Upper gastrointestinal bleeding with embolization
Bleeding post D1 ulcer. Two attempts at clipping. Ongoing melena, decreasing Hb and increasing norad.
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The GDA was selected with 5Fr Cobra. The bleeding point was identified inferior to the endoluminal clips. A Progreat catheter was used to selectively explore GDA branches and isolate the appropriate feeders. A large extravasation was evident inferior to the clips. Occlusion with 0.18 fibred coils. Post procedural angiography demonstrated no residual extravasation.