Prophylactic angiographic embolisation in high-risk peptic ulcer bleeding after achieved endoscopic control: maximising outcomes

We read with great interest the article by Lau et al recently published in Gut and evaluating the role of prophylactic angiographic arterial embolisation performed after achieved endoscopic haemostasis in the management of patients with high-risk ulcer bleeding.1 We have several comments. First of all, we would like to congratulate the authors for their study which represents the largest multicentre randomised controlled trial to date reporting results of additional embolisation in selected high-risk patients with peptic ulcer bleeding. The authors' hypothesis was that added angiographic embolisation performed within 12 hours from successful endoscopic therapy may reduce the rate of rebleeding in patients with bleeding from high-risk peptic ulcers. Unfortunately, the authors failed to demonstrate any statistically significant impact of added embolisation on outcomes of these patients, as a consequence of lack of power. Indeed, of 118 patients randomised to receive added angiographic embolisation, 22 (18.6%) did not undergo allocated...

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