Empiric embolization by vasospasm therapy for acute lower gastrointestinal bleeding: a preliminary report

被引:0
|
作者
Liang, Huei-Lung [1 ,2 ,3 ]
Chiang, Chia-Ling [1 ,3 ]
Li, Ming-Feng [1 ,3 ]
机构
[1] Kaohsiung Vet Gen Hosp, Dept Radiol, Kaohsiung, Taiwan
[2] Antai Tian Sheng Mem Hosp, Intervent Ctr, Donggang, Taiwan
[3] Shu Zen Jr Coll Med & Management, Dept Med Imaging & Radiol, Kaohsiung, Taiwan
来源
SCIENTIFIC REPORTS | 2024年 / 14卷 / 01期
关键词
Lower gastrointestinal bleeding (LGIB); Pharmaco-induced; Embolotherapy; Empiric embolization; Vasospasm; TRANSCATHETER ARTERIAL EMBOLIZATION; MANAGEMENT; EFFICACY; TRACT; ANGIOGRAPHY; SAFETY;
D O I
10.1038/s41598-024-76408-8
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
To report the preliminary result of empiric embolization for angiographycally-negative lower gastrointestinal bleeding (LGIB) by using the pharmaco-induced vasospasm technique with or without the adjunctive use of intra-arterial multi-detector computed tomography (MDCT). 23 LGIB patients with positive MDCT findings but negative angiographic results underwent empiric pharmaco-induced vasospasm therapy. The presumed bleeding artery was semi-selectively catheterized, and a segment of bowel was temporarily spasmed with bolus injection of epinephrine and immediately followed by 4-h' vasopressin infusion. The rebleeding, primary and overall clinical success rates were reported. MDCT showed 19 bleeders in the SMA territory and 4 bleeders in the IMA territory. Early rebleeding was found in 6 patients (26.1%): 2 local rebleeding, 3 from new-foci bleeding and 1 uncertain. Of the 10 small bowel bleeding patients, only 1 out of the 7 who underwent intra-arterial MDCT showed rebleeding, whereas 2 out of the 3 without intra-arterial MDCT rebled. No patients exhibited procedure-related major complications, including bowel ischemia and cardiopulmonary distress. The overall clinical success rate was 91.3% (21/23) with a 30-day mortality rate of 26.1% (2 of the 6 patients had early rebleeding). Empiric pharmaco-induced vasospasm therapy, when localized with/without adjunctive intra-arterial MDCT, seems to be a safe and effective method to treat angiographically-negative LGIB patients.
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页数:9
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