title: Glue embolization for gastroduodenal ulcer bleeding: contribution to hemodynamics and healing process.
abstract: BACKGROUND
  Although the morbidity of bowel ischemic events after glue embolization has been suggested, a causal relationship between glue and ischemia has not been clearly established.
  
  
  OBJECTIVE
  To evaluate the efficiency and safety of transcatheter arterial embolization with n-butyl cyanoacrylate (NBCA-TAE) for upper gastrointestinal hemorrhage (GIH).
  
  
  METHODS
  Between October 2006 and October 2012, 21 patients with upper GIH underwent NBCA-TAE, and endoscopic data were obtained within 30 days of follow-up. Shock index prior to and immediately after NBCA-TAE were compared to determine changes in hemodynamics. Days to Forrest type III, as assessed by follow-up endoscopy, was used as an indicator of the healing process. Other clinical outcomes included days for starting ingestion and for hospital discharge.
  
  
  RESULTS
  Sixteen gastric and five duodenal ulcers, classified into Forrest type I, were treated. Immediate hemostasis was achieved in all the patients, and no re-bleeding occurred within the follow-up period. Shock index significantly (P < 0.001) improved from before (0.99 ± 0.076) to immediately after NBCA-TAE (0.67 ± 0.038). Sequential mucosal healing processes were observed in all the patients, and the number of days to Forrest type III was 9.6 ± 7.1. The number of days for starting ingestion and hospital discharge was 9.0 ± 4.5 and 15 ± 7.7 days, respectively.
  
  
  CONCLUSIONS
  NBCA-TAE is an effective and safe method for the control of nonvariceal upper GIH, in terms of contribution to hemodynamics and healing process of the gastroduodenal mucosa.
authors.affiliation: Department of Radiology/Center for Advanced Medical Technology, Nippon Medical School, Tokyo.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Mine
authors.forename: S
authors.initials: S
authors.lastname: Murata
authors.forename: K
authors.initials: K
authors.lastname: Nakazawa
authors.forename: S
authors.initials: S
authors.lastname: Onozawa
authors.forename: T
authors.initials: T
authors.lastname: Ueda
authors.forename: M
authors.initials: M
authors.lastname: Miyauchi
authors.forename: S
authors.initials: S
authors.lastname: Morita
authors.forename: S
authors.initials: S
authors.lastname: Kumita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D003287:Contrast Media / Q000008:administration & dosage; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications*; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D003287:Contrast Media; D007459:Iodized Oil; D004659:Enbucrilate
keywords: Arterial embolization; gastroduodenal ulcer; gastrointestinal hemorrhage; interventional radiology; n-Butyl cyanoacrylate