Empiric Transcatheter Embolization for Acute Arterial Upper Gastrointestinal Bleeding: A Meta-Analysis

Current Status and Future Perspective of Artificial Intelligence in the Management of Peptic Ulcer Bleeding: A Review of Recent Literature

“…In addition, a seamless integration of such AI systems with patient electronic medical records and the endoscopy platforms should be considered to improve the current clinical workflow. Fourth, throughout PUB management, interventional radiologists provide an essential salvage therapy position for patients with refractory bleeding [44,45]. Although the application of AI for the analysis during coronary artery angiography has already been researched [46], no such studies have been conducted for GIB cases.…”

Treatment of acute upper gastrointestinal bleeding occurred after percutaneous coronary intervention for acute myocardial infarction in patients with acute renal impairment: a case report

“…After empiric TAE, the patient’s condition gradually stabilized and he was discharged successfully. A meta-analysis also reported that empiric embolization is well-tolerated and appears to be as effective as targeted embolization in preventing rebleeding and mortality in patients with angiographically negative acute UGI bleeding [ 18 ]. Despite a recent reported 1 month of dual antiplatelet therapy was noninferior to the continuation of therapy for at least 2 additional months with regard to the occurrence of net adverse clinical events and major adverse cardiac or cerebral events and the abbreviated therapy also resulted in a lower incidence of major or clinically relevant nonmajor bleeding in patients at high bleeding risk [ 19 ].…”

Complications of Arterial Transcatheter Embolization for Treatment of Gastrointestinal Hemorrhage

“…11,12 Chronic sequela of ischemia such as duodenal strictures is more common than acute infarction or frank necrosis following treatment of upper GI bleed but are still uncommon and are often asymptomatic. 11 While superselective embolization is preferred to minimize the risk of ischemic complications, the robust collateral supply allows embolization of some larger vessels, such as the gastroduodenal artery, with near impunity in many cases. Ischemic complications following embolization for lower GI hemorrhage are much higher, reported at a rate of 4.6%, in some cases requiring bowel resection.…”

“…Nontarget embolization to the liver more commonly results in transient elevation in liver enzymes but can cause liver infarction or liver abscess in rare circumstances. 11 Similarly splenic infarct and/or abscess is rare given the robust collateral supply to the spleen. While acute pancreatitis as a direct result of inadvertent embolic delivery to the pancreas is a theoretical complication, large meta-analyses report no cases of this complication following embolization for upper GI hemorrhage.…”

“…Likely due in large part to the robust collateral arterial supply to the upper GI tract, the rate of recurrent bleeding following embolization for upper GI hemorrhage is reported to be between 26.5 and 36.5%. 11,12 Not unexpectedly, the incidence has been shown to be higher following empiric embolization (36.5%) compared with targeted embolization of active extravasation seen at the time of angiogram (26.6%). 11 Because many vessels supplying the upper GI tract, particularly the duodenum, have collateral supply arising from both the celiac and superior mesenteric arteries, it is essential to perform an angiogram of both vessels even if the hemorrhage has been successfully embolized from one direction to ensure there is no filling from another collateral vessel (►Fig.…”