Endovascular Arterial Embolization in the Treatment of Gastroduodenal Ulcer Bleeding

I A Soloviev; I M Musinov; A E Chikin; A S Ganin

doi:10.17816/brmma12210

Bulletin of the Russian Military Medical Academy ›› 2018, Vol. 20 ›› Issue (3) : 7 -11. DOI: 10.17816/brmma12210

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Endovascular Arterial Embolization in the Treatment of Gastroduodenal Ulcer Bleeding

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Abstract

Currently, it is possible to improve the outcome of the treatment of gastroduodenal ulcer bleeding by reducing the mortality, primarily in patients with a persistent high risk of rebleeding against the background of the conservative treatment and high operational risk. Unacceptably high postoperative mortality in high-risk surgical patients reaching 60%, often forces the surgeons to use the conservative treatment for these patients, which often leads to rebleeding, open surgery despite the high risk and unsatisfactory outcome of the treatment. A minimally invasive technique such as transcatheter embolization of the gastric and duodenal arteries in gastrointestinal ulcer bleeding, allowing to affect the source of bleeding by endovascularization with a minimal surgical trauma, made it possible to achieve hemostasis in 60 of 61 patients (98%). Rebleeding after arterial embolization occurred in 3 patients (5%). In 51 patients (85%), endovascular hemostasis was permanent. Additionally, 6 patients (10%) underwent delayed surgery at different times after arterial embolization. Overall mortality in high-risk surgical patients was 9.2% and was not related to arterial embolization, which compares this data favorably with many literary sources. With its impact, arterial embolization with an adhesive composite based on N-butyl-2-cyanoacrylate is an alternative to the surgical treatment of gastroduodenal ulcer bleeding and an operation of choice for high-risk surgical patients.

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transcatheter arterial embolization / endovascular hemostasis / chronic gastric ulcer / chronic duodenal ulcer / bleeding / endoscopic hemostasis / rebleeding / high operational risk

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I A Soloviev, I M Musinov, A E Chikin, A S Ganin. Endovascular Arterial Embolization in the Treatment of Gastroduodenal Ulcer Bleeding. Bulletin of the Russian Military Medical Academy, 2018, 20(3): 7-11 DOI:10.17816/brmma12210

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