Feasibility of using vessel-detection software for the endovascular treatment of visceral arterial bleeding

We aimed to investigate the feasibility of using vessel-detection software to identify damaged arteries during endovascular embolization in five patients with visceral arterial hemorrhages. We used a software program originally developed to detect tumor feeder vessels in liver tumor embolization with C-arm computed tomography datasets to detect the vessels responsible for the arterial hemorrhages in patients with splenic artery pseudoaneurysms (n=2), lower gastrointestinal bleeding (n=2), and bladder tumor bleeding (n=1). In all cases, the injured vessel was identified accurately on a three-dimensional vascular map at the optimal working angle with a relatively short mean processing time of 118 s (range, 107-136 s). The operating angiographers used this information to direct the catheter into the damaged artery without sequential angiographic runs. The software analysis was also used to plan coil delivery to the most appropriate site in the injured artery. The results suggest that the vessel-detection software for liver tumor embolization can also be used to detect damaged vessels and to plan treatment strategies in endovascular embolization of visceral arterial hemorrhage.