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TAE and Surgery in Patients With Peptic Ulcer Bleeding Uncontrolled by Endoscopic Therapy

The Chinese University of Hong Kong logo

The Chinese University of Hong Kong

Status

Terminated

Conditions

Peptic Ulcer
Bleeding

Treatments

Procedure: Trans-catheter arterial embolization
Procedure: Surgery

Study type

Interventional

Funder types

Other

Identifiers

Details and patient eligibility

About

The aim of the study is to compare the outcomes of trans-catheter arterial embolization (TAE) and surgery as salvage therapy of peptic ulcer bleeding after failed endoscopic therapy.

Full description

The aim of the study is to examine the hypothesis that trans-catheter arterial embolization (TAE) is safer than and probably as effective as surgery in the control of bleeding from ulcers after failed endoscopic therapy. Patients with major arterial bleeding that cannot be stopped by endoscopic therapy will be randomly assigned to receive immediate TAE or surgery. Primary outcome will be death within 30 days of randomization. Secondary outcomes include recurrent bleeding after assigned treatment, need for additional intervention either in the form of interventional radiology or surgery, and post procedural morbidities.

Enrollment

34 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Patients with bleeding peptic ulcers documented during endoscopic therapy AND anyone of the following:
  • Forrest I bleeding that fails to be controlled by therapy during first endoscopy
  • Check endoscopy after clinical re-bleeding of Forrest I bleeding
  • Forrest IIa or an initial IIb but a sizable artery unveiled upon clot elevation in a high risk ulcer defined by:
  • posterior bulbar duodenal ulcer > 2cm, or
  • an angular notch / lesser curve gastric ulcer > 5cm that fail an attempt at endoscopic therapy together with evidence of a significant bleed (hypotension with SBP < 90mmHg, fresh hematemesis or hematochezia).

Exclusion criteria

  • Refusal to participate in trial
  • No consent
  • Age < 18
  • Pregnancy
  • Moribund patients
  • Patients with terminal malignancy

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

34 participants in 2 patient groups

TAE group
Active Comparator group
Description:
Trans-catheter arterial embolization
Treatment:
Procedure: Trans-catheter arterial embolization
Surgery group
Active Comparator group
Description:
Surgery
Treatment:
Procedure: Surgery

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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