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CardioVascular and Interventional Radiology

, Volume 36, Issue 4, pp 970–977 | Cite as

Is There a Role for Empiric Gastroduodenal Artery Embolization in the Management of Patients with Active Upper GI Hemorrhage?

  • Shaheen Dixon
  • Victoria Chan
  • Vivek Shrivastava
  • Susan Anthony
  • Raman Uberoi
  • Mark Bratby
Clinical Investigation

Abstract

Purpose

To assess the relative efficacy of empiric gastroduodenal artery (GDA) embolization in reducing recurrent hemorrhage compared to image-guided targeted embolization.

Methods

Data were retrospectively collected for consecutive patients who had catheter angiography for major upper gastrointestinal hemorrhage from May 2008 to November 2010 (n = 40). The total number of cases were divided into two main groups according to angiographic findings: those that demonstrated a site of hemorrhage on catheter angiography (group 1, n = 13), and those where the site of hemorrhage was not identified on catheter angiography (group 2, n = 27). Group 2 was then further divided into patients who received empiric embolization (group 2a, n = 20) and those who had no embolization performed after angiography (group 2b, n = 7).

Results

The technical and clinical success rates for embolization in groups 1 and 2a were, respectively, 100 vs. 95 %, and 85 vs. 80 %. There was no statistical significance in the recurrent hemorrhage rate, reintervention rate, or 30 day mortality between targeted and empiric embolization groups. There were no complications attributed to embolization within this study cohort.

Conclusion

Cases of duodenal-related major upper gastrointestinal hemorrhage where no embolization is performed have poor outcome. Empiric embolization of the GDA in patients with major upper gastrointestinal hemorrhage refractory to endoscopic treatment appears to be a safe and effective treatment, with low reintervention rates and good clinical outcome comparable to patients where the site of hemorrhage is localized and embolized with computed tomographic angiography or catheter angiography and embolized.

Keywords

Angiography Embolization Gastroduodenal artery Upper gastrointestinal bleeding 

Notes

Conflict of interest

The authors declare that they have no conflict of interest. The authors also declare there are no potential benefits in any form from a commercial party related directly or indirectly to the subject of the article or to any of the authors.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2012

Authors and Affiliations

  • Shaheen Dixon
    • 1
  • Victoria Chan
    • 1
  • Vivek Shrivastava
    • 1
    • 2
  • Susan Anthony
    • 1
  • Raman Uberoi
    • 1
  • Mark Bratby
    • 1
  1. 1.Department of RadiologyThe John Radcliffe HospitalHeadington, OxfordUK
  2. 2.Department of RadiologyHull Royal InfirmaryHullUK

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