The Use of Endoscopic Ultrasound-Guided Vascular Embolization for Acute Duodenal Tumor-Related Bleeding: A Pilot Study (With Video).
Acute gastrointestinal bleeding caused by duodenal tumors remains a clinical challenge. Conventional endoscopic hemostasis has limited efficacy in preventing rebleeding, and surgical resection presents significant risks and is often not feasible. Endoscopic ultrasound-guided embolization (EUS-VE) with cyanoacrylate is widely performed for variceal bleeding, but its application to tumor-related bleeding is uncommon. In this study, we used EUS-VE for acute duodenal tumor-related bleeding. A total of 13 EUS-VE procedures were performed in 12 patients from August 2024 to December 2025. The technical success rate was 100%, and the clinical success rate within 30 days was 84.6% (11/13). Among the 12 patients, the 90-day rebleeding and mortality events occurred in 1 (8.33%) and 3 (25%) patients, respectively. Three patients (25%) developed fever after EUS-VE, including one case suspected to be procedure-related. This pilot study suggests that EUS-VE may be a feasible alternative for duodenal tumor-related bleeding. Its efficacy and safety require further validation with larger sample sizes.