Therapeutic transcatheter arterial embolization in the management of intractable haemorrhage from pelvic urological malignancies: preliminary experience and long‐term follow‐up

Abstract

OBJECTIVE To evaluate the feasibility, efficacy and complications of internal iliac artery embolization as a palliative measure in the control of intractable haemorrhage from advanced pelvic urological malignancies. PATIENTS AND METHODS Six patients (mean age 80 years, range 76–87) with advanced pelvic malignancies (three each with bladder carcinoma and prostate carcinoma) underