Outcome of Rectal Arterial Embolization for Rectal Bleeding in 34 Patients: A Single-Center Retrospective Study over 20 Years.
J Vasc Interv Radiol
; 31(4): 576-583, 2020 Apr.
Article
em En
| MEDLINE
| ID: mdl-31530489
ABSTRACT
PURPOSE:
To report the efficacy of rectal artery embolization (RAE) for the treatment of rectal bleeding and the prognostic factors related to recurrent bleeding. MATERIALS ANDMETHODS:
A total of 34 patients in a single center who underwent RAE for treatment of rectal bleeding between September 1998 and December 2018 were retrospectively reviewed. Procedure details including angiographic findings and embolic materials used, technical success rate, bleeding control rate during hospital stay, major adverse event rate, and prognostic factors associated with recurrent bleeding were evaluated.RESULTS:
Technical success rate was 97.1% (33 of 34). Bleeding control during hospital stay was achieved in 64.7% of patients (n = 22). The most common bleeding focus was in the superior rectal artery. Recurrent bleeding occurred in 11 patients. Incomplete initial angiography with only an inferior mesenteric or internal iliac angiogram had been performed in 90.9% of patients with recurrent bleeding (10 of 11) and 52.2% of patients with bleeding control (12 of 23; P = .053). The use of N-butyl-2-cyanoacrylate was related to a significantly lower incidence of recurrent bleeding (P = .014), whereas coagulopathy (P = .001) and transfusion of > 10 U of packed red blood cells (PRBCs; P = .003) were related to higher recurrent bleeding rates. One patient had a puncture site-related complication, and no bowel infarction was noted during follow-up.CONCLUSIONS:
RAE was feasible and safe. The use of N-butyl-2-cyanoacrylate, presence of coagulopathy, and transfusion of > 10 U of PRBCs were significant factors related to recurrent bleeding. Bilateral inferior mesenteric artery and internal iliac artery angiography is highly recommended in the initial RAE session to achieve a high rate of bleeding control.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Reto
/
Embolização Terapêutica
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Embucrilato
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Hemorragia Gastrointestinal
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Vasc Interv Radiol
Assunto da revista:
ANGIOLOGIA
/
RADIOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article