A UK study of minimally invasive emergency treatment of sudden bleeding from the lower bowel
| ISRCTN | ISRCTN18144604 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN18144604 |
| Integrated Research Application System (IRAS) | 351622 |
| Sponsor | University Hospitals Plymouth NHS Trust |
| Funders | Royal College of Radiologists, British Society of Interventional radiology |
- Submission date
- 21/01/2026
- Registration date
- 15/04/2026
- Last edited
- 17/04/2026
- Recruitment status
- Recruiting
- Overall study status
- Ongoing
- Condition category
- Circulatory System
Plain English summary of protocol
Background and study aims
Bleeding from the gut can be life-threatening and can lead to hospitalisation, serious complications or death. Traditionally, surgery has been used to stop the bleeding, but this can carry significant risks.
Interventional radiology plays an important role in diagnosis and treatment. Small catheters can be placed by pinhole techniques and directed by X-rays to examine the blood vessels and find the source of bleeding. If a bleeding source is identified, an embolisation procedure can be performed to block the affected blood vessel. During embolisation, the doctor can inject small particles or coils into the artery through the catheter to stop blood flow to the bleeding area while allowing normal blood flow to the rest of the body. This is a quick and effective procedure and is now widely accepted as an effective way to manage life threatening bleeding, avoiding major surgery.
We will be looking back in time to identify patients who underwent embolisation for bleeding from the back passage. The aim is to analyse the current practice of emergency embolisation for this type of bleeding. We will assess predictors of successful embolisation and assess whether timing affects outcomes. The findings could help guide hospital policy and improve emergency management.
Who can participate?
Adult patients (≥18 years) who have undergone transcatheter arterial embolisation for acute non-variceal lower gastrointestinal bleeding at participating centres during the study period will be eligible for inclusion. Patients with upper gastrointestinal bleeding or variceal bleeding will be excluded.
What does the study involve?
This study is a retrospective observational study. No additional tests, procedures or hospital visits are required. Researchers will review existing hospital records, imaging reports and procedural documentation to collect information about patients who have previously undergone embolisation for lower gastrointestinal bleeding. Data collected will include clinical presentation, imaging findings, details of the embolisation procedure and patient outcomes such as rebleeding or complications.
What are the possible benefits and risks of participating?
Benefits:
Although there is no direct benefit to individual patients, the study aims to improve understanding of outcomes following embolisation for lower gastrointestinal bleeding. The findings will help inform future patient selection, procedural techniques and management strategies.
Risks:
There are no additional risks to patients as the study involves only the review of existing clinical records and imaging. No additional procedures or interventions are required.
Where is the study run from?
The study is coordinated from the United Kingdom and conducted across multiple participating centres internationally, including NHS hospitals and collaborating institutions.
When is the study starting and how long is it expected to run for?
February 2026 to October 2028
Who is funding the study?
Royal College of Radiologists and British Society of Interventional Radiology
Who is the main contact?
Deevia Kotecha, deevia.kotecha@gmail.com
Contact information
Principal investigator, Public, Scientific
University Hospitals Plymouth NHS Trust, Derriford Road, Crownhill
Plymouth
PL6 8DH
United Kingdom
 ORCID ID |
0000-0003-3010-5906 |
|---|---|
| deevia.kotecha@gmail.com |
Study information
| Primary study design | Observational |
|---|---|
| Observational study design | Cross sectional study |
| Scientific title | A multi-centre retrospective observational study investigating outcomes after emergency transcatheter arterial embolisation for acute non-variceal lower GI bleeding |
| Study acronym | MAGIC-Embo |
| Study objectives | Primary objective: To establish the rate of mortality, rebleeding, re-intervention, embolisation failure and complications after embolisation for acute non-variceal lower GI bleeding Secondary objectives: 1. To determine variations in embolisation technique/agents used and assess whether these impact on technical and clinical outcome 2. To determine clinical features that predict a successful or unsuccessful embolisation procedure 3. To determine whether CT imaging features correlate with DSA findings 4. To determine whether clinical variables correlate with DSA findings |
| Ethics approval(s) | Ethics approval not required |
| Health condition(s) or problem(s) studied | Patients who have undergone angiography +/- embolisation for acute non-variceal lower GI haemorrhage. |
