When do diagnostic angiography and percutaneous transcatheter therapy play a role in the management of GI bleeding

When do diagnostic angiography and percutaneous transcatheter therapy play a role in the management of GI bleeding? 

Acute GI bleeding that is refractory to conservative management or invasive endoscopic techniques requires angiographic evaluation. For the interventional radiologist to identify the bleeding site, the following conditions must be met:

• The patient must be actively bleeding at the time of the study unless a structural lesion is the cause of intermittent bleeding.

• The bleeding must be brisk enough to be detectable during the arteriogram, usually more than 0.5 mL/min.

• The bleeding must be arterial or capillary bleeding; venous bleeding is rarely detected on the venous phase of an arteriogram.

Once the bleeding site is identified, transcatheter embolization is a treatment option.

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