{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"Wysdom Radio™","title":"From CTA to the Angio Suite: A GI Bleeding Playbook","html":"","width":"100%","height":180,"duration":1327,"description":"This episode breaks down the 2024 ACG/Society of Abdominal Radiology consensus statement alongside a 2025 Duke University update, mapping out exactly which imaging test to reach for at each stage of a GI bleed and when IR should step in.  Dr. Rusty Hofmann from Stanford University closes with his commentary.\nCTA Takes First-Line: For unstable patients or high clinical suspicion, CTA now leads with ~95% accuracy, and even a negative scan is useful, it predicts lower rebleeding and reintervention rates.\nThe RBC Scan's Blind Spot: Reserved for stable, post-negative-colonoscopy cases, tagged RBC scans carry a 10-33% localization error, enough to send an IR team down the wrong vessel entirely.\nCTE Over Capsule for Small Bowel: CT enterography is now preferred first-line for small bowel bleeding, especially with capsule-retention risk or suspected GISTs that a pill camera would miss.\nCoils Beat Particles: At the vasa recta, particle embolization carried 5.3% severe ischemia risk versus 0% for coils alone, a strong case for targeted, extravasation-confirmed embolization.\nThe Break-Glass Option: When all standard imaging fails, provocative mesenteric angiography proved safe via first-pass hepatic clearance of TPA, but only pays off with hematochezia plus a prior positive study; melena with clean imaging predicts a wasted procedure.\nTune in to build a modality-by-modality protocol, from first scan to break-glass angiogram.\nThis podcast is generated using an AI model that has been trained in the context of endovascular surgery and interventional radiology in addition context of the article cited below. The content was reviewed and edited by multiple healthcare professionals in the field.\n\nACG and SAR Consensus Statement on GI Bleeding Imaging: Sengupta N, Kastenberg DM, Bruining DH, et al. The Role of Imaging for GI Bleeding: ACG and SAR Consensus Recommendations. Radiology. 2024;310(3):e232298\nDuke University Provocative Angiography Study: Benvenuti et al. Provocative...","thumbnail_url":"https://img.transistorcdn.com/MTWsVlQNVWnqK7R-Z-jI7G_aa5KttFr_japy-P3mayc/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS81ODli/OTVlYjRiZjJlZGZi/ZDQxYmE2NDU2YmUx/Y2ZhMy5qcGc.webp","thumbnail_width":300,"thumbnail_height":300}