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Trans-arterial embolization for treatment of acute lower gastrointestinal bleeding—a multicenter analysis.

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Title: Trans-arterial embolization for treatment of acute lower gastrointestinal bleeding—a multicenter analysis.
Authors: Hosse, Clarissa1 (AUTHOR), Moos, Maximilian2 (AUTHOR), Becker, Lena S.3 (AUTHOR), Sieren, Malte4 (AUTHOR), Müller, Lukas2 (AUTHOR), Stoehr, Fabian2 (AUTHOR), Schaarschmidt, Benedikt M.5 (AUTHOR), Barbone, Gianluca6 (AUTHOR), Collettini, Federico1,7 (AUTHOR), Fehrenbach, Uli1 (AUTHOR), Hinrichs, Jan B.8 (AUTHOR), Kloeckner, Roman4 (AUTHOR), Geisel, Dominik1 (AUTHOR), Tacke, Frank6 (AUTHOR), Gebauer, Bernhard1 (AUTHOR), Auer, Timo A.1,7 (AUTHOR) timo-alexander.auer@charite.de
Source: European Radiology. May2025, Vol. 35 Issue 5, p2746-2754. 9p.
Subjects: Gastrointestinal hemorrhage, Therapeutic embolization, Treatment effectiveness, Medical research, Emergency medical services, Safety, Feasibility studies, Ischemia
Abstract: Purpose: To assess the technical feasibility, safety, and clinical success rate of trans-arterial embolization (TAE) as an emergency treatment for acute lower gastrointestinal bleeding (LGIB). Materials and methods: Consecutive patients who received urgent TAE due to active LGIB at five academic centers in Germany were retrospectively analyzed. LGIB was confirmed and localized using contrast-enhanced computed tomography (CT) or endoscopy. Outcome parameters including technical and clinical success rates as well as ischemia-related adverse events were analyzed. Furthermore, treatment-related variables that may affect technical and clinical success were analyzed using a regression model. Results: One hundred and forty-one patients were included. TAE was performed in 91% (128/141) of patients. In 81% (114/141) of patients, TAE was performed due to active bleeding visible at angiography, the remaining 10% (14/141) underwent empiric embolization based on pre-interventional imaging. In 9% (13/141) of patients, no TAE was performed. Microcoils were the most used embolic 48.5% (62/128), followed by glue 23.5% (30/128) and Microparticles (8%; 10/128). In the case of bleeding visible in angiography, the technical success rate was 100% (114/114); the clinical success rate was 93.6% (120/128). Severe ischemia-related adverse events necessitating bowel surgery occurred in 14% (18/128) of all patients after embolization. Thirty-day mortality was 14% (21/141). Regression analysis revealed no significant correlations but a statistical trend toward a higher incidence of bowel resection when glue was used (p = 0.090) and toward a higher 30-day mortality when an unselective embolization was performed (p = 0.057). Conclusion: TAE for LGIB has a high technical and clinical success rate. Severe ischemia-related adverse events necessitating bowel surgery occurred in 14% of patients without identifying a significant correlation to the embolization technique or an embolic. Key Points: QuestionIs trans-arterial embolization (TAE) viable as an emergency treatment for acute lower gastrointestinal bleeding (LGIB)? FindingsTAE demonstrated a 100% technical and 93.6% clinical success rate in treating acute LGIB, with severe ischemia-related adverse events occurring in 14% of patients. Clinical relevanceTAE is highly effective and has an acceptable complication rate in treating lower gastrointestinal bleeding, emphasizing the need for a direct head-to-head comparison between endovascular and endoscopic therapy. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Trans-arterial embolization for treatment of acute lower gastrointestinal bleeding—a multicenter analysis.
