Diagnostic and Interventional Radiology
Interventional Radiology - Original Article

Efficacy and safety of transcatheter arterial embolization for active arterial esophageal bleeding: a single-center experience

1.

Department of Radiology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia

2.

Department of Radiological Science, College of Health Science, Kangwon National University, Samcheok-si, Korea

3.

Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

4.

University of Hail, Faculty of Medicine, Hail, Saudi Arabia

Diagn Interv Radiol 2021; 27: 519-523
DOI: 10.5152/dir.2021.20253
Read: 192 Downloads: 46 Published: 10 July 2020

PURPOSE 
The study aimed to evaluate the safety and clinical efficacy of transcatheter arterial embolization (TAE) for the treatment of arterial esophageal bleeding.

METHODS
Nine patients (8 male, 1 female; mean age, 62.3±7.5 years) who underwent TAE for arterial esophageal bleeding between January 2004 and January 2020 were included. Preceding endoscopic treatment was unsuccessful in five patients and was not attempted in four patients due to the non-cooperation of the patients in endoscopic treatment. The etiologies of bleeding were esophageal cancer (n=4), Mallory-Weiss syndrome (n=3), erosive esophagitis (n=1), and esophageal ulcer (n=1). Technical and clinical success, recurrent bleeding, procedure-related complications, and clinical outcomes were retrospectively reviewed.

RESULTS
The angiographic findings for bleeding were contrast media extravasation (n=8) or tumor staining without a definite bleeding focus (n=1). The bleeding focus at the distal esophagus (n=8) was the left gastric artery, whereas that at the middle esophagus (n=1) was the right bronchial artery. Technical success was achieved in all patients. The embolic agents were n-butyl cyanoacrylate (NBCA, n=5), gelatin sponge particles (n=2), microcoils (n=1), and NBCA with gelatin sponge particles (n=1). Clinical success was achieved in 77.8% of cases (7/9); two patients with recurrent bleeding one day after the first TAE showed culprit arteries different from the bleeding foci at the first TAE. One patient who underwent embolization of both the left and short gastric arteries died of gastric infract/perforation one month after TAE. 

CONCLUSION
TAE can be an alternative to the treatment of arterial esophageal bleeding. TAE can be attempted in the treatment of recurrent bleeding, but there is a risk of ischemia/infarct in the gastrointestinal tract involved.

You may cite this article as: Alrashidi I, Kim TH, Shin JH, Alreshidi M, Park M, Jang EB. Efficacy and safety of transcatheter arterial embolization for active arterial esophageal bleeding: a single-center experience. Diagn Interv Radiol 2021; 27:519-523

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