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Angiographic Embolization for Gastroduodenal Hemorrhage: Safety, Efficacy, and Predictors of Outcome—Invited Critique
Michael E. Zenilmani, MD
Arch Surg. 2008;143(5):461-462.
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Poultsides and colleagues conducted a retrospective review over a 10-year period of patients with uncontrolled upper GI tract hemorrhage who were treated with angiography and embolization. This highly selective group of 57 patients had significant comorbidities: one-quarter had multiple organ system failure; similar percentages had immunocompromise, renal failure, or coagulopathy. Remarkably, some patients were referred to angiography by consultants who chose not to obtain a surgical consultation.
What they found was not surprising. The initial success in controlling bleeding was 94%, but 44% of the patients rebled and there was only a 51% overall success rate. About half of the patients who failed ultimately needed surgery, and the overall mortality rate was 21%. Complications included ischemic bowel from the angiography or embolization.
Few studies have looked at prognostic indicators in patients as complicated as these. Using multivariate analysis, Poultsides and colleagues nicely show that those patients . . . [Full Text of this Article]
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Angiographic Embolization for Gastroduodenal Hemorrhage: Safety, Efficacy, and Predictors of Outcome
George A. Poultsides, Christine J. Kim, Rocco Orlando, III, George Peros, Michael J. Hallisey, and Paul V. Vignati
Arch Surg. 2008;143(5):457-461.
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