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  Data: <searchLink fieldCode="AR" term="%22Hosse%2C+Clarissa%22">Hosse, Clarissa</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Moos%2C+Maximilian%22">Moos, Maximilian</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Becker%2C+Lena+S%2E%22">Becker, Lena S.</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sieren%2C+Malte%22">Sieren, Malte</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Müller%2C+Lukas%22">Müller, Lukas</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stoehr%2C+Fabian%22">Stoehr, Fabian</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Schaarschmidt%2C+Benedikt+M%2E%22">Schaarschmidt, Benedikt M.</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Barbone%2C+Gianluca%22">Barbone, Gianluca</searchLink><relatesTo>6</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Collettini%2C+Federico%22">Collettini, Federico</searchLink><relatesTo>1,7</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fehrenbach%2C+Uli%22">Fehrenbach, Uli</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hinrichs%2C+Jan+B%2E%22">Hinrichs, Jan B.</searchLink><relatesTo>8</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kloeckner%2C+Roman%22">Kloeckner, Roman</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Geisel%2C+Dominik%22">Geisel, Dominik</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tacke%2C+Frank%22">Tacke, Frank</searchLink><relatesTo>6</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gebauer%2C+Bernhard%22">Gebauer, Bernhard</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Auer%2C+Timo+A%2E%22">Auer, Timo A.</searchLink><relatesTo>1,7</relatesTo> (AUTHOR)<i> timo-alexander.auer@charite.de</i>
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  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. May2025, Vol. 35 Issue 5, p2746-2754. 9p.
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  Data: <searchLink fieldCode="DE" term="%22Gastrointestinal+hemorrhage%22">Gastrointestinal hemorrhage</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutic+embolization%22">Therapeutic embolization</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+research%22">Medical research</searchLink><br /><searchLink fieldCode="DE" term="%22Emergency+medical+services%22">Emergency medical services</searchLink><br /><searchLink fieldCode="DE" term="%22Safety%22">Safety</searchLink><br /><searchLink fieldCode="DE" term="%22Feasibility+studies%22">Feasibility studies</searchLink><br /><searchLink fieldCode="DE" term="%22Ischemia%22">Ischemia</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: To assess the technical feasibility, safety, and clinical success rate of trans-arterial embolization (TAE) as an emergency treatment for acute lower gastrointestinal bleeding (LGIB). Materials and methods: Consecutive patients who received urgent TAE due to active LGIB at five academic centers in Germany were retrospectively analyzed. LGIB was confirmed and localized using contrast-enhanced computed tomography (CT) or endoscopy. Outcome parameters including technical and clinical success rates as well as ischemia-related adverse events were analyzed. Furthermore, treatment-related variables that may affect technical and clinical success were analyzed using a regression model. Results: One hundred and forty-one patients were included. TAE was performed in 91% (128/141) of patients. In 81% (114/141) of patients, TAE was performed due to active bleeding visible at angiography, the remaining 10% (14/141) underwent empiric embolization based on pre-interventional imaging. In 9% (13/141) of patients, no TAE was performed. Microcoils were the most used embolic 48.5% (62/128), followed by glue 23.5% (30/128) and Microparticles (8%; 10/128). In the case of bleeding visible in angiography, the technical success rate was 100% (114/114); the clinical success rate was 93.6% (120/128). Severe ischemia-related adverse events necessitating bowel surgery occurred in 14% (18/128) of all patients after embolization. Thirty-day mortality was 14% (21/141). Regression analysis revealed no significant correlations but a statistical trend toward a higher incidence of bowel resection when glue was used (p = 0.090) and toward a higher 30-day mortality when an unselective embolization was performed (p = 0.057). Conclusion: TAE for LGIB has a high technical and clinical success rate. Severe ischemia-related adverse events necessitating bowel surgery occurred in 14% of patients without identifying a significant correlation to the embolization technique or an embolic. Key Points: QuestionIs trans-arterial embolization (TAE) viable as an emergency treatment for acute lower gastrointestinal bleeding (LGIB)? FindingsTAE demonstrated a 100% technical and 93.6% clinical success rate in treating acute LGIB, with severe ischemia-related adverse events occurring in 14% of patients. Clinical relevanceTAE is highly effective and has an acceptable complication rate in treating lower gastrointestinal bleeding, emphasizing the need for a direct head-to-head comparison between endovascular and endoscopic therapy. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00330-024-11102-x
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        Text: English
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    Subjects:
      – SubjectFull: Gastrointestinal hemorrhage
        Type: general
      – SubjectFull: Therapeutic embolization
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      – SubjectFull: Treatment effectiveness
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      – SubjectFull: Medical research
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      – SubjectFull: Feasibility studies
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      – SubjectFull: Ischemia
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