Purpose: To evaluate clinical, laboratory and procedural factors that may predict positive correlation rates between computed tomography angiography (CTA) and subsequent catheter angiography (CA) for gastrointestinal (GI) bleeding.
Material and Methods: An IRB-approved retrospective review identi ed patients, CTA and CA imaging over a 3-year period (January 2016 – December 2018) that were initially evaluated for and diagnosed with GI bleeding via CTA and subsequently underwent CA. Pre-procedural clinical and laboratory values along with procedural details were analyzed using univariate statistics.
Results: A total of 77 patients and their respective CTA and angiograms were included for review. 54.6% (45/77) of angiograms were positive for GI bleeding following positive CTA imaging. Mean time from review of CTA imaging to start of angiography was 196.2 vs. 310.1 minutes for positive and negative angiograms respectively (p=0.12). Angiograms performed within 5.5 hours of positive CTA imaging and angiograms performed after 5.5 hours from positive CTA imaging completion were positive on CA for bleeding in 37/60 (61.7%) and 5/17 (29.4%) patients respectively (p<0.03). Patients with positive CA versus negative CA for GI bleeding had mean pre-procedural hemoglobin levels of 8.08 vs. 8.88 respectively (p=0.11). Patients with pre-procedural hemoglobin levels less than 7 and greater than 7 had positive CA rates for GI bleeding of 75% (15/20) and 39.6% (27/57) respectively (p=0.04).
Conclusions: Clinical and procedural details including hemoglobin levels and interval time between CTA imaging and angiography procedure start may help predict positive CA identi cation of GI bleeding.