Introduction. We aimed to assess the efficacy and safety of digital subtraction angiography (DSA) and super-selective mesenteric\nartery embolization (SMAE) in managing lower GI bleeding (LGIB). Method. A retrospective case series of patients with LGIB\ntreated with SMAE in our health service. Patients with confirmed active LGIB, on either radionuclide scintigraphy (RS) or\ncontrast-enhanced multidetector CT angiography (CE-MDCT), were referred for DSA +/âË?â?? SMAE. Data collected included\npatient characteristics, screeningmodality, bleeding territory, embolization technique, technical and clinical success, short-termto\nmedium-term complications, 30-day mortality, and progression to surgery related to procedural failure or complications. Results.\nThere were fifty-five hospital admissions with acute unstable lower gastrointestinal bleeding which were demonstrable on CEMDCT\nor RS over a 31-month period. Eighteen patients proceed to embolization, with immediate success in all. Eight patients\n(44%) had clinical rebleeding after intervention, warranting repeated imaging. Only one case (5.6%) demonstrated radiological\nrebleeding and was reembolized. Complication rate was excellent: no bowel ischaemia, ischaemic stricture, progression to surgery,\nor 30-day mortality. Conclusion. SMAE is a viable, safe, and effective first-line management for localised LGIB. Our results overall\ncompare favourably with the published experiences of other institutions. It is now accepted practice at our institution to manage\nlocalised LGIB with embolization.
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