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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">surgonco</journal-id><journal-title-group><journal-title xml:lang="ru">Креативная хирургия и онкология</journal-title><trans-title-group xml:lang="en"><trans-title>Creative surgery and oncology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2076-3093</issn><issn pub-type="epub">2307-0501</issn><publisher><publisher-name>Башкирский государственный медицинский университет</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.24060/2076-3093-2026-16-1-52-61</article-id><article-id custom-type="elpub" pub-id-type="custom">surgonco-1179</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОР ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Эндоваскулярный гемостаз в лечении артериальных кровотечений из верхних отделов желудочно‑кишечного тракта: обзор литературы</article-title><trans-title-group xml:lang="en"><trans-title>Endovascular Hemostasis in the Management of Arterial Upper Gastrointestinal Bleeding: Literature Review</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6427-4295</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Щеголев</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shchegolev</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Щеголев Александр Андреевич — д.м.н., профессор, кафедра госпитальной хирургии Института хирургии.</p><p>Москва</p></bio><bio xml:lang="en"><p>Aleksandr A. Shchegolev — Dr. Sci. (Med.), Prof., Department of Hospital Surgery, Institute of Surgery.</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7500-4987</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Громов</surname><given-names>Д. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Gromov</surname><given-names>D. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Громов Дмитрий Геннадьевич — д.м.н., кафедра рентген-эндоваскулярных методов диагностики и лечения, отделение по рентген-эндоваскулярным диагностике и лечению регионального сосудистого центра.</p><p>Москва</p></bio><bio xml:lang="en"><p>Dmitry G. Gromov — Dr. Sci. (Med.), Department of X-ray Endovascular Methods of Diagnosis and Treatment, Department of X-ray Endovascular Diagnostics and Treatment of the Regional Vascular Center.</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кальченко</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kal’chenko</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кальченко Евгений Александрович — аспирант, кафедра госпитальной хирургии Института хирургии.</p><p>Москва</p></bio><bio xml:lang="en"><p>Evgenij A. Kal’chenko — Postgraduate Student, Department of Hospital Surgery, Institute of Surgery.</p><p>Moscow</p></bio><email xlink:type="simple">Amenk@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3753-4834</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Молохоев</surname><given-names>Е. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Molohoev</surname><given-names>E. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Молохоев Евгений Борисович — д.м.н., отделение рентгенохирургических методов диагностики и лечения и хирургического лечения сложных нарушений ритма сердца и электрокардиостимуляции.</p><p>Москва</p></bio><bio xml:lang="en"><p>Evgeniy B. Molohoev — Dr. Sci. (Med.), Unit of X-ray Surgery in Diagnosis and Treatment, and Surgical Treatment of Complex Cardiac Rhythm Disorders and Cardiac Pacing.</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8616-0678</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Панков</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Pankov</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Панков Алексей Сергеевич — к.м.н., отделение рентгенохирургических методов диагностики и лечения и хирургического лечения сложных нарушений ритма сердца и электрокардиостимуляции.</p><p>Москва</p></bio><bio xml:lang="en"><p>Alexey S. Pankov — Cand. Sci. (Med.), Unit of X-ray Surgery in Diagnosis and Treatment, and Surgical Treatment of Complex Cardiac Rhythm.</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Российский национальный исследовательский медицинский университет имени Н.И. Пирогова; Городская клиническая больница имени Ф.И. Иноземцева Департамента здравоохранения города Москвы</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pirogov Russian National Research Medical University; F.I. Inozemtsev City Hospital, Moscow Department of Health</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Российский национальный исследовательский медицинский университет имени Н.И. Пирогова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pirogov Russian National Research Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Клиническая больница № 1 Управления делами Президента РФ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Clinical Hospital No. 1, the Аdministrative Directorate of the President of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>09</day><month>04</month><year>2026</year></pub-date><volume>16</volume><issue>1</issue><fpage>52</fpage><lpage>61</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Щеголев А.А., Громов Д.Г., Кальченко Е.А., Молохоев Е.Б., Панков А.С., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Щеголев А.А., Громов Д.Г., Кальченко Е.А., Молохоев Е.Б., Панков А.С.</copyright-holder><copyright-holder xml:lang="en">Shchegolev A.A., Gromov D.G., Kal’chenko E.A., Molohoev E.B., Pankov A.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.surgonco.ru/jour/article/view/1179">https://www.surgonco.ru/jour/article/view/1179</self-uri><abstract><p>Артериальные кровотечения из верхних отделов желудочно-кишечного тракта сохраняют высокую клиническую значимость из-за частых рецидивов даже после технически успешного эндоскопического гемостаза. Систематический анализ 60 современных публикаций демонстрирует трансформацию транскатетерной артериальной эмболизации из резервного метода в стратегический компонент мультидисциплинарного алгоритма достижения стойкого гемостаза. Обобщены показания и противопоказания к эндоваскулярному вмешательству; предложен алгоритм подбора эмболизата с учетом калибра, анатомической вариабельности и патологического ремоделирования артерий целиако-мезентериального бассейна. Превентивная эмболизация у пациентов с успешным эндоскопическим гемостазом, но с критериями высокого риска рецидива достоверно снижает частоту повторных геморрагий и госпитальную летальность по сравнению с изолированным эндоскопическим гемостазом. Метод демонстрирует высокую эффективность при рефрактерных кровотечениях, предлагая органосохраняющую альтернативу хирургическому вмешательству у пациентов с высоким операционным риском и обосновывая необходимость внедрения превентивной эмболизации в клинические протоколы ведения данной категории больных.</p></abstract><trans-abstract xml:lang="en"><p>Arterial upper gastrointestinal bleeding (UGIB) remains a major clinical challenge due to high rates of rebleeding even after technically successful endoscopic hemostasis. A systematic analysis of 60 contemporary publications shows that transcatheter arterial embolization (TAE) has evolved from a rescue intervention into an integral component of multidisciplinary strategies aimed at achieving durable hemostasis. Indications and contraindications for endovascular treatment are summarized, and an algorithm for embolic agent selection is proposed based on vessel caliber, anatomic variability, and pathologic remodeling of the celiac and mesenteric arterial systems. Prophylactic embolization in patients who achieve primary endoscopic hemostasis but meet high-risk criteria for rebleeding significantly reduces recurrent hemorrhage and in-hospital mortality compared with endoscopic therapy alone. In cases of refractory bleeding, TAE demonstrates high clinical efficacy and offers an organ-preserving alternative to surgery, particularly in patients with elevated operative risk. The accumulated evidence supports the incorporation of preventive embolization into clinical protocols for this patient population.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>желудочно-кишечные кровотечения</kwd><kwd>эндоваскулярный гемостаз</kwd><kwd>транскатетерная артериальная эмболизация</kwd><kwd>целиако-мезентериальный бассейн</kwd><kwd>превентивная эмболизация</kwd><kwd>селективная ангиография</kwd></kwd-group><kwd-group xml:lang="en"><kwd>gastrointestinal bleeding</kwd><kwd>endovascular hemostasis</kwd><kwd>transcatheter arterial embolization</kwd><kwd>celiac and mesenteric arteries</kwd><kwd>prophylactic embolization</kwd><kwd>selective angiography</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Barkun A.N., Laine L., Leontiadis G.I., Gralnek I.M., Carman N., Ibrahim M., et al. 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