Determinants of clinical outcome after transarterial embolization for nonvariceal gastrointestinal bleeding: a retrospective cohort study

Background Transarterial embolization (TAE) is an established treatment for non-variceal gastrointestinal bleeding (GIB), yet standardized protocols and patient selection criteria remain limited. This study aimed to identify predictors of clinical success and 30-day mortality. Methods We retrospectively analyzed catheter angiography procedures for GIB at Semmelweis University (May 2022–November 2024). TAE was performed in 67/73 (91.8%) cases, including six repeat embolizations. Clinical and procedural data, including CTA, endoscopic, and surgical findings, were reviewed. Factors assessed included age, sex, Charlson Comorbidity Index (CCI), antithrombotic use, PRBC transfusions, vasopressor therapy, and embolization characteristics. Results Clinical success (no rebleeding within 30 days) was 82.0%. The 30-day all-cause mortality rate was 23.0%, with disease-specific mortality at 13.1%. Complications occurred in 4.5% of cases. Patients receiving vasopressors had significantly higher rebleeding (92.3% vs. 63.6%, p = 0.012) and mortality (87.2% vs. 59.1%, p = 0.024). Those who died within 30 days received more transfusions (13.14 ± 10.14 vs. 5.96 ± 6.36; p < 0.01). Multivariate analysis identified vasopressor use and antithrombotic therapy as independent predictors of clinical failure, while vasopressor use and elevated CCI were linked to increased mortality. Conclusions Our study further supports TAE as an effective treatment for GIB with a low complication rate. Vasopressor use was the strongest predictor of clinical failure and 30-day mortality, highlighting the need for further research in hemodynamically unstable patients.