| Intervention | Data will be collected by a named doctor as part of the IR trainee research collaborative (UNITE) or interventional radiology trainees, junior doctors and medical students at each participating centre and will be maintained on an anonymised (REDCap) database. They will be supervised by an Interventional Radiology Consultant who will be a permanent employee of that centre. This type of work is part of their expected role for the purposes of quality improvement and revalidation. Registrars will collect this data as part of their training time where there is a requirement to be involved in audit and research. Applicants from participating sites can register to be an Associate PI for this study as part of the NIHR Associate Principal Investigator Scheme. All data will be anonymised prior to leaving the centre. All data will be collected using the purpose-built electronic database Research Electronic Data Capture (REDCap) platform, which is overseen by the University of Plymouth. No identifiable data (patient number, full name, date of birth) will be recorded or shared. Data collected falls into the following categories (examples given after each category are not exhaustive ): ● Participant ID number (pseudo-anonymised) ● Demographics: Age, gender, date of admission ● Comorbidities ● Pre-procedural imaging: Dates, modalities, diagnosis ● Treatments offered prior to procedure: Antibiotics, IV fluids, blood transfusion, endoscopy ● Procedure: Date, procedural findings ● Intraoperative complications ● Post-operative complications: Types, date of occurrence, treatment ● Follow up: readmissions, 30-day mortality, cause of death, further interventions The patients will not be contacted at any point. At no point will the data be identifiable outside the site at which embolisation was performed. Only anonymised data will be sent to the central research team for analysis. Data will be collected, analysed and held on secure Trust PC and on the purpose-built electronic database Research Electronic Data Capture (REDCap) platform overseen by the University of Plymouth. All data will be stored on a Trust computer in a password protected file with access only available by the local lead. Anonymised data only will be shared with the central team. Archiving will be authorised by the Sponsor following submission of the end of study declaration. Upon completion of the study, study documents will be archived for a minimum of 5 years as per the participating Trust’s Research Archiving SOP. Once the archiving retention period has been reached, the Sponsor will liaise with the CI regarding destruction. |
| Intervention type | Not Specified |
| Primary outcome measure(s) |
|
| Key secondary outcome measure(s) |
|
| Completion date | 01/10/2028 |
Eligibility
| Participant type(s) | |
|---|---|
| Age group | Mixed |
| Lower age limit | 16 Years |
| Upper age limit | 150 Years |
| Sex | All |
| Target sample size at registration | 800 |
| Key inclusion criteria | 1. Adult patients (aged 16 years or more) undergoing emergency embolisation for acute non-variceal lower GI bleeding 2. Date of procedure from 01/01/2023 to 01/06/2025 |
| Key exclusion criteria | 1. Patients who underwent embolisation for variceal GI bleeding 2. Patients who underwent embolisation for upper GI bleeding 3. Patients who underwent embolisation for chronic gastrointestinal bleeding (defined as >30 days) |
| Date of first enrolment | 01/02/2026 |
| Date of final enrolment | 01/02/2028 |
Locations
Countries of recruitment
- United Kingdom
- England
- Northern Ireland
- Scotland
- Wales
- Australia
- Ireland
- New Zealand
- Singapore
Study participating centres
Derriford Road
Derriford
Plymouth
PL6 8DH
England
Colney
Norwich
NR4 7UY
England
Herries Road
Sheffield
S5 7AU
England
Headley Way
Headington
Oxford
OX3 9DU
England
Prescot Street
Liverpool
L7 8XP
England
Anlaby Road
Hull
HU3 2JZ
England
Aberdeen
AB25 2ZN
Scotland
Hardwick Lane
Bury St. Edmunds
IP33 2QZ
England
Hills Road
Cambridge
CB2 0QQ
England
Sandford Road
Cheltenham
GL53 7AN
England
Freeman Road
High Heaton
Newcastle upon Tyne
NE7 7DN
England
Watford Road
Harrow
HA1 3UJ
England
St Marys Hospital
South Wharf Road
London
W2 1BL
England
Tremona Road
Southampton
SO16 6YD
England
1055 Great Western Road
Glasgow
G12 0XH
Scotland
Sharoe Green Lane
Fulwood
Preston
PR2 9HT
England
Cliftonville
Northampton
NN1 5BD
England
Stoke-on-trent
ST4 6QG
England
Ethelbert Road
Canterbury
CT1 3NG
England
Bath
BA1 3NG
England
Turner Road
Colchester
CO4 5JL
England
Cowbridge Road East
Cardiff
CF11 9XB
Wales
Derby Road
Nottingham
NG7 2UH
England
Williams Avenue
Dorchester
DT1 2JY
England
Beckett Street
Leeds
LS9 7TF
England
Pond Street
London
NW3 2QG
England
Wolverhampton Road
Heath Town
Wolverhampton
WV10 0QP
England
Wigginton Road
York
YO31 8HE
England
Windmill Road
Gillingham
ME7 5NY
England
80 Newark Street
London
E1 2ES
England
Durham
DH1 5TW
England
Westminster Bridge Road
London
SE1 7EH
England
Mindelsohn Way
Edgbaston
Birmingham
B15 2GW
England
Upney Lane
Barking
IG11 9LX
England
Southmead Road
Westbury-on-trym
Bristol
BS10 5NB
England
Frimley
Camberley
GU16 7UJ
England
Edinburgh
EH10 5HF
Scotland
Aberford Road
Wakefield
WF1 4DG
England
London
NW1 2PG
England
Infirmary Square
Leicester
LE1 5WW
England
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|---|
| IPD sharing plan summary | Not expected to be made available |
| IPD sharing plan |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol file | version 1.0 | 26/11/2025 | 21/01/2026 | No | No |
Additional files
- 48876 MAGIC-Embo+Protocol+V1.0+26.11.2025.pdf
- Protocol file
Editorial Notes
17/04/2026: Contact details updated.
21/01/2026: Trial's existence confirmed by NHS HRA.
