Kitamura Ryoichi, Maruhashi Takaaki, Woodhams Reiko, Suzuki Koyo, Kurihara Yutaro, Fujii Kaoru, Asari Yasushi
Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan.
Department of Comprehensive Medicine, Division of Interventional Radiology, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Kanagawa, Japan.
CVIR Endovasc. 2024 Sep 13;7(1):67. doi: 10.1186/s42155-024-00481-3.
To determine the ability of CO-enhanced angiography to detect active diverticular bleeding that is not detected by iodinated contrast medium (ICM)-enhanced angiography and its impact on clinical outcomes when used to confirm embolization, particularly the risks of rebleeding and ischemic complications.
We retrospectively identified a cohort of patients with colonic diverticular bleeding who underwent catheter angiography between August 2008 and May 2023 at our institution. We divided them according to whether they underwent CO angiography following a negative ICM angiography study or to confirm hemostasis post-embolization (the CO angiography group) or ICM angiography alone in the absence of active bleeding or for confirmation of hemostasis post-embolization (the ICM angiography group). The ability to detect active colonic diverticular bleeding and clinical outcomes were compared between the two groups.
There were 31 patients in the ICM angiography group and 29 in the CO angiography group. The rate of detection of active bleeding by CO angiography that was not identified by ICM angiography was 48%. The rebleeding rate was 23% in the ICM angiography group and 6.9% in the CO angiography group. Among the patients who underwent TAE, the ischemic complications rate was 7.1% in the ICM angiography group and 4.5% in the CO angiography group.
CO angiography may detect active diverticular bleeding that is not detectable by ICM angiography and appears to be associated with a lower rebleeding rate.
IV.
确定一氧化碳增强血管造影术检测碘造影剂（ICM）增强血管造影术未检测到的活动性憩室出血的能力，以及在用于确认栓塞时对临床结果的影响，尤其是再出血和缺血性并发症的风险。
我们回顾性确定了一组2008年8月至2023年5月在我院接受导管血管造影术的结肠憩室出血患者。根据他们在ICM血管造影研究结果为阴性后是否接受一氧化碳血管造影术以确认栓塞后止血（一氧化碳血管造影组），或在无活动性出血时单独接受ICM血管造影术或用于确认栓塞后止血（ICM血管造影组）进行分组。比较两组检测活动性结肠憩室出血的能力和临床结果。
ICM血管造影组有31例患者，一氧化碳血管造影组有29例患者。一氧化碳血管造影检测到而ICM血管造影未识别出的活动性出血率为48%。ICM血管造影组的再出血率为23%，一氧化碳血管造影组为6.9%。在接受经动脉栓塞术（TAE）的患者中，ICM血管造影组的缺血性并发症发生率为7.1%，一氧化碳血管造影组为4.5%。
一氧化碳血管造影术可能检测到ICM血管造影术无法检测到的活动性憩室出血，且似乎与较低的再出血率相关。
四级。
