Comparative efficacy of gelatin sponge, microcoils, and nbca in arterial gastrointestinal bleeding: a retrospective study.

Background: Arterial gastrointestinal bleeding poses a serious threat to life that requires timely and effective intervention. This study evaluated the effectiveness of three different embolization strategies: the use of gelatin sponge alone, in combination with microcoils, and in combination with n-butyl cyanoacrylate (NBCA).

Methods: This retrospective study included 68 patients with acute arterial gastrointestinal bleeding (Forrest F1), categorized into three embolization groups: gelatin sponge alone (n = 23), gelatin sponge + microcoils (*n* = 23), and gelatin sponge + NBCA (n = 22). Clinical success was defined as complete hemostasis without rebleeding within 30 days. Multivariate analysis adjusted for age, NSAID use, and bleeding site.

Results: The gelatin sponge + NBCA group achieved 100% clinical success, significantly higher than gelatin sponge + microcoils (91.30%) and gelatin sponge alone (65.22%) (P < 0.001). Rebleeding rates were lowest with NBCA (0% vs. 34.78% for gelatin sponge alone; P < 0.001), and complication rates favored NBCA (13.6% vs. 47.8%; P = 0.013). Multivariate analysis confirmed the superiority of combination strategies, with gelatin sponge + NBCA showing the highest odds of success (adjusted OR = 24.12, 95% CI: 2.98-195.21, P = 0.003). Subgroup analyses revealed no significant interaction between embolic strategy and bleeding site (P > 0.05), though upper GI cases trended toward higher success rates (92.3-100%) compared to lower GI (80-100%).

Conclusion: The study underscores the superiority of combination embolic strategies over the application of gelatin sponge alone for managing arterial gastrointestinal bleeding. The addition of microcoils and NBCA to gelatin sponge enhances both the efficacy and durability of embolic interventions, suggesting their preferential use in clinical practice to optimize patient outcomes.