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Vascular disorders of gastrointestinal tract - Diagnostics and endovascular therapy
MOKRÁ, Michaela
An important group of diseases affecting gastrointestinal tract is derived from impaired function of the blood vessels. These disorders involve bleeding (arterial and venous), aneurysms and intestinal ischaemia. Interventional approaches to treat gastrointestinal haemorrhage differ in arterial and venous bleedings. In treatment of arterial bleeding, embolization techniques are utilized for selective occlusion of a damaged artery. In case of venous varices, transjugular intrahepatic portosystem shunt (TIPS) must be introduced. Chronic mesenteric ischaemia is relieved by angioplasty with a stent placement. Endovascular extraction in acute intestinal ischaemia is performed with aspiration thrombectomy of the blood clot at the site of peripheral vascular occlusion. In our department, we treated 99 patients with disorders of gastrointestinal blood vessels in the course of two years. In 27 patients, we searched for the cause of arterial bleeding (in 33.3%, the bleeding was not confirmed). We performed 24 embolizations. In 55 patients, TIPS was placed; of these, additional embolization of portosystemic collateral was performed in 44 patients. Two patients suffering with mesenteric ischaemia were treated with PTA and stent placement. Seven patients with intestinal ischaemia were treated with the use of aspiration thrombectomy with a promising result - a complete recanalization was reached in 4 cases. Nowadays, endovascular therapy is a method of choice in therapy of vascular disorders of the gastrointestinal tract. In correct indications, endovascular therapy represents a save and effective method that shows a relatively good technical and clinical efficacy.
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