What two types of transcatheter therapy are used for GI bleeding?
Selective embolization and vasopressin (Pitressin) infusion. Vasopressin infusion is rarely used today because of the cardiovascular complications (myocardial ischemia, arrhythmias, visceral ischemia), high rate of rebleeding after discontinuation of the infusion, difficulty in maintaining catheter position, and the long treatment times of 12 to 24 hours. Modern coaxial systems and microcatheters permit superselective catheterization with accurate deposition of embolic material at the bleeding site ( Figure 68-6 ). These advances have decreased the risk of bowel infarction, making transcatheter embolization a relatively safe procedure even in the small bowel and colon.