Superselective catheterization and embolization as first-line therapy for lower gastrointestinal bleeding

Heather B. Neuman, Ben L. Zarzaur, Anthony A. Meyer, Bruce A. Cairns, Preston B. Rich, Kenneth E. Chandler, Talmadge A. Bowden, Michael L. Hawkins, Richard M. Peterson, William C. Wood

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Emergent operative intervention for lower gastrointestinal bleeding (LGIB) is associated with significant morbidity and mortality. Advances in endovascular techniques have made superselective catheterization and embolization (SSCE) of small visceral arterial branches possible. We hypothesized that SSCE for LGIB would be an effective first-line therapy and associated with low mortality. We identified all patients that underwent visceral angiography at our institution from 1997 to 2003. Records from all patients with documented LGIB and in whom SSCE was used as first-line therapy were reviewed. Twenty-three patients (69 ± 11 years) were treated with SSCE as an initial intervention for LGIB. A definitive bleeding site was identified in 95 per cent of cases (22/23). Eleven patients (48%) developed an early complication [recurrent bleeding (n = 5; two required surgery), asymptomatic ischemic colonic mucosa (n = 3), acute renal insufficiency (n = 1; resolved), and femoral pseudo-aneurysm (n = 2; one treated operatively)]. Long-term (mean 19 months) follow-up was available for 17 patients. Five patients (22%) experienced recurrent LGIB, and three patients had evidence of colonie ischemic. One patient required endoscopic dilation of a stricture, and three underwent surgical resection. There was no mortality in our series. In this series, SSCE was an effective first-line therapy for LGIB. Rebleeding and ischemia rates were low.

Original languageEnglish (US)
Pages (from-to)539-545
Number of pages7
JournalAmerican Surgeon
Volume71
Issue number7
StatePublished - Dec 1 2005

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Catheterization
Hemorrhage
Therapeutics
Mortality
Endovascular Procedures
Thigh
Acute Kidney Injury
Aneurysm
Dilatation
Angiography
Pathologic Constriction
Mucous Membrane
Ischemia
Morbidity

ASJC Scopus subject areas

  • Surgery

Cite this

Neuman, H. B., Zarzaur, B. L., Meyer, A. A., Cairns, B. A., Rich, P. B., Chandler, K. E., ... Wood, W. C. (2005). Superselective catheterization and embolization as first-line therapy for lower gastrointestinal bleeding. American Surgeon, 71(7), 539-545.

Superselective catheterization and embolization as first-line therapy for lower gastrointestinal bleeding. / Neuman, Heather B.; Zarzaur, Ben L.; Meyer, Anthony A.; Cairns, Bruce A.; Rich, Preston B.; Chandler, Kenneth E.; Bowden, Talmadge A.; Hawkins, Michael L.; Peterson, Richard M.; Wood, William C.

In: American Surgeon, Vol. 71, No. 7, 01.12.2005, p. 539-545.

Research output: Contribution to journalArticle

Neuman, HB, Zarzaur, BL, Meyer, AA, Cairns, BA, Rich, PB, Chandler, KE, Bowden, TA, Hawkins, ML, Peterson, RM & Wood, WC 2005, 'Superselective catheterization and embolization as first-line therapy for lower gastrointestinal bleeding', American Surgeon, vol. 71, no. 7, pp. 539-545.
Neuman HB, Zarzaur BL, Meyer AA, Cairns BA, Rich PB, Chandler KE et al. Superselective catheterization and embolization as first-line therapy for lower gastrointestinal bleeding. American Surgeon. 2005 Dec 1;71(7):539-545.
Neuman, Heather B. ; Zarzaur, Ben L. ; Meyer, Anthony A. ; Cairns, Bruce A. ; Rich, Preston B. ; Chandler, Kenneth E. ; Bowden, Talmadge A. ; Hawkins, Michael L. ; Peterson, Richard M. ; Wood, William C. / Superselective catheterization and embolization as first-line therapy for lower gastrointestinal bleeding. In: American Surgeon. 2005 ; Vol. 71, No. 7. pp. 539-545.
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