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Titolo:
Arterial embolotherapy for upper gastrointestinal hemorrhage: Outcome assessment
Autore:
Aina, R; Oliva, VL; Therasse, E; Perreault, P; Bui, BT; Dufresne, MP; Soulez, G;
Indirizzi:
CHUM Notre Dame Hosp, Dept Radiol, Montreal, PQ H2L 4M1, Canada CHUM NotreDame Hosp Montreal PQ Canada H2L 4M1 treal, PQ H2L 4M1, Canada CHUM St Luc Hosp, Dept Radiol, Montreal, PQ, Canada CHUM St Luc Hosp Montreal PQ Canada p, Dept Radiol, Montreal, PQ, Canada
Titolo Testata:
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
fascicolo: 2, volume: 12, anno: 2001,
pagine: 195 - 200
SICI:
1051-0443(200102)12:2<195:AEFUGH>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT GASTRIC ARTERY; TRANSCATHETER EMBOLIZATION; DUODENAL-ULCER; COMPLICATIONS; VASOPRESSIN; INFARCTION; THERAPY;
Keywords:
arteries, gastroduodenal; arteries, therapeutic blockade; embolization; gastrointestinal tract, hemorrhage; gastrointestinal tract, interventional procedure;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Oliva, VL CHUM Notre Dame Hosp, Dept Radiol, 1560 Sherbrooke E, Montreal, PQ H2L 4M1, Canada CHUM Notre Dame Hosp 1560 Sherbrooke E Montreal PQ Canada H2L 4M1
Citazione:
R. Aina et al., "Arterial embolotherapy for upper gastrointestinal hemorrhage: Outcome assessment", J VAS INT R, 12(2), 2001, pp. 195-200

Abstract

PURPOSE: To identify predictors of clinical outcome after arterial embolotherapy for upper gastrointestinal (UGI) hemorrhage. MATERIALS AND METHODS: Seventy-five consecutive patients (mean age, 62.5 y) underwent arterial embolization for acute UGI hemorrhage. Bleeding was detected at endoscopy and angiography in 22 patients, at endoscopy alone in 29 patients, and at angiography alone in 24 patients. As such, embolization was directed by angiography in 46 patients (61.3%) and by endoscopy (referred to as "blind" embolization) in 29 patients (38.7%). The embolic agents used were metallic coils, polyvinyl alcohol particles (size range, 355-710 mum), gelatin sponge, and tissue adhesive. Predictors of bleeding recurrenceand mortality were analyzed with logistic regression and Cox models, respectively. RESULTS: The technical success rate of embolization was 98.7%. Primary clinical success was achieved in 57 patients (76%). Secondary clinical successoccurred in five additional patients (82.5%) after repeat embolization. There were four (5.3%) complications: two cases of self-resolving duodenal ischemia, one hepatic infarct, and one inguinal hematoma. The periprocedural mortality rate was 34.6% (26 of 75), mostly related to underlying illness. Early recurrence of bleeding (within 30 days of embolization) was associated with coagulation disorders (international normalized ratio >1.5, partial thromboplastin time >45 seconds, or platelet count <80,000/<mu>L; odds ratio, 19.46; P = .001) and with the use of coils as the only embolic agent (odds ratio, 7.73; P = .01). Cirrhosis and cancer shortened the overall survival of patients after embolic therapy. The mean patient follow-up time was 34.5 months. CONCLUSION: Arterial embolotherapy for UGI hemorrhage is safe, effective, and durable. Coagulopathy and the use of coils as the only embolic agent were associated with a higher risk of early bleeding recurrence.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/04/20 alle ore 00:07:19