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Gastrointestinal bleeding: treatment with gastrointestinal arterial embolization
C E Encarnacion1, S Kadir, C A Beam
1Department of Radiology, Duke University Medical Center, Durham, NC.
Radiology
|May 1, 1992
Summary
Coagulopathy significantly impacts gastrointestinal bleeding embolization success. While embolization is less successful in patients with coagulopathy, it remains a viable option when bleeding is severe, with early correction of coagulopathy recommended.
Area of Science:
- Interventional Radiology
- Gastroenterology
- Hematology
Background:
- Gastrointestinal bleeding (GIB) is a common clinical problem.
- Embolization is a key treatment for severe GIB.
- The impact of coagulopathy on embolization outcomes requires further clarification.
Purpose of the Study:
- To evaluate the influence of coagulopathy on the success of embolization for GIB.
- To determine if embolization is a safe and effective option for patients with GIB and coagulopathy.
Main Methods:
- Retrospective analysis of 36 embolization procedures in 29 patients with GIB.
- Assessment of coagulopathy presence and its correlation with embolization outcomes.
- Statistical analysis to compare outcomes between patients with and without coagulopathy.
Main Results:
- Embolization success rate was 62% overall.
- Embolization failure was significantly higher in patients with coagulopathy (73% of failures).
- Patients with coagulopathy had a 2.9 times higher likelihood of unsuccessful embolization and a 9.6 times higher likelihood of death from bleeding.
Conclusions:
- Coagulopathy is a significant negative predictor of embolization success in GIB.
- Embolization can be successful in patients with GIB and coagulopathy (43% success rate in this group).
- Embolization should be considered for GIB even in the presence of coagulopathy, with concurrent efforts to correct the coagulopathy.