Open AccessEndovascular Arterial Embolization in the Treatment of Gastroduodenal Ulcer Bleeding
Author(s) -
I A Soloviev,
И. М. Мусинов,
А. Е. Чикин,
А. С. Ганин
Publication year - 2018
Publication title -
vestnik rossijskoj voenno-medicinskoj akademii
Language(s) - English
Resource type - Journals
eISSN - 2687-1424
pISSN - 1682-7392
DOI - 10.17816/brmma12210
Subject(s) - medicine , embolization , hemostasis , arterial embolization , surgery , gastroduodenal artery , gastroduodenal ulcer , artery , peptic ulcer
Currently, it is possible to improve the outcome of the treatment of gastroduodenal ulcer bleeding by reducing the mortality, primarily in patients with a persistent high risk of rebleeding against the background of the conservative treatment and high operational risk. Unacceptably high postoperative mortality in high-risk surgical patients reaching 60%, often forces the surgeons to use the conservative treatment for these patients, which often leads to rebleeding, open surgery despite the high risk and unsatisfactory outcome of the treatment. A minimally invasive technique such as transcatheter embolization of the gastric and duodenal arteries in gastrointestinal ulcer bleeding, allowing to affect the source of bleeding by endovascularization with a minimal surgical trauma, made it possible to achieve hemostasis in 60 of 61 patients (98%). Rebleeding after arterial embolization occurred in 3 patients (5%). In 51 patients (85%), endovascular hemostasis was permanent. Additionally, 6 patients (10%) underwent delayed surgery at different times after arterial embolization. Overall mortality in high-risk surgical patients was 9.2% and was not related to arterial embolization, which compares this data favorably with many literary sources. With its impact, arterial embolization with an adhesive composite based on N-butyl-2-cyanoacrylate is an alternative to the surgical treatment of gastroduodenal ulcer bleeding and an operation of choice for high-risk surgical patients.