Gastric bleeding: therapy with intraarterial vasopressin and transcatheter embolization.

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Abstract
Angiographic therapy to control gastric bleeding was attempted in 200 patients. Patients (194) were treated with intraarterial vasopressin [VP], and 17 of them were also treated with transcatheter embolization. Six patients underwent primary embolization, and an additional 6 received i.v. VP. The initial rate of bleeding control in all angiographically treated patients was 73%. When embolization was used in some of the patients who did not respond to VP, the overall control rate increased to 79%. Recurrent bleeding occurred in 18%. When angiographic therapy was attempted again in the patients with recurrent hemorrhage, the bleeding was stopped in 36%. Major complications occurred in 6.5%, and minor ones in 17.5%. Of the patients with bleeding that was angiographically controlled, 73% survived and 27% died of associated clinical conditions. Among the failures of angiographic therapy, 48% died during the same hospital admission. Intraarterial infusions of VP or transcatheter embolization evidently are useful for the control of gastric bleeding.

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