Results of using transcatheter arterial embolization in gastroduodenal ulcer bleeding: a review of studies

Abstract

The authors present the results of research comparing the efficacy and safety of different methods of hemostasis in patients with gastrointestinal ulcer bleeding. The work focuses on the possibilities of transcatheter arterial embolization (embolization of the syndrome-responsible arteries of the stomach and duodenum) in the treatment of this disorder. Objective. Based on information sources, to evaluate the potential of transcatheter arterial embolization in comparison with the results of surgical and endoscopic hemostasis in the management and prevention of recurrent gastroduodenal ulcer bleeding. Materials and methods. The authors analyzed data from 51 domestic and international information sources on the subject of this work. Results. Studies on the treatment of active ulcerative gastroduodenal bleeding refractory to endoscopic hemostasis, have demonstrated the advantage of transcatheter arterial embolization over surgical interventions in terms of the incidence of non-fatal surgical complications. Surgical interventions were associated with a lower incidence of recurrent bleeding compared to endovascular interventions. According to research results, there were no difference in overall mortality between the groups of endovascular and surgical hemostasis. The use of prophylactic transcatheter embolization of the syndrome-responsible artery in cases of ulcerative gastroduodenal bleeding in addition to effective primary endoscopic hemostasis showed promising results. In such cases, patients with initially high risk of hemorrhagic complications had significantly lower rate of recurrent bleeding, surgical complications, and mortality comparing to patients with effective primary endoscopic hemostasis but without subsequent transcatheter arterial embolization. Conclusion. Despite current advances in the field of surgery ulcerative gastroduodenal bleeding remains an acute medical and social problem that requires the search for new effective methods of hemostasis and prevention of recurrent hemorrhagic complications. In the majority of studies, transcatheter embolization of the syndrome-responsible arteries of the stomach and duodenum is used as such. Keywords: gastrointestinal ulcer bleeding, endoscopic hemostasis, transcatheter arterial embolization, prophylactic endovascular embolization