Biomaterial Database

Ultraselective transcatheter arterial embolization with small-sized microcoils for acute lower gastrointestinal bleeding. 2021

Mitsuhiro Kinoshita, and Hiroshi Kondo, and Suguru Hitomi, and Takuya Hara, and Ryusei Zako, and Masayoshi Yamamoto, and Junichiro Hiraoka, and Yukiko Takaoka, and Hideaki Enomoto, and Naoki Matsunaga, and Katsuya Takechi, and Ryozo Shirono, and Yoko Akagawa, and Kyosuke Osaki, and Norio Ohnishi, and Hayato Tani

Department of Radiology, Tokushima Red Cross Hospital, 103 Irinokuchi Komatsushima-cho, Komatsushima City, Tokushima, 773-8502, Japan.

OBJECTIVE To evaluate the clinical outcome of ultraselective transcatheter arterial embolization (TAE) with small-sized microcoils for acute lower gastrointestinal bleeding (LGIB). METHODS The subjects were 17 consecutive patients (mean age, 69 years) with LGIB who were treated with ultraselective TAE using small-sized microcoils between December 2013 and December 2019. Ultraselective TAE was defined as embolization of one or both of the long or short branches of the vasa recta. The etiologies of bleeding were colonic diverticulosis in 16 patients (94%) and malignancy in one patient (6%). The bleeding foci were in the ascending colon in 11 patients (65%), transverse colon in 2 patients (12%), and sigmoid colon in 4 patients (23%). A total of 18 branches (diameter: range 0.5-1.5 mm, mean 1.1 mm) of the vasa recta in 17 patients were embolized with small-sized microcoils (size range 1-3 mm, mean combined lengths of all microcoils 7.6 cm). The mean follow-up period was 19 months (range 1-80 months). The technical and clinical success rate, recurrent bleeding rate, major complications and long-term clinical outcomes were retrospectively evaluated. RESULTS Technical and clinical success was achieved in all patients (17/17). The rates of early recurrent bleeding (within 30 days of TAE) and major complications were 0% (0/17). Recurrent bleeding occurred in one patient at 2 months after TAE, but was stopped with conservative treatment. There were no other bleeding episodes or complications in the follow-up period. CONCLUSIONS Ultraselective TAE with small-sized microcoils is a highly effective and safe treatment modality for LGIB.