Transarterial embolization of gastroduodenal peptic ulcer bleeding: a single-center study of safety and efficacy

Objectives: To investigate the safety and efficacy of transarterial embolization (TAE) in patients with bleeding gastroduodenal peptic ulcers with an emphasis on prophylactic TAE (pTAE). Methods: This retrospective cohort study was conducted from 1 January 2010 to 30 June 2022. The primary outcome was rebleeding rate after TAE. Secondary outcomes were frequency and severity of complications, 30-day mortality rate, and overall survival. Results: 87 patients were included. The overall rebleeding rate after TAE was 13/87 (15%). The rebleeding rate was non-significantly higher in the therapeutic TAE (tTAE) group (31%) when compared to the pTAE group (12%). Minor complications were observed in 14/87 patients (16%) and severe complications were observed in 6/87 patients (7%). The complication rate did not differ between the tTAE and pTAE groups. The 30-day overall mortality rate was 19/87 (22%). The 30-day mortality rate was non-significantly higher in the tTAE-group (31%) when compared to the pTAE group (20%). Of the 19 mortalities within 30-days, three were considered procedure-related. The overall median survival rate was 21 months (95% CI: 9.8 – 31). A non-significant higher median survival of 46.7 months (95% CI 1.2 – 74.9) was observed in the tTAE group when compared to 20.5 months (95% CI 7.1–29.1) in the pTAE group. Conclusion: TAE is safe and efficient but is associated with a high 30-day mortality rate and poor overall survival owing to a high burden of comorbidity and disease-related rather than TAE-related complications. Further studies are needed to clarify the gain and selection criteria for pTAE.