Chengshi Chen1, Pyeong Hwa Kim2, Ji Hoon Shin3,4, Ki Woong Yoon5, Mi Sun Chung6, Hai-Liang Li1, Bumsik Hong7. 1. Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, No. 127 Dongming Road, Zhengzhou, 450008, China. 2. Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea. 3. Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, No. 127 Dongming Road, Zhengzhou, 450008, China. jhshin@amc.seoul.kr. 4. Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea. jhshin@amc.seoul.kr. 5. Department of Radiology, Chamjoeun Hospital, Gwangju, Korea. 6. Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea. 7. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract
PURPOSE: To explore the effect of transcatheter arterial embolization (TAE) in controlling intractable, nontraumatic bladder hemorrhage in cancer patients. MATERIALS AND METHODS: A literature review (PubMed and EMBASE), followed by a retrospective analysis of all cancer patients with intractable hematuria from bladder treated by TAE at our tertiary referral center. RESULTS: At our institution, 27 consecutive cancer patients who underwent TAE for refractory hematuria from bladder were identified. The systematic review included 13 studies published between 1981 and 2019. In our local cohort, 27 patients were treated with 100% technical success, clinical success in 88.9%, no major complications, and rebleeding rate within the first month of 7.4%. In the systematic review cohort of 201 patients, there was technical success in 99.0%, clinical success in 80.9%, major complications in 5.5%, and a rebleeding rate within the first month of 4.5%. Bilateral embolization was performed in 81.1%, and embolization levels were mostly anterior division of internal iliac artery (73.7%) and vesical artery (23.2%). CONCLUSION: TAE is effective and safe to control intractable hematuria from bladder origin in cancer patients after failure of conservative management, providing effective temporary hemostasis. For bladder hemorrhage unsuitable for surgery, TAE should be considered at an early stage. A literature review, followed by retrospective analysis of all patients with intractable hematuria from bladder treated by transcatheter arterial embolization at our tertiary referral center. Transcatheter arterial embolization is effective and safe to control intractable hematuria from bladder. The major complication rate and rebleeding within the first month are acceptable.
PURPOSE: To explore the effect of transcatheter arterial embolization (TAE) in controlling intractable, nontraumatic bladder hemorrhage in cancerpatients. MATERIALS AND METHODS: A literature review (PubMed and EMBASE), followed by a retrospective analysis of all cancerpatients with intractable hematuria from bladder treated by TAE at our tertiary referral center. RESULTS: At our institution, 27 consecutive cancerpatients who underwent TAE for refractory hematuria from bladder were identified. The systematic review included 13 studies published between 1981 and 2019. In our local cohort, 27 patients were treated with 100% technical success, clinical success in 88.9%, no major complications, and rebleeding rate within the first month of 7.4%. In the systematic review cohort of 201 patients, there was technical success in 99.0%, clinical success in 80.9%, major complications in 5.5%, and a rebleeding rate within the first month of 4.5%. Bilateral embolization was performed in 81.1%, and embolization levels were mostly anterior division of internal iliac artery (73.7%) and vesical artery (23.2%). CONCLUSION:TAE is effective and safe to control intractable hematuria from bladder origin in cancerpatients after failure of conservative management, providing effective temporary hemostasis. For bladder hemorrhage unsuitable for surgery, TAE should be considered at an early stage. A literature review, followed by retrospective analysis of all patients with intractable hematuria from bladder treated by transcatheter arterial embolization at our tertiary referral center. Transcatheter arterial embolization is effective and safe to control intractable hematuria from bladder. The major complication rate and rebleeding within the first month are acceptable.