title: A comparison of the results of arterial embolization for bleeding and non-bleeding gastroduodenal ulcers.
abstract: BACKGROUND
  Although some authors have advocated the practice of arterial embolization for angiographically negative acute hemorrhage from gastroduodenal ulcers, this technique remains controversial.
  
  
  OBJECTIVE
  To compare the results of arterial embolization for bleeding (BU) and non-bleeding (NBU) gastroduodenal ulcers.
  
  
  METHODS
  Transcatheter embolization was performed in 57 patients (39 men, 18 women, mean age 69.8 years) who experienced acute bleeding from gastroduodenal ulcers. At the time of embolization active contrast extravasation was seen in 36 of 57 patients, while in the remaining 21 patients embolization was based on endoscopic findings. Patient demographics, clinical success, need for re-intervention secondary to re-bleeding, and 30-day complication and mortality rates were reviewed and compared between the two groups by using statistical analyses.
  
  
  RESULTS
  In the BU group, the gastroduodenal artery (GDA) was embolized in 31 patients (86.1%), the left gastric artery (LGA) in three patients (8.3%), and the left gastroepiploic artery (LGEA) in two patients (5.6%). In the NBU group, the GDA was embolized in 18 patients (85.7%), and the LGA in three patients (14.3%). Clinical success (61.9 vs. 75.0%, P = 0.30), need for re-intervention (38.1 vs. 27.8%, P = 0.42), and 30-day complication (9.5 vs. 5.6%, P = 0.57), and mortality (28.6 vs. 25%, P = 0.77) rates were not statistically different between the two groups. Embolization in patients in NBU group did not have impact on clinical success (OR, 0.54; 95%CI, 0.17-1.72; P = 0.30).
  
  
  CONCLUSIONS
  Arterial embolization in patients with angiographically NBU is as safe and effective as embolization in patients with BU.
authors: Russell H Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, Johns Hopkins Hospital, Baltimore, Maryland, USA. romaric.loffroy@gmail.com
authors: Romaric
authors: R
authors: Loffroy
authors: MingDe
authors: M
authors: Lin
authors: Carol
authors: C
authors: Thompson
authors: Amith
authors: A
authors: Harsha
authors: Pramod
authors: P
authors: Rao
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010437:Peptic Ulcer / Q000628:therapy*; D010438:Peptic Ulcer Hemorrhage / Q000628:therapy*; D019233:Retreatment; D016019:Survival Analysis; D016896:Treatment Outcome