Yapay Zeka Hızlı Bakış & Çıkarımlar
AI InsightTAE can be attempted in the treatment of recurrent bleeding, but there is a risk of ischemia/infarct in thegastrointestinal tract involved.
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Özet
PURPOSEThe study aimed to evaluate the safety and clinical efficacy of transcatheter arterial embolization (TAE) for the treatment of arterial esophageal bleeding.METHODSNine patients (8 male, 1 female; mean age, 62.3±7.5 years) who underwent TAE for arterialesophageal bleeding between January 2004 and January 2020 were included. Preceding endoscopic treatment was unsuccessful in five patients and was not attempted in four patientsdue to the non-cooperation of the patients in endoscopic treatment. The etiologies of bleeding were esophageal cancer (n=4), Mallory-Weiss syndrome (n=3), erosive esophagitis (n=1),and esophageal ulcer (n=1). Technical and clinical success, recurrent bleeding, procedure-related complications, and clinical outcomes were retrospectively reviewed.RESULTSThe angiographic findings for bleeding were contrast media extravasation (n=8) or tumorstaining without a definite bleeding focus (n=1). The bleeding focus at the distal esophagus (n=8) was the left gastric artery, whereas that at the middle esophagus (n=1) was theright bronchial artery. Technical success was achieved in all patients. The embolic agentswere n-butyl cyanoacrylate (NBCA, n=5), gelatin sponge particles (n=2), microcoils (n=1), andNBCA with gelatin sponge particles (n=1). Clinical success was achieved in 77.8% of cases(7/9); two patients with recurrent bleeding one day after the first TAE showed culprit arteriesdifferent from the bleeding foci at the first TAE. One patient who underwent embolization ofboth the left and short gastric arteries died of gastric infract/perforation one month after TAE.CONCLUSIONTAE can be an alternative to the treatment of arterial esophageal bleeding. TAE can be attempted in the treatment of recurrent bleeding, but there is a risk of ischemia/infarct in thegastrointestinal tract involved.