Clinical Outcome of Lower Gastrointestinal Bleeding Treated by Transcatheter Arterial Embolization

The purpose of this study is to evaluate the efficacy, safety and clinical outcome of lower gastrointestinal bleeding treated by transcatheter arterial embolization. We retrospectively reviewed the patients who underwent transcatheter arterial embolization for lower gastrointestinal bleeding in our hospital from January 2006 to November 2016. We reviewed the characteristics of patients, bleeding location, etiology, details of embolization and clinical outcomes on medical records. Totally, we enrolled 29 patients in this study. These patents had more medical comorbidities and were not suitable for invasive surgical intervention, so they received transcatheter arterial embolization to treat lower gastrointestinal bleeding. There were six patients with early recurrent bleeding and two patient with bowel ischemia after embolization. Two patients with local recurrent bleeding underwent secondary embolization for recurrent bleeding and the bleeding was stopped successfully. The total clinical success rate was 86.2%. Transcatheter arterial embolization was effective and safe to treat lower gastrointestinal bleeding for non-surgical candidate. Embolization should be performed as distally as possible, but superselective embolization of vasa recta still carried risk of post-embolization bowel ischemia. Intensive observation after embolization was necessary to detect post-embolization bowel ischemia and recurrent bleeding.