Methods: A retrospective analysis of GIB treated between January 2010 and December 2020 was performed. TAE was performed using different embolic agents (coils, particles, glue, gelatin sponge, and EVOH-based agents). Technical success, secondary technical success, clinical success, and complications were evaluated. Results: Technical success was achieved in 74/91 (81.32%) patients. Seventeen patients (18.68%) required re-intervention. Secondary technical success was achieved in all cases (100.0%). Clinical success was achieved in 81/91 patients (89.01%). No major complications were recorded; overall, minor complications occurred in 20/91 patients. Conclusions: TAE is a technically feasible and safe therapeutic option for patients with GIB from a known or blind anatomic source where endoscopic therapy has failed or is deemed unfeasible.

Highlights

Gastrointestinal bleeding (GIB) is one of the major causes of hospitalization, responsible for 1–2% of all admissions and burdened with a high death rate of up to 25% [1,2].The incidence increases with age, occurring in 70% of patients older than 65 years [1], and with comorbidities, especially in those cases requiring blood thinners
Acute GIB complicates the clinical course of critically ill patients admitted with other primary diagnoses [3,4]
Ninety-one consecutive patients with GIB were submitted to transarterial embolization (TAE)

Summary

Introduction

Gastrointestinal bleeding (GIB) is one of the major causes of hospitalization, responsible for 1–2% of all admissions and burdened with a high death rate of up to 25% [1,2].The incidence increases with age, occurring in 70% of patients older than 65 years [1], and with comorbidities, especially in those cases requiring blood thinners. Gastrointestinal bleeding (GIB) is one of the major causes of hospitalization, responsible for 1–2% of all admissions and burdened with a high death rate of up to 25% [1,2]. Acute GIB complicates the clinical course of critically ill patients admitted with other primary diagnoses [3,4]. The main causes of GIB include peptic ulcer disease, esophagitis, gastritis and duodenitis, varices, angiodysplasia, diverticular disease, malignancy, arteritis, aortoenteric fistulas, inflammatory bowel disease, and colitis [4,5,6]. The diagnostic-therapeutic care pathway for GIB varies based on the gastrointestinal tract involved, with important differences in terms of epidemiology, clinical management, and prognosis [1]. Many different treatment strategies can be used—e.g., conservative endoscopic therapy, transarterial embolization (TAE), and surgery; a multidisciplinary approach to the problem is essential [7]

Methods

Results

Discussion

Conclusion