Evaluation of Transcatheter Arterial Embolization in Treating Gastrointestinal Bleeding Due to Angiodysplasia: A Retrospective Study on Twelve Cases

Abstract

Background: Angiodysplasia (AD) is a common cause of otherwise unexplained gastrointestinal bleeding and anemia and it increases in frequency with aging. Objectives: To investigate the safety and efficacy of transcatheter arterial embolization (TAE) in treating gastrointestinal bleeding caused by angiodysplasia. Patients and Methods: A total of 12 patients (five men, seven women; mean age: 50 ± 18 years; range: 31 - 82 years) with gastrointestinal bleeding, who had failed after endoscopic therapy and were not eligible for surgery, were treated via TAE. The presentations of patients included hematemesis (n = 2), melena (n = 7), and hematochezia (n = 5). The details of procedures and follow-up records were reviewed. Results: The procedures of TAE were performed using poly vinyl alcohol particles and/or coils. The procedures were achieved and the hemorrhage was controlled in all cases. In three patients, the small AD lesions were not found during the first session of angiography, but were instead detected on the repeated angiography conducted one week later. All the patients were discharged without any severe complications. No rebleeding occurred within 30 days following the embolization. Hemorrhage recurred in two patients within one year after hospital discharge. TAE procedures were performed once more using microcoils, and the bleeding was controlled. Conclusion: For the patients with refractory and repeated gastrointestinal hemorrhage due to angiodysplasia, TAE seems to be an effective alternative option when endoscopic examination and treatment do not work.