Gastrointestinal bleeding: treatment with gastrointestinal arterial embolization.
Retrospective analysis of 36 embolization procedures in 29 patients with gastrointestinal bleeding was undertaken, and the presence or absence of coagulopathy was identified as a major factor affecting embolization outcome. Embolization was successful in 18 of 29 (62%) patients and unsuccessful in 11 (38%). Eight of 11 failures (73%) occurred in patients with a coagulopathy, whereas three patients (27%) in whom embolization was successful also had a coagulopathy. Embolization was 2.9 times more likely to be unsuccessful (P = .0463) and death from bleeding after embolization was 9.6 times more likely to occur (P = .0065) in patients with a coagulopathy than in those without. Because embolization was successful in six of 14 (43%) coagulopathy patients, the authors advocate embolization in patients with gastrointestinal bleeding and coagulopathy, while all efforts to correct the coagulopathy would be made as early as possible.
Encarnacion
C E
CE
Department of Radiology, Duke University Medical Center, Durham, NC.
Kadir
S
S
Beam
C A
CA
Payne
C S
CS
D000293:Adolescent; D000328:Adult; D000368:Aged; D001158:Arteries; D001778:Blood Coagulation Disorders / Q000150:complications* / Q000209:etiology; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013272:Stomach Diseases / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D065227:Transfusion Reaction