Embolization with Quick-Soluble Gelatin Sponge Particles for Lower Gastrointestinal Bleeding: A Multicenter Study

Background and Objectives: Transcatheter arterial embolization (TAE) serves as a valuable alternative for gastrointestinal bleeding when endoscopy fails or is inaccessible. Quick-soluble gelatin sponge particles (QS-GSP) dissolve rapidly and may reduce ischemic complications compared to permanent embolic agents. This study evaluated the safety and effectiveness of TAE using QS-GSP for acute lower gastrointestinal bleeding. Materials and Methods: This retrospective multicenter study analyzed patients who underwent TAE with QS-GSP for acute nonvariceal lower GI bleeding between 2021 and 2024. Technical success (occlusion or stasis of blood flow in target artery), clinical success (cessation of bleeding symptoms with hemodynamic stability during the week following TAE without major complications), and procedure-related complications were assessed. Results: A total of 29 patients (mean age 64.9 years) were included. Active bleeding was detected in 6 patients (20.7%) on angiography. Embolized arteries included jejunal (n=7), ileal (n=7), ileocolic anastomotic (n=1), cecal (n=2), colic (n=7), and rectosigmoid (n=5) arteries. QS-GSPs (150–350 μm [n=10] or 350–560 μm [n=19]), which dissolve completely within 4 hours, were used as the sole embolic agents. Technical and clinical success rates were 100% and 75.9% (22/29), respectively. Clinical failure occurred in 7 patients (24.1%) due to persistent (n=4) or recurrent (n=3) bleeding within one week. Transient bowel ischemia occurred in 2 patients (6.9%) but resolved spontaneously. The clinical success rate did not differ significantly between patients with active bleeding (66.7%) versus those without (73.9%). Conclusions: TAE with QS-GSP for acute lower GI bleeding demonstrated a favorable safety profile with clinical success exceeding 75%. Transient bowel ischemia occurred in 6.9% of patients with spontaneous resolution, and no bowel infarction was observed.