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| 1 | Recent advances in endovascular techniques for management of acute nonvariceal upper gastrointestinal bleeding显示文摘Over the past two decades,transcatheter arterial embolization has become the first-line therapy for the management of upper gastrointestinal bleeding that is refractory to endoscopic hemostasis.Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options,have expanded the role of interventional radiology in the management of hemorrhage for a variety of indications,such as peptic ulcerbleeding,malignant disease,hemorrhagic Dieulafoy lesions and iatrogenic or trauma bleeding.Transcatheter interventions include the following:selective embolization of the feeding artery,sandwich coil occlusion of the gastroduodenal artery,blind or empiric embolization of the supposed bleeding vessel based on endoscopic findings and coil pseudoaneurysm or aneurysm embolization by three-dimensional sac packing with preservation of the parent artery.Transcatheter embolization is a fast,safe and effective,minimally invasive alternative to surgery when endoscopic treatment fails to control bleeding from the upper gastrointestinal tract.This article reviews the various transcatheter endovascular techniques and devices that are used in a variety of clinical scenarios for the management of hemorrhagic gastrointestinal emergencies. | Romaric F Loffroy Basem A Abualsaud Ming D Lin Pramod P Rao | 2011 | World Journal of Gastrointestinal Surgery2011，3，7： | 28 |
| 2 | Role of transcatheter arterial embolization for massive bleeding from gastroduodenal ulcers显示文摘Intractable bleeding from gastric and duodenal ulcers is associated with significant morbidity and mortality. Aggressive treatment with early endoscopic hemostasis is essential for a favourable outcome. In as many as 12%-17% of patients,endoscopy is either not available or unsuccessful. Endovascular therapy with selective catheterization of the culprit vessel and injection of embolic material has emerged as an alternative to emergent operative intervention in high-risk patients. There has not been a systematic literature review to assess the role for embolotherapy in the treatment of acute upper gastrointestinal bleeding from gastroduo-denal ulcers after failed endoscopic hemostasis. Here,we present an overview of indications,techniques,and clinical outcomes after endovascular embolization of acute peptic-ulcer bleeding. Topics of particular relevance to technical and clinical success are also discussed. Our review shows that transcatheter arterial embolization is a safe alternative to surgery for massive gastroduodenal bleeding that is refractory to endoscopic treatment,can be performed with high technical and clinical success rates,and should be considered the salvage treatment of choice in patients at high surgical risk. | Romaric Loffroy Boris Guiu | 2009 | World Journal of Gastroenterology2009，15，47： | 27 |
| 3 | Transjugular intrahepatic portosystemic shunt for the management of acute variceal hemorrhage显示文摘Acute variceal hemorrhage,a life-threatening condition that requires a multidisciplinary approach for effective therapy,is defined as visible bleeding from an esophageal or gastric varix at the time of endoscopy,the presence of large esophageal varices with recent stigmata of bleeding,or fresh blood visible in the stomach with no other source of bleeding identified.Transfusion of blood products,pharmacological treatments and early endoscopic therapy are often effective;however,if primary hemostasis cannot be obtained or if uncontrollable early rebleeding occurs,transjugular intrahepatic portosystemic shunt(TIPS)is recommended as rescue treatment.The TIPS represents a major advance in the treatment of complications of portal hypertension.Acute variceal hemorrhage that is poorly controlled with endoscopic therapy is generally well controlled with TIPS,which has a 90%to 100%success rate.However,TIPS is