Clinical Efficacy Analysis of Angio-CT-Assisted Interventional Embolization in the Treatment of Superior Mesenteric Artery-Derived Gastrointestinal Hemorrhage

Objective To explore the diagnostic value of computed tomography angiography (angio-CT) in superior mesenteric artery-derived gastrointestinal hemorrhage, as well as the safety and efficacy of interventional embolization, and to compare its detection difference with digital subtraction angiography (DSA). Methods A retrospective analysis was performed on the clinical data of 25 patients with superior mesenteric artery-derived gastrointestinal hemorrhage admitted to our hospital from January 2023 to June 2025. All patients underwent DSA and angio-CT to confirm the bleeding site, followed by DSA-guided interventional embolization. The bleeding detection rates of the two examination methods, interventional embolization success rate, postoperative complication rate, and rebleeding rate during follow-up were compared, and the application value of angio-CT in preoperative evaluation was analyzed. Results Among the 25 patients, DSA identified 16 bleeding sites (detection rate 64.0%), while angio-CT accurately identified 25 bleeding sites (detection rate 100.0%), with a statistically significant difference (χ²=11.976, P < 0.05). The bleeding sites included 16 cases (64.0%) of main branches of the superior mesenteric artery, 5 cases (20.0%) of jejunal artery branches, and 4 cases (16.0%) of ileal artery branches. The technical success rate of interventional embolization was 100%, and the clinical hemostasis success rate was 92.0% (23/25). Postoperatively, 2 cases had mild abdominal pain and 1 case had fever, with no serious complications (such as intestinal necrosis or severe infection). During the 3 ~ 12 months of follow-up, 2 patients experienced rebleeding, which was successfully stopped by secondary embolization, resulting in a rebleeding rate of 8.0%. Conclusion Angio-CT can quickly and accurately locate the bleeding site of superior mesenteric artery-derived gastrointestinal hemorrhage, making up for the disadvantage of DSA in identifying low-flow or static-phase bleeding. It provides precise navigation for interventional embolization, improving the treatment success rate. Interventional embolization has the advantages of minimal invasiveness, high efficiency, and few complications, which is worthy of clinical promotion and application.