SUCCESSFUL EMERGENCY ARTERIAL EMBOLIZATION FOR MASSIVE GASTRODUODENAL BLEEDING IN HIGH-RISK PATIENT. CASE REPORT

Area of Science:

• Interventional Cardiology
• Gastroenterology
• Vascular Surgery

Background:

• Massive upper gastrointestinal bleeding poses significant clinical challenges, particularly in high-risk individuals.
• Management often involves complex decisions due to patient comorbidities and previous treatment failures.

Observation:

• A 78-year-old male with multiple comorbidities presented with acute coronary syndrome, successfully treated with percutaneous coronary intervention.
• Post-PCI, the patient developed severe gastroduodenal bleeding from a duodenal ulcer, refractory to endoscopic hemostasis.
• Open surgery was deemed excessively high-risk due to the patient's unstable condition and comorbidities.

Findings:

• Transcatheter arterial embolization of the gastroduodenal artery was successfully performed via a radial approach.
• The procedure utilized a hemostatic sponge and embolization coils for rapid hemostasis.
• The patient's condition stabilized, and he was discharged on day 10.

Implications:

• Transcatheter arterial embolization is a viable and safe endovascular treatment option for massive gastrointestinal bleeding in high-risk patients.
• This approach serves as a crucial alternative when endoscopic methods fail and surgical intervention is contraindicated.
• Successful management highlights the importance of multidisciplinary collaboration in complex critical care cases.