Analysis of time delay between computed tomography and digital subtraction angiography on the technical success of interventional embolisation for treatment of lower gastrointestinal bleeding

Abstract

Introduction: A retrospective study was undertaken to determine a potential relationship, based on the time delay, between a positive lower gastrointestinal bleed demonstrated on computed tomography (CT) and a positive digital subtraction angiographic (DSA) study and the impact on technical success. Methods: This study investigated the correlation of time delays between imaging modalities and technical success with endovascular embolisation procedures over a 10-year period. Results: A total of 110 patient events were analysed, and it was observed that the greater the time delay between modalities (up to 7 h), the weaker the correlation between a bleed observed on CT and DSA. This was also reflected by the technical success of the embolisation treatment. Patients experienced shorter delays when the event occurred out of normal business hours, however with decreased rates of technical success. Conclusions: There is a suggestion patients should be escalated to the angiography suite for DSA imaging as soon as possible to maximise the ability to angiographically observe acute bleeding and treat appropriately with interventional embolisation. More research in this area is required to statistically confirm this.