Role of angiography and embolization for massive gastroduodenal hemorrhage

Walsh, R. Matthew; Anain, Paul; Geisinger, Michael A.; Vogt, David; Mayes, James T.; Grundfest‐Broniatowski, Sharon; Henderson, J. Michael

doi:10.1016/s1091-255x(99)80010-9

Cited by 100 publications

(74 citation statements)

References 22 publications

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“…tissue adhesives such as cyanoacrylate) or very small particles (e.g. gelatine sponge powder) [41][42][43][44] . Although cases have been reported at the acute phase, post-embolization ischemia usually presents as duodenal stenosis at the chronic phase.…”

Section: Risk For Gastrointestinal Tract Necrosismentioning

confidence: 99%

Role of transcatheter arterial embolization for massivebleeding from gastroduodenal ulcers

Loffroy¹,

Guiu²

2009

WJG

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Intractable bleeding from gastric and duodenal ulcers is associated with significant morbidity and mortality. Aggressive treatment with early endoscopic hemostasis is essential for a favourable outcome. In as many as 12%-17% of patients, endoscopy is either not available or unsuccessful. Endovascular therapy with selective catheterization of the culprit vessel and injection of embolic material has emerged as an alternative to emergent operative intervention in high-risk patients. There has not been a systematic literature review to assess the role for embolotherapy in the treatment of acute upper gastrointestinal bleeding from gastroduodenal ulcers after failed endoscopic hemostasis. Here, we present an overview of indications, techniques, and clinical outcomes after endovascular embolization of acute peptic-ulcer bleeding. Topics of particular relevance to technical and clinical success are also discussed. Our review shows that transcatheter arterial embolization is a safe alternative to surgery for massive gastroduodenal bleeding that is refractory to endoscopic treatment, can be performed with high technical and clinical success rates, and should be considered the salvage treatment of choice in patients at high surgical risk.

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Section: Risk For Gastrointestinal Tract Necrosismentioning

confidence: 99%

Role of transcatheter arterial embolization for massivebleeding from gastroduodenal ulcers

Loffroy¹,

Guiu²

2009

WJG

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“…A few studies have selectively addressed embolization of duodenal ulcer hemorrhages [17, 18, 19, 20]. Several other series consist of patients with upper gastrointestinal hemorrhage due to a variety of causes including gastric and duodenal ulcers [21, 22].…”

Section: Case Reportmentioning

confidence: 99%

Management of Bleeding Gastroduodenal Ulcers

Lanschot

Leerdam²,

Delden³

et al. 2002

Dig Surg

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“…Upper GI bleeding is treated with endoscopy, such as clipping and bipolar electrocoagulation (4) However, for patients for whom endoscopic treatment fails, interventional radiology is applied (5,6). The mortality rate rises to 40% when patients become hemodynamically unstable (7); therefore, it is important to predict upper GI bleeding prior to this.…”

Section: Introductionmentioning

confidence: 99%

Change ratio of hemoglobin has predictive value for upper gastrointestinal bleeding

et al. 2016

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Abstract. The present study aimed to identify novel predictors of upper gastrointestinal (GI) bleeding by assessing change ratios of blood test variables. Records of 1,023 patients (431 men and 592 women) who underwent endoscopy between October 2014 and September 2015 at the National Hospital Organization Shimoshizu Hospital (Yotsukaido, Japan) were retrospectively analyzed. Patients whose blood test variables for the time-point of endoscopy and three months previously were available were enrolled and subsequently categorized into a group with and another one without upper GI bleeding (n=32 and 84, respectively), and the respective change ratios were calculated for each group. One-way analysis of variance revealed that in patients with upper GI bleeding, change ratios of white blood cell count and alkaline phosphatase were significantly higher than those in patients without, while change ratios of hemoglobin (Hb), total protein and albumin were significantly reduced. Logistic regression analysis demonstrated that the change ratio of Hb was significantly correlated with upper GI bleeding. Receiver-operator characteristic analysis revealed that an 18.7% reduction of Hb was the threshold value for the prediction of upper GI bleeding. In conclusion, the present study revealed that a ≥18.7% reduction in Hb over three months has predictive value for upper GI bleeding.

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Role of angiography and embolization for massive gastroduodenal hemorrhage

Cited by 100 publications

References 22 publications

Role of transcatheter arterial embolization for massivebleeding from gastroduodenal ulcers

Role of transcatheter arterial embolization for massivebleeding from gastroduodenal ulcers

Management of Bleeding Gastroduodenal Ulcers

Change ratio of hemoglobin has predictive value for upper gastrointestinal bleeding

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