ReviewFrontiers in radiology2026
Prophylactic transarterial embolization after endoscopic hemostasis in patients with non-variceal upper gastrointestinal bleeding - is it time to act?
Review in Frontiers in radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Non-variceal upper gastrointestinal bleeding (NVUGIB) continues to present a significant clinical burden due to rebleeding after apparently successful endoscopic hemostasis, particularly in ulcers overlying large-caliber arterial territories. Prophylactic transarterial embolization (pTAE) has been proposed as a strategy to prevent rebleeding in high-risk patients. This mini-review evaluates the evidence for pTAE after successful endoscopic control in NVUGIB, focusing on patient selection, technical approaches, outcomes, and complications. Methods: A literature search of PubMed and Scopus (January 2010-September 2025) was conducted, yielding 10 studies (two randomized trials, three prospective, and five retrospective) evaluating pTAE. Only studies addressing prophylactic, not empiric, embolization were included. Results: Evidence suggests that pTAE is technically feasible and generally safe when guided by ulcer location, size (≥15-20 mm), Rockall score (≥5), and arterial territory (GDA or LGA). While randomized trials did not show overall superiority in intention-to-treat analyses, per-protocol data and observational studies suggest reduced rebleeding and a lower need for surgical rescue in well-selected patients. Complications are infrequent when standardized techniques and early timing (≤24 h) are applied. Conclusion: Routine pTAE is not supported by current guidelines or RCT-level evidence. However, in anatomically and clinically high-risk ulcers, pTAE may offer meaningful benefits. Further multicenter randomized trials with uniform protocols are warranted to clarify its role and optimize patient selection.
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