Ozen Cihan, Al-Hashimi Muhanad, Tornby Stender Mogens, Thorlacius-Ussing Ole, Larsen Anders Christian
Department of Surgery, Aalborg University Hospital, Hobrovej 18-22, 9100, Aalborg, Denmark.
Department of Radiology, Aalborg University Hospital, Aalborg, Denmark.
Langenbecks Arch Surg. 2025 Apr 2;410(1):117. doi: 10.1007/s00423-025-03695-8.
To investigate the safety and efficacy of transarterial embolization (TAE) in patients with bleeding gastroduodenal peptic ulcers with an emphasis on prophylactic TAE (pTAE).
This retrospective cohort study was conducted from 1 January 2010 to 30 June 2022. The primary outcome was rebleeding rate after TAE. Secondary outcomes were frequency and severity of complications, 30-day mortality rate, and overall survival.
87 patients were included. The overall rebleeding rate after TAE was 13/87 (15%). The rebleeding rate was non-significantly higher in the therapeutic TAE (tTAE) group (31%) when compared to the pTAE group (12%). Minor complications were observed in 14/87 patients (16%) and severe complications were observed in 6/87 patients (7%). The complication rate did not differ between the tTAE and pTAE groups. The 30-day overall mortality rate was 19/87 (22%). The 30-day mortality rate was non-significantly higher in the tTAE-group (31%) when compared to the pTAE group (20%). Of the 19 mortalities within 30-days, three were considered procedure-related. The overall median survival rate was 21 months (95% CI: 9.8 - 31). A non-significant higher median survival of 46.7 months (95% CI 1.2 - 74.9) was observed in the tTAE group when compared to 20.5 months (95% CI 7.1-29.1) in the pTAE group.
TAE is safe and efficient but is associated with a high 30-day mortality rate and poor overall survival owing to a high burden of comorbidity and disease-related rather than TAE-related complications. Further studies are needed to clarify the gain and selection criteria for pTAE.
探讨经动脉栓塞术（TAE）治疗胃十二指肠消化性溃疡出血患者的安全性和有效性，重点关注预防性经动脉栓塞术（pTAE）。
本回顾性队列研究于2010年1月1日至2022年6月30日进行。主要结局是TAE术后再出血率。次要结局是并发症的发生率和严重程度、30天死亡率和总生存率。
纳入87例患者。TAE术后总体再出血率为13/87（15%）。与pTAE组（12%）相比，治疗性TAE（tTAE）组的再出血率略高，但无统计学意义（31%）。14/87例患者（16%）出现轻微并发症，6/87例患者（7%）出现严重并发症。tTAE组和pTAE组的并发症发生率无差异。30天总死亡率为19/87（22%）。与pTAE组（20%）相比，tTAE组的30天死亡率略高，但无统计学意义（31%）。在30天内的19例死亡病例中，3例被认为与手术相关。总体中位生存率为21个月（95%CI：9.8 - 31）。与pTAE组的20.5个月（95%CI 7.1 - 29.1）相比，tTAE组观察到中位生存期为46.7个月（95%CI 1.2 - 74.9），略高但无统计学意义。
TAE是安全有效的，但由于合并症负担高以及与疾病相关而非TAE相关的并发症，导致30天死亡率高且总生存率较差。需要进一步研究以明确pTAE的获益和选择标准。
