Emergency radiology special feature: Commentary New advances in lower gastrointestinal bleeding management with embolotherapy

Lower gastrointestinal bleeding (LGIB) is associated with high morbidity and mortality. Embolization is currently proposed as the first step in the treatment of acute, life-threatening LGIB, when endoscopic approach is not possible or is unsuccessful. Like most procedures performed in emergency sett...

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Detalles Bibliográficos
Autores: Ierardi, Anna Maria, Urbano, José, De Marchi, Giuseppe, Micieli, Camilla, Duka, Ejona, Iacobellis, Francesca, Fontana, Federico, Carrafiello, Gianpaolo
Tipo de recurso: artículo
Fecha de publicación:2016
País:España
Institución:Universidad Autónoma de Madrid
Repositorio:Biblos-e Archivo. Repositorio Institucional de la UAM
Idioma:inglés
OAI Identifier:oai:repositorio.uam.es:10486/679071
Acceso en línea:http://hdl.handle.net/10486/679071
https://dx.doi.org/10.1259/bjr.20150934
Access Level:acceso abierto
Palabra clave:Lower gastrointestinal bleeding (LGIB)
Morbidity and mortality
Treatment
Damaged vessel
Angiography
Medicina
Descripción
Sumario:Lower gastrointestinal bleeding (LGIB) is associated with high morbidity and mortality. Embolization is currently proposed as the first step in the treatment of acute, life-threatening LGIB, when endoscopic approach is not possible or is unsuccessful. Like most procedures performed in emergency setting, time represents a significant factor influencing outcome. Modern tools permit identifying and reaching the bleeding site faster than two-dimensional angiography. Non-selective cone-beam CT arteriography can identify a damaged vessel. Moreover, sophisticated software able to detect the vessel may facilitate direct placement of a microcatheter into the culprit vessel without the need for sequential angiography. A further important aspect is the use of an appropriate technique of embolization and a safe and effective embolic agent. Current evidence shows the use of detachable coils (with or without a triaxial system) and liquid embolics has proven advantages compared with other embolic agents. The present article analyses these modern tools, making embolization of acute LGIB safer and more effective.