Outcome of Rectal Arterial Embolization for Rectal Bleeding in 34 Patients: A Single-Center Retrospective Study over 20 Years.

Autor:	Park S; Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea., Kim Y; Department of Radiology, Chungbuk National University Hospital, Cheongju, Korea., Shin JH; Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Olympic-ro 43gil, Seoul 05505, Korea. Electronic address: jhshin@amc.seoul.kr., Yang WJ; Department of Radiology, Korea University Guro Hospital, Seoul, Korea., Noh SY; Department of Radiology, Soon Chun Hyang University Seoul Hospital, Seoul, Korea., Chu HH; Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Olympic-ro 43gil, Seoul 05505, Korea., Chen CS; Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China., Yoon HK; Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Olympic-ro 43gil, Seoul 05505, Korea.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2020 Apr; Vol. 31 (4), pp. 576-583. Date of Electronic Publication: 2019 Sep 14.
DOI:	10.1016/j.jvir.2019.05.013
Abstrakt:	Purpose: To report the efficacy of rectal artery embolization (RAE) for the treatment of rectal bleeding and the prognostic factors related to recurrent bleeding. Materials and Methods: A total of 34 patients in a single center who underwent RAE for treatment of rectal bleeding between September 1998 and December 2018 were retrospectively reviewed. Procedure details including angiographic findings and embolic materials used, technical success rate, bleeding control rate during hospital stay, major adverse event rate, and prognostic factors associated with recurrent bleeding were evaluated. Results: Technical success rate was 97.1% (33 of 34). Bleeding control during hospital stay was achieved in 64.7% of patients (n = 22). The most common bleeding focus was in the superior rectal artery. Recurrent bleeding occurred in 11 patients. Incomplete initial angiography with only an inferior mesenteric or internal iliac angiogram had been performed in 90.9% of patients with recurrent bleeding (10 of 11) and 52.2% of patients with bleeding control (12 of 23; P = .053). The use of N-butyl-2-cyanoacrylate was related to a significantly lower incidence of recurrent bleeding (P = .014), whereas coagulopathy (P = .001) and transfusion of > 10 U of packed red blood cells (PRBCs; P = .003) were related to higher recurrent bleeding rates. One patient had a puncture site-related complication, and no bowel infarction was noted during follow-up. Conclusions: RAE was feasible and safe. The use of N-butyl-2-cyanoacrylate, presence of coagulopathy, and transfusion of > 10 U of PRBCs were significant factors related to recurrent bleeding. Bilateral inferior mesenteric artery and internal iliac artery angiography is highly recommended in the initial RAE session to achieve a high rate of bleeding control. (Copyright © 2019 SIR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu