Empirical transarterial embolization in angiographically negative lower gastrointestinal bleeding using vessel tracking and 3D navigation tools: report of 2 patients
- Resource Type
- article
- Authors
- Laurens Hermie; Luc Defreyne
- Source
- CVIR Endovascular, Vol 6, Iss 1, Pp 1-5 (2023)
- Subject
- Gastrointestinal hemorrhage
Lower gastrointestinal tract
Embolization, therapeutic
Cone-beam computed tomography
Arterial intervention
Diseases of the circulatory (Cardiovascular) system
RC666-701
- Language
- English
- ISSN
- 2520-8934
Abstract Background 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. Case presentation 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. Conclusion 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.