Efficacy Analysis of Transcatheter Arterial Embolization in Acute Non-Variceal Upper Gastrointestinal Bleeding

LIU Bang-xi, WANG Xiao-ze, YAN Yu-ling, XIAO Xue, YANG Li, LUO Xue-feng

Abstract

To evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) in the treatment of acute non-variceal upper gastrointestinal bleeding (ANVUGIB), and to guide clinical practice and continue to optimize diagnosis and treatment strategies.  Methods  This retrospective study included 266 patients who underwent angiography due to ANVUGIB between March 2016 and March 2021. Data on the positive rate of angiography, the technical success rate and clinical success rate of TAE, and the rebleeding rate and the all-cause mortality within 30 days after TAE treatment were collected, and the influencing factors relevant to the above events were analyzed accordingly.  Results  All 266 patients completed angiography--the positive rate of angiography was 54.1% (144/266), the total technical success rate was 97.3% (217/223), the clinical success rate was 73.1% (155/212), and the rebleeding rate and all-cause mortality within 30 days were 26.9% (57/212) and 16.1% (35/217), respectively. This study found that shock index>1 (OR=5.950; 95% CI: 1.481-23.895; P=0.012), computed tomography angiography (CTA) positive result (OR=6.813; 95% CI: 1.643-28.252; P=0.008) and interval<24 h (OR=10.530; 95% CI: 2.845-38.976; P<0.001) were independent predictors of positive angiography. Shock index>1 (OR=2.544; 95% CI: 1.301-4.972; P=0.006) and INR>1.5 (OR=3.207; 95% CI: 1.381-7.451; P=0.007) were independent risk factors for rebleeding. Patients with postoperative bleeding (OR=3.174; 95% CI: 1.164-8.654; P=0.024) and patients with rebleeding after embolization (OR=34.665; 95% CI: 11.471-104.758; P<0.001) had a higher risk of death within 30 days.  Conclusion  TAE is safe and effective in the treatment of ANVUGIB. Patients with shock index>1 and positive CTA are more likely to be angiographic positive, and should undergo angiography as early as possible after bleeding. In addition, rebleeding after embolization deserves high attention.

 

Keywords: Acute non-variceal upper gastrointestinal bleeding, Angiography, Transcatheter arterial embolization

 

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