The efficacy and clinical outcomes of transarterial embolization in acute massive upper gastrointestinal bleeding: a single-center experience

Abstract

Objective: To evaluate the efficacy of transarterial embolization (TAE) in the treatment of acute upper gastrointestinal bleeding (UGIB) and identify potential factors affecting the treatment outcome.Patients and Methods: Eighteen patients with UGIB treated with TAE were included in the study. The demographic data, causes of bleeding, angiography findings, treatments applied, and clinical outcomes were retrospectively analyzed.Results: Thirteen (72.2%) patients were male, five (27.8%) were female, and the mean age was 55 years (range: 33-68 years). A pseudoaneurysm (n = 7; 38.9%) was the most common finding, followed by tumor staining (n = 4; 22.2%). The most common pathology causing bleeding was peptic ulcer disease (n = 9; 50%). The most commonly embolized artery was the gastroduodenal artery (n = 11; 61.1%). There were three (16.7%) patients with hemobilia due to iatrogenic hepatic artery pseudoaneurysm. In most cases (n = 9; 50%), coils and polyvinyl alcohol particles were used in combination. Technical success was achieved in all patients. The clinical success rate was 78.5% (11/14 patients) after the exclusion of patients who died for non-UGIB causes (n = 4; 22.2%). Conclusion:Transarterial embolization is an effective method used with high technical and clinical success rates in the treatment of endoscopy-refractory acute UGIB.