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Published on: June 18, 2020
Gastric bleeding: therapy with intraarterial vasopressin and transcatheter embolization
Insights
Angiographic therapies, including vasopressin infusion and embolization, effectively control gastric bleeding. While initial success rates are high, recurrent bleeding may occur, necessitating further intervention for improved outcomes.
Area of Science:
- Interventional Radiology
- Gastroenterology
Background:
- Gastric bleeding poses significant clinical challenges.
- Effective hemostatic strategies are crucial for patient management.
Purpose of the Study:
- To evaluate the efficacy and safety of angiographic therapies for controlling gastric bleeding.
- To assess the impact of different angiographic techniques on bleeding control and patient survival.
Main Methods:
- Retrospective analysis of 200 patients undergoing angiographic therapy for gastric bleeding.
- Treatments included intraarterial vasopressin infusion and transcatheter embolization.
- Patients received either primary or adjunctive angiographic interventions.
Main Results:
- Initial bleeding control achieved in 73% of patients.
- Overall control rate increased to 79% with the addition of embolization.
- Recurrent bleeding occurred in 18%, with 36% of these cases successfully re-treated.
- Major and minor complication rates were 6.5% and 17.5%, respectively.
- Survival rate for angiographically controlled bleeding was 73%.
Conclusions:
- Intraarterial vasopressin infusion and transcatheter embolization are valuable tools for managing gastric bleeding.
- Angiographic therapy offers a viable option for hemostasis in gastric hemorrhage.
- While effective, careful patient selection and monitoring are essential due to potential complications and recurrence.
Abstract:
Angiographic therapy to control gastric bleeding was attempted in 200 patients. One hundred ninety-four patients were treated with intraarterial vasopressin and 17 of them were also treated with transcatheter embolization. Six patients underwent primary embolization, and an additional six received intravenous vasopressin. The initial rate of bleeding control in all patients angiographically treated was 73%. When embolization was used in some of the patients who did not respond to vasopressin, the overall control rate increased to 79%. Recurrent bleeding occurred in 18%. When angiographic therapy was attempted again in the patients with recurrent hemorrhage, the bleeding was stopped in 36%. Major complications occurred in 6.5% and minor in 17.5%. Of the patients with bleeding that was angiographically controlled, 73% survived and 27% died of associated clinical conditions. Among the failures of angiographic therapy, 48% died during the same hospital admission. Intraarterial infusions of vasopressin or transcatheter embolization are useful for the control of gastric bleeding.
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