SUPERSELECTIVE COIL EMBOLIZATION IN ACUTE GASTROINTESTINAL HEMORRHAGE- PERSONAL-EXPERIENCE IN 10 PATIENTS AND REVIEW OF THE LITERATURE

PURPOSE: To evaluate the safety and efficiency of microcoil embolizati on in upper and lower gastrointestinal hemorrhage. PATIENTS AND METHOD S: Superselective microcoil embolization was performed in 10 patients (upper gastrointestinal bleeding, n = 3; lower gastrointestinal bleedi ng, n = 7) who had acute gastrointestinal hemorrhage, Embolization was performed as peripherally as possible with use of coaxial catheter sy stems, Embolization materials included microcoils (2-4 mm) alone (n = 5), microcoils and polyvinyl alcohol particles (355-500 mu m) (n = 4), and microcoils and gelatin sponge particles (n = 1), RESULTS: Immedia te hemostasis was achieved in eight patients, In two patients with dua l blood supply of the bleeding site, significant reduction of hemorrha ge resulted, In these two patients, it was technically impossible to p lace the coaxial catheter distally enough to allow safe embolization o f both feeding vessels, No clinical signs of ischemia or infarction we re observed after intervention, CONCLUSION: Microcoil embolization is a safe and efficient procedure for controlling acute lower gastrointes tinal bleeding if performed in a superselective catheter position, In upper gastrointestinal bleeding, microcoil embolization is an establis hed treatment. and can be performed more proximally.