Original article—alimentary tractArterial Embolotherapy for Endoscopically Unmanageable Acute Gastroduodenal Hemorrhage: Predictors of Early Rebleeding
Section snippets
Patient Selection
We retrospectively reviewed the medical records of all patients who underwent angiographic embolization for refractory bleeding from gastroduodenal ulcers from October 1999 to January 2008 at our institution. Patients were identified using the database maintained prospectively by our Interventional Radiology Department. Patients with hemobilia or bleeding from varices, malignancies, or traumatic lesions were excluded. We identified 63 angiographic embolization procedures in 60 consecutive
Patient Characteristics
We reviewed 63 consecutive embolization procedures in 60 patients. There were 41 men and 19 women with a mean age of 69.4 years (range, 29–95 y). Most of the patients had a high surgical risk related to advanced age and comorbidities. Thus, 61.7% (37 of 60) of patients were older than 70 years, 38.3% (23 of 60) were older than 75 years, and 23.3% (14 of 60) were older than 80 years. Of the 60 patients, 54 (90%) had at least one serious comorbid condition and 25 (42%) had at least 2 comorbid
Discussion
Although sonography has been used as a diagnostic tool, with visualization of an intragastric clot being taken as evidence of bleeding,15 endoscopy remains the first-line method for diagnosing and treating actively bleeding peptic ulcers because its success rate is high. Recent advances in endoscopic hemostasis techniques ensure bleeding control in most patients. Endoscopic treatment is particularly valuable in patients whose advanced age or comorbid conditions pose a high surgical risk. When
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Conflicts of interest The authors disclose no conflicts.