Stavros Spiliopoulos1, Riccardo Inchingolo2,3, Pierleone Lucatelli4, Roberto Iezzi2, Athanasios Diamantopoulos5, Alessandro Posa2, Bryan Barry5, Carmelo Ricci4, Marco Cini4, Chrysostomos Konstantos6, Konstantinos Palialexis6, Lazaros Reppas6, Artemis Trikola6, Michele Nardella3, Andreas Adam5, Elias Brountzos6. 1. 2nd Department of Radiology, Interventional Radiology Unit, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece. stavspiliop@med.uoa.gr. 2. Department of Radiological Sciences, Institute of Radiology, Università Cattolica del Sacro Cuore, Rome, Italy. 3. Institute of Radiology, Madonna delle Grazie Hospital, Matera, Italy. 4. Vascular Interventional Radiology Unit, University of Siena, Viale Mario Bracci 53, 53100, Siena, Italy. 5. Department of Interventional Radiology, Guy's and St Thomas' Hospitals, NHS Foundation Trust, London, UK. 6. 2nd Department of Radiology, Interventional Radiology Unit, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.
Abstract
PURPOSE: To investigate the outcomes of transcatheter arterial embolization (TAE) for the treatment of peptic ulcer bleeding (PUB). MATERIALS AND METHODS: This is a retrospective, multicenter study, which investigated all patients who underwent TAE for the treatment of severe upper gastrointestinal hemorrhage from peptic ulcers in five European centers, between January 1, 2012 and May 1, 2017. All patients had undergone failed endoscopic hemostasis. Forty-four patients (male; mean age 74.0 ± 11.1 years, range 49-94), with bleeding from duodenum (36/44; 81.8%) or gastric ulcer (8/44; 18.2%) were followed up to 3.5 years (range 2-1354 days). In 42/44 cases, bleeding was confirmed by pre-procedural CT angiography. In 50% of the cases, coils were deployed, while in the remaining glue, microparticles, gel foam and combinations of the above were used. The study's outcome measures were 30-day survival technical success (occlusion of feeding vessel and/or no extravasation at completion DSA), overall survival, bleeding relapse and complication rates. RESULTS: The technical success was 100%. The 30-day survival rate was 79.5% (35/44 cases). No patients died due to ongoing or recurrent hemorrhage. Re-bleeding occurred in 2/44 cases (4.5%) and was successfully managed with repeat TAE (one) or surgery (one). The rate of major complications was 4.5% (2/44; one acute pancreatitis and one partial pancreatic ischemia), successfully managed conservatively. According to Kaplan-Meier analysis survival was 71.9% at 3.5 years. CONCLUSIONS: TAE for the treatment of PUB was technically successful in all cases and resulted in high clinical success rate. Minimal re-bleeding rates further highlight the utility of TAE as the second line treatment of choice, after failed endoscopy.
PURPOSE: To investigate the outcomes of transcatheter arterial embolization (TAE) for the treatment of peptic ulcer bleeding (PUB). MATERIALS AND METHODS: This is a retrospective, multicenter study, which investigated all patients who underwent TAE for the treatment of severe upper gastrointestinal hemorrhage from peptic ulcers in five European centers, between January 1, 2012 and May 1, 2017. All patients had undergone failed endoscopic hemostasis. Forty-four patients (male; mean age 74.0 ± 11.1 years, range 49-94), with bleeding from duodenum (36/44; 81.8%) or gastric ulcer (8/44; 18.2%) were followed up to 3.5 years (range 2-1354 days). In 42/44 cases, bleeding was confirmed by pre-procedural CT angiography. In 50% of the cases, coils were deployed, while in the remaining glue, microparticles, gel foam and combinations of the above were used. The study's outcome measures were 30-day survival technical success (occlusion of feeding vessel and/or no extravasation at completion DSA), overall survival, bleeding relapse and complication rates. RESULTS: The technical success was 100%. The 30-day survival rate was 79.5% (35/44 cases). No patients died due to ongoing or recurrent hemorrhage. Re-bleeding occurred in 2/44 cases (4.5%) and was successfully managed with repeat TAE (one) or surgery (one). The rate of major complications was 4.5% (2/44; one acute pancreatitis and one partial pancreatic ischemia), successfully managed conservatively. According to Kaplan-Meier analysis survival was 71.9% at 3.5 years. CONCLUSIONS:TAE for the treatment of PUB was technically successful in all cases and resulted in high clinical success rate. Minimal re-bleeding rates further highlight the utility of TAE as the second line treatment of choice, after failed endoscopy.
Authors: Christophoros S Kosmidis; Georgios D Koimtzis; Georgios Anthimidis; Nikolaos Varsamis; Stefanos Atmatzidis; Ioannis S Koskinas; Triantafyllia Koletsa; Katerina Zarampouka; Eleni Georgakoudi; Sofia Baka; Christophoros Efthimiadis; Maria S Kosmidou; Georgios Kouklakis Journal: Am J Case Rep Date: 2018-07-28
Authors: Armin Kuellmer; Tobias Mangold; Dominik Bettinger; Lars Maruschke; Andreas Wannhoff; Karel Caca; Edris Wedi; Ali Seif Amir Hosseini; Tobias Kleemann; Thomas Schulz; Carlo Jung; Robert Thimme; Arthur Schmidt Journal: United European Gastroenterol J Date: 2021-08-25 Impact factor: 4.623