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Endovascular therapy of gastroinestinal bleeding.

BACKGROUND
 Gastrointestinal (GI) bleeding is a frequently occurring disease pattern, with a broad variety of possible causes. The most acute bleeding responds well to conservative, medicinal and endoscopic therapies. Nevertheless, a certain amount of endoscopically not-identifiable or controllable non-varicose GI-bleeding requires alternative, sometimes surgical, therapy concepts. The updated S2k guideline "gastrointestinal bleeding" makes the case for interventional radiology with its minimally invasive endovascular techniques.


METHODS
 This review article discusses the role of interventional radiology in the therapy of non-variceal upper and lower gastrointestinal bleeding according to the current literature and updated guideline. In this regard it covers the indications, techniques, results and complications of endovascular therapy.


RESULTS AND CONCLUSION
 Considering interdisciplinary therapy options, the guideline-oriented endovascular treatment of gastrointestinal bleeding, using embolization and implantion of covered stents, shows to be a reasonable option with good technical and clinical success rates and a low rate of complications. In this context solid knowledge of vascular anatomy is essential to acquire adequate hemostasis.


KEY POINTS
  · Interventional radiology contributes significantly to the diagnosis and treatment of non-variceal bleedings of various etiologies.. · In this context the S2K guideline "gastrointestinal bleeding" is the foundation for the decision-making process for hemostatic therapy.. · Embolization is the first choice when it comes to endovascular treatment of gastrointestinal bleeding.. · Adequate periinterventional management increases the success rate of endovascular therapy..


CITATION FORMAT
· Augustin AM, Fluck F, Bley T et al. Endovascular therapy of gastroinestinal bleeding. Fortschr Röntgenstr 2019; DOI: 10.1055/a-0891-1116.