Outcomes of Transcatheter Arterial Embolization for Acute Hemorrhage Originating from Gastric Adenocarcinoma

Meehan, Timothy; Stecker, Michael S.; Kalva, Sanjeeva P.; Öklü, Rahmi; Walker, T. Gregory; Ganguli, Suvranu

doi:10.1016/j.jvir.2014.02.005

Cited by 25 publications

(22 citation statements)

References 25 publications

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“…In cases of gastric tumors, the left gastric artery alone or in association with the right gastroepiploic artery was the most frequent target vessel for embolization in the current study, which was in agreement with that seen in prior reports [22][23][24]. The choice of target vessels for embolization should be based on the tumor sites; for tumors located in the greater curvature side, the right gastroepiploic artery could be considered and the left gastric artery could be considered for tumors located in the fundus.…”

Section: Discussionsupporting

confidence: 93%

“…Rebleeding occurred secondary to the temporary nature of the gelatin sponge particles as embolic material (3/5) similar to Park et al, who reported rebleeding in 4 patients secondary to recanalized left gastric artery after embolization with absorbable gelatin sponge [24]. A variety of embolic materials were previously reported to control tumor-related GIT bleeding including coils, particles, and N-butyl cyanoacrylate [22][23][24][25][26][27]; however, there are no guidelines indicating the optimal choice of embolic materials. All repeat procedures in the current study were done using PVA particles to prevent recanalization of target vessels.…”

Section: Discussionmentioning

confidence: 61%

“…Nevertheless, as Tandberg et al [21] reported in a study that included 26 patients, a 68% clinical success rate at 30 days following embolization for GI bleeding due to primary and secondary GI neoplasms. Lee et al [22] and Meehan et al [23] reported 52% and 40% clinical success rates in 23 and 10 patients at 30 days following embolization performed to manage bleeding from gastric adenocarcinoma. In a more recent study by Park et al, technical and clinical success rates of TAE were 85.0% and 65.0% in 40 patients with gastric adenocarcinoma as well [24].…”

Section: Discussionmentioning

confidence: 99%

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Trans-arterial embolization of malignant tumor-related gastrointestinal bleeding: technical and clinical efficacy

Elmokadem

Abdelsalam

El-Morsy

et al. 2019

Egypt J Radiol Nucl Med

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Background: Gastrointestinal (GI) tract bleeding is a major cause of mortality among patients with GI malignancies. We aimed to assess the technical and clinical efficacy of trans-arterial embolization (TAE) as a symptomatic treatment of tumor-related GI bleeding. This study was conducted for patients with GI bleeding secondary to histopathologically proven different GI malignancies. Fourteen patients underwent trans-arterial embolization. Patients were followed up clinically for any complications or episodes of recurrent bleeding. Results: Fourteen patients were included (9 males and 5 females) with mean age 55.5 years (range 42-69 years). All procedures were technically successful with post-procedural hemorrhage control and no immediate complication. The 30-day post-procedural clinical success rate was 78.4%. Three repeated clinically successful TAE sessions were done for recurrent bleeding. The median post-procedural follow-up duration was 241 days. The 30-day mortality rate was 7.1%, while the overall mortality rate was 35.7%. Conclusion: Trans-arterial embolization of tumor-related GI bleeding controlled hemorrhage with acceptable clinical success rate and without complication in this small group of patients.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Trans-arterial embolization of malignant tumor-related gastrointestinal bleeding: technical and clinical efficacy

Elmokadem

Abdelsalam

El-Morsy

et al. 2019

Egypt J Radiol Nucl Med

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“…For the setting of uncontrolled gastrointestinal hemorrhage because of tumor involvement very limited reported patient outcomes exist with two studies reporting on 10 patients and 26 patients, by Meehan et al and Tandberg et al, respectively [78,82]. These studies demonstrated relative safety and efficacy of the procedure though QOL metrics were not reported.…”

Section: Trans-arterial Embolization For Uncontrolled Hemorrhagementioning

confidence: 99%

The role of interventional oncology in the palliative care of cancer patients

Hussaini

Kang

et al. 2016

Expert Review of Quality of Life in Cancer Care

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Interventional oncologists have expertise in delivery of state of the art, minimally invasive, imageguided procedures. As such, interventional oncologists are well-suited to provide palliative options for cancer patients, who often have complex comorbidities precluding them from more invasive options. The broad spectrum of procedures developed into clinical practice highlight the integral role of interventional oncology in the palliation of cancer patients. This review will focus on several of the more common procedures performed by interventional oncologists to provide symptomatic relief: 1. Tunneled peritoneal or pleural catheter placement for fluid drainage; Peritoneovenous shunt placement for fluid drainage; 2. Ablation with focus on metastatic bone ablation for pain control; 3. Neurolysis with focus on celiac neurolysis for pain control; 4. Decompressive gastrostomies or cecostomies for gastric and bowel obstruction; 5. Transarterial embolization for uncontrolled hemorrhage. A description of each procedure and its relative efficacy in providing palliation will be summarized. ARTICLE HISTORY

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“…However, when DSA does not clearly display extravasation or pseudoaneurysm, particularly when only tumor staining is observed, there is no established consensus regarding the type of embolic material that should be utilized. In a recent study, it was reported that TAE with EmboSpheres for life-threatening hemorrhages in patients with gastric cancer [10,11], breast cancer [12] and neurofibroma [13] was safe and effective. Calibrated microspheres are able to access distal regions of the target arteries resulting in disappearance of tumor staining.…”

Section: Introductionmentioning

confidence: 99%

Salvage Embolization and Histologic Analysis of Gastric Cancer with Hemorrhagic Shock Using Spherical Embolic Material

et al. 2018

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SummaryBackgroundIn a recent study, it was reported that transcatheter arterial embolization with spherical embolic material for life-threatening hemorrhages in various cancer patients was safe and effective. Calibrated microspheres are able to access distal regions of the target arteries, which results in the disappearance of tumor staining. However, there are few reports on the pathological behavior of EmboSpheres in gastric cancer specimens. In this case, we succeeded in salvage embolization for advanced gastric cancer with hemorrhagic shock using spherical embolic material. To our knowledge, this is the first report of a pathological evaluation of spherical embolic microspheres in a gastric cancer specimen.Case ReportA 70-year-old man with scirrhous gastric cancer was admitted to our hospital for staging laparoscopy. Unfortunately, he had a sudden onset of hematemesis and melena leading to hemorrhagic shock due to bleeding from the gastric cancer. While undergoing a rapid blood transfusion, he underwent emergent embolization to achieve hemostasis. The left gastric and right gastroepiploic arteries were embolized with spherical embolic material, and the patient survived. Two days later, the patient was able to undergo gastrectomy. A large number of microspheres were observed in areas of hemorrhage. The range and median diameter of the minor axis were 177–1048 μm and 281 μm, respectively.ConclusionsTranscatheter arterial embolization using spherical embolic material could become one of safe and effective options, especially when there is no extravasation or pseudoaneurysm but only tumor staining from the clinical and pathological point of view.

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Outcomes of Transcatheter Arterial Embolization for Acute Hemorrhage Originating from Gastric Adenocarcinoma

Cited by 25 publications

References 25 publications

Trans-arterial embolization of malignant tumor-related gastrointestinal bleeding: technical and clinical efficacy

Trans-arterial embolization of malignant tumor-related gastrointestinal bleeding: technical and clinical efficacy

The role of interventional oncology in the palliative care of cancer patients

Salvage Embolization and Histologic Analysis of Gastric Cancer with Hemorrhagic Shock Using Spherical Embolic Material

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