Muhammad Idris MBBS, Presenter: Nothing to Disclose

Tanveer Ul Haq MBBS, Abstract Co-Author: Nothing to Disclose

Basit Salam MBBS, Abstract Co-Author: Nothing to Disclose

Sidra Humayun MBBS, Abstract Co-Author: Nothing to Disclose

To establish and compare the effectiveness of microcoils and polyvinyl alcohol particles in angioembolisation of non variceal acute gastrointestinal bleed.

Retrospective cross sectional study of patients who underwent angioembolisation of nonvariceal acute GI bleed from Jan 1995 to Dec 2010 at Aga Khan Hospital, Karachi. The patients selected on basis of embolisation material including microcoils and PVA particles or both. Both were compared in terms of their technical and clinical success, rebleed rate and ischemic complications. Technical success defined as complete cessation of bleeding at time of embolisation. Clinical success defined as cessation of bleeding with stable hemodynamics and no rebleed within two weeks of embolisation. Rebleed defined as bleed which controlled with embolization but started later any time in particular hospitalization. Ischemic complications defined as bowel ischemia requiring surgery. Data was analyzed on SPSS windows version 16. Chi square test was used to compare the technical success , clinical success and rebleed rates and ischemic complications of microcoils and PVA particles. A p value of <0.005 was considered significant.

A total 91 patients underwent embolisation, out of whome 75% were males and 25% were females. Coil embolisation was performed in 64% (58/91) and PVA embolisation in 32% (29/91) cases while both materials used in 4% (4/91) cases. 100% technical success achieved in all cases with both treatment methods. Clinical success was 90% with microcoils and 76% with PVA particles while rebleed rate was 10% with microcoils and 24% with PVA particles. There were 2% ischemic complications with microcoils while no ischemic complication seen with PVA embolisation. There is no statistically significant difference in both techniques in terms of their technical success rate, clinical success rate, rebleed rate and procedure related bowel ischemic complications.

In angioembolization of acute nonvariceal GI bleed microcoils and PVA particles are equally effective and safe however there are slight differences in clinical success, rebleed rate and bowel ischemia which is statistically insignificant.  

Since both techniques are equally effective in embolisation so PVA particles can be used specially in difficult cases due to tortuosity of vessels or inability to place the microcatheter in vasa recta

Idris, M, Haq, T, Salam, B, Humayun, S, Comparison of Microcoils and Poly Vinyl Alcohol Particles in Selective Microcatheter Angioembolization of Non-variceal Acute Gastrointestinal Hemorrhage.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11006888.html