“Upper gastrointestinal bleeding is a common emergency in people. With a hospitalization rate of 67 per 100,000 in the USA and an in-hospital mortality of 1.9 per 100 cases, it is a severe condition. The most common cause of upper gastrointestinal bleeding is a peptic ulcer in the stomach or duodenum. The aetiology of peptic ulcers is complex, but known risk factors for complications of peptic ulcers are Helicobacter pylori infection, and the use of non-steroidal anti-inflammatory drugs (NSAIDs). The definition of a peptic ulcer is a loss of tissue from the mucosa. The bleeding is often from the arteries in the submucosa or tunica muscularis, but there can be erosions of larger arteries, such as the gastroduodenal, right gastric, or left gastric arteries.”

Types of outcome measures

We will consider the following outcomes.

Primary outcomes

Re-bleeding as defined by authors of the included studies, within
30 days, or at the time point closest to 30 days after randomization.

Secondary outcomes

• Need for re-intervention within 30 days, defined as the need for
  endoscopic, embolization, or surgical re-intervention to obtain
  haemostasis.
  ◦ Need for re-intervention will be calculated as the total
  number of re-interventions in the two groups. This means
  that a participant that has received both endoscopic and
  surgical re-intervention will count twice. This will be done
  in order to estimate the total number of re-interventions
  that can be expected depending on whether TAE is used or
  not. Furthermore, the need for re-intervention will also be
  counted as the number of patients needing re-interventions
  in the two groups.
• Death within 30 days. If possible, we will analyse all-cause
  mortality and bleeding-related mortality separately.
• Complications within 30 days. If possible, this outcome
  will be graded according to the Clavien-Dindo classification
• Duration of hospitalization, calculated as the total length of stay
  at index admission plus any re-admissions within 30 days of
  discharge from index admission.
• Success rate of the embolization. Both technical success
  (successful cessation of haemorrhage evaluated by angiography
  at the conclusion of the procedure) and clinical failure (no re-
  bleeding within 30 days after embolization)

Roost I, et al Prophylactic arterial embolization in patients with bleeding peptic ulcers following endoscopic control of bleeding. Cochrane Database Syst Rev. 2022 Jun 13;2022(6):CD014999. Free Full Text