New Trends in Management of Vascular Lower GI bleeding between Endoscopy and Angiography: Literature review

Abstract

Vascular lower gastrointestinal (GI) bleeding remains a challenging condition to manage due to its potential severity and diverse etiologies. This review examines recent advances in the management of vascular lower GI bleeding, focusing on endoscopic and angiographic modalities. Endoscopic innovations, including high-definition imaging, narrow-band imaging, and improved hemostatic devices, have enhanced diagnostic accuracy and therapeutic efficacy. Conversely, angiographic techniques, especially computed tomographic angiography (CTA) and superselective embolization, offer alternative and often complementary solutions, particularly for patients in whom endoscopy is not feasible or effective. Comparative analysis highlights the unique strengths and limitations of each approach, underscoring the importance of patient-specific factors such as age, comorbidities, and bleeding site. Future directions in this field include artificial intelligence integration in endoscopy, novel embolic agents in angiography, and hybrid approaches that combine these modalities for optimal patient outcomes. The findings suggest a shift toward a more personalized, integrative approach in managing vascular lower GI bleeding, informed by ongoing research and technological advances.