Transcatheter Arterial Embolization for Upper Gastrointestinal Nonvariceal Hemorrhage: Is Empiric Embolization Warranted?

Arrayeh, Elnasif; Fidelman, Nicholas; Gordon, Roy L.; LaBerge, Jeanne M.; Kerlan, Robert K.; Климов, А. Е.; Bloom, Allan I.

doi:10.1007/s00270-012-0351-y

Cited by 24 publications

(17 citation statements)

References 12 publications

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“…Angiographic confirmation of a bleeding site seems not a prerequisite for TAE in the upper GI bleeding. Several studies showed no difference in clinical outcomes between patients with negative and patients with positive angiography results when both were treated with TAE 14,16-19…”

Section: Discussionmentioning

confidence: 99%

Refractory Gastrointestinal Bleeding: Role of Angiographic Intervention

Shin

2013

Clin Endosc

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Although endoscopic hemostasis remains initial treatment modality for nonvariceal gastrointestinal (GI) bleeding, severe bleeding despite endoscopic management occurs in 5% to 10% of the patients, requiring surgery or transcatheter arterial embolization (TAE). TAE is now considered the first-line therapy for massive GI bleeding refractory to endoscopic management. GI endoscopists need to be familiar with indications, principles, outcomes, and complications of TAE, as well as embolic materials available.

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Section: Discussionmentioning

confidence: 99%

Refractory Gastrointestinal Bleeding: Role of Angiographic Intervention

Shin

2013

Clin Endosc

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“…I found the discussion a little surprising because every published study to date has concluded that empiric embolization is equally as effective as embolization for angiographically visible bleeding. [5][6][7][8][9][10] As such, as a rule, if angiography is performed for upper GI bleeding, it should be done with intention to treat. I believe that empiric embolization for lower GI bleeding is also appropriate in the era of CTA if the bleeding site is unequivocally demonstrated, although this has not been established by any studies to date.…”

Section: Empiric Embolizationmentioning

confidence: 99%

Gastrointestinal Bleeding on Call: Questions and Answers and One Person's Opinions

Funaki

2020

Semin intervent Radiol

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Gastrointestinal (GI) bleeding represents one of the more morbid forms of hemorrhage that interventional radiologists deal with on an on-call basis. Bleeding from the GI tract takes many forms and has many etiologies. While venous bleeds from varices are often treated emergently with placement of a transjugular intrahepatic portosystemic shunt, arterial hemorrhages are treated most effectively with embolization procedures. Embolization must be performed in specific ways, however, in an effort to decrease the risk of bowel ischemia; this also requires choosing the right patients in whom to perform embolization procedures. This article will provide a discussion on when to perform embolization and how, what to do with specific patient populations such as those with coagulopathy, and which patients should be considered for emergent treatment versus those that can be postponed.

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“…Several studies have shown no differences in clinical outcomes between patients with negative and positive angiographic findings after TAE. [47][48][49] In the case of gastric bleeding that is visible on endoscopy, the left gastric artery is often embolised (Figure 10). endoscopy findings or clip placement around the area of the bleeding vessel.…”

Section: Embolisationmentioning

confidence: 99%

Transcatheter Arterial Embolisation of Acute Nonvariceal Upper Gastrointestinal Bleeding Refractory to Endoscopic Haemostasis

Kwon

2020

Hong Kong Journal of Radiology

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Upper gastrointestinal tract bleeding (UGIB) originates in the distal oesophagus, stomach, and duodenum (proximal to the ligament of Treitz). The most common cause of nonvariceal UGIB is peptic ulcer disease, but it is associated with many different diagnoses, including benign and malignant tumours, ischaemia, gastritis, arteriovenous malformations such as Dieulafoy's lesions, Mallory-Weiss tears, trauma, and iatrogenic causes. Endoscopic haemostasis remains the initial treatment modality, but when endoscopic treatment fails to control bleeding, transcatheter arterial embolisation is a safe, effective, and minimally invasive treatment compared with surgery. Advances in catheterbased techniques and embolic agents have expanded the role of interventional radiology in UGIB treatment. This article discusses the aetiologies of UGIB, methods of embolisation, characteristics of embolic agents, and evidence in the literature regarding the technical and clinical outcomes of transcatheter arterial embolisation in patients with acute nonvariceal UGIB.

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Transcatheter Arterial Embolization for Upper Gastrointestinal Nonvariceal Hemorrhage: Is Empiric Embolization Warranted?

Abstract: Empiric arterial embolization may be advantageous in patients with a duodenal source of hemorrhage but not in patients with gastric hemorrhage.

Cited by 24 publications

References 12 publications

Refractory Gastrointestinal Bleeding: Role of Angiographic Intervention

Refractory Gastrointestinal Bleeding: Role of Angiographic Intervention

Gastrointestinal Bleeding on Call: Questions and Answers and One Person's Opinions

Transcatheter Arterial Embolisation of Acute Nonvariceal Upper Gastrointestinal Bleeding Refractory to Endoscopic Haemostasis

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