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经动脉栓塞治疗急性下消化道出血:一项回顾性双中心研究

Transarterial embolization for acute lower gastrointestinal bleeding: a retrospective bicentric study.

作者信息

Tiralongo Francesco, Perini Daniele, Crimi Luca, Taninokuchi Tomassoni Makoto, Braccischi Lorenzo, Castiglione Davide Giuseppe, Modestino Francesco, Vacirca Francesco, Falsaperla Daniele, Libra Federica Maria Rosaria, Palmucci Stefano, Foti Pietro Valerio, Lionetti Francesco, Mosconi Cristina, Basile Antonio

机构信息

Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia", University Hospital Policlinico "G. Rodolico-San Marco", University of Catania, 95123, Catania, Italy.

Department of Radiology, IRCCS Azienda Ospedaliero Universitaria Di Bologna, Via Albertoni 15, 40138, Bologna, Italy.

出版信息

Radiol Med. 2025 Apr 18. doi: 10.1007/s11547-025-02012-z.

Abstract

Transcatheter arterial embolization (TAE) represents an effective treatment option for acute lower gastrointestinal bleeding (LGIB). This retrospective, bicentric study evaluated the safety and efficacy of TAE in 77 patients with LGIB. The mean patient age was 68.39 ± 17.54 years, and the mean pre-procedural hemoglobin was 7.87 ± 1.89 g/dL. The most common cause of LGIB was angiodysplasia (36.2%). Pre-procedural computed tomography angiography (CTA) detected active bleeding in 83% of cases. Technical success was achieved in 98.7% of patients, and 30-day clinical success was achieved in 87%. The rebleeding rate was 13%, and the ischemic complication rate was 11.7%. There were no significant associations between clinical success and sex, age, coagulopathy, first-line management, active bleeding signs, culprit vessel, superior mesenteric artery, or time between CTA and digital subtraction angiography. TAE is a safe and effective procedure for LGIB, with high technical and acceptable clinical success rates. It should be considered a standard procedure in select patients, especially when endoscopic treatment is contraindicated or not feasible.

摘要

经导管动脉栓塞术(TAE)是治疗急性下消化道出血(LGIB)的一种有效方法。这项回顾性、双中心研究评估了TAE治疗77例LGIB患者的安全性和有效性。患者平均年龄为68.39±17.54岁,术前平均血红蛋白为7.87±1.89g/dL。LGIB最常见的病因是血管发育异常(36.2%)。术前计算机断层血管造影(CTA)在83%的病例中检测到活动性出血。98.7%的患者技术成功,87%的患者30天临床成功。再出血率为13%,缺血性并发症发生率为11.7%。临床成功与性别、年龄、凝血病、一线治疗、活动性出血迹象、责任血管、肠系膜上动脉或CTA与数字减影血管造影之间的时间无显著相关性。TAE是一种治疗LGIB安全有效的方法,技术成功率高,临床成功率可接受。在特定患者中,尤其是在内镜治疗禁忌或不可行时,应将其视为标准治疗方法。

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