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Title: Long-term outcome of transcatheter embolotherapy for acute lower gastrointestinal hemorrhage
Authors: Maleux, Geert ×
Roeflaer, Filip
Heye, Sam
Vandersmissen, Jo
Vliegen, Anne-Sophie
Demedts, Ingrid
Wilmer, Peter Alexander #
Issue Date: Aug-2009
Publisher: Nature Publishing Group
Series Title: American Journal of Gastroenterology vol:104 issue:8 pages:2042-2046
Abstract: OBJECTIVES: We sought to assess the safety, short- and long-term efficacy, and durability of transcatheter embolization for lower gastrointestinal hemorrhage (LGH) unresponsive to endoscopic therapy and to analyze the overall survival of the embolized patients. METHODS: Between January 1997 and January 2008, 122 patients were referred for angiographic evaluation to control major LGH. Overall, 43 patients (35.3%) presented with angiographic signs of contrast extravasation. In 39 patients (26 men, 13 women; mean age 67.7 years), a transcatheter embolization was performed to stop the bleeding. RESULTS: In all 39 patients, no contrast extravasation could be depicted on completion of angiography after embolization. Rebleeding occurred in eight patients (20%), in six of them within the first 30 days after embolization. Ischemic intestinal complications requiring surgery occurred in four patients (10%) within 24 h after embolization. Long-term follow-up depicted estimated survival rates of 70.6, 56.5, and 50.8% after 1, 3, and 5 years, respectively. CONCLUSIONS: Transcatheter embolotherapy to treat lower gastrointestinal bleeding is very effective, with a relatively low rebleeding and ischemic complication rate, mostly occurring within the first month after the embolization. Long-term follow-up shows a very low late rebleeding rate, and half of the embolized patients survive more than 5 years. This study shows that the majority of patients presenting with lower gastrointestinal bleeding, unresponsive to endoscopic therapy, do not benefit from transcatheter embolization. In cases of angiography extravasation, a good immediate clinical outcome-defined as high immediate success with acceptable rebleeding-and ischemic complication rate may be obtained.
ISSN: 0002-9270
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory for Clinical Infectious and Inflammatory Disorders
Radiology
Translational Research in GastroIntestinal Disorders
× corresponding author
# (joint) last author

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