Embolization of the vasa recta in acute lower gastrointestinal hemorrhage: A report of five cases

Embolization of the vasa recta in acute lower gastrointestinal hemorrhage: A report of five cases
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DOI:
10.1007/s002709900395
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发表时间:
1999-07-01
影响因子:
2.9
通讯作者:
Zollikofer, CL
Zollikofer, CL
中科院分区:
医学3区
文献类型:
--
作者:
Ledermann, HP;Schoch, E;Zollikofer, CL

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目的:介绍急性消化道出血直肠血管栓塞治疗的初步经验。方法:对5例急性消化道出血患者中的4例进行超选择性直肠血管栓塞术。在一名患者中,出血的输精管直肠超选择性导尿术在技术上是不可能的,这条血管的起源在终端拱廊水平被栓塞。采用以下栓塞材料:微线圈和聚乙烯醇颗粒(355 ~ 500 μ m), n = 2;仅微线圈,n = 2;明胶泡沫颗粒,n = 1。结果:2例在小肠(空肠和回肠)出血,3例在结肠出血。所有患者均立即止血。干预后未见缺血或梗死迹象。结论:在我们的小患者组中,超选择性直血管栓塞是有效和安全的。该技术的优点是将栓塞区域缩小到最小,并直接控制止血。
Purpose: To present our preliminary experience in embolization of the vasa recta in acute gastrointestinal hemorrhage.Methods: In four of five patients with acute gastrointestinal hemorrhage superselective embolization of the vasa recta was performed. In one patient in whom superselective catheterization of the bleeding vas rectum was technically impossible, the origin of this vessel was embolized at the level of the terminal arcade. The following embolization materials were used: microcoils and polyvinyl alcohol particles (355-500 mu m), n = 2; microcoils only, n = 2; Gelfoam particles, n = 1.Results: Bleeding was found in two patients in the small bowel (jejunum and ileum) and in three patients in the colon. Immediate hemostasis was achieved in all patients. No signs of ischemia or infarction were observed after intervention.Conclusions: Superselective embolization of the vasa recta proved efficient and safe in our small patient group. Advantages of this technique are reduction of the embolized area to a minimum and direct control of hemostasis.