Endoscopic Marking with a Metallic Clip Facilitates Transcatheter Arterial Embolization in Upper Peptic Ulcer Bleeding
| Autor: | Rickard Nyman, Magnus Sundbom, Lars-Gunnar Eriksson, Sven Gustavsson |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Contrast Media Target vessel Radiography Interventional Gastroduodenal artery medicine.artery Gastroscopy Humans Medicine Radiology Nuclear Medicine and imaging Superior mesenteric artery Aged Aged 80 and over business.industry Arterial Embolization Hemostasis Endoscopic Middle Aged Surgical Instruments Embolization Therapeutic Peptic Ulcer Hemorrhage Treatment Outcome Female Radiology Peptic ulcer bleeding Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Vascular and Interventional Radiology. 17:959-964 |
| ISSN: | 1051-0443 |
| DOI: | 10.1097/01.rvi.0000223719.79371.46 |
| Popis: | To enable accurate transcatheter arterial embolization (TAE) of the target vessel, a new technique to localize the exact position of a bleeding ulcer was tested that involves endoscopic marking of the ulcer with a metallic clip.In 13 patients (mean age, 75 years) with acute bleeding ulcers (11 duodenal ulcers, two malignant ulcers), a metallic clip was placed at gastroscopy followed or preceded by routine endoscopic treatment. The metallic clip was placed in the fibrous edge of the ulcer adjacent to the bleeding point. In 10 patients, TAE was indicated as a result of continued or recurrent bleeding. The artery was embolized with microcoils as close as possible to the clip. In three patients, there was no indication for TAE, so plain abdominal radiography was performed to determine whether the marking clip was still in place.In 11 patients, the clip was still in place on radiography; in two, it had disappeared. Hemostasis was achieved in eight of 10 patients after TAE. In six patients, the clip was essential to identify the bleeding vessel.Marking of the bleeding ulcer with a clip before TAE enhances the possibility that the correct vessel is embolized. This will most likely minimize the risk of recurrent bleeding after embolization, especially in patients who do not show contrast medium extravasation. |
| Databáze: | OpenAIRE |
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