Affiliation:
1. A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation
2. City Clinical Hospital named after V.P. Demikhov of the Moscow City Health Department
Abstract
Goal: to evaluate the results of the use of preventive endovascular hemostasis in patients with a high risk of recurrent bleeding from the upper gastrointestinal tract. Material and methods. The work is based on the study of the results of 158 patients with ulcerative gastroduodenal bleeding and a high risk of its recurrence treatment (17 points or more on the scale of the recurrence of bleeding prediction), Forrest 1–2 A/B and fatal cases (30 points or more on SAPS II). To prevent recurrent bleeding, endovascular embolization of the left gastric or gastroduodenal arteries was performed. Results. The technical success of endovascular hemostasis was achieved in 94.4% of cases (153 patients). In 5 patients, embolization could not be performed due to technical reasons. A complication after transcatheter angiography and embolization was noted in one case (retroperitoneal hematoma that required surgical intervention). Relapse of bleeding after technically successful embolization was noted in 11 (7%) patients. PVA microemboli were used for embolization of the left gastric artery (LVA). Spirals and, in some cases, additional PVA microemboli were used for embolization of the gastroduodenal artery (GDA). The fatal outcome occurred in 26 cases (16.5% of all cases). Conclusion. According to our data, 7% of patients with severe somatic diseases (30 points or more according to SAPS II) and a high risk of bleeding recurrence (17 points or more according to SRBP) occurred in 7% (11 out of all 158 cases).
Publisher
Medical Informational Agency Publishers
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