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CardioVascular and Interventional Radiology

, Volume 41, Issue 9, pp 1333–1339 | Cite as

Transcatheter Arterial Embolization for Bleeding Peptic Ulcers: A Multicenter Study

  • Stavros SpiliopoulosEmail author
  • Riccardo Inchingolo
  • Pierleone Lucatelli
  • Roberto Iezzi
  • Athanasios Diamantopoulos
  • Alessandro Posa
  • Bryan Barry
  • Carmelo Ricci
  • Marco Cini
  • Chrysostomos Konstantos
  • Konstantinos Palialexis
  • Lazaros Reppas
  • Artemis Trikola
  • Michele Nardella
  • Andreas Adam
  • Elias Brountzos
Clinical Investigation

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.

Keywords

Peptic ulcer Transcatheter arterial embolization Upper gastrointestinal bleeding 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Procedural informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  • Stavros Spiliopoulos
    • 1
    Email author
  • Riccardo Inchingolo
    • 2
    • 3
  • Pierleone Lucatelli
    • 4
  • Roberto Iezzi
    • 2
  • Athanasios Diamantopoulos
    • 5
  • Alessandro Posa
    • 2
  • Bryan Barry
    • 5
  • Carmelo Ricci
    • 4
  • Marco Cini
    • 4
  • Chrysostomos Konstantos
    • 1
  • Konstantinos Palialexis
    • 1
  • Lazaros Reppas
    • 1
  • Artemis Trikola
    • 1
  • Michele Nardella
    • 3
  • Andreas Adam
    • 5
  • Elias Brountzos
    • 1
  1. 1.2nd Department of Radiology, Interventional Radiology Unit, National and Kapodistrian University of AthensAttikon University HospitalAthensGreece
  2. 2.Department of Radiological Sciences, Institute of RadiologyUniversità Cattolica del Sacro CuoreRomeItaly
  3. 3.Institute of RadiologyMadonna delle Grazie HospitalMateraItaly
  4. 4.Vascular Interventional Radiology UnitUniversity of SienaSienaItaly
  5. 5.Department of Interventional Radiology, Guy’s and St Thomas’ HospitalsNHS Foundation TrustLondonUK

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