Acute UGINH remains a clinical challenge with increased mortality rates, even with high technical success rates. Patients with negative findings on angiography have lower early rebleeding rates than patients with active bleeding during angiography or endoscopy-guided prophylactic/empiric embolization.

M ost acute lower gastrointestinal (GI) bleeding stop spontaneously; therefore, no intervention or invasive diagnostic test such as conventional angiography is necessary (1). Prior to mesenteric arteriogram, colonoscopy, flexible sigmoidoscopy, and radionuclide imaging are usually performed. Recently computed tomography (CT) angiography has demonstrated promising results (1, 2). If the diagnostic tests locate the bleeding, or if intractable bleeding occurs, more invasive test warrants arteriogram and possible intervention. While other authors have performed similar analyses of patients with lower GI bleeding who required conventional angiography, they differed from our study in that some analyzed upper and lower GI bleeds together (3, 4), or patients with negative angiograms were not factored into the analysis (5), or more importantly, the patients were not separated in terms of first-time versus multiple bleeders (3)(4)(5)(6)(7)(8). We aimed to analyze patients with acute lower GI bleeding who presented to the emergency department for the first time and required conventional angiography for localization of the bleed and potential endovascular treatment. We also wanted to identify a subgroup of procedural factors, comorbidities associated with rebleeding, technical success, clinical success and mortality in association with lower gastrointestinal bleeds. Methods PatientsInstitutional review board approved this retrospective study. Consecutive cases of acute lower GI bleeding between 2001 and 2012 were reviewed retrospectively. We included all 23This project was an oral presentation in ARRS annual meeting in 2012. I N T E R V E N T I O N A L R A D I O LO G Y O R I G I N A L A R T I C L E PURPOSEWe aimed to investigate patients with lower gastrointestinal bleeding who presented to the emergency department requiring initial conventional angiography. We report risk-stratified and mesenteric conventional angiography outcomes. METHODSWe retrospectively reviewed patients with lower gastrointestinal bleeding between 2001 and 2012. We included all consecutive patients with clinical lower gastrointestinal bleeding with a requirement of further angiography and possible embolization. Patients who had prior interventions or surgery were excluded. RESULTSA total of 88 patients (35 women, 53 men) with a median age of 71 years (range, 23-99 years) were included in the analysis. Conventional angiography was positive and endovascular treatment was intended in 35 patients. Once the source of bleeding was found angiographically, endovascular treatment had a technical success rate of 90.3% and clinical success rate of 71.4%. Overall early rebleeding rate (<30 days) was 14.8% and late rebleeding rate (>30 days) was 13.6%. CONCLUSIONIdentifying the source of lower gastrointestinal bleeding remains to be a clinical and angiographic challenge. Although we did not observe an association between mortality and clinical success, increased early rebleeding rates were associated with higher mortality rates.You may cite this article as: Sıl...

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