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Clin Radiol. 2011 Jun;66(6):500-9. doi: 10.1016/j.crad.2010.11.016. Epub 2011 Mar 2.

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

Author information

1
Department of Radiology, Leeds General Infirmary, Leeds, UK.

Abstract

AIM:

To assess the published evidence on the endovascular treatment of non-variceal upper gastrointestinal haemorrhage.

MATERIALS AND METHODS:

An Ovid Medline search of published literature was performed (1966-2009). Non-English literature, experimental studies, variceal haemorrhage and case series with fewer than five patients were excluded. The search yielded 1888 abstracts. Thirty-five articles were selected for final analysis.

RESULTS:

The total number of pooled patients was 927. The technical and clinical success of embolization ranged from 52-100% and 44-100%, respectively. The pooled mean technical/clinical success rate in primary upper gastrointestinal tract haemorrhage (PUGITH) only, trans-papillary haemorrhage (TPH) only, and mixed studies were 84%/67%, 93%/89%, and 93%/64%, respectively. Clinical outcome was adversely affected by multi-organ failure, shock, corticosteroids, transfusion, and coagulopathy. The anatomical source of haemorrhage and procedural variables did not affect the outcome. A successful embolization improved survival by 13.3 times. Retrospective comparison with surgery demonstrated equivalent mortality and clinical success, despite embolization being applied to a more elderly population with a higher prevalence of co-morbidities.

CONCLUSIONS:

Embolization is effective in this very difficult cohort of patients with outcomes similar to surgery.

PMID:
21371695
DOI:
10.1016/j.crad.2010.11.016
[Indexed for MEDLINE]

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