Thomas J. An , Kaiz Esmail , Ivan Dimov , Ryan Adams , Vincent Wu , Patrick D. Sutphin , Sanjeeva Kalva , Omar Zurkiya
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引用次数: 0
Abstract
Purpose
Mesenteric angiography and embolization is an effective treatment of gastrointestinal bleeding. In the setting of occult bleeding, provocative maneuvers with intra-arterial vasodilators and thrombolytics can increase the diagnostic yield of angiography. This study aimed to assess the clinical outcomes of provocative angiography and factors that increase the positivity rate for active bleeding at the time of provocation.
Methods
An institutional database was used to retrospectively identify patients that underwent provocative angiography for identification and treatment of gastrointestinal bleeding between 2015 and 2024. Patient demographic data, laboratory values, and clinical outcomes were recorded from the electronic medical record. Provocative angiography was performed using intra-arterial injection of heparin, nitroglycerin, and/or tPA.
Results
Provocative angiography identified active gastrointestinal bleeding in 35 % (14/40) of patients. There was no significant difference in age, hemoglobin level, transfusion requirement, ICU admission, or vasopressor requirement between patients that were positive versus negative for bleeding. 50 % (20/40) of patients had undergone prior mesenteric angiography that was negative for active hemorrhage. The mean doses of heparin, nitroglycerin, and tPA were 4973 +/− 2242 U, 507.3 +/− 317.2 μg, and 16.9 +/− 8.3 mg, respectively. Active bleeding was treated successfully in 100 % (14/14) patients. There were no bleeding complications related to provocative maneuvers.
Discussion
Provocative angiography is safe and effective for the identification of intermittent gastrointestinal bleeding during mesenteric angiography. There were no factors identified that increased the likelihood of identification of active bleeding during provocative angiography. There were no bleeding complications related to provocative mesenteric angiography in this study.
期刊介绍:
The mission of Clinical Imaging is to publish, in a timely manner, the very best radiology research from the United States and around the world with special attention to the impact of medical imaging on patient care. The journal''s publications cover all imaging modalities, radiology issues related to patients, policy and practice improvements, and clinically-oriented imaging physics and informatics. The journal is a valuable resource for practicing radiologists, radiologists-in-training and other clinicians with an interest in imaging. Papers are carefully peer-reviewed and selected by our experienced subject editors who are leading experts spanning the range of imaging sub-specialties, which include:
-Body Imaging-
Breast Imaging-
Cardiothoracic Imaging-
Imaging Physics and Informatics-
Molecular Imaging and Nuclear Medicine-
Musculoskeletal and Emergency Imaging-
Neuroradiology-
Practice, Policy & Education-
Pediatric Imaging-
Vascular and Interventional Radiology