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Efficacy and safety of transcatheter arterial embolization for active arterial esophageal bleeding: a single-center experience

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Abstract
PURPOSE
The study aimed to evaluate the safety and clinical efficacy of transcatheter arterial embolization (TAE) for the treatment of arterial esophageal bleeding.
METHODS
Nine patients (8 male, 1 female; mean age, 62.3±7.5 years) who underwent TAE for arterial esophageal bleeding between January 2004 and January 2020 were included. Preceding endoscopic treatment was unsuccessful in five patients and was not attempted in four patients due to the non-cooperation of the patients in endoscopic treatment. The etiologies of bleeding were esophageal cancer (n=4), Mallory-Weiss syndrome (n=3), erosive esophagitis (n=1), and esophageal ulcer (n=1). Technical and clinical success, recurrent bleeding, procedure-related complications, and clinical outcomes were retrospectively reviewed.
RESULTS
The angiographic findings for bleeding were contrast media extravasation (n=8) or tumor staining without a definite bleeding focus (n=1). The bleeding focus at the distal esophagus (n=8) was the left gastric artery, whereas that at the middle esophagus (n=1) was the right bronchial artery. Technical success was achieved in all patients. The embolic agents were n-butyl cyanoacrylate (NBCA, n=5), gelatin sponge particles (n=2), microcoils (n=1), and NBCA with gelatin sponge particles (n=1). Clinical success was achieved in 77.8% of cases (7/9); two patients with recurrent bleeding one day after the first TAE showed culprit arteries different from the bleeding foci at the first TAE. One patient who underwent embolization of both the left and short gastric arteries died of gastric infract/perforation one month after TAE.
CONCLUSION
TAE can be an alternative to the treatment of arterial esophageal bleeding. TAE can be attempted in the treatment of recurrent bleeding, but there is a risk of ischemia/infarct in the gastrointestinal tract involved.
Author(s)
김태형박민호신지훈장은비Ibrahim AlrashidiMeshael Alreshidi
Issued Date
2021
Type
Article
Keyword
Care and treatmentEsophageal diseasesHemorrhageMethodsPatient outcomesTherapeutic embolization
DOI
10.5152/dir.2021.20253
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8304
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2555641555&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Efficacy%20and%20safety%20of%20transcatheter%20arterial%20embolization%20for%20active%20arterial%20esophageal%20bleeding:%20a%20single-center%20experience&offset=0&pcAvailability=true
Publisher
Diagnostic and Interventional Radiology
Location
터키
Language
영어
ISSN
1305-3825
Citation Volume
27
Citation Number
4
Citation Start Page
519
Citation End Page
525
Appears in Collections:
Medicine > Medicine
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