Predictors of positive angiography and evaluation of the outcome of transcatheter control of non variceal upper gastrointestinal hemorrhage

摘要

Purpose To identify clinical factors influencing the positive angiographic findings identifying the bleeding source by angiography and to evaluation of the clinical outcome of embolization in angiography positive and in empiric embolization without identifying the bleeding source of upper gastrointestinal (UGI) bleeding. Materials and methods Twenty-one patients were candidates for transcatheter angiography and embolization and followed up for 3–38 months. Results Transcatheter angiography and embolization was technically and clinically successful in 95% and 86% respectively. Angiography identified the source in 11/20 and no source of bleeding seen in 9/20 in whom empiric embolization was carried out. Technical and clinical success or complications were not different. No procedure related major complications were encountered. Early and late mortalities were not different. Blood transfusion requirement and rate of hemoglobin drop were higher in positive compared to empiric group 9 vs 7 U and 5.7 vs 6.5 g/dL respectively ( p = 0.02), ( p = 0.1). Coagulopathy was found in 64% ( n = 7) in positive and in 38% ( n = 3) in empiric group ( p = 0.02). Recurrent UGI bleeding was noticed in patients with coagulopathy and were treated by coils alone. Conclusion Transcatheter angiography and embolization is safe and effective. Embolization can be done empirically even when angiographically negative is based on endoscopic localization of bleeding source.