Preventive transarterial embolization in upper nonvariceal gastrointestinal bleeding.

Area of Science:

• Gastroenterology
• Interventional Radiology
• Vascular Surgery

Background:

• Non-variceal acute upper gastrointestinal bleeding (NVUGIB) poses a significant risk of rebleeding after initial endoscopic haemostasis.
• Patients with high-risk NVUGIB often require additional interventions to prevent recurrent bleeding.
• Transarterial embolization (TAE) is a therapeutic option for managing such high-risk cases.

Purpose of the Study:

• To preliminarily assess the safety and efficacy of preventive transarterial embolization (TAE) in patients with NVUGIB.
• To evaluate clinical outcomes, including rebleeding rates and need for surgery, following preventive TAE.
• To compare outcomes between patients receiving preventive TAE and those undergoing endoscopic haemostasis alone.

Main Methods:

• A prospective study comparing a group receiving preventive visceral angiography and TAE (PE+ group) with a control group receiving only endoscopic haemostasis (PE- group).
• Patients in both groups had NVUGIB and were considered at high risk for recurrent bleeding.
• Key outcomes measured included technical success of TAE, completeness of haemostasis, rebleeding incidence, and need for surgical intervention.

Main Results:

• The PE+ group (25 patients) and PE- group (50 patients) were similar in demographics and clinical characteristics.
• Rebleeding rates were comparable between groups, but surgical treatment was significantly less frequent in the PE+ group (8% vs. 35%).
• While not statistically significant, overall mortality was lower in the PE+ group (4% vs. 20%).

Conclusions:

• Preventive transarterial embolization (TAE) is a feasible, safe, and effective minimally invasive haemostasis technique.
• TAE decreases the risk of repeated bleeding in high-risk NVUGIB patients.
• This approach can help stabilize patients, preparing them for definitive surgical intervention if necessary.