Angiographic diagnosis and endovascular management of nonvariceal gastrointestinal hemorrhage.

Published

Journal Article

Diagnostic angiography still plays an essential role in the diagnosis of patients,particularly those with acute lower GI bleeding. Transcatheter therapy appears to be a viable treatment alternative in selected patients with GI bleeding. Many interventionists today believe embolotherapy to be more effective initially and to have better long-term results, specifically less rebleeding, than vasopressin infusion with at least equal complication rates. Unfortunately, direct comparison of the two techniques in a randomized, controlled fashion has not been performed. Small patient series, such as those summarized here, suggest that the results of the two techniques are essentially equal, and ischemic complications appear more prevalent with embolotherapy. The use of embolotherapy--either empirically based on endoscopic or surgical findings or directed against a site found to have contrast extravasation-represents the current intervention of choice in the case of upper GI bleeding refractory to endoscopic intervention. Head-to-head studies directly comparing the efficacy, morbidity, and mortality associated with endovascular or surgical correction of bleeding from the upper GI tract is needed. Although the current tide favors embolotherapy in the lower GI tract, infusion of vasoconstricting agents deserves more attention. To that end, there is a great need for scientific data regarding the safety and efficacy of transcatheter therapy for upper and lower GI bleeding.

Full Text

Duke Authors

Cited Authors

  • Miller, M; Smith, TP

Published Date

  • December 2005

Published In

Volume / Issue

  • 34 / 4

Start / End Page

  • 735 - 752

PubMed ID

  • 16303580

Pubmed Central ID

  • 16303580

International Standard Serial Number (ISSN)

  • 0889-8553

Digital Object Identifier (DOI)

  • 10.1016/j.gtc.2005.09.001

Language

  • eng

Conference Location

  • United States