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Outcome of acute nonvariceal gastrointestinal haemorrhage after nontherapeutic arteriography compared with embolization

Luc Defreyne UGent, Peter Vanlangenhove, Johan Decruyenaere UGent, GEORGES VAN MAELE, Martine De Vos UGent, Roberto Troisi UGent and Piet Pattyn UGent (2003) EUROPEAN RADIOLOGY. 13(12). p.2604-2614
abstract
In acute nonvariceal gastrointestinal (GI) bleeding, immediate arteriographic haemostasis is presently assumed to be a therapeutic advantage. This study assesses whether the risk of a delayed haemostasis, caused by arteriographic findings precluding embolization, might influence patient outcome. We performed a 5.5-year retrospective database search to find all patients referred for arteriography to arrest acute nonvariceal GI bleeding with embolization. The embolized and nonembolized patients were compared for differences in baseline characteristics and bleeding parameters. In both groups the outcome of all endoscopic or surgical interventions after catheterization was included in the follow-up. Clinical success (at 30 days, after all therapy) and in-hospital mortality in the embolized and nonembolized group were compared. We retrieved 63 nonembolized bleedings in 58 patients and 49 embolized bleedings in 49 patients. In the nonembolized group, transfusion need and haemodynamic instability were significantly less severe. Forty-two of 63 (66%) nonembolized bleedings persisted requiring haemostasis by surgery (n=23), endoscopy (n=13) or supportive transfusions. Thirteen of 49 (27%) embolized bleedings recurred and were managed by surgery (n=7), endoscopy (n=3) or transfusion. Overall clinical success rate was 88.9% (56 of 63) in the nonembolized and 87.8% (43 of 49) in the embolized group. Mortality rate was 17.2% (10 of 58) in the nonembolized vs 30.6% (15 of 49) in the embolized patients (P=0.115). Whether or not arteriographic findings afforded the opportunity to embolize, outcome of acute nonvariceal GI bleeding did not differ significantly; however, patients undergoing embolization were more critically bleeding and ill.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
MANAGEMENT, ANGIOGRAPHY, ULCERS, TRACT, SURGERY, SURVIVAL, embolization, arteriography, gastrointestinal tract, haemorrhage, POLYVINYL-ALCOHOL PARTICLES, EMBOLOTHERAPY, ARTERIAL EMBOLIZATION, TRANSCATHETER EMBOLIZATION
journal title
EUROPEAN RADIOLOGY
Eur. Radiol.
volume
13
issue
12
pages
2604 - 2614
Web of Science type
Article
Web of Science id
000186778800008
JCR category
RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
JCR impact factor
1.969 (2003)
JCR rank
29/82 (2003)
JCR quartile
2 (2003)
ISSN
0938-7994
DOI
10.1007/s00330-003-1882-z
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
211563
handle
http://hdl.handle.net/1854/LU-211563
date created
2004-04-14 12:21:00
date last changed
2016-12-19 15:38:14
@article{211563,
  abstract     = {In acute nonvariceal gastrointestinal (GI) bleeding, immediate arteriographic haemostasis is presently assumed to be a therapeutic advantage. This study assesses whether the risk of a delayed haemostasis, caused by arteriographic findings precluding embolization, might influence patient outcome. We performed a 5.5-year retrospective database search to find all patients referred for arteriography to arrest acute nonvariceal GI bleeding with embolization. The embolized and nonembolized patients were compared for differences in baseline characteristics and bleeding parameters. In both groups the outcome of all endoscopic or surgical interventions after catheterization was included in the follow-up. Clinical success (at 30 days, after all therapy) and in-hospital mortality in the embolized and nonembolized group were compared. We retrieved 63 nonembolized bleedings in 58 patients and 49 embolized bleedings in 49 patients. In the nonembolized group, transfusion need and haemodynamic instability were significantly less severe. Forty-two of 63 (66\%) nonembolized bleedings persisted requiring haemostasis by surgery (n=23), endoscopy (n=13) or supportive transfusions. Thirteen of 49 (27\%) embolized bleedings recurred and were managed by surgery (n=7), endoscopy (n=3) or transfusion. Overall clinical success rate was 88.9\% (56 of 63) in the nonembolized and 87.8\% (43 of 49) in the embolized group. Mortality rate was 17.2\% (10 of 58) in the nonembolized vs 30.6\% (15 of 49) in the embolized patients (P=0.115). Whether or not arteriographic findings afforded the opportunity to embolize, outcome of acute nonvariceal GI bleeding did not differ significantly; however, patients undergoing embolization were more critically bleeding and ill.},
  author       = {Defreyne, Luc and Vanlangenhove, Peter and Decruyenaere, Johan and VAN MAELE, GEORGES and De Vos, Martine and Troisi, Roberto and Pattyn, Piet},
  issn         = {0938-7994},
  journal      = {EUROPEAN RADIOLOGY},
  keyword      = {MANAGEMENT,ANGIOGRAPHY,ULCERS,TRACT,SURGERY,SURVIVAL,embolization,arteriography,gastrointestinal tract,haemorrhage,POLYVINYL-ALCOHOL PARTICLES,EMBOLOTHERAPY,ARTERIAL EMBOLIZATION,TRANSCATHETER EMBOLIZATION},
  language     = {eng},
  number       = {12},
  pages        = {2604--2614},
  title        = {Outcome of acute nonvariceal gastrointestinal haemorrhage after nontherapeutic arteriography compared with embolization},
  url          = {http://dx.doi.org/10.1007/s00330-003-1882-z},
  volume       = {13},
  year         = {2003},
}

Chicago
Defreyne, Luc, PETER VANLANGENHOVE, Johan Decruyenaere, GEORGES VAN MAELE, Martine De Vos, Roberto Troisi, and Piet Pattyn. 2003. “Outcome of Acute Nonvariceal Gastrointestinal Haemorrhage After Nontherapeutic Arteriography Compared with Embolization.” European Radiology 13 (12): 2604–2614.
APA
Defreyne, L., VANLANGENHOVE, P., Decruyenaere, J., VAN MAELE, G., De Vos, M., Troisi, R., & Pattyn, P. (2003). Outcome of acute nonvariceal gastrointestinal haemorrhage after nontherapeutic arteriography compared with embolization. EUROPEAN RADIOLOGY, 13(12), 2604–2614.
Vancouver
1.
Defreyne L, VANLANGENHOVE P, Decruyenaere J, VAN MAELE G, De Vos M, Troisi R, et al. Outcome of acute nonvariceal gastrointestinal haemorrhage after nontherapeutic arteriography compared with embolization. EUROPEAN RADIOLOGY. 2003;13(12):2604–14.
MLA
Defreyne, Luc, PETER VANLANGENHOVE, Johan Decruyenaere, et al. “Outcome of Acute Nonvariceal Gastrointestinal Haemorrhage After Nontherapeutic Arteriography Compared with Embolization.” EUROPEAN RADIOLOGY 13.12 (2003): 2604–2614. Print.