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Over‐the‐scope clip vs. transcatheter arterial embolization to treat refractory peptic ulcer bleeding

Over‐the‐scope clip vs. transcatheter arterial embolization to treat refractory peptic ulcer bleeding Over‐the‐scope clip vs. transcatheter arterial embolization to treat refractory peptic ulcer bleeding
Over‐the‐scope clip vs. transcatheter arterial embolization to treat refractory peptic ulcer bleeding Over‐the‐scope clip vs. transcatheter arterial embolization to treat refractory peptic ulcer bleeding

A retrospective, multicenter sudy was carried out for comparing over-the-scope clips (OTSC) treatment vs. transcatheter arterial embolization (TAE) in peptic ulcer bleeding. 

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Key take away

For management of refractory peptic ulcer bleeding, over-the-scope clips therapy showed superiority to transcatheter arterial embolization in terms of in-hospital mortality and ICU stay.

Background

A retrospective, multicenter sudy was carried out for comparing over-the-scope clips (OTSC) treatment vs. transcatheter arterial embolization (TAE) in peptic ulcer bleeding. 

Method

The analysis incorporated 128 people managed with OTSC (n = 66) or TAE (n = 62) for refractory peptic ulcer bleeding of the upper gastrointestinal tract. The clinical success (hemostasis + no rebleeding within seven days) was the major outcome parameter while adverse events, length of intensive care unit (ICU) stay, and mortality were the secondary outcome parameters. For adjustment of the differences in the baseline characteristics, propensity score matching was executed.

Result

Both the groups exhibited similar patient characteristics. However, ulcers in TAE-treated participants were much larger, and most commonly located in the duodenal bulb, and the percentage of Forrest Ia bleedings was more in TAE group. Clinical success was similar in both TAE and OTSC groups. The TAE group displayed longer ICU stay, higher serious adverse events after re-therapy and in-hospital death when compared to OTSC group (Table 1).


Following propensity score matching, the differences noted regarding ICU stay (4.9± 5.9 and 9.2 ± 11.2) and in-hospital death (5% vs. 22.5%) remained significant.

Conclusion

Endoscopic hemostasis with OTSC exhibits comparable technical and clinical success, but is linked with shorter ICU stay and minimized in‐hospital mortality in comparison with TAE for refractory peptic ulcer bleeding.

Source:

United European Gastroenterology Journal

Article:

Over-the-scope clip versus transcatheter arterial embolization for refractory peptic ulcer bleeding-A propensity score matched analysis

Authors:

Armin Kuellmer et al.

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