Place for arteriae embolization in patients with recurrent gastrointestinal bleeding in case of ulcer

Objective. To determine the place for safety and efficacy percutaneous transcatheter arteriae embolization in patients with recurrent gastrointestinal ulcer bleeding. Material and methods. A retrospective, observational study was conducted. The results of treatment of 76 patients were studied. Group 1 — selective angiography was not used (66%, 50/76). Group 2 — selective angiography was performed (34%, 26/76). In second group, 6 patients underwent transcatheter arterial embolization. Results. In group 1, mortality was 58% (29/50), in the period of 30 days due to recurrence of gastrointestinal bleeding readmission 14% (3/21). Satisfactory results of treatment were achieved in 36% (18/50) of patients of group 1. In group 2, all patients were discharged in a satisfactory condition, cases of readmission due to recurrence of ulcerative gastrointestinal bleeding and the consequences of transcatheter arterial embolization have not been established. The use of interventional hemostatic measures is advisable in patients with relapse and a high risk of recurrence of severe ulcer bleeding combined with: Indications for blood transfusion and repeated blood transfusion. Age over 70 years, polymorbidity. long-term use of anticoagulants; long history of ulcers. Total plasma protein content less than 55 g/l. Activated partial thromboplastin time over 45 sec. Platelet count ≥350·109/l. A contraindication for interventional hemostatic measures in gastrointestinal bleeding is a high risk of recurrence of severe ulcerative bleeding in acute erosive and ulcerative lesions of the stomach and duodenum, as well as in venous gastrointestinal bleeding. Conclusion. Percutaneous transcatheter arterial embolization is an effective, safe and low-traumatic method of hemostasis in case of recurrence and high risk of recurrence of severe ulcer bleeding.