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A comparison of the results of arterial embolization for bleeding and non-bleeding gastroduodenal ulcers.
MedLine Citation:
PMID:  22006986     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BackgroundAlthough some authors have advocated the practice of arterial embolization for angiographically negative acute hemorrhage from gastroduodenal ulcers, this technique remains controversial.PurposeTo compare the results of arterial embolization for bleeding (BU) and non-bleeding (NBU) gastroduodenal ulcers.Material and MethodsTranscatheter embolization was performed in 57 patients (39 men, 18 women, mean age 69.8 years) who experienced acute bleeding from gastroduodenal ulcers. At the time of embolization active contrast extravasation was seen in 36 of 57 patients, while in the remaining 21 patients embolization was based on endoscopic findings. Patient demographics, clinical success, need for re-intervention secondary to re-bleeding, and 30-day complication and mortality rates were reviewed and compared between the two groups by using statistical analyses.ResultsIn the BU group, the gastroduodenal artery (GDA) was embolized in 31 patients (86.1%), the left gastric artery (LGA) in three patients (8.3%), and the left gastroepiploic artery (LGEA) in two patients (5.6%). In the NBU group, the GDA was embolized in 18 patients (85.7%), and the LGA in three patients (14.3%). Clinical success (61.9 vs. 75.0%, P = 0.30), need for re-intervention (38.1 vs. 27.8%, P = 0.42), and 30-day complication (9.5 vs. 5.6%, P = 0.57), and mortality (28.6 vs. 25%, P = 0.77) rates were not statistically different between the two groups. Embolization in patients in NBU group did not have impact on clinical success (OR, 0.54; 95%CI, 0.17-1.72; P = 0.30).ConclusionArterial embolization in patients with angiographically NBU is as safe and effective as embolization in patients with BU.
Authors:
Romaric Loffroy; Mingde Lin; Carol Thompson; Amith Harsha; Pramod Rao
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-17
Journal Detail:
Title:  Acta radiologica (Stockholm, Sweden : 1987)     Volume:  -     ISSN:  1600-0455     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706123     Medline TA:  Acta Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Russell H Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, Johns Hopkins Hospital, Baltimore, Maryland.
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