title: Empiric transcatheter arterial embolization for massive bleeding from duodenal ulcers: efficacy and complications.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of empiric transcatheter arterial embolization (TAE) for patients with massive bleeding from duodenal ulcers.
  
  
  METHODS
  During January 2000 and December 2009, 59 patients with duodenal ulcer bleeding in whom TAE was attempted after endoscopic therapy failed were retrospectively analyzed. The patients were divided into empiric TAE (n = 36) and identifiable TAE (n = 23) groups according to angiographic findings with or without identification of the bleeding sites. The technical and clinical success rate, recurrent bleeding rate, procedure-related complications, and clinical outcomes were evaluated.
  
  
  RESULTS
  The technical and clinical success rates of TAE were 100% and 83%. The recurrent bleeding rate, clinical success, duodenal stenosis, and 30-day mortality after TAE were not significantly different between the empiric and identifiable TAE groups.
  
  
  CONCLUSIONS
  A high rate of technical and clinical success was obtained with empiric TAE comparable to identifiable TAE in patients with massive bleeding from duodenal ulcers. There were no severe complications. Empiric TAE is an effective and safe method when a bleeding site cannot determined by angiography.
authors.affiliation: Department of Radiology, Miyakonojo Medical Association Hospital, 5822-3 Oiwadacho, Miyakonojo 885-0062, Japan. iku@cap.bbiq.jp
authors.forename: Ikushima
authors.initials: I
authors.lastname: Ichiro
authors.forename: Higashi
authors.initials: H
authors.lastname: Shushi
authors.forename: Ishii
authors.initials: I
authors.lastname: Akihiko
authors.forename: Iryo
authors.initials: I
authors.lastname: Yasuhiko
authors.forename: Yamashita
authors.initials: Y
authors.lastname: Yasuyuki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000401:mortality; D004381:Duodenal Ulcer / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D015641:Radiography, Interventional; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome