Ledermann H P, Schoch E, Jost R, Decurtins M, Zollikofer C L
Department of Radiology, Kantonsspital Winterthur, Switzerland.
J Vasc Interv Radiol. 1998 Sep-Oct;9(5):753-60. doi: 10.1016/s1051-0443(98)70387-2.
To evaluate the safety and efficiency of microcoil embolization in upper and lower gastrointestinal hemorrhage.
Superselective microcoil embolization was performed in 10 patients (upper gastrointestinal bleeding, n = 3; lower gastrointestinal bleeding, n = 7) who had acute gastrointestinal hemorrhage. Embolization was performed as peripherally as possible with use of coaxial catheter systems. Embolization materials included microcoils (2-4 mm) alone (n = 5), microcoils and polyvinyl alcohol particles (355-500 microm) (n = 4), and microcoils and gelatin sponge particles (n = 1).
Immediate hemostasis was achieved in eight patients. In two patients with dual blood supply of the bleeding site, significant reduction of hemorrhage resulted. In these two patients, it was technically impossible to place the coaxial catheter distally enough to allow safe embolization of both feeding vessels. No clinical signs of ischemia or infarction were observed after intervention.
Microcoil embolization is a safe and efficient procedure for controlling acute lower gastrointestinal bleeding if performed in a superselective catheter position. In upper gastrointestinal bleeding, microcoil embolization is an established treatment and can be performed more proximally.
评估微线圈栓塞术在上、下消化道出血治疗中的安全性和有效性。
对10例急性胃肠道出血患者（上消化道出血3例，下消化道出血7例）实施超选择性微线圈栓塞术。使用同轴导管系统尽可能在周边部位进行栓塞。栓塞材料包括单独使用微线圈（2 - 4毫米）（5例）、微线圈与聚乙烯醇颗粒（355 - 500微米）联合使用（4例）以及微线圈与明胶海绵颗粒联合使用（1例）。
8例患者实现即刻止血。2例出血部位存在双重供血的患者，出血显著减少。在这2例患者中，从技术角度无法将同轴导管放置得足够远以对两条供血血管进行安全栓塞。干预后未观察到缺血或梗死的临床体征。
如果在超选择性导管位置进行操作，微线圈栓塞术是控制急性下消化道出血的一种安全有效的方法。在上消化道出血中，微线圈栓塞术是一种既定的治疗方法，且可在更靠近近端的部位进行。
