This thesis is dedicated to problem of usage of endovascular interventions in diagnosis, treatment and prophylactic of varicose and nonvaricose bleedings. Main prospective group was formed by 117 patients with acute gastroduodenal bleedings.Nonvaricose upper gastrointestinal haemorrhage group was formed by 35 patients. Patients were divided in 2 subgroups: ulcerative and oncologic bleedings (19 patients) and pancreatic pseudocysts bleedings (16 patients). In 14 (73,6%) patients was effective single embolisation of left gastric artery. Recurrent bleeding was in 4 (21%) patients. Early delayed conventional operation was performed in 2 (10,5%) patients and urgent in 1(5,3%). Plane operation was performed in 4 (21%) patients. 5 (26,3%) patients died in this group, 1 (5,3%) of them – from the recurrent bleeding. Pancreatic pseudocyst bleeding was the cause of gastro-intestinal bleeding in 16 patients. In all cases we performed succesfull embolisation. In 3 patients we had to repeat embolisation. We did not perform conventional operation in any patients due to rebleeding. Prospective group of portal hypertension was formed by 82 patients.Gastro-esophageal bleedings in the past had place in 74 (92,2%) patients, 65 (79,3%) had more than one episode.Conservative treatment was performed due to Baveno consensuses. Endoscopic lagation was used in 69 (84,1%) of patients, and in majority of cases had place 2 sessions (35 persons – 50,7%). In the ame of prophylactic of varicose bleeding as a second stage we performed embolisation of splenic artery. In the period of 10-30 postembolisation days the were recurrence of bleeding in 2 (2,7%) patients with C stage of liver cirrhosis due to Child-Pugh classification. After splenic artery embolisation we noted decrease of portal vein diameter from 15,0 to 13,5mm (p<0,001) and splenic vein diameter from 12,0 to 9,3mm (p<0,001). Next marker was ascites. After splenic artery embolisation the number of patients without ascites increased from 51,2% to 69,5% (p<0,001) and decreased number of patients with 2 stage ascites from 20,7% to 12,2% (p<0,001) and with 3 stage from 19,5% to 9,8% (p<0,001). During 1 month post embolisation most significantly increased (+202%) the number of throbocytes (p<0,001), as well as number of leucocytes and haemoglobin level (p<0,001). This means the reduction of hypersplenic syndrome. The median of cumulative nonexidental survive by Kaplan-Meier was 53,9 months. Received data allowed us to create and introduce in clinical practice algorithms of complex treatment of patients with varicose and nonvaricose upper gastro-intestinal bleedings, which includes endovascular procedures.
