Hermie Laurens, Defreyne Luc
Department of Vascular and Interventional Radiology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, 9000, Belgium.
CVIR Endovasc. 2023 Apr 20;6(1):26. doi: 10.1186/s42155-023-00372-z.
Recently, an empiric Cone-beam Computed Tomography (CBCT)-guided transarterial embolization (TAE) technique has been investigated for lower gastrointestinal bleeding (LGIB). Although this empirical strategy reduced the rate of rebleeding in hemodynamically unstable patients compared to a 'wait and see' strategy, the specified technique is challenging and time-consuming.
We present two methods to perform a prompt empiric TAE in LGIB when catheter angiography is negative. Based on the pre-procedural Computed Tomography Angiography bleeding site and using vessel detection and navigation software tools that are integrated in contemporary angiosuites, the culprit bleeding artery could be targeted with only one selective intraprocedural CBCT acquisition.
The proposed techniques are promising to reduce procedure time and facilitate the implementation of empiric CBCT-guided TAE in clinical practice when angiography is negative.
最近，一种经验性的锥形束计算机断层扫描（CBCT）引导下的经动脉栓塞术（TAE）已被用于研究下消化道出血（LGIB）。尽管与“观察等待”策略相比，这种经验性策略降低了血流动力学不稳定患者的再出血率，但特定技术具有挑战性且耗时。
我们介绍了两种在导管血管造影为阴性时对LGIB进行快速经验性TAE的方法。基于术前计算机断层扫描血管造影的出血部位，并使用当代血管造影设备中集成的血管检测和导航软件工具，仅通过一次术中选择性CBCT采集即可靶向出血动脉。
当血管造影为阴性时，所提出的技术有望减少手术时间，并促进经验性CBCT引导下的TAE在临床实践中的实施。
