ABSTRACT
There is a concept that embolization does not change the underlying pathophysiology of peptic ulcer disease, so endovascular therapy is still used as an alternative treatment to surgery, only in high-risk patients. In this study, we assess the usefulness of endovascular therapy as an alternative to operation in low risk patients with massive bleeding from a peptic ulcer. A retrospective study of 22 consecutive embolization procedures in endoscopically unmanageable, hemodynamically unstable patients, referred from 2004 to 2010. Different techniques and embolization materials were used. Mean follow-up was 7 months. Endoscopy was performed for 12 patients 5 to 9 months after embolization to assess healing of the ulcer. Gastric ulcer was noted in 7 patients, bulbar duodenal ulcer in 13 patients and postbulbar duodenal ulcer in 2 patient. The technical success rate was 100%. The rebleeding rate was 9%, and 30-days mortality rate was 4%. No major complications were reported. Follow up endoscopy revealed healing of the ulcer in 10 of the 12 patients [83%]. Angio-embolization is safe and effective for controlling life-threatening endoscopically unmanageable, bleeding from gastroduodenal ulcers especially in low risk patients. Whenever combined with proper medical therapy it allows ulcer healing without the need for higher risk laparotomy