Embolization for non-variceal upper gastrointestinal tract haemorrhage: A systematic review

Mirsadraee, Saeed; Tirukonda, Prasanna; Nicholson, Anthony A.; Everett, Simon; McPherson, Simon

doi:10.1016/j.crad.2010.11.016

Cited by 92 publications

(68 citation statements)

References 66 publications

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“…In the present study, the type of embolic material did not seem to affect the clinical outcomes or recurrence rates, as found in previous studies [17,18,28]. Various combinations of embolic materials should sometimes be considered when incomplete embolization is suspected with the use of one embolic material or when advancement of the microcatheter is difficult.…”

Section: Discussionsupporting

confidence: 82%

“…without other embolic materials used in conjunction, because this has been shown to not affect clinical outcomes [17,18]. The current study was conducted at a large single center to evaluate the clinical effectiveness of TAE with NBCA for acute nonvariceal gastrointestinal tract bleeding and to evaluate the clinical factors that may affect the outcomes in patients who undergo this procedure.…”

Section: Tae With Nbca To Control Acute Gastrointestinal Tract Bleedingmentioning

confidence: 99%

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Clinical Outcome of Transcatheter Arterial Embolization With N-Butyl-2-Cyanoacrylate for Control of Acute Gastrointestinal Tract Bleeding

Koo

Shin

Kim

et al. 2015

American Journal of Roentgenology

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ing, renal arterial bleeding, and even gastrointestinal tract bleeding [2][3][4][5][6][7][8]. NBCA is highly penetrable because of its liquid nature and is less affected by coagulopathies; thus, it may be used as an adjunct to other embolic materials to ensure the embolic effect [9,10]. However, NBCA is difficult to handle effectively and safely and is inherently more prone to cause ischemic necrosis.Although there have been several reports on the use of TAE with NBCA for acute gastrointestinal tract bleeding, 9-84 patients were included in those studies, and neither long-term clinical data nor analyses evaluating clinical factors affecting the clinical success of NBCA were presented [11][12][13][14][15][16]. Therefore, studies in larger patient populations are warranted to determine the clinical effectiveness of NBCA in the setting of acute gastrointestinal tract bleeding, with or AJR 2015; 204:662-668 0361-803X/15/2043-662 © American Roentgen Ray Society E ndoscopy is a rapid diagnostic and therapeutic modality that is widely accepted as the preferred method for identifying and providing hemostasis at sites of gastrointestinal tract bleeding. In cases of endoscopic treatment failure or where the site of bleeding is inaccessible by endoscopy, such as distal small-bowel bleeding, transcatheter arterial embolization (TAE) may be an effective alternative to endoscopy. A previous study showed that TAE in the management of gastrointestinal tract bleeding is effective with good long-term clinical outcomes [1]. Va s c u l a r a n d I nt e r ve nt io n a l R a d io l og y • O r ig i n a l R e s e a rc hAmong the various embolic materials that have been evaluated, N-butyl-2-cyanoacrylate (NBCA) was first used to embolize cerebral aneurysms but now is widely used for controlling active bleeding, including intramuscular hemorrhage, uterine arterial bleed- OBJECTIVE. The purpose of this article is to evaluate the clinical effectiveness of transcatheter arterial embolization (TAE) with N-butyl-2-cyanoacrylate (NBCA), with or without other embolic materials for acute nonvariceal gastrointestinal tract bleeding, and to determine the factors associated with clinical outcomes.MATERIALS AND METHODS. TAE using NBCA only or in conjunction with other materials was performed for 102 patients (80 male and 22 female patients; mean age, 61.3 years) with acute nonvariceal gastrointestinal tract bleeding. Technical success, clinical success, and clinical factors, including age, sex, bleeding tendency, endoscopic attempts at hemostasis, number of transfusions, and bleeding causes (i.e., cancer vs noncancer), were retrospectively evaluated. Univariate and multivariable logistic regression analyses were performed to evaluate clinical factors and their ability to predict patient outcomes. Survival curves were obtained using Kaplan-Meier analyses and log-rank tests.RESULTS. There were 36 patients with cancer-related bleeding and 66 with non-cancerrelated bleeding. Overall technical and clinical success rates were 100% (102/102) and 76.5% ...

