Comparison of Prophylactic Transcatheter Arterial Embolization and Standard Therapy in High-Risk Non-Variceal Upper Gastrointestinal Bleeding: A Meta-Analysis
Bibliographic record
Abstract
Background: Rebleeding is a major challenge and a serious complication of non-variceal upper gastrointestinal bleeding (NVUGIB). Prophylactic transcatheter arterial embolization (P-TAE) has emerged as a potential management strategy for high-risk cases. This study aimed to evaluate the efficacy and safety of P-TAE compared with no embolization (NE) in the absence of angiographic evidence of bleeding or therapeutic arterial embolization (TAE). Methods: The study systematically searched Medline and Embase databases from inception until November 15, 2024. The primary outcome was the overall rebleeding rate, while secondary outcomes included mortality, need for additional interventions, transfusion requirements, hospital/intensive care unit (ICU) stay, and procedure-related adverse events. Results: The meta-analysis included 10 studies with a total population of 1,253 patients. Compared to NE, the pooled data indicated that P-TAE was not associated with significantly reduced rates of rebleeding (odds ratio (OR): 0.69, 95% confidence interval (CI): 0.39 - 1.22, P = 0.20) or all-cause mortality (OR: 0.70, 95% CI: 0.40 - 1.23). Although P-TAE trended towards lower rates of repeat interventions, blood transfusions, and shorter hospital stays, these differences were not statistically significant. Conversely, P-TAE and TAE had similar rates of rebleeding (OR: 1.08, 95% CI: 0.70 - 1.68, P = 0.05) and all-cause mortality (OR: 0.72, 95% CI: 0.34 - 1.51, P = 0.39). The analysis found no significant differences in adverse events or the need for repeat procedures between the two embolization approaches. Conclusion: This review suggests that P-TAE may not significantly reduce rebleeding or mortality compared with standard therapy for high-risk NVUGIB. However, the current findings remain inconclusive, and further comprehensive research with larger sample sizes is required to conclusively substantiate these observations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.016 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.047 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".