Role of transcatheter arterial embolization for massive bleeding from gastroduodenal ulcers. - Archive ouverte HAL Access content directly
Journal Articles World Journal of Gastroenterology Year : 2009

Role of transcatheter arterial embolization for massive bleeding from gastroduodenal ulcers.

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Abstract

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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Dates and versions

inserm-00476643 , version 1 (26-04-2010)

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  • HAL Id : inserm-00476643 , version 1
  • PUBMED : 20014452

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Romaric Loffroy, Boris Guiu. Role of transcatheter arterial embolization for massive bleeding from gastroduodenal ulcers.. World Journal of Gastroenterology, 2009, 15 (47), pp.5889-97. ⟨inserm-00476643⟩

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