Provocative mesenteric angiography for occult gastrointestinal bleeding: a systematic review

Siddhi Hegde; Patrick D Sutphin; Omar Zurkiya; Sanjeeva P Kalva

doi:10.1186/s42155-023-00386-7

Provocative mesenteric angiography for occult gastrointestinal bleeding: a systematic review

CVIR Endovasc. 2023 Aug 17;6(1):42. doi: 10.1186/s42155-023-00386-7.

Authors

Siddhi Hegde¹, Patrick D Sutphin², Omar Zurkiya², Sanjeeva P Kalva²

Affiliations

¹ Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. siddhi.hegde5@gmail.com.
² Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Abstract

Occult gastrointestinal bleeding (GIB) is a challenge for physicians to diagnose and treat. A systematic literature search of the PubMed and Embase databases was conducted up to January 1, 2023. Eligible studies included primary research studies with patients undergoing provocative mesenteric angiography (PMA) for diagnosis or localization of occult GIB. Twenty-seven articles (230 patients) were included in the review. Most patients (64.8%) presented with lower GIB. The average positivity rate for provocative angiography was 48.7% (58% with heparin and 46.7% in thrombolytics). Embolization was performed in 46.4% of patients, and surgical management was performed in 37.5%. Complications were rare. PMA can be an important diagnostic and treatment tool but studies with high-level evidence and standardized protocols are needed to establish its safety and optimal use.

Keywords: Heparin; Occult gastrointestinal bleeding; Provocative angiography; Thrombolytics.

Publication types

Review