Selective arterial embolization for the control of lower gastrointestinal bleeding
Selective arterial embolization for the control of lower gastrointestinal bleeding
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DOI：
10.1016/s0002-9610(97)00044-5
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发表时间：
1997-07-01
影响因子：
3
通讯作者：
Welton, ML
中科院分区：
文献类型：
--
作者：
Gordon, RL;Ahl, KL;Welton, ML
背景：经导管栓塞术被认为是治疗上消化道急性出血的一种安全方法。尽管越来越多的临床证据表明，在Treitz韧带下方使用这种技术仍然存在犹豫不决的情况，因为人们认为肠梗塞的风险高得令人无法接受。方法：对连续17例血管造影证实的小肠或结肠出血患者进行回顾性分析。结果：14例患者中13例(93%)出血停止，17例患者中13例(76%)有意治疗。有3例患者未能达到足够选择性的插管以允许栓塞术。结论：亚选择性栓塞术是治疗下消化道出血的一种安全的治疗方法，适用于大多数患者，大多数患者有效。当不能达到合适的导管位置时，谨慎的技术和放弃栓塞术的准备是重要的。(C)1997年，由Excerpta Medica，Inc.
BACKGROUND: Transcatheter embolization is accepted as a safe method for treating acute bleeding from the upper gastrointestinal (GI) tract. Hesitancy persists using this technique below the ligament of Treitz, based on the belief that the risk of intestinal infarction is unacceptably high, despite mounting clinical evidence to the contrary.METHODS: A series of 17 consecutive patients with angiographically demonstrated small intestinal or colonic bleeding was retrospectively reviewed. The success and complication rate of subselective embolization was assessed.RESULTS: Bleeding was stopped in 13 of 14 patients (93%) in whom embolization was possible, and in 13 of 17 patients (76%) where there was an intention to treat. Sufficiently selective catheterization to permit embolization could not be achieved in 3 patients. No clinically apparent bowel infarctions were caused.CONCLUSION: Subselective embolization is a safe treatment option for lower GI bleeding, suitable for many patients and effective in most. Careful technique and a readiness to abandon embolization when a suitable catheter position cannot be achieved are important. (C) 1997 by Excerpta Medica, Inc.