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World Journal of Emergency Surgery

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Open Access 01-12-2021 | Endoscopy | Research article

Prophylactic transcatheter arterial embolization for high-risk ulcers following endoscopic hemostasis: a meta-analysis

Authors: Qian Yu, Chenyu Liu, Biagio Collura, Rakesh Navuluri, Mikin Patel, Zhiyong Yu, Osman Ahmed

Published in: World Journal of Emergency Surgery | Issue 1/2021

Abstract

Background

To conduct a meta-analysis to assess the safety and efficacy of prophylactic transcatheter arterial embolization (PTAE) for the treatment of high-risk bleeding peptic ulcers after achieving endoscopic hemostasis.

Methods

PubMed and Cochrane Library were queried for full-text articles published up to December 2019. The following keywords were used: “prophylactic embolization”, “supplement embolization”, “gastrointestinal bleeding”, and “ulcer bleeding”. High-risk ulcers were defined based on endoscopic findings (i.e., large ulcers, Forrest class I-IIb) and/or clinical presentation (i.e., hypotension, decreased hemoglobin during endoscopy). Only comparative studies investigating PTAE versus conservative treatment after achieving endoscopic hemostasis were included. Baseline study characteristics, rebleeding rate, need for surgery, mortality, and PTAE-related complication rates were investigated. Quantitative analyses were performed with Stata 15.1.

Results

Among the five included original studies, a total of 265 patients received PTAE and 617 were managed conservatively after endoscopy. The rebleeding rate (6.8% vs 14.3%, p = 0.003) and mortality (4.5% vs 8.8%, p = 0.032) of patients from the PTAE group were lower than the control group. PTAE also reduced the cumulative need for future surgical intervention (3.0% vs 14.4%, p = 0.005). The PTAE-related major and minor events were 0.75% and 14.4%, respectively.

Conclusion

PTAE had therapeutic potentials in reducing rebleeding risk, need for surgical intervention, and morality in high-risk peptic ulcers after achieving endoscopic hemostasis. The embolization-associated adverse events were minimal. Future studies should aim to increase the sample size and resources for performing endovascular interventions.

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Title: Prophylactic transcatheter arterial embolization for high-risk ulcers following endoscopic hemostasis: a meta-analysis
Authors: Qian Yu
Chenyu Liu
Biagio Collura
Rakesh Navuluri
Mikin Patel
Zhiyong Yu
Osman Ahmed
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Endoscopy
Interventional Radiology
Gastrointestinal Bleeding
Published in: World Journal of Emergency Surgery / Issue 1/2021
Electronic ISSN: 1749-7922
DOI: https://doi.org/10.1186/s13017-021-00371-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prophylactic transcatheter arterial embolization for high-risk ulcers following endoscopic hemostasis: a meta-analysis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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