Loffroy RF, Abualsaud BA, Lin MD, Rao PP. Recent advances in endovascular techniques for management of acute nonvariceal upper gastrointestinal bleeding. World J Gastrointest Surg 2011; 3(7): 89-100 [PMID: 21860697 DOI: 10.4240/wjgs.v3.i7.89]
Corresponding Author of This Article
Romaric F Loffroy, MD, PhD, LE2I Laboratory, CNRS UMR 5158, Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 Bd Maréchal de Lattre de Tassigny, BP 77908, 21079 Dijon, France. romaric.loffroy@chu.dijon.fr
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jul 27, 2011; 3(7): 89-100 Published online Jul 27, 2011. doi: 10.4240/wjgs.v3.i7.89
Recent advances in endovascular techniques for management of acute nonvariceal upper gastrointestinal bleeding
Romaric F Loffroy, Basem A Abualsaud, Ming D Lin, Pramod P Rao
Romaric F Loffroy, LE2I Laboratory, CNRS UMR 5158, Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 Bd Maréchal de Lattre de Tassigny, BP 77908, 21079 Dijon, France
Basem A Abualsaud, Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 Bd Maréchal de Lattre de Tassigny, BP 77908, 21079 Dijon, France
Ming D Lin, Clinical Informatics, Interventional, and Translational Solutions, Philips Research North America, 345 Scarborough Road, Briarcliff Manor, NY 10510, United States
Pramod P Rao, Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, Johns Hopkins Hospital, 600 North Wolfe Street, Blalock 545, Baltimore, MD 21287, United States
Author contributions: Loffroy RF, Abualsaud BA, Lin MD and Rao PP contributed equally to this paper (conception and design, acquisition of data, drafting the article and revising it critically for important intellectual content, and final approval of the version to be published).
Correspondence to: Romaric F Loffroy, MD, PhD, LE2I Laboratory, CNRS UMR 5158, Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 Bd Maréchal de Lattre de Tassigny, BP 77908, 21079 Dijon, France. romaric.loffroy@chu.dijon.fr
Telephone: +33-380-293677 Fax: +33-380-295455
Received: February 10, 2011 Revised: July 9, 2011 Accepted: July 15, 2011 Published online: July 27, 2011
Abstract
Over the past two decades, transcatheter arterial embolization has become the first-line therapy for the management of upper gastrointestinal bleeding that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the management of hemorrhage for a variety of indications, such as peptic ulcer bleeding, malignant disease, hemorrhagic Dieulafoy lesions and iatrogenic or trauma bleeding. Transcatheter interventions include the following: selective embolization of the feeding artery, sandwich coil occlusion of the gastroduodenal artery, blind or empiric embolization of the supposed bleeding vessel based on endoscopic findings and coil pseudoaneurysm or aneurysm embolization by three-dimensional sac packing with preservation of the parent artery. Transcatheter embolization is a fast, safe and effective, minimally invasive alternative to surgery when endoscopic treatment fails to control bleeding from the upper gastrointestinal tract. This article reviews the various transcatheter endovascular techniques and devices that are used in a variety of clinical scenarios for the management of hemorrhagic gastrointestinal emergencies.
