JVIR ’ Scientific Session
Results: In 300-500μm BAE pigs, weight gain was similar to
sham pigs. However, 100-300μm BAE pigs demonstrated a
small but consistent reduction in weight gain relative to sham
(0.26 vs. 2.55 lb @ 1 wk; 54.4 vs. 61.6 lb @ 16 wk; Po0.001).
Fasting GLP-1 did not significantly differ between the treated
and sham pigs in either group. In the 100-300μm group there
was a non-significant trend towards decreased Ghrelin in the
experimental group when compared to sham whereas no
difference was seen in the 300-500μm BAE pigs. Superficial
mucosal ulcers in the gastric fundus were present in 2 of 5 pigs
treated with 300-500μm spheres, and in all pigs treated with
100-300μm spheres.
Conclusions: BAE using larger beads (300-500μm) produced
neither significant weight loss nor significant changes in
Ghrelin or GLP-1. BAE using medium beads (100-300μm)
showed a small decrease in weight gain and a trend towards
decreased fasting Ghrelin. This combined with data from prior
studies with small spheres (40-50μm) suggests that a smaller
caliber bead size is likely to be more effective for bariatric
embolization.
3:45 PM Abstract No. 16
Safety and outcome of prophylactic
embolotherapy for angiographic negative lower
gastrointestinal bleeding
S. Li1, S. Sun1, S. Wang2; 1University of Iowa Hospitals
and Clinics, Iowa City, IA; 2Department of Radiology,
Iowa City, IA.
Purpose: Successful angiographic localization of lower
gastrointestinal bleeding (LGIB) can only be achieved in less
than 50% patients. Purpose of this study was to examine the
safety and outcome of prophylactic embolotherapy in
management of angiographic negative LGIB patients.
Materials: A retrospective study of 126 patients of LGIB for
whom an initial mesenteric angiography was performed from
March 2006 to July 2015. Study included 72 (57.1%) males and
54 (42.9%) females and age ranged from 31 – 92 yrs. These
patients are first divided into 2 groups based on initial positive
or negative angiography. Patients with negative angiography
are further divided into 2 groups based on whether a
prophylactic embolization was performed. Incidence of re-
bleeding in one week following the initial angiography/
embolization that led to further intervention is retrospectively
evaluated in each group.
Results: 88 patients had positive initial angiography,
consequently underwent totally 103 embolization procedures.
The remaining 38 patients failed to find bleeding by the initial
angiography, of these, 18 patients underwent 24 prophylactic
embolization procedures based on the pre-angiographic
localization by colonoscopy/CT angiogram/Nuclear
scintigraphy. The other 20 angiographically negative patients
received no intervention during the initial angiography, due to
lack of pre-angiographic localization or operator’s concern for
complications. 24 re-bleeding (23.3%) and 5 bowel infarct
(4.9%) were found in the initial angiography positive group,
while 8 re-bleeding (33.3%) and 1 bowel infarct (4.2%) were
demonstrated following the prophylactic procedures, compared
to 14 re-bleeding (70.0%) with no bowel infarct presented in the
non-intervention group.
Sunday ’ S11
Conclusions: Prophylactic embolotherapy is safe and effective
in management of LGIB. A definitive pre-angiographic
localization of LGIB is crucial for decision making. Future
studies should be conducted to address issues that may
contribute to re-bleeding such as coagulopathy, massive
transfusion, and different etiologies of LGIB.
References
1. Funaki B. Microcatheter Embolization of Lower Gastrointestinal
Hemorrhage: An Old Idea Whose Time Has Come. Cardioascular and
SUNDAY: Scientific Sessions
International Radiology. 2004 (27): 591-599.
2. Funaki B. On-Call Treatment of Acute Gastrointestinal Hemorrhage. Semin
Intervent Radiol. 2006 (23): 215-222.
3. Shin J H. Recent Update of Embolization of Upper Gastrointestinal Tract
Bleeding. Korean J Radiol. 2012 (13): S31-S39.
4. Tan K, Wong D, Sim R. Superselective Embolization for Lower
Gastrointestinal Hemorrhage: An Institutional Review Over 7 Years. World
J Surgery. 2008 (32): 2707-2715.
3:54 PM Abstract No. 17
Predictors of active extravasation on angiography
for acute intra-abdominal bleeding
Z. Haber1, H. Charles1, A. Deipolyi1; 1NYU Langone
Medical Center and School of Medicine, New York, NY.
Purpose: To identify factors predicting active extravasation on
mesenteric and visceral angiography performed for intra-
abdominal bleeding.
Materials: All conventional angiograms performed (1/2013-
6/2015) for intra-abdominal bleeding at one academic center
were reviewed retrospectively for active contrast
extravasation. A total 75 angiograms (46, gastrointestinal;
6, splenic; 4 hepatic; 12, uterine; and 7 other sources of intra-
abdominal hemorrhages) were performed in 70 patients (26
women; 44 men) with mean age of 59 (range 21-92) yr.
Variables were assessed over the 24 hr prior to angiography:
percent change in hematocrit (Δhct); urine output;
vasopressor administration; units of packed red blood cells
(pRBC) and volume of intravenous fluids (IVF) given; and
mean arterial pressure (MAP) and pulse immediately
preceding the study.
Results: Of 75 exams, 20 (27%) showed contrast extravasation
consistent with active bleeding and 50 (73%) did not. Multiple
logistic regression showed Δhct was the only independent
predictor of contrast extravasation (p¼0.017), whereas MAP,
pulse, treatment with pressors, number of units of pRBC
transfusion, and volume of IVF administered were not
predictive. Patients with active extravasation had larger Δhct
compared to those without extravasation (–17% vs –1%;
p¼0.01). Findings were similar for the subset of 46 studies
performed for gastrointestinal hemorrhage: Δhct was the only
independent predictor of extravasation (–21% vs –1%;
p¼0.049) (Table). Neither CT angiography nor endoscopy
accurately predicted which studies had contrast extravasation
(p40.3).
Conclusions: Greater decrease in hct over 24 hr prior to
conventional angiography predicts active extravasation in
patients with intra-abdominal and gastrointestinal bleeding.
Patients with large hct declines should be triaged for rapid
angiography to increase the likelihood of detecting a treatable
abnormal vascular focus.
 S12 ’ Sunday Scientific Session ’ JVIR

Hct Change Over 24 hr Prior Active Extravasation Conclusions: Colonic hemorrhage is a common life
to Angiography threatening problem. Often the bleeding scan is positive while
–40% to –60% 60% the angiogram is negative in up to 50% of patients. We present
–20% to –40% 50% a simple inexpensive technique to allow accurate localization of
0 to –20% 12%
a bleeding site even when the angiogram is negative. We feel
that this is a viable alternative to emergency surgery.
Any increase 19%
References
1. Syed MI, Shaikh A. Accurate localization of life threatening colonic
hemorrhage during nuclear medicine bleeding scan as an aid to selective
4:03 PM Abstract No. 18
SUNDAY: Scientific Sessions

angiography. World J Emerg Surg. 2009 May 27;4:20.

2. Gillespie CJ, Sutherland AD, Mossop PJ, Woods RJ, Keck JO, Heriot AG.
Mesenteric embolization for lower gastrointestinal bleeding. Dis Colon
Empiric embolization of lower gastrointestinal Rectum.2010 Sep;53(9):1258-64. Sunday
hemorrhage using nuclear medicine bleeding scan
localization
T. Akhter1, T. Akhter1, M. Syed2, H. Chaudhry3, S. Patel4, Scientific Session 3
A. Shaikh4; 1Temple University Hospital, Philadelphia,
PA; 2Dayton Interventional Radiology, Springfield, OH;
3
CMH Lahore Medical College, Beavercreek, OH; 4Dayton IVC Filters I
Interventional Radiology, Dayton, OH.

Purpose: To propose an efficient therapy to treat lower gastric Sunday, April 3, 2016
hemorrhage via empiric superselective embolization using
nuclear medicine scan as an aid to localization.
3:00 PM – 4:30 PM
Materials: A marker was utilized during the nuclear medicine Room: 116/117
GI bleeding scan to localize the bleeding site. During
angiography, if no active bleed was seen, empiric embolization
was performed using up to .4 vials of 500-700 micron embolic 3:00 PM Abstract No. 19
particles using a microcatheter, sub-selection of the arterial
branch as close as possible to the marker. Embolization was Electrification of IVC filters with radiofrequency
not performed to stasis. IRB approval was obtained. ablation to facilitate removal: ex vivo phantom study
Results: See table. All 10 patients had cessation of bleeding. One R. Seifabadi1, L. Jiang2, V. Krishnasamy3, A. Negussie4,
patient developed ischemic colitis which responded to conservative F. Banovac5, B. Wood6; 1National Institute of Health,
management. No patients required surgical colonic resection.

Table
Nuclear
Hb Level on Medicine Angio- Hemostasis Etiology of
Presentation Source of graphically after Bleed by
Patient # Age/Sex (g/dL) Bleed Positive Embolization Colonoscopy
1 70/M 11.4 Hepatic Yes Yes Diverticulosis
flexure
2 84/F 5.4 Hepatic No Yes Diverticulosis
flexure
3 65/F 7 Splenic No Yes Unknown
flexure
4 55/F 7.9 Splenic No Yes Submucosal
flexure vascular
ectasia
5 68/M 11 Rectum Yes Yes Rectal ulcer
due to rectal
tube
6 93/M 4 Splenic No Yes Colorectal
flexure carcinoma
7 92/F 9 Cecum Yes Yes Diverticulosis
8 81/F 10.4 Sigmoid No Yes Diverticulosis
colon
9 80/M 9 Sigmoid No Yes Suspected
colon diverti-
culosis
10 85/F 10 Sigmoid No Yes Diverti-
colon culosis