Gastrointestinal bleeding: imaging and interventions in cancer patients

Wang, Mindy X.; Guccione, Jeffrey; Korivi, Brinda Rao; Abdelsalam, Mohamed E.; Klimkowski, Sergio; Soliman, Moataz; Shalaby, Ahmed; Elsayes, Khaled M.

doi:10.1259/bjr.20211158

Cited by 2 publications

(1 citation statement)

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“…However, in cases where no source of bleeding is identified or in cases where bleeding is not controlled with non-invasive measures, catheter-based angiography (CA) is often indicated. CA can detect bleeding at a rate of 0.5 mL/min and allows for direct embolization of bleeding vessels in appropriate patients [ 5 ]. However, data on the accuracy of both of these studies in an oncologic population are limited.…”

Section: Introductionmentioning

confidence: 99%

Computed Tomography Angiography and Conventional Angiography for the Diagnosis and Treatment of Non-variceal Gastrointestinal Bleeding at a Tertiary Cancer Center

Kessler,

Pham,

Pedersoli

et al. 2023

Cureus

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Introduction: To evaluate the diagnostic value of computed tomography angiography (CTA) and conventional angiography (CA) and the therapeutic value of transarterial embolization for acute gastrointestinal bleeding in patients with malignancy.Methods: A retrospective review of 100 patients who underwent CTA and/or CA for gastrointestinal bleeding at a comprehensive cancer center between the years 2011-2021 was performed. Clinical and patient outcome data were collected and analyzed using Kruskal-Wallis tests for continuous variables and chi-square tests or Fisher's exact tests (whichever is appropriate) for categorical variables in univariate analysis. All tests were two-sided at a significance level of 0.05. Analyses were performed using SAS version 9.4 (SAS Institute, Cary, NC).Results: Fifty-two percent of our patients underwent CTA alone, 29% underwent CA alone, and 19% underwent both procedures. Overall, CTA was positive in 11.3% (8/71) of patients and CA was positive in 22.9% (11/38) of patients. Of patients who underwent both studies, 52.6% (10/19) were positive for both. ICU admission was associated with CTA and/or CA positivity (p=0.015). Of 48 patients with data for embolization, 50% of patients underwent transarterial embolization for bleeding, 11 patients had identifiable bleeding on CA, and 13 patients underwent prophylactic embolization at the site of suspected bleeding. Rebleeding following embolization was found in 33.3% (8/24) of patients, including six patients who underwent prophylactic embolization and two patients who were treated for visualized bleeding.Conclusion: CTA and CA are two critical studies for patients with GI bleeding and a history of malignancy. Neither alone can effectively exclude an identifiable source of bleeding. In patients with a history of malignancy, transarterial embolization may be an effective treatment of both angiographically visible and occult sources of GI bleeding.

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Section: Introductionmentioning

confidence: 99%