To conduct a meta-analysis to assess the safety and efficacy of prophylactic transcatheter arterial embolization (PTAE) for the treatment of high-risk bleeding peptic ulcers after achieving endoscopic hemostasis. PubMed and Cochrane Library were queried for full-text articles published up to December 2019. The following keywords were used: “prophylactic embolization”, “supplement embolization”, “gastrointestinal bleeding”, and “ulcer bleeding”. High-risk ulcers were defined based on endoscopic findings (i.e., large ulcers, Forrest class I-IIb) and/or clinical presentation (i.e., hypotension, decreased hemoglobin during endoscopy). Only comparative studies investigating PTAE versus conservative treatment after achieving endoscopic hemostasis were included. Baseline study characteristics, rebleeding rate, need for surgery, mortality, and PTAE-related complication rates were investigated. Quantitative analyses were performed with Stata 15.1. Among the five included original studies, a total of 265 patients received PTAE and 617 were managed conservatively after endoscopy. The rebleeding rate (6.8% vs 14.3%, p = 0.003) and mortality (4.5% vs 8.8%, p = 0.032) of patients from the PTAE group were lower than the control group. PTAE also reduced the cumulative need for future surgical intervention (3.0% vs 14.4%, p = 0.005). The PTAE-related major and minor events were 0.75% and 14.4%, respectively. PTAE had therapeutic potentials in reducing rebleeding risk, need for surgical intervention, and morality in high-risk peptic ulcers after achieving endoscopic hemostasis. The embolization-associated adverse events were minimal. Future studies should aim to increase the sample size and resources for performing endovascular interventions.

中文翻译：

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内镜止血后高危溃疡的预防性经导管动脉栓塞：荟萃分析

进行一项荟萃分析，以评估预防性经导管动脉栓塞术 (PTAE) 治疗内镜止血后高危出血性消化性溃疡的安全性和有效性。查询 PubMed 和 Cochrane 图书馆至 2019 年 12 月发表的全文文章。使用了以下关键词：“预防性栓塞”、“补充栓塞”、“胃肠道出血”和“溃疡出血”。高危溃疡是根据内窥镜检查结果（即大溃疡，Forrest I-IIb 级）和/或临床表现（即内窥镜检查期间低血压、血红蛋白降低）定义的。仅纳入了调查内镜止血后 PTAE 与保守治疗的比较研究。基线研究特征、再出血率、手术需求、死亡率、PTAE 相关并发症发生率进行了调查。使用 Stata 15.1 进行定量分析。在纳入的五项原始研究中，共有 265 名患者接受了 PTAE，617 名患者在内窥镜检查后接受了保守治疗。PTAE 组患者的再出血率 (6.8% vs 14.3%, p = 0.003) 和死亡率 (4.5% vs 8.8%, p = 0.032) 低于对照组。PTAE 还减少了对未来手术干预的累积需求（3.0% 对 14.4%，p = 0.005）。PTAE 相关的主要和次要事件分别为 0.75% 和 14.4%。PTAE 在降低再出血风险、手术干预的需要和实现内镜止血后高危消化性溃疡的道德方面具有治疗潜力。栓塞相关的不良事件极少。