Gastric bleeding: therapy with intraarterial vasopressin and transcatheter embolization.

Angiographic therapy to control gastric bleeding was attempted in 200 patients. One hundred ninety-four patients were treated with intraarterial vasopressin and 17 of them were also treated with transcatheter embolization. Six patients underwent primary embolization, and an additional six received intravenous vasopressin. The initial rate of bleeding control in all patients angiographically treated was 73%. When embolization was used in some of the patients who did not respond to vasopressin, the overall control rate increased to 79%. Recurrent bleeding occurred in 18%. When angiographic therapy was attempted again in the patients with recurrent hemorrhage, the bleeding was stopped in 36%. Major complications occurred in 6.5% and minor in 17.5%. Of the patients with bleeding that was angiographically controlled, 73% survived and 27% died of associated clinical conditions. Among the failures of angiographic therapy, 48% died during the same hospital admission. Intraarterial infusions of vasopressin or transcatheter embolization are useful for the control of gastric bleeding.