Prophylactic transcatheter arterial embolization for high-risk ulcers following endoscopic hemostasis: a meta-analysis

Abstract Background To conduct a meta-analysis to assess the safety and efficacy of prophylactic transcatheter arterial embolization (PTAE) for treatment high-risk bleeding peptic ulcers after achieving endoscopic hemostasis. Methods PubMed Cochrane Library were queried full-text articles published up December 2019. The following keywords used: “prophylactic embolization”, “supplement “gastrointestinal bleeding”, “ulcer bleeding”. High-risk defined based on findings (i.e., large ulcers, Forrest class I-IIb) and/or clinical presentation hypotension, decreased hemoglobin during endoscopy). Only comparative studies investigating PTAE versus conservative hemostasis included. Baseline study characteristics, rebleeding rate, need surgery, mortality, PTAE-related complication rates investigated. Quantitative analyses performed with Stata 15.1. Results Among five included original studies, total 265 patients received 617 managed conservatively endoscopy. rate (6.8% vs 14.3%, p = 0.003) mortality (4.5% 8.8%, 0.032) from group lower than control group. also reduced cumulative future surgical intervention (3.0% 14.4%, 0.005). major minor events 0.75% respectively. Conclusion had therapeutic potentials in reducing risk, intervention, morality embolization-associated adverse minimal. Future should aim increase sample size resources performing endovascular interventions.