Dr George Poultsides and colleagues from Greece examined the safety, efficacy, and predictors of outcome of angiographic embolization in the management of gastroduodenal hemorrhage.
|The clinical success rate after repeat embolization was 56%|
|Archives of Surgery|
The team referred all of the patients after endoscopic treatment failure.
Surgery was not immediately considered because of poor surgical risk, refusal to consent, or endoscopist's decision.
The team excluded from review patients with coagulopathy, hemobilia, and variceal or traumatic upper gastrointestinal tract bleeding.
The team performed 70 embolization procedures in 57 patients between 1996 and 2006.
The team evaluated technical and clinical success rates as well as complications.
The researchers found that the technical success rate was 94%.
The primary clinical success rate was 51%, and the clinical success rate after repeat embolization was 56%.
The team found 2 factors to be independent predictors of poor outcome by multivariate analysis.
These factors included recent duodenal ulcer suture ligation, and blood transfusion of more than 6 units prior to the procedure.
The research team observed no predictive value for angiographic failure based on age, sex, prior coagulopathy or renal failure at presentation.
The team also noted no predictive value for angiographic failure based on immunocompromised status, multiple organ system failure, blind embolization, and use of permanent vs temporary embolic agents.
Dr Poultsides' team concluded, "Repeat embolizations were helpful for postsphincterotomy bleeding."
"The team found major ischemic complications were associated with previous foregut surgery."