Twenty-six retrospective case series (n=315) were included. Seven case series (n=103) were included in the meta-analysis.
Where reported, the overall median re-bleeding rate at 30 days was 14% (range: 0 to 75). The most commonly reported complications after re-bleeding were intestinal ischaemia (range: 0 to 33%) and reoperation (range: 0 to 50%). The time to re-bleeding, where reported, ranged from 1 to 300 days after embolisation.
Studies with adequate individual case data.
Significant statistical heterogeneity was found (p<0.01). Multiple regression showed that disease type significantly influenced the re-bleeding rate (p<0.01), but that age, method of embolisation and individual study were not significantly associated with the re-bleeding rate.
Patients with AVD and other non-diverticular diseases had a significantly higher rate of re-bleeding at 30 days compared with patients with diverticular disease (OR 3.53, 95% confidence interval: 1.33, 9.41, p<0.01). Omitting each study in turn did not influence the results.
The funnel plot did not show major asymmetry. The Kaplan-Meier analysis showed that the overall failure rate was approximately 15% for patients with diverticulitis compared with almost 45% for patients with non-diverticular diseases (based on data from 6 studies).