{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T23:48:03Z","timestamp":1780616883358,"version":"3.54.1"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T00:00:00Z","timestamp":1721433600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T00:00:00Z","timestamp":1721433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["CVIR Endovasc"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Ulcer erosion into the cystic artery is a rare cause of bleeding in duodenal ulcers, with only a limited number of cases described in the literature. Historically, treatment has predominantly involved surgical intervention.\u00a0We present three cases of duodenal ulcer bleeding due to cystic artery erosion, which were successfully managed with cystic artery embolization.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>This case series includes three male patients with duodenal ulcer bleeding, aged 90, 81, and 82\u00a0years, respectively, and no prior history of biliary system disorders. The ulcer locations were identified as two in the post-bulbar region and one in the anterior bulb. After the failure of medical and endoscopic treatment, transcatheter arterial embolization was adopted. Initial angiography did not reveal any contrast medium extravasation. Empirical embolization of the gastroduodenal artery using gelatin sponge particles and coils failed to achieve hemostasis. Super-selective cystic artery angiography confirmed the source of bleeding as the cystic artery. One patient was embolized with gelatin sponge particles and coils, while the other two patients were embolized with N-butyl-cyanoacrylate. All patients achieved successful hemostasis without gallbladder infraction.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Cystic artery embolization proved to be a minimally invasive technique for achieving hemostasis in these cases, indicating that it may be a safe and effective alternative to surgery for this uncommon cause of upper gastrointestinal bleeding. Validation through further studies is warranted.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s42155-024-00470-6","type":"journal-article","created":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T03:26:57Z","timestamp":1721446017000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Transcatheter embolization for duodenal ulcer bleeding originating from cystic artery erosion"],"prefix":"10.1186","volume":"7","author":[{"given":"Peng","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangwen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingpeng","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rengui","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7829-8482","authenticated-orcid":false,"given":"Yaochang","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,20]]},"reference":[{"key":"470_CR1","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1177\/000331977202300907","volume":"23","author":"SM Ring","year":"1972","unstructured":"Ring SM, Beranbaum ER, Madayag MA, et al. Peptic erosion of the cystic artery. An unusual etiology of spontaneous gastro-intestinal hemorrhage. Angiology. 1972;23:554\u20137.","journal-title":"Angiology."},{"key":"470_CR2","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1148\/radiology.136.3.7403539","volume":"136","author":"HB Glazer","year":"1980","unstructured":"Glazer HB, Stanley RJ, Koehler RE. Cystic artery hemorrhage: a complication of penetrating duodenal ulcer. Radiology. 1980;136:623\u20135.","journal-title":"Radiology."},{"key":"470_CR3","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1007\/BF02577035","volume":"11","author":"SG Cooper","year":"1988","unstructured":"Cooper SG, Morse SS, Strauss EB. Peptic erosion of the cystic artery with massive duodenal hemorrhage: therapeutic embolization. Cardiovasc Intervent Radiol. 1988;11:278\u201380.","journal-title":"Cardiovasc Intervent Radiol"},{"key":"470_CR4","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1136\/pgmj.66.772.144","volume":"66","author":"GA Ford","year":"1990","unstructured":"Ford GA, Simpson AH, Gear MW, et al. Duodenal ulceration into the cystic artery. Postgrad Med J. 1990;66:144\u20136.","journal-title":"Postgrad Med J."},{"key":"470_CR5","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1097\/00004836-199903000-00019","volume":"28","author":"T Iwamura","year":"1999","unstructured":"Iwamura T, Uchino R, Oshikata S, et al. Duodenal ulceration into the cystic artery with massive hemorrhage. J Clin Gastroenterol. 1999;28:171\u20134.","journal-title":"J Clin Gastroenterol."},{"key":"470_CR6","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1136\/pgmj.71.832.125-a","volume":"71","author":"MA Memon","year":"1995","unstructured":"Memon MA, Hussan K, Shennan JM. Post-bulbar chronic duodenal ulcer with major upper gastrointestinal bleeding from the cystic artery. Postgrad Med J. 1995;71:125\u20136.","journal-title":"Postgrad Med J."},{"key":"470_CR7","first-page":"337","volume":"99","author":"F Calot\u0103","year":"2004","unstructured":"Calot\u0103 F, M\u0103nescu P, Me\u015fin\u0103 C, et al. Upper digestive tract bleeding from ulcer with unusual etiology. Chirurgia (Bucur). 2004;99:337\u201340.","journal-title":"Chirurgia (Bucur)"},{"key":"470_CR8","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1177\/000313480407001114","volume":"70","author":"C Britt Rebecca","year":"2004","unstructured":"Britt Rebecca C, Collins Jay N, Cole Frederic J, et al. Duodenal ulceration into the cystic artery with resultant massive hemorrhage. Am Surg. 2004;70:999\u20131001.","journal-title":"Am Surg"},{"key":"470_CR9","doi-asserted-by":"publisher","first-page":"1160149","DOI":"10.3389\/fsurg.2023.1160149","volume":"10","author":"HC Kim","year":"2023","unstructured":"Kim HC, Jeong YS, Han K, et al. Transcatheter arterial embolization of cystic artery bleeding. Front Surg. 2023;10:1160149.","journal-title":"Front Surg."},{"key":"470_CR10","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1055\/a-1369-5274","volume":"53","author":"IM Gralnek","year":"2021","unstructured":"Gralnek IM, Stanley AJ, Morris AJ, et al. Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2021. 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