Angiographic evaluation and management of acute gastrointestinal hemorrhage

Figure 13 Example of nontarget embolization during treatment of lower gastrointestinal bleeding. A: Superior mesenteric artery arteriogram obtained in a patient with lower gastrointestinal bleeding shows a focal contrast collection (black arrow) arising from a branch of the ileocolic artery; B: A microcatheter was introduced and was subselectively positioned with the tip (long black arrow) immediately proximal to the focal extravasation and a microcoil (black arrow) was placed; C: While attempting to place a second microcoil, the microcatheter tip was displaced proximally resulting in coil placement in a nontarget location (black arrowhead). Repeat digital subtraction angiography shows that the second coil is nonocclusive and the initially placed coil has successfully controlled the bleeding source.