Needle or knife? The role of interventional radiology in managing uncontrolled gastrointestinal bleeding

• Main Authors: Thomas G. Morgan (Author), Tarryn Carlsson (Author), Eric Loveday (Author), Neil Collin (Author), Graham Collin (Author), Peter Mezes (Author), Anne M. Pullyblank (Author)
• Format: Book
• Published: Society of Gastrointestinal Intervention, 2021-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Background : : Increasingly interventional radiology has been used to stop uncontrolled gastrointestinal (GI) bleeding leading to a reduction in the requirement for surgical intervention. To examine the safety and efficacy of angiography and embolisation for the treatment of GI bleeding in a United Kingdom tertiary hospital. Methods : : This was a single-centre retrospective study of 112 procedures performed on 105 patients who underwent catheter angiography for GI bleeding over 7 years. Fifty procedures were for upper GI bleeding and 62 were for lower GI bleeding. Primary outcome was clinical success rate. Other measures were re-bleeding rates and 30-day mortality. Results : : In patients with upper GI bleeds, 71.6% of cases had a bleeding point that was identified at the time of initial catheter angiogram. Overall, the clinical success rate was 70.4% with a 20% 30-day mortality. Technical success with embolisation was 98% with no major complications. In patients with lower GI bleeds, 50% of cases had a bleeding point that was identified at the time of initial catheter angiogram. Overall clinical success rate was 83.0% with a 13.6% 30-day mortality. Technical success with embolisation was 100% with no major complications. Conclusion : : Catheter directed angiography and embolisation is safe and efficacious in patients with GI bleeding who have a positive computed tomography angiogram and should be considered as an alternative to surgery.

Item Description

2636-0004
10.18528/ijgii200018