Super-Sele. Embolization of Vesical Arteries with Micro-Catheter Technique in the Treatment of Intractable Hemorrhage due to Bladder Cancer

Abstract

Ge liş Ta ri hi/Re cei ved: 13.08.2016 Ka bul Ta ri hi/Ac cep ted: 24.08.2016 2013 Üroonkoloji Kongresi ve 2014 EAU-SEEM toplantısında sunulmuştur. © Üroonkoloji Bülteni, Ga le nos Ya yı ne vi ta ra fın dan ba sıl mış tır./ © Bulletin of Urooncology, Pub lis hed by Ga le nos Pub lis hing.Objective: We aimed to share our experience about the super-selective embolization of the vesical artery performed with micro-catheter technique which was used as a palliative approach to control intractable hematuria in patients with bladder cancer. Materials and Methods: Super-selective embolization of the vesical artery with micro-catheter technique was performed in 12 bladder cancer patients whose hematuria could not be controlled with other palliative methods in our clinic. Hemoglobin levels, blood transfusion amounts, complications and urethral catheter removal duration before and after embolization were evaluated. Results: The average age of the patients was 73.3 (65-85, range) years. For the embolization process, n-butyl-2cyaboacrylate (glue) was used as the primary method in 3 patients and polyvinylalcohol (PVA) particle was used in the remaining 9 patients. In two of the patients whose hematuria could not be controlled after PVA embolization glue embolization was performed as the secondary procedure within one week. Super-selective embolization of the vesical artery with micro-catheter technique was performed in all of our cases. In 4 cases, embolization of the vesical artery was performed only to the side of the tumor, which was determined with cystoscopy. Bilateral embolization was performed to the remaining 8 cases. The average hemoglobin value before and after the embolization procedure was 7.9 g/dL and 9.2 g/dL, respectively. The average blood transfusion amounts before and after the procedure were 4 (2-15) and 2.3 (1-4) units erythrocyte/ whole blood, respectively. The average urethral catheter duration after the procedure was 7 (2-16) days in 10 patients, who were treated one single embolization session. Urethral catheters were removed once the hematuria dissolved completely. There were no major complications or mortality related to the treatment after the embolization procedure. Conclusion: Super-selective embolization of the vesical artery performed with micro-catheter technique is a safe and effective alternative in patients with intractable hematuria due to bladder cancer whose hematuria could not be controlled with other palliative methods.

Transcatheter bilateral superselective arterial embolization, a minimally invasive method for persistent hematuria in elderly and comorbid patients with bladder and prostate cancer

“…2016' da Şahin, B. ve arkadaşlarının yaptığı çalışmada mesane kanserine bağlı dirençli hematürili hastalarda süperselektif vezikal arter embolizasyonu uygulanmış olup Girişimsel Radyoloji tarafından uygulanan embolizasyon sırasında n-butil-2-siyanoakrilat (glue) ya da PVA partikülü içeren materyaller kullanılmış (18). Bizim çalışmamızda ise hem mesane hem de prostat kanserine bağlı dirençli hematüri hastaları dahil edildi ve embolizan ajan olarak sadece PVA partikilü kullanıldı.…”