The effect of transcatheter arterial embolisation for nonvariceal upper gastrointestinal bleeding.

INTRODUCTION: The aim of this investigation was to evaluate the clinical efficacy and safety of transcatheter arterial embolisation with coils for nonvariceal upper gastrointestinal (GI) bleeding after failed endoscopic therapy. MATERIAL AND METHODS: Between 2007 and 2009, transcatheter arterial embolisation was performed in 40 patients. We evaluated the angiographic and clinical success rate, recurrent bleeding rate, procedure-related complications and clinical outcomes. RESULTS: Primary technical success was achieved in all patients. In 82% of the patients, haemostasis was achieved with clinical improvement and without need for further therapy. There were no ischaemic GI complications. Recurrent bleeding occurred in seven patients (18%) within the first week after treatment, and in three cases these were managed successfully with a second embolisation. The overall 30-day mortality rate was 18%, and mortality related to bleeding was 10%. The mean follow-up period was 13 months (range 1-31 months). Non-bleeding-related mortality was 15% in the follow-up period. There were no hospital readmissions due to upper GI bleeding. CONCLUSION: Transcatheter arterial embolisation for upper GI bleeding is a safe and effective minimally invasive method, but it entails relatively high rates of early rebleeding as well as relatively high mortality rates both related to GI bleeding and to non-GI bleeding causes.