Embolization for non-variceal upper gastrointestinal tract haemorrhage: A systematic review

作者：Mirsadraee S; Tirukonda P; Nicholson A; Everett S M; McPherson S J^*

来源：Clinical Radiology, 2011, 66(6): 500-509.

DOI：10.1016/j.crad.2010.11.016

AIM: To assess the published evidence on the endovascular treatment of non-variceal upper gastrointestinal haemorrhage. MATERIALS AND
METHODS: An Ovid Medline search of published literature was performed (1966-2009). Non-English literature, experimental studies, variceal haemorrhage and case series with fewer than five patients were excluded. The search yielded 1888 abstracts. Thirty-five articles were selected for final analysis.
RESULTS: The total number of pooled patients was 927. The technical and clinical success of embolization ranged from 52-100% and 44-100%, respectively. The pooled mean technical/clinical success rate in primary upper gastrointestinal tract haemorrhage (PUGITH) only, transpapillary haemorrhage (TPH) only, and mixed studies were 84%/67%, 93%/89%, and 93%/64%, respectively. Clinical outcome was adversely affected by multi-organ failure, shock, corticosteroids, transfusion, and coagulopathy. The anatomical source of haemorrhage and procedural variables did not affect the outcome. A successful embolization improved survival by 13.3 times. Retrospective comparison with surgery demonstrated equivalent mortality and clinical success, despite embolization being applied to a more elderly population with a higher prevalence of co-morbidities.
CONCLUSIONS: Embolization is effective in this very difficult cohort of patients with outcomes similar to surgery.

• 出版日期2011-6