Zain M Khazi, Jasraj Marjara, Michael Nance, Yezaz Ghouri, Ghassan Hammoud, Ryan Davis, Ambarish Bhat
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引用次数: 2
Abstract
Objective: To determine the efficacy of gastroduodenal artery embolization (GDAE) for bleeding peptic ulcers that failed endoscopic intervention. To identify incidence and risk factors for failure of GDAE.
Materials and methods: A retrospective review of patients who underwent GDAE for hemorrhage from peptic ulcer disease refractory to endoscopic intervention were included in the study. Refractory to endoscopic intervention was defined as persistent hemorrhage following at least two separate endoscopic sessions with two different endoscopic techniques (thermal, injection, or mechanical) or one endoscopic session with the use of two different techniques. Demographics, comorbidities, endoscopic and angiographic findings, significant post-embolization pRBC transfusion, and index GDAE failure were collected. Failure of index GDAE was defined as the need for re-intervention (repeat embolization, endoscopy, or surgery) for rebleeding or mortality within 30 days after GDAE. Multivariate analyzes were performed to identify independent predictors for failure of index GDAE.
Results: There were 70 patients that underwent GDAE after endoscopic intervention for bleeding peptic ulcers with a technical success rate of 100%. Failure of index GDAE rate was 23% (n = 16). Multivariate analysis identified ≥2 comorbidities (odds ratio [OR]: 14.2 [1.68-19.2], P = 0.023), days between endoscopy and GDAE (OR: 1.43 [1.11-2.27], P = 0.028), and extravasation during angiography (OR: 6.71 [1.16-47.4], P = 0.039) as independent predictors of index GDAE failure. Endoscopic Forrest classification was not a significant predictor for the failure of index GDAE (P > 0.1).
Conclusion: The study demonstrates safety and efficacy of GDAE for hemorrhage from PUD that is refractory to endoscopic intervention. Days between endoscopy and GDAE, high comorbidity burden, and extravasation during angiography are associated with increased risk for failure of index GDAE.
期刊介绍：
The Journal of Clinical Imaging Science (JCIS) is an open access peer-reviewed journal committed to publishing high-quality articles in the field of Imaging Science. The journal aims to present Imaging Science and relevant clinical information in an understandable and useful format. The journal is owned and published by the Scientific Scholar. Audience Our audience includes Radiologists, Researchers, Clinicians, medical professionals and students. Review process JCIS has a highly rigorous peer-review process that makes sure that manuscripts are scientifically accurate, relevant, novel and important. Authors disclose all conflicts, affiliations and financial associations such that the published content is not biased.
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