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Trans Arterial Embolization of Non-variceal Upper Gastrointestinal Bleeding: Is the Use of Ethylene–Vinyl Alcohol Copolymer as Safe as Coils?

  • Clinical Investigation
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Abstract

Purpose

The safety of liquid embolics over the conventional coils for the treatment of non-variceal upper gastrointestinal bleeding (UGIB) approach is still unclear. Purpose of this study is to assess the safety of ethylene–vinyl alcohol copolymer (EVOH 6%) over coils in the treatment of UGIB.

Materials and Methods

All the upper gastrointestinal tract embolization procedures performed in a single center in a 6-year period were reviewed. Patients embolised with coils (Group A) versus those embolised with EVOH 6% (Group B) were compared. Technical/clinical success, bleeding recurrence, complication and mortality rates were analyzed.

Results

A total 71 patients were included in the study (41 Group A and 30 Group B). Coagulopathy was present in 21% of Group A and 46% of Group B patients (p < 0.05). Technical and clinical success was 97.6 and 92.7% for Group A, and 100 and 93.3% for Group B respectively, (p > 0.05). Ten patients (17% Group A; 10% Group B) re-bled within the first 36 h and all of them were re-treated successfully with a second embolization. In Group A one major complication (bowel ischemia) occurred. No complication occurred in Group B. The survival rate in the first 30 days was 90.3% for group A and 90% for group B (p > 0.05).

Conclusion

This study demonstrated EVOH 6% appears to be as safe and effective as coils in the treatment of non-variceal UGIB.

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Authors and Affiliations

  1. Department of Radiology, Sant’Andrea University Hospital La Sapienza, Rome, Italy

    Marcello Andrea Tipaldi, Gianluigi Orgera & Michele Rossi

  2. Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK

    Miltiadis Krokidis

  3. Department of Surgical and Biomedical Science, University of Perugia, Perugia, Italy

    Alberto Rebonato & Daniele Maiettini

  4. Department of Interventional Radiology, San Giovanni Hospital, Rome, Italy

    Simone Vagnarelli & Cesare Ambrogi

Authors
  1. Marcello Andrea Tipaldi
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  2. Gianluigi Orgera
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  3. Miltiadis Krokidis
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  4. Alberto Rebonato
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  5. Daniele Maiettini
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  6. Simone Vagnarelli
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  7. Cesare Ambrogi
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  8. Michele Rossi
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Corresponding author

Correspondence to Miltiadis Krokidis.

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Tipaldi, M.A., Orgera, G., Krokidis, M. et al. Trans Arterial Embolization of Non-variceal Upper Gastrointestinal Bleeding: Is the Use of Ethylene–Vinyl Alcohol Copolymer as Safe as Coils?. Cardiovasc Intervent Radiol 41, 1340–1345 (2018). https://doi.org/10.1007/s00270-018-1981-5

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  • DOI: https://doi.org/10.1007/s00270-018-1981-5

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