Safety and Efficacy of Transcatheter Arterial Embolization for Lower Gastrointestinal Bleeding: A Single-center Experience with 112 Patients

Purpose: To assess the safety and efficacy of transcatheter arterial embolization for lower gastrointestinal bleeding (LGIB) and to determine the prognostic factors that affect clinical outcome. Material's and Methods: All patients diagnosed with LGIB by angiography at a single institution from April 2006 to January 2013 were included in a retrospective study: The rates of technical success, early recurrent bleeding, Major complications, Clinical success, and in-hospital mortality for transcatheter arterial embolization were determined. The influence of possible prognostic factors On the outcome was analyzed. Results: A total of 112 patients were included (36 with small-bowel LGIB, 36 with colon LGIB, and 40 With rectal LGIB). N-butyl cyanoacrylate (NBCA) was the embolic agent for 84 patients (75.0%, whereas gelatin sponge pledgets (n = 20), microcoils (n = 2), polyvinyl alcohol particles, with adjunctive gelatin sponge pledgets (n = 1), and blood clots (n = 1) were used in the other patients. The technical success rate was 96.4%. For the entire group, the rates of early recurrent bleeding, major complications, clinical success, and in-hospital mortality were 17.4%, 4.6%, 74.5%, and 25.0%,respectively. These were 15.2%, 4.8%, 75.3%, and 26.2%, respectively, in the NBCA group. Hematologic malignancy, immobilization status, and coagulopathy were significant prognostic factors for clinical outcomes. Conclusions: Transcatheter arterial embolization is a safe and effective treatment for LGIB. NBCA could be used as a primary embolic agent for this procedure.