
Mortality After GI bleed Catheter Embolisation (MAGIC Embo)
Project Summary
Gastrointestinal (GI) bleeding is a common major medical emergency that can be challenging to treat and life-threatening in instances. Lower GI bleeding refers to bleeding which originates from the intestines (small bowel and colon). When bleeding does not resolve spontaneously, it can be controlled via endoscopy. This is a procedure where a doctor inserts a long flexible telescope tube with a camera at the end through the patient’s anus to look inside the stomach and intestines.
During this procedure, the doctor can also inject medication, use heat or apply clips inside the digestive tract to stop the bleeding at the same time. If this fails, an angiogram may be required to specifically identify the source of the bleeding. An angiogram is a procedure where X-rays are used to examine blood vessels. Contrast dye can be injected into the artery via a tube to produce detailed images of the arteries and identify a possible source of bleeding. If a bleeding source is identified an embolisation procedure can be performed to block the affected blood vessel. In particular, during embolisation, the doctor can inject small particles or coils into the artery, stopping blood flow to the bleeding area while allowing normal blood flow to the rest of the body.
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Previous research done to evaluate emergency interventions and treatments suggests that the time of the day at which a procedure is performed can impact on clinical outcomes for patients admitted to hospital.
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This study aims to analyse the current practice of emergency embolisation for lower tract GI bleeding and will assess whether time of the day has an impact on management. The difference could be related to staff numbers, working hours and other issues in relation to service functionality based on the time of day. The results of this study will be used as the basis for determining whether any additional support is needed with out-of-hours services.
The details
Study design
Muticentre retrospective study
Inclusion Criteria
Exclusion criteria
Adult Patients undergoing emergency embolisation for non-variceal lower GI bleeding. Date of procedure 01/07/22 - 01/07/24.
Patients who underwent embolisation for variceal GI bleeding, upper GI bleeding, chronic GI bleeding > 30 days.
Sample size
30 local patients with contributions from other centres in the UK (minimum 800 patients expected)
Follow-up Duration
6 months from date of procedure or date of death, whichever is sooner
Planned Study Period
24 months
Primary objective
Not calculated
To assess predictors of outcomes for non-variceal lower GI embolisation
Team and funding
Principal Investigators
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Dr Deevia Kotecha – Interventional Radiology Registrar, NW Deanery, United Kingdom (UK)
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Miss Noemi Cinti, Medical Student, Hull York Medical School, UK
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Dr Indrajeet Mandal, Interventional Radiology Registrar, Oxford Deanery, UK
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Dr Paul Jenkins, Consultant Vascular Interventional Radiologist, University Hospitals Plymouth NHS Trust, Plymouth, UK
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Dr Nirmal Kakani, Consultant Vascular Interventional Radiologist, Manchester University NHS Foundation Trust, UK
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Dr Tariq Ali, Consultant Vascular Interventional Radiologist, Norfolk and Norwich University Hospitals, UK
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Dr Raghuram Lakshminarayan, Consultant Vascular Interventional Radiologist, Hull University Teaching Hospitals, UK
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Ethics and Funding
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The retrospective observational study will be conducted in compliance with the principles of the ICH GCP guidelines and in accordance with all applicable regulatory guidance including, but not limited to the UK Policy Framework for Health and Social Care research.
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IRAS and ethical approval will be sought. All data will be held pseudo-anonymised at the point of collection and no patient identifiable information will be stored by the central research team.
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​No external sources of funding have been sought for this study. Data will be collected at all centres by clinical research staff who are otherwise salaried and will be contributing data for free in exchange for appropriate recognition in the research output of the study.