Pitrone Pietro, Stagno Alberto, Cattafi Antonino, Caloggero Simona, Silipigni Salvatore, Ascenti Velio, Catanzariti Francesca, Cinquegrani Antonella, Bottari Antonio
Department of Biomedical and Dental Sciences and of Morphological and Functional Images, Section of Radiological Sciences, University of Messina, Messina, Italy.
Department of Imaging, Interventional Radiology Unit, University Hospital "G. Martino", Messina, Italy.
BJR Case Rep. 2022 Sep 12;8(5):20210130. doi: 10.1259/bjrcr.20210130.
Gastrointestinal angiodysplasia (GIAD) represents one of the most frequent causes of recurrent lower gastrointestinal bleeding in the elder population. Clinical manifestations are highly variable, diagnosis is done with colonoscopy or CT and management consists of either endoscopic or, more conservatively, endovascular approach. Trans-arterial embolization (TAE) reduces blood flow into the lesion and may complicate with perforation, dissection, vasospasm and bowel ischaemia. To date, coils and Gelfoam represent the most employed embolizing agents, followed by PVA and onyx. We report the successful embolization of GIADs in four patients with n-butyl 2-cyanoacrylate (NBCA) and Lipiodol Ultra-Fluid (LUF): despite the reported higher risk of bowel infarction when compared with the other agents, no major complication or short-term recurrence occurred in our series.
胃肠道血管发育异常(GIAD)是老年人群反复发生下消化道出血的最常见原因之一。其临床表现高度多变,通过结肠镜检查或CT进行诊断,治疗方法包括内镜治疗或更保守的血管内治疗。经动脉栓塞术(TAE)可减少病变部位的血流,但可能并发穿孔、夹层、血管痉挛和肠缺血。迄今为止,弹簧圈和明胶海绵是最常用的栓塞剂,其次是聚乙烯醇(PVA)和氰基丙烯酸正丁酯(ONYX)。我们报告了4例使用氰基丙烯酸正丁酯(NBCA)和超液化碘油(LUF)成功栓塞GIAD的病例:尽管与其他栓塞剂相比,报道称使用该方法发生肠梗死的风险更高,但在我们的病例系列中未发生重大并发症或短期复发。