What information from the endoscopy report is essential when performing an embolization procedure for an upper GI bleed?
Because clinically significant upper GI bleeding may be intermittent or too slow to be identified angiographically, arteriograms performed in this setting often display normal results. Empiric embolizations are commonly performed even when arteriograms have normal results. Embolization of an arteriographically “normal” vessel can be performed safely because of the redundant collateral supply to the stomach and duodenum. Ischemic complications of such embolizations are rare unless the patient has a compromised network of collaterals from previous surgery. Before the procedure, it is necessary to know exactly where the patient is bleeding. If the source is duodenal, the gastroduodenal artery is embolized. If the source is gastric, the left gastric artery is embolized.
How can nontarget embolization be minimized?
Meticulous preembolization diagnostic angiography can ensure proper selective catheterization of the desired vessel.