Triaxial transarterial embolization for lower gastrointestinal bleeding: A retrospective case series

Abstract

Objective: Superselective transcatheter arterial embolization (TAE) is important for lower gastrointestinal (GI) bleeding. A new 1.9-Fr. no-taper microcatheter has recently become available and can be inserted into a 2.7-Fr. microcatheter. We assessed the applicability of this new triple co-axial (triaxial) system to TAE for lower GI bleeding. Material and methods: Five patients with lower GI bleeding underwent TAE with the triaxial system. The approach was via the femoral artery with a 4-Fr. sheath in all cases. The 4-Fr. catheter and triaxial system were inserted into the artery in which extravasation had occurred. Coil embolization was performed with 0.010-inch coils. We evaluated technical success rate, clinical success rate and complications. Results: All five cases of bleeding occurred at the ascending colon, and were caused by diverticulosis in four cases, and an injury to the artery during polypectomy in one case. The 1.9-Fr. no-taper microcatheter could be inserted into the site of extravasation, the vasa recta, in all procedures and TAE was performed successfully. The disappearance of extravasation was confirmed in all cases following TAE. No patients exhibited any signs of recurrent bleeding or complication. Conclusion: The triaxial system appears to be effective and useful in superselective TAE for lower GI bleeding.