title: Outcomes of transcatheter arterial embolization for acute hemorrhage originating from gastric adenocarcinoma.
abstract: OBJECTIVE
  To evaluate the indications, complications, and clinical outcomes of transcatheter embolization for acute hemorrhage associated with gastric adenocarcinoma.
  
  
  METHODS
  Ten patients underwent catheter-directed arterial embolization at two institutions for acute gastrointestinal hemorrhage related to pathology-proven gastric adenocarcinoma from March 2002 to March 2012. The electronic medical record for each patient was reviewed for clinical presentation, endoscopy history, procedural complications, and long-term follow-up results.
  
  
  RESULTS
  Between March 2002 and March 2012, 10 patients (eight men; mean age, 61.1 y ± 15.3) underwent transcatheter arterial embolization for gastrointestinal hemorrhage caused by gastric adenocarcinoma. Endoscopic therapy had failed in all patients before embolization. Embolization involving branches of the left gastric artery was performed in all patients. No deaths or complications related to the procedure were identified. Mean survival was 301 days, but with a wide range, from 1 day to 1,852 days and counting. Those with unresectable disease (n = 7; 70%) had a median survival time of 9 days, significantly worse (P < .01) than those with resectable disease (n = 3; 30%), who had a median survival of 792 days. Six patients, all with unresectable disease, did not live beyond 30 days. Two of the three patients with resectable disease had subsequent curative resection.
  
  
  CONCLUSIONS
  Transcatheter arterial embolization can be considered for cases of acute hemorrhagic gastric adenocarcinoma, with improved outcomes in patients with localized disease compared with nonresectable gastric adenocarcinoma.
authors.affiliation: Department of Radiology, Massachusetts General Hospital.
authors.forename: Timothy
authors.initials: T
authors.lastname: Meehan
authors.affiliation: Division of Angiography and Interventional Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Stecker
authors.affiliation: Department of Interventional Radiology, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Sanjeeva P
authors.initials: SP
authors.lastname: Kalva
authors.affiliation: Division of Interventional Radiology, Massachusetts General Hospital.
authors.forename: Rahmi
authors.initials: R
authors.lastname: Oklu
authors.affiliation: Division of Interventional Radiology, Massachusetts General Hospital.
authors.forename: T Gregory
authors.initials: TG
authors.lastname: Walker
authors.affiliation: Division of Interventional Radiology, Massachusetts General Hospital. Electronic address: sganguli@partners.org.
authors.forename: Suvranu
authors.initials: S
authors.lastname: Ganguli
mesh_terms: D000208:Acute Disease; D000230:Adenocarcinoma / Q000098:blood supply / Q000150:complications* / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000098:blood supply / Q000150:complications* / Q000401:mortality / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States