Abstract
Background
Although the morbidity of bowel ischemic events after glue embolization has been suggested, a causal relationship between glue and ischemia has not been clearly established.
Purpose
To evaluate the efficiency and safety of transcatheter arterial embolization with n-butyl cyanoacrylate (NBCA–TAE) for upper gastrointestinal hemorrhage (GIH).
Material and Methods
Between October 2006 and October 2012, 21 patients with upper GIH underwent NBCA–TAE, and endoscopic data were obtained within 30 days of follow-up. Shock index prior to and immediately after NBCA–TAE were compared to determine changes in hemodynamics. Days to Forrest type III, as assessed by follow-up endoscopy, was used as an indicator of the healing process. Other clinical outcomes included days for starting ingestion and for hospital discharge.
Results
Sixteen gastric and five duodenal ulcers, classified into Forrest type I, were treated. Immediate hemostasis was achieved in all the patients, and no re-bleeding occurred within the follow-up period. Shock index significantly (P < 0.001) improved from before (0.99 ± 0.076) to immediately after NBCA–TAE (0.67 ± 0.038). Sequential mucosal healing processes were observed in all the patients, and the number of days to Forrest type III was 9.6 ± 7.1. The number of days for starting ingestion and hospital discharge was 9.0 ± 4.5 and 15 ± 7.7 days, respectively.
Conclusion
NBCA–TAE is an effective and safe method for the control of nonvariceal upper GIH, in terms of contribution to hemodynamics and healing process of the gastroduodenal mucosa.
Keywords
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