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Transcatheter Arterial Embolization of Gastrointestinal Bleeding with N-Butyl Cyanoacrylate: A Systematic Review and Meta-Analysis of Safety and Efficacy
Authors:Pyeong Hwa Kim  Jiaywei Tsauo  Ji Hoon Shin  Sung-Cheol Yun
Institution:1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Republic of Korea;2. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Republic of Korea
Abstract:

Purpose

To evaluate the safety and efficacy of transcatheter arterial embolization with N-butyl cyanoacrylate (NBCA) for the treatment of gastrointestinal (GI) bleeding via a meta-analysis of published studies.

Materials and Methods

The MEDLINE/PubMed and EMBASE databases were searched for English-language studies from January 1990 to March 2016 that included patients with nonvariceal GI bleeding treated with transcatheter arterial embolization with NBCA with or without other embolic agents. The exclusion criteria were a sample size of < 5, no extractable data, or data included in subsequent articles or duplicate reports.

Results

The cases of 440 patients (mean age, 63.8 y ± 14.3; 319 men 72.5%] and 121 women 27.5%]) from 15 studies were evaluated. Of these patients, 261 (59.3%) had upper GI bleeding (UGIB) and 179 (40.7%) had lower GI bleeding (LGIB). Technical success was achieved in 99.2% of patients with UGIB (259 of 261) and 97.8% of those with LGIB (175 of 179). The pooled clinical success and major complication rates in the 259 patients with UGIB in whom technical success was achieved were 82.1% (95% confidence interval CI], 73.0%–88.6%; P = 0.058; I2 = 42.7%) and 5.4% (95% CI, 2.8%–10.0%; P = 0.427; I2 = 0.0%), respectively, and those in the 175 patients with LGIB in whom technical success was achieved were 86.1% (95% CI, 79.9%–90.6%; P = 0.454; I2 = 0.0%) and 6.1% (95% CI, 3.1%–11.6%; P = 0.382; I2 = 4.4%), respectively.

Conclusions

Transcatheter arterial embolization with NBCA is safe and effective for the treatment of GI bleeding.
Keywords:CI  confidence interval  GI  gastrointestinal  LGIB  lower gastrointestinal bleeding  NBCA  OR  odds ratio  PRISMA  Preferred Reporting Items for Systematic Reviews and Meta-Analyses  UGIB  upper gastrointestinal bleeding
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