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Section: Discussionsupporting

confidence: 82%

Section: Tae With Nbca To Control Acute Gastrointestinal Tract Bleedingmentioning

confidence: 99%

Clinical Outcome of Transcatheter Arterial Embolization With N-Butyl-2-Cyanoacrylate for Control of Acute Gastrointestinal Tract Bleeding

Koo

Shin

Kim

et al. 2015

American Journal of Roentgenology

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“…This is well in line with case series and explained by the fact that vessels supplying the duodenal anatomy are largerly collateralized [28]. Furthermore, in a long-term prospective study that lasted for more than five years, Lang et al showed that duodenal stenosis may develop as one of the long-term complications following duodenal embolization [29].…”

Section: Discussionsupporting

confidence: 64%

Transcatheter arterial embolisation in upper gastrointestinal bleeding in a sample of 29 patients in a gastrointestinal referral center in Germany

et al. 2015

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Objective: This is a retrospective analysis of interventional embolisation performed with catheter angiography in 29 patients with upper gastrointestinal bleeding in the setting of a secondary care hospital. Patients, Materials, and Methods: From April 2007 to February 2013, 29 patients with upper gastrointestinal bleeding underwent endovascular diagnostics and treatment. The diagnosis was established by endoscopy, computed tomography or clinically based on a significant decrease in hemoglobin. Transcatheter arterial embolisation was performed with coils, liquid embolic agents, and particles. The technical and clinical outcomes were assessed by postinterventional endoscopy, hemoglobin concentrations, number of necessary transfusions, or surgical interventions, as well as by post-interventional mortality within 28 days after the procedure. Results: Selective angiographic embolisation in upper gastrointestinal bleeding was primarily successful technically and clinically in 22 of 29 patients. In 4/29 cases an angiographic reintervention was performed, which was successful in 3?cases. In 3 cases of primarily technically unsuccessful procedures reintervention was not attempted. No catheterisation-related complications were recorded. Peri-interventional mortality was 31?%, but only 2 of these patients died due to uncontrolled massive bleeding, whereas the lethal outcome in the other 7 patients was due to their underlying diseases. Conclusion: Transcatheter arterial embolisation is an effective and rapid method in the management of upper gastrointestinal bleeding. Radiological endovascular interventions may considerably contribute to reduced mortality in GI bleeding by avoiding a potential surgical procedure following unsuccessful endoscopic treatment. The study underlines the importance of the combination of interventional endoscopy with interventional radiology in secondary care hospitals for patient outcome in complex and complicated upper gastrointestinal bleeding situations.

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“…In a review that included patients undergoing embolization for upper gastrointestinal bleeding, complications occurred in 5% to 9% of the patients (bowel ischemia and infarction accounted for the majority of complications) [38] (Table 7). …”

Section: Complicationsmentioning

confidence: 99%

Upper Gastrointestinal Bleeding in Oncological Patients

Alberti

Santos

Àlex

et al. 2016

GHOA

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Bleeding is a relatively common phenomenon in patients with solid neoplasms, occurring in up to 10% of all patients in advanced stages of cancer. Therefore, this study aims to discuss clinical support management, endoscopic strategies, radiotherapy, chemotherapy, as well as endovascular and surgical interventions. AbstractBleeding is a relatively common phenomenon in patients with solid neoplasms, occurring in up to 10% of all patients in advanced stages of cancer. The objective of this article is to review the etiology, clinical manifestations, and treatment of acute upper gastrointestinal bleeding in cancer patients, understanding that chronic and occult blood losses are not within the scope of this text. To achieve better outcomes in the management of this entity, a multidisciplinary approach is mandatory. Therefore, this study aims to discuss clinical support management, endoscopic strategies, radiotherapy, chemotherapy, as well as endovascular and surgical interventions.

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Embolization for non-variceal upper gastrointestinal tract haemorrhage: A systematic review

Cited by 92 publications

References 66 publications

Clinical Outcome of Transcatheter Arterial Embolization With N-Butyl-2-Cyanoacrylate for Control of Acute Gastrointestinal Tract Bleeding

Clinical Outcome of Transcatheter Arterial Embolization With N-Butyl-2-Cyanoacrylate for Control of Acute Gastrointestinal Tract Bleeding

Transcatheter arterial embolisation in upper gastrointestinal bleeding in a sample of 29 patients in a gastrointestinal referral center in Germany

Upper Gastrointestinal Bleeding in Oncological Patients

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