Endoscopy 2025; 57(S 02): S322-S323
DOI: 10.1055/s-0045-1805793
Abstracts | ESGE Days 2025
ePosters

Risk Factors for Rebleeding after Trans-Arterial Embolization in Patients with Non-Variceal Upper Gastrointestinal Bleeding

Authors

  • J Yu

    1   Seongnam-si, Republic of Korea

  • J Y Seo

    2   Bundang Jesaeng Hospital, Seongnam-si, Republic of Korea

  • A Y Lee

    3   Cha Medical Center Gangnam, Seoul, Republic of Korea
Weitere Informationen
Auch verfügbar auf
 

Aims Non-variceal upper gastrointestinal bleeding can usually be controlled endoscopically; however, if endoscopic hemostasis fails, it can pose a life-threatening risk. Trans-arterial embolization is a less invasive, safe, and effective rescue therapy that can serve as an alternative to surgery. Identifying factors influencing rebleeding after trans-arterial embolization in advance could lead to more efficient and safer patient management. Therefore, we aim to investigate these factors.

Methods We retrospectively investigated 167 patients treated with TAE between January 2008 and June 2023. All patients underwent emergent endoscopy prior to TAE. Re-bleeding was defined as the presence of melena, hematemesis, or hematochezia with a fall in hemoglobin levels (> 0.8 g/dl) or shock after TAE. The primary outcomes was 30-day re-bleeding rate.

Results Total of 104 patients with non-variceal upper gastrointestinal bleeding were selected. Re-bleeding within a month after TAE was noted in 24 patients (23.1%). Patients with re-bleeding had significantly higher rates of thrombocytopenia (50.0% vs. 15.0%, p=0.001) and coagulopathy (20.8% vs. 5.0%, p=0.045) than those without re-bleeding. Additionally, 7-day mortality (16.7% vs. 2.5%, p=0.035), AIMS65 score (2.0 vs. 1.0, p=0.029), and ABC score (7.0 vs. 4.0, p=0.002) were significantly elevated in patients with re-bleeding. A multivariate logistic analysis showed thrombocytopenia (odds ratio: 5.44, 95% confidence interval: 1.84–16.92, p=0.002) and an ABC score≥6 (odds ratio: 2.87, 95% confidence interval: 1.02–8.66, p=0.005) significantly increased the risk of re-bleeding after TAE.

Conclusions TAE could be an effective and safe treatment for non-variceal upper gastrointestinal bleeding. However, thrombocytopenia and elevated ABC scores might be associated with a higher 30-day rebleeding rate after TAE. Therefore, patients with these risk factors should be carefully monitored and managed.



Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany