title: Embolization of bleeding duodenal ulcer using Amplatzer vascular plug II and hydrogel coils: case report.
abstract: OBJECTIVE
  To present a case of upper gastrointestinal bleeding (UGIB) that was treated with percutaneous endovascular embolization using Amplatzer vascular plug and hydrogel coils after failed endoscopic treatment.
  
  
  METHODS
  A 78-year-old male was referred for endovascular treatment of massive recurrent UGIB from a duodenal ulcer. Attempts at endoscopic treatment were unsuccessful. Based on our knowledge of the site of the bleeder in the duodenum from prior endoscopy, we decided to empirically embolize the gastroduodenal artery (GDA) and the right gastroepiploic artery using a combination of coils (Azur peripheral hydrocoil; Terumo Medical Corporation, Somerset, New Jersey) and Amplatzer vascular plug II (AVP II; AGA Medical, Plymouth, Minnesota).
  
  
  CONCLUSIONS
  We present this case of UGIB where effective, rapid, precise, and controlled embolization of the GDA was achieved using AVP II device in combination with coils. To our knowledge, the use of AVP II in embolization of GDA for treatment of emergent UGIB has not been described in the literature.
authors.affiliation: Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham (UAB), Birmingham, Alabama 35249, USA. akamel@uabmc.edu
authors.forename: Ahmed K
authors.initials: AK
authors.lastname: Abdel-Aal
authors.forename: Sherif
authors.initials: S
authors.lastname: Osman
authors.forename: Maysoon F
authors.initials: MF
authors.lastname: Hamed
authors.forename: Souheil
authors.initials: S
authors.lastname: Saddekni
authors.forename: Wael E A
authors.initials: WE
authors.lastname: Saad
mesh_terms: D000368:Aged; D004381:Duodenal Ulcer / Q000150:complications* / Q000188:drug therapy; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004867:Equipment Design; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D010438:Peptic Ulcer Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D015641:Radiography, Interventional; D017211:Treatment Failure
chemical_list: D054328:Proton Pump Inhibitors