associated with a mortality of 30%to 50%in such a setting.Emergency TIPS should be considered early in patients with refractory variceal bleeding once medical treatment and endoscopic sclerotherapy failure,before the clinical condition worsens.Furthermore,admission to specialized centers is mandatory in such a setting and regional protocols are essential to be organized effectively.This review article discusses initial management and then focuses on the specific role of TIPS as a primary therapy to control acute variceal hemorrhage,particularly as a rescue therapy following failure of endoscopic approaches. | Romaric Loffroy Louis Estivalet Violaine Cherblanc Sylvain Favelier Pierre Pottecher Samia Hamza Anne Minello Patrick Hillon Pierre Thouant Pierre-Henri Lefevre Denis Krausé Jean-Pierre Cercueil | 2013 | World Journal of Gastroenterology2013，19，37： | 25 |
| 4 | Endovascular management of visceral artery aneurysms: When to watch, when to intervene?显示文摘Visceral artery aneurysms(VAA) include splanchnic and renal artery aneurysms. They represent a rare clinical entity, although their detection is rising due to an increased use of cross-sectional imaging. Rupture is the most devastating complication, and is associated with a high morbidity and mortality. In addition, increased percutaneous endovascular interventions have raised the incidence of iatrogenic visceral artery pseudoaneurysms(VAPAs). For this reason, elective repair is preferable in the appropriately chosen patient. Controversy still exists regarding their treatment. Over the past decade, there has been steady increase in the utilization of minimally invasive, non-operative interventions, for vascular aneurysmal disease. All VAAs and VAPAs can technically be fixed by endovascular techniques but that does not mean they should. These catheter-based techniques constitute an excellent approach in the elective setting. However, in the emergent setting it may carry a higher morbidity and mortality. The decision for intervention has to take into account the size and the natural history of the lesion, the risk of rupture, which is high during pregnancy, and the relative risk of surgical or radiological intervention. For splanchnic artery aneurysms, we should recognize that we are not, in reality, well informed about their natural history. For most asymptomatic aneurysms, expectant treatment is acceptable. For large, symptomatic or aneurysms with a high risk of rupture, endovascular treatment has become the firstline therapy. Treatment of VAPAs is always mandatory because of the high risk of rupture. We present our point of view on interventional radiology in the splanchnic arteries, focusing on what has been achieved and the remaining challenges. | Romaric Loffroy Sylvain Favelier Pierre Pottecher Pierre-Yves Genson Louis Estivalet Sophie Gehin Jean-Pierre Cercueil Denis Krausé | 2015 | World Journal of Radiology2015，7，7： | 11 |
| 5 | Management of duodenal ulcer bleeding resistant to endoscopy:Surgery is dead!显示文摘Acute massive duodenal bleeding is one of the most frequent complications of peptic ulcer disease.Endoscopy is the first-line method for diagnosing and treating actively bleeding peptic ulcers because its success rate is high.Of the small group of patients whose bleeding fails to respond to endoscopic therapy,increasingly the majority is referred for embolotherapy.Indeed,advances in catheter-based techniques and newer embolic agents,as well as recognition of the effectiveness of minimally invasive treatment options,have expanded the role of interventional radiology in the management of hemorrhage from peptic ulcers over the past decade.Embolization may be effective for even the most gravely ill patients for whom surgery is not a viable option,even when extravasation is not visualized by angiography.However,it seems that careful selection of the embolic agents according to the bleeding vessel may play a role in a successful outcome.The role of the surgeon in this clinical sphere is dramatically diminishing and will certainly continue to diminish in ensuing years,surgery being typically reserved for patients whose bleeding failed to respond all previous treatments.Such a setting has become extremely rare. | Romaric Loffroy | 2013 | World Journal of Gastroenterology2013，19，7： | 5 |
| 6 | Transcatheter Arterial Embolization of Splenic Artery Aneurysms and Pseudoaneurysms: Short- and Long-Term Results显示文摘 | Romaric Loffroy Boris Guiu Jean-Pierre Cercueil C?me Lepage Nicolas Cheynel Eric Steinmetz Frédéric Ricolfi Denis Krausé | 2008 | Annals of Vascular Surgery2008，，5： | 2 |
| 7 | Novel imaging biomarkers of response to transcatheter arterial chemoembolization in hepatocellular carcinoma patients显示文摘Hepatocellular carcinoma(HCC)is the third most common cause of cancer death worldwide(1).Most patients present with intermediate or advanced disease that is not amenable to curative treatment,and the median survival in this group is 6-8 months(2).Several studies and welldesigned randomized trials have shown a positive | Sylvain Favelier Louis Estivalet Pierre Pottecher Romaric Loffroy | 2015 | Chinese Journal of Cancer Research2015，27，6： | 2 |
| 8 | Role of percutaneous ar- terial embolization in renal pathology 显示文摘 | Loffroy R Abualsaud B Delgal A | 2010 | Prog Urol2010，20，3： | 1 |
| 9 | Interventional radiology for hepatocellular car- cinoma显示文摘 | Loffroy R | 2011 | Minerva Gastroenterol Dietol2011，57，3： | 1 |
| 10 | Embolization of acute nonvariceal upper gastrointestinal hemorrhage resistant to endoscopic treatment: results and predictors of recurrent bleeding 显示文摘 | Loffroy R Rao P Ota S | 2010 | Cardiovasc Intervent Radiol2010，33，6： | 1 |
| 11 | Arterial embolotherapy for endoscopically unmanageable acute gastroduodenal hemo- rrhage : predictors of early rebleeding 显示文摘 | Loffroy R Guiu B Dathis P | 2009 | Clin Gastroenterol Hepatol2009，7，5： | 1 |
| 12 | Transcatheter arterial em- bolization of splenic artery aneurysms and psedoaneurysms: short-and long-term results显示文摘 | Loffroy R Guiu B Cereueil J P etal | 2008 | Ann Vasc Surg2008，22，： | 1 |
| 13 | Embolization of acute nonvariccal upper gastrointestinal hemorrhage resistant to endoscopic treatment:results and predictors of recurrent bleeding显示文摘 | Loffroy R Rao P Ota S | 2010 | Cardiovasc Intervent Radiol2010，33，： | 1 |
| 14 | Embolization of Acute Nonvariceal Upper Gastrointestinal Hemorrhage Resistant to Endoscopic Treatment: Results and Predictors of Recurrent Bleeding显示文摘 | Romaric Loffroy Pramod Rao Shinichi Ota Ming Lin Byung-Kook Kwak Jean-Fran?ois Geschwind | 2010 | CardioVascular and Interventional Radiology2010，，6： | 1 |
| 15 | Management of post-biopsy renal allografl arteriovenous fistulas with selective arterial embolizalion:immediate and long-term outcomes显示文摘 | Loffroy R Guiu B Lambert A etal | 2008 | Clin Radiol2008，63，6： | 1 |
| 16 | Increased levels of endothelial mieroparticles CD144 (VE-Cadherin) positives in type 2 diabetic patients with coronary nonealcified plaques evaluated by multideteetor computed tomography (MDCT) 显示文摘 | Bernard S Loffroy R S6xusclat A | 2009 | Atherosclerosis2009，203，2： | 1 |
| 17 | Endovascular management of a posttraumatic pseudoaneurysm of the common carotid artery with superselective coil embolization 显示文摘 | Loffroy R Gergele F Rao P et at | 2011 | J Vasc Surg2011，53，4： | 1 |
| 18 | Role of transcatheter arterial embolization for massive bleeding from gastroduodenal ulcers 显示文摘 | Romaric Loffroy Boris Guiu | 2012 | World Journal of Gastroenterology2012，7，3： | 1 |
| 19 | Interventional radiology for hepatocellular carcinoma显示文摘 | Loffroy R | 2011 | Minerva Gastroenterol Dietol2011，57，3： | 1 |
| 20 | Arterial embolotherapy for endoscopically unmanageable acute gastroduodenal hemorrhage: predictors of early rebleeding 显示文摘 | Loffroy R Guiu B D'athis P | 2009 | Clin Gastroenterol Hepatol2009，7，： | 1 |
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