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The efficacy and clinical outcomes of transarterial embolization in acute massive upper gastrointestinal bleeding: a single-center experience

Yıl 2021, Cilt: 34 Sayı: 2, 180 - 188, 31.05.2021
https://doi.org/10.5472/marumj.944254

Öz

Objective: To evaluate the efficacy of transarterial embolization (TAE) in the treatment of acute upper gastrointestinal bleeding
(UGIB) and identify potential factors affecting the treatment outcome.
Patients and Methods: Eighteen patients with UGIB treated with TAE were included in the study. The demographic data, causes of
bleeding, angiography findings, treatments applied, and clinical outcomes were retrospectively analyzed.
Results: Thirteen (72.2%) patients were male, five (27.8%) were female, and the mean age was 55 years (range: 33-68 years). A
pseudoaneurysm (n = 7; 38.9%) was the most common finding, followed by tumor staining (n = 4; 22.2%). The most common
pathology causing bleeding was peptic ulcer disease (n = 9; 50%). The most commonly embolized artery was the gastroduodenal
artery (n = 11; 61.1%). There were three (16.7%) patients with hemobilia due to iatrogenic hepatic artery pseudoaneurysm. In most
cases (n = 9; 50%), coils and polyvinyl alcohol particles were used in combination. Technical success was achieved in all patients. The
clinical success rate was 78.5% (11/14 patients) after the exclusion of patients who died for non-UGIB causes (n = 4; 22.2%).
Conclusion: Transarterial embolizati

Kaynakça

  • Bua-Ngam C, Norasetsingh J, Treesit T, et al. Efficacy of emergency transarterial embolization in acute lower gastrointestinal bleeding: A single-center experience. Diagn Interv Imaging 2017;98:499-505. doi.org/10.1016/j. diii.2017.02.005.
  • Augustin AM, Fluck F, Bley T, Kickuth R. Endovascular therapy of gastrointestinal bleeding. RöFo Fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgeb Verfahren 2019;191:1073-82. doi.org/10.1055/a-0891-1116.
  • Chang WC, Liu CH, Hsu HH, et al. Intra-arterial treatment in patients with acute massive gastrointestinal bleeding after endoscopic failure: Comparisons between positive versus negative contrast extravasation groups. Korean J Radiol 2011;12:568–78. doi.org/10.3348/kjr.2011.12.5.568.
  • Loffroy RF. Recent advances in endovascular techniques for management of acute nonvariceal upper gastrointestinal bleeding. World J Gastrointest Surg 2011;3:89. doi. org/10.4240/wjgs.v3.i7.89.
  • Pannatier M, Duran R, Denys A, Meuli R, Zingg T, Schmidt S. Characteristics of patients treated for active lower gastrointestinal bleeding detected by CT angiography: Interventional radiology versus surgery. Eur J Radiol 2019;120:108691. doi.org/10.1016/j.ejrad.2019.108691.
  • Köhler G, Koch OO, Antoniou SA, et al. Relevance of Surgery after Embolization of Gastrointestinal and Abdominal Hemorrhage. World J Surg 2014;38:2258-66. doi.org/10.1007/ s00268.014.2570-7.
  • Loffroy R, Rao P, Ota S, De Lin M, Kwak B-K, Geschwind J-F. Embolization of acute nonvariceal upper gastrointestinal hemorrhage resistant to endoscopic treatment: results and predictors of recurrent bleeding. Cardiovasc Intervent Radiol 2010;33:1088-100. doi.org/10.1007/s00270.010.9829-7.
  • Loffroy R, Guiu B, Mezzetta L, et al. Short – and long-term results of transcatheter embolization for massive arterial hemorrhage from gastroduodenal ulcers not controlled by endoscopic hemostasis. Can J Gastroenterol 2009;23:115-20. doi.org/10.1155/2009/795460.
  • Loffroy R, Favelier S, Pottecher P, et al. Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes. Diagn Interv Imaging 2015;96:731-44. doi.org/10.1016/j.diii.2015.05.002.
  • Muhammad A, Awais M, Sayani R, et al. Empiric transcatheter arterial embolization for massive or recurrent gastrointestinal bleeding: ten-year experience from a single tertiary care center. Cureus 2019;11:e4228. doi.org/10.7759/cureus.4228.
  • Hongsakul K, Pakdeejit S, Tanutit P. Outcome and predictive factors of successful transarterial embolization for the treatment of acute gastrointestinal hemorrhage. Acta Radiol 2014;55:186-94. doi.org/10.1177/028.418.5113494985.
  • Gillespie CJ, Sutherland AD, Mossop PJ, Woods RJ, Keck JO, Heriot AG. Mesenteric embolization for lower gastrointestinal bleeding. Dis Colon Rectum 2010;53:1258-64. doi. org/10.1007/DCR.0b013e3181e10e90.
  • An JY, Lee JS, Kim DR, et al. Coil embolization of ruptured intrahepatic pseudoaneurysm through percutaneous transhepatic biliary drainage. Yeungnam Univ J Med 2018;35:109-13. doi.org/10.12701/yujm.2018.35.1.109.
  • Tessier DJ, Fowl RJ, Stone WM, et al. Iatrogenic hepatic artery pseudoaneurysms: an uncommon complication after hepatic, biliary, and pancreatic procedures. Ann Vasc Surg 2003;17:663-9. doi.org/10.1007/s10016.003.0075-1.
  • Tétreau R, Beji H, Henry L, Valette P-J, Pilleul F. Arterial splanchnic aneurysms: Presentation, treatment and outcome in 112 patients. Diagn Interv Imaging 2016;97:81-90. doi. org/10.1016/j.diii.2015.06.014.
  • Dohan A, Eveno C, Dautry R, et al. Role and effectiveness of percutaneous arterial embolization in hemodynamically unstable patients with ruptured splanchnic artery pseudoaneurysms. Cardiovasc Intervent Radiol 2015;38:862- 70. doi.org/10.1007/s00270.014.1002-2.
  • Aina R, Oliva VL, Therasse É, et al. Arterial embolotherapy for upper gastrointestinal hemorrhage: outcome assessment. J Vasc Interv Radiol 2001;12:195-200. doi.org/10.1016/S1051- 0443(07)61825-9.
  • Loffroy R, Guiu B, D’Athis P, et al. Arterial embolotherapy for endoscopically unmanageable acute gastroduodenal hemorrhage: Predictors of early rebleeding. Clin Gastroenterol Hepatol 2009;7:515-23. doi.org/10.1016/j.cgh.2009.02.003.
  • Padia SA, Geisinger MA, Newman JS, Pierce G, Obuchowski NA, Sands MJ. Effectiveness of coil embolization in angiographically detectable versus non-detectable sources of upper gastrointestinal hemorrhage. J Vasc Interv Radiol 2009;20:461-6. doi.org/10.1016/j.jvir.2009.01.006.
  • Zhang J, Khalifeh A, Santini-Dominguez R, et al. Endovascular reconstruction of the hepatic arterial system for the management of mycotic pseudoaneurysm in a liver transplant patient. Ann Vasc Surg 2019;61:473.e7-473.e11. doi.org/10.1016/j.avsg.2019.05.060.
Yıl 2021, Cilt: 34 Sayı: 2, 180 - 188, 31.05.2021
https://doi.org/10.5472/marumj.944254

Öz

Kaynakça

  • Bua-Ngam C, Norasetsingh J, Treesit T, et al. Efficacy of emergency transarterial embolization in acute lower gastrointestinal bleeding: A single-center experience. Diagn Interv Imaging 2017;98:499-505. doi.org/10.1016/j. diii.2017.02.005.
  • Augustin AM, Fluck F, Bley T, Kickuth R. Endovascular therapy of gastrointestinal bleeding. RöFo Fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgeb Verfahren 2019;191:1073-82. doi.org/10.1055/a-0891-1116.
  • Chang WC, Liu CH, Hsu HH, et al. Intra-arterial treatment in patients with acute massive gastrointestinal bleeding after endoscopic failure: Comparisons between positive versus negative contrast extravasation groups. Korean J Radiol 2011;12:568–78. doi.org/10.3348/kjr.2011.12.5.568.
  • Loffroy RF. Recent advances in endovascular techniques for management of acute nonvariceal upper gastrointestinal bleeding. World J Gastrointest Surg 2011;3:89. doi. org/10.4240/wjgs.v3.i7.89.
  • Pannatier M, Duran R, Denys A, Meuli R, Zingg T, Schmidt S. Characteristics of patients treated for active lower gastrointestinal bleeding detected by CT angiography: Interventional radiology versus surgery. Eur J Radiol 2019;120:108691. doi.org/10.1016/j.ejrad.2019.108691.
  • Köhler G, Koch OO, Antoniou SA, et al. Relevance of Surgery after Embolization of Gastrointestinal and Abdominal Hemorrhage. World J Surg 2014;38:2258-66. doi.org/10.1007/ s00268.014.2570-7.
  • Loffroy R, Rao P, Ota S, De Lin M, Kwak B-K, Geschwind J-F. Embolization of acute nonvariceal upper gastrointestinal hemorrhage resistant to endoscopic treatment: results and predictors of recurrent bleeding. Cardiovasc Intervent Radiol 2010;33:1088-100. doi.org/10.1007/s00270.010.9829-7.
  • Loffroy R, Guiu B, Mezzetta L, et al. Short – and long-term results of transcatheter embolization for massive arterial hemorrhage from gastroduodenal ulcers not controlled by endoscopic hemostasis. Can J Gastroenterol 2009;23:115-20. doi.org/10.1155/2009/795460.
  • Loffroy R, Favelier S, Pottecher P, et al. Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes. Diagn Interv Imaging 2015;96:731-44. doi.org/10.1016/j.diii.2015.05.002.
  • Muhammad A, Awais M, Sayani R, et al. Empiric transcatheter arterial embolization for massive or recurrent gastrointestinal bleeding: ten-year experience from a single tertiary care center. Cureus 2019;11:e4228. doi.org/10.7759/cureus.4228.
  • Hongsakul K, Pakdeejit S, Tanutit P. Outcome and predictive factors of successful transarterial embolization for the treatment of acute gastrointestinal hemorrhage. Acta Radiol 2014;55:186-94. doi.org/10.1177/028.418.5113494985.
  • Gillespie CJ, Sutherland AD, Mossop PJ, Woods RJ, Keck JO, Heriot AG. Mesenteric embolization for lower gastrointestinal bleeding. Dis Colon Rectum 2010;53:1258-64. doi. org/10.1007/DCR.0b013e3181e10e90.
  • An JY, Lee JS, Kim DR, et al. Coil embolization of ruptured intrahepatic pseudoaneurysm through percutaneous transhepatic biliary drainage. Yeungnam Univ J Med 2018;35:109-13. doi.org/10.12701/yujm.2018.35.1.109.
  • Tessier DJ, Fowl RJ, Stone WM, et al. Iatrogenic hepatic artery pseudoaneurysms: an uncommon complication after hepatic, biliary, and pancreatic procedures. Ann Vasc Surg 2003;17:663-9. doi.org/10.1007/s10016.003.0075-1.
  • Tétreau R, Beji H, Henry L, Valette P-J, Pilleul F. Arterial splanchnic aneurysms: Presentation, treatment and outcome in 112 patients. Diagn Interv Imaging 2016;97:81-90. doi. org/10.1016/j.diii.2015.06.014.
  • Dohan A, Eveno C, Dautry R, et al. Role and effectiveness of percutaneous arterial embolization in hemodynamically unstable patients with ruptured splanchnic artery pseudoaneurysms. Cardiovasc Intervent Radiol 2015;38:862- 70. doi.org/10.1007/s00270.014.1002-2.
  • Aina R, Oliva VL, Therasse É, et al. Arterial embolotherapy for upper gastrointestinal hemorrhage: outcome assessment. J Vasc Interv Radiol 2001;12:195-200. doi.org/10.1016/S1051- 0443(07)61825-9.
  • Loffroy R, Guiu B, D’Athis P, et al. Arterial embolotherapy for endoscopically unmanageable acute gastroduodenal hemorrhage: Predictors of early rebleeding. Clin Gastroenterol Hepatol 2009;7:515-23. doi.org/10.1016/j.cgh.2009.02.003.
  • Padia SA, Geisinger MA, Newman JS, Pierce G, Obuchowski NA, Sands MJ. Effectiveness of coil embolization in angiographically detectable versus non-detectable sources of upper gastrointestinal hemorrhage. J Vasc Interv Radiol 2009;20:461-6. doi.org/10.1016/j.jvir.2009.01.006.
  • Zhang J, Khalifeh A, Santini-Dominguez R, et al. Endovascular reconstruction of the hepatic arterial system for the management of mycotic pseudoaneurysm in a liver transplant patient. Ann Vasc Surg 2019;61:473.e7-473.e11. doi.org/10.1016/j.avsg.2019.05.060.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Original Articles
Yazarlar

Mehmet Tahtabası Bu kişi benim 0000-0001-9668-8062

Mehmet Kolu Bu kişi benim 0000-0001-9659-6053

Yayımlanma Tarihi 31 Mayıs 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 34 Sayı: 2

Kaynak Göster

APA Tahtabası, M., & Kolu, M. (2021). The efficacy and clinical outcomes of transarterial embolization in acute massive upper gastrointestinal bleeding: a single-center experience. Marmara Medical Journal, 34(2), 180-188. https://doi.org/10.5472/marumj.944254
AMA Tahtabası M, Kolu M. The efficacy and clinical outcomes of transarterial embolization in acute massive upper gastrointestinal bleeding: a single-center experience. Marmara Med J. Mayıs 2021;34(2):180-188. doi:10.5472/marumj.944254
Chicago Tahtabası, Mehmet, ve Mehmet Kolu. “The Efficacy and Clinical Outcomes of Transarterial Embolization in Acute Massive Upper Gastrointestinal Bleeding: A Single-Center Experience”. Marmara Medical Journal 34, sy. 2 (Mayıs 2021): 180-88. https://doi.org/10.5472/marumj.944254.
EndNote Tahtabası M, Kolu M (01 Mayıs 2021) The efficacy and clinical outcomes of transarterial embolization in acute massive upper gastrointestinal bleeding: a single-center experience. Marmara Medical Journal 34 2 180–188.
IEEE M. Tahtabası ve M. Kolu, “The efficacy and clinical outcomes of transarterial embolization in acute massive upper gastrointestinal bleeding: a single-center experience”, Marmara Med J, c. 34, sy. 2, ss. 180–188, 2021, doi: 10.5472/marumj.944254.
ISNAD Tahtabası, Mehmet - Kolu, Mehmet. “The Efficacy and Clinical Outcomes of Transarterial Embolization in Acute Massive Upper Gastrointestinal Bleeding: A Single-Center Experience”. Marmara Medical Journal 34/2 (Mayıs 2021), 180-188. https://doi.org/10.5472/marumj.944254.
JAMA Tahtabası M, Kolu M. The efficacy and clinical outcomes of transarterial embolization in acute massive upper gastrointestinal bleeding: a single-center experience. Marmara Med J. 2021;34:180–188.
MLA Tahtabası, Mehmet ve Mehmet Kolu. “The Efficacy and Clinical Outcomes of Transarterial Embolization in Acute Massive Upper Gastrointestinal Bleeding: A Single-Center Experience”. Marmara Medical Journal, c. 34, sy. 2, 2021, ss. 180-8, doi:10.5472/marumj.944254.
Vancouver Tahtabası M, Kolu M. The efficacy and clinical outcomes of transarterial embolization in acute massive upper gastrointestinal bleeding: a single-center experience. Marmara Med J. 2021;34(2):180-8.