Angiographic embolization of colonic hemorrhage

Developed in the early 1970s, embolotherapy for colonic hemorrhage fell out of favor because of the high rate of infarction reported in the early studies. Development of new catheters and embolic agents has led to re-examination of this technique. Using microcatheters and microcoils, it is now possible to perform superselective embolizations at the level of the marginal artery or beyond. Technical success for colonic embolization is high and bleeding can be terminated in the majority of cases. In the recent literature, significant ischemic complications or infarction are very rare when superselective techniques are used. Embolotherapy is no longer strictly contraindicated in colonic hemorrhage and in many situations it may be preferred over vasopressin therapy. Further study is needed to determine if certain pathologic conditions or anatomic regions of the colon are more amenable to embolization.