ORIGINAL ARTICLE   

Il Giornale Italiano di Radiologia Medica 2019 Settembre-Ottobre;6(5):436-42

DOI: 10.23736/S2283-8376.19.00220-1

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

Endovascular embolization management of gastrointestinal angiodysplasia: single center three-year experience

Milena COPPOLA ¹ ✉, Francesco GIURAZZA ², Fabio CORVINO ², Francesco PANE ¹, Mattia SILVESTRE ², Raffaella NIOLA ²

¹ Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy; ² Department of Interventional Radiology, Cardarelli Hospital, Naples, Italy

BACKGROUND: Gastrointestinal angiodysplasias (GIA) are the most frequent vascular malformations of the digestive tract, causing up to 50% of occult gastrointestinal (GI) hemorrhages. When endoscopy fails or is unfeasible, endovascular embolization represents a valuable treatment option. Aim of this study is to report on a single center experience in the endovascular treatment of GIA.
METHODS: Single center retrospective analysis of nine patients affected by GIA and treated by endovascular embolization, using different embolizing agents (microspheres, coils and EVOH based liquid) between September 2016 and December 2018 for acute bleeding and/or melena and/or occult blood stool.
RESULTS: At digital subtraction angiography examination, active bleeding was proved in three cases (33.3%); in the remaining 66.6% indirect signs of bleeding were identified. Superselectively embolization with microcatheter was performed to reduce the risk of complications, especially non target embolization. The technical success rate was 100%, while clinical success was achieved in 7 patients (77.7%).
CONCLUSIONS: In this series endovascular embolization proves to be a safe and effective approach to localize and control GI bleeding due to angiodysplasia. In patients not suitable for endoscopic management, endovascular embolization could be considered as valuable alternative.

KEY WORDS: Angiodysplasia; Bleeding; Embolization, therapeutic