Embolization of the left gastric artery in the absence of angiographic extravasation.

Nine high-risk patients with endoscopic evidence of bleeding from the left gastric artery territory without angiographic extravasation were embolized to prevent rebleeding. Three were embolized with Gelfoam particles, 1 with Gianturco coils, and 5 with Gelfoam plus coils. Three patients rebled; 2 were embolized with Gelfoam only, and the third with coils only. No rebleeding occurred in the 5 patients treated with Gelfoam plus coils. No ischemic complications occurred. We conclude that embolization of the left gastric artery, despite absence of extravasation, is effective in preventing rebleeding in high-risk patients and that both Gelfoam and coils be used.