title: Early angiographic embolization is more effective than delayed angiographic embolization in patients with duodenal ulcer bleeding.
abstract: OBJECTIVE
  Though angiographic embolization (AE) is a type of effective treatment modality for duodenal ulcer bleeding, the optimum time at which to perform the procedure, early or delayed, is unknown. The authors compared the prognosis of early AE (EAE) and delayed AE (DAE) in patients with duodenal ulcer bleeding.
  
  
  METHODS
  A total of 54 patients with duodenal ulcer bleeding were evaluated with first-look endoscopy followed by AE. The patients were divided into two groups, the EAE group and DAE group, according to endoscopic attempts to stop the bleeding during the first-look endoscopy.
  
  
  RESULTS
  The success rate of AE, rebleeding rate, and number of patients who underwent surgery was not significantly different between the EAE group and DAE group (91.3% vs 93.5%, 21.7% vs 29.0% and 4.3% vs 16.1%, respectively; P > 0.05). With respect to death and intensive care unit (ICU) care rate, multivariate analysis showed more favorable results in the EAE group (0% vs 22.6%, P = 0.016 and 4.3% vs 57.4%, P = 0.003, respectively). Multivariate analysis also showed that prolonged prothrombin time (PT) > 1.2 international normalized ratio and the endoscopic attempt were independent factors associated with ICU care.
  
  
  CONCLUSIONS
  When the AE was performed early with correction for prolonged PT, the patients with duodenal ulcer bleeding had a more favorable prognosis.
authors: Aerospace Medical Center, Republic of Korea Air Force, Cheongwon-gun, Chungcheongbuk-do, Korea. soo@jbnu.ac.kr
authors: Seok
authors: S
authors: Lee
authors: Sang Wook
authors: SW
authors: Kim
authors: Jin Chang
authors: JC
authors: Moon
authors: Ji Won
authors: JW
authors: Jang
authors: Heyoung Il
authors: HI
authors: Kim
authors: Won Seok
authors: WS
authors: Park
authors: Byung Jun
authors: BJ
authors: Jeon
authors: Ji Youn
authors: JY
authors: Sohn
authors: Seong Hun
authors: SH
authors: Kim
authors: In Hee
authors: IH
authors: Kim
authors: Seung Ok
authors: SO
authors: Lee
authors: Soo Teik
authors: ST
authors: Lee
mesh_terms: D000368:Aged; D000792:Angiography; D016009:Chi-Square Distribution; D003422:Critical Care; D004381:Duodenal Ulcer / Q000150:complications*; D004621:Embolization, Therapeutic; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology / Q000628:therapy*; D011517:Prothrombin Time; D015641:Radiography, Interventional; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome