Department of Radiology, Miyakonojo Medical Association Hospital, 5822-3 Oiwadacho, Miyakonojo 885-0062, Japan.
J Vasc Interv Radiol. 2011 Jul;22(7):911-6. doi: 10.1016/j.jvir.2011.03.001. Epub 2011 May 14.
To evaluate the efficacy and safety of empiric transcatheter arterial embolization (TAE) for patients with massive bleeding from duodenal ulcers.
During January 2000 and December 2009, 59 patients with duodenal ulcer bleeding in whom TAE was attempted after endoscopic therapy failed were retrospectively analyzed. The patients were divided into empiric TAE (n = 36) and identifiable TAE (n = 23) groups according to angiographic findings with or without identification of the bleeding sites. The technical and clinical success rate, recurrent bleeding rate, procedure-related complications, and clinical outcomes were evaluated.
The technical and clinical success rates of TAE were 100% and 83%. The recurrent bleeding rate, clinical success, duodenal stenosis, and 30-day mortality after TAE were not significantly different between the empiric and identifiable TAE groups.
A high rate of technical and clinical success was obtained with empiric TAE comparable to identifiable TAE in patients with massive bleeding from duodenal ulcers. There were no severe complications. Empiric TAE is an effective and safe method when a bleeding site cannot determined by angiography.
评估经验性经导管动脉栓塞术（TAE）治疗十二指肠溃疡大出血患者的疗效和安全性。
回顾性分析 2000 年 1 月至 2009 年 12 月期间内镜治疗失败后尝试 TAE 的 59 例十二指肠溃疡出血患者。根据有无明确出血部位的血管造影表现，将患者分为经验性 TAE（n = 36）和可识别性 TAE（n = 23）组。评估技术和临床成功率、再出血率、与操作相关的并发症和临床结局。
TAE 的技术和临床成功率分别为 100%和 83%。经验性 TAE 组与可识别性 TAE 组的再出血率、临床成功率、十二指肠狭窄和 30 天死亡率无显著差异。
在无法通过血管造影确定出血部位的情况下，经验性 TAE 治疗十二指肠溃疡大出血患者可获得较高的技术和临床成功率，且无严重并发症。经验性 TAE 是一种有效且安全的方法。
