Efficacy and Safety of Rapidly Resorbable Gelatin Microspheres for Transcatheter Arterial Embolization in Acute Arterial Gastrointestinal Bleeding.

PURPOSE: To investigate the clinical efficacy, safety profile, and factors associated with clinical success of transcatheter arterial embolization (TAE) using rapidly resorbable gelatin microspheres (rrGMs) for acute arterial gastrointestinal (GI) bleeding. MATERIALS AND METHODS: This retrospective, single-center study included 47 consecutive patients undergoing 50 TAE sessions using rrGMs between November 2023 and March 2026. Embolization was primarily segmental when pinpoint bleeding was unidentifiable. Primary endpoints included technical success, overall clinical success and bowel ischemia incidence, evaluated using the Society of Interventional Radiology (SIR) classification. RESULTS: Technical success was 100%. Among 50 sessions, 33 (66.0%) lacked a definitive pinpoint focus, requiring primary empiric segmental embolization with rrGMs. In 17 sessions (34.0%), definitive bleeding was treated with primary agents (e.g., cyanoacrylate), using rrGMs solely as an adjunctive measure. Overall patient-level clinical success was 72.3% (34/47). To better assess the standalone efficacy of rrGMs, session-level hemostatic outcomes were stratified by embolic material strategy: hemostatic success was achieved in 73.3% (22/30 sessions) when rrGMs were used alone and in 70.0% (14/20 sessions) when rrGMs were combined with other embolic agents. Despite broad empiric embolization, severe bowel ischemia (SIR Grade 3) requiring appendectomy occurred in only 1 patient (2.1%), suggesting a favorable safety profile. CONCLUSION: TAE using rrGMs is a feasible and well-tolerated treatment for acute arterial GI bleeding, even with hemodynamic instability. Its rapid resorption profile offers a favorable safety margin against ischemia, supporting its potential utility as a versatile embolic agent for empiric and adjunctive use in emergency settings.