Transcatheter Arterial Embolization with N-Butyl Cyanoacrylate for Nonvariceal Upper Gastrointestinal Bleeding in Hemodynamically Unstable Patients: Results and Predictors of Clinical Outcomes |
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| Affiliation: | 1. Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei;2. Department of Medical Imaging, National Taiwan University Hospital and College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 100, Taiwan;3. Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 100, Taiwan;4. Department of Medical Imaging, National Taiwan University Hospital Yun Lin Branch, Yun-Lin, Taiwan.;1. Department of Medicine, University of Colorado Health Sciences Center, Aurora;2. Cardiology Division, Denver Health Medical Center, 777 Bannock St., MC 0960, Denver, CO 80204;1. Cardiology Division, National Taiwan University Hospital Hsinchu Branch, No. 25, Lane 442, Sec. 1, Jingguo Rd., Hsinchu City 300, Taiwan;2. Nursing Department, National Taiwan University Hospital Hsinchu Branch, No. 25, Lane 442, Sec. 1, Jingguo Rd., Hsinchu City 300, Taiwan;3. College of Medicine, National Taiwan University, Far Eastern Memorial Hospital, Taipei, Taiwan;4. School of Medicine, National Yang-Ming University, Far Eastern Memorial Hospital, Taipei, Taiwan;5. Nuclear Medicine and Cardiovascular Center, Far Eastern Memorial Hospital, Taipei, Taiwan;1. Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago, Tottori 683-8504 Japan;2. Department of Radiology, Sanin Rosai Hospital, Yonago;3. Department of Radiology, National Hospital Organization Osaka Minami Medical Center, Osaka, Japan;1. Department of Radiodiagnosis, Christian Medical College and Hospital, Vellore, Tamil Nadu, India 632004;2. Department of General Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India 632004;3. Department of Pathology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India 632004. |
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| Abstract: | ![]()
PurposeTo assess the safety, efficacy, clinical outcomes, and prognostic factors associated with transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) for nonvariceal upper gastrointestinal (GI) hemorrhage in hemodynamically unstable patients.Materials and MethodsBetween January 2008 and December 2012, 49 hemodynamically unstable patients (systolic blood pressure < 90 mm Hg and ongoing transfusion requirement) underwent emergency TAE with NBCA for nonvariceal upper GI bleeding and were included in the study. The technical (cessation of extravasation) and clinical (no residual bleeding within 7 d) success rates, incidence of ischemic complications, and clinical and technical predictors of recurrent bleeding within 30 days were analyzed.ResultsThe technical and clinical success rates were 98% and 71%, respectively. There were no ischemic bowel complications; one patient experienced hepatic infarction with elevated liver enzymes. The incidence of major complications was 2%. The incidence of rebleeding within 30 days was 39%. Hematologic malignancies (P = .017), coagulopathy (P = .003), steroid pulse therapy (P = .025), and the absence of NBCA in the target lesions (P = .003) were associated with recurrent bleeding.ConclusionsNBCA embolization can be safely performed in hemodynamically unstable patients with active nonvariceal upper GI bleeding. The clinical factors associated with rebleeding might influence the clinical outcome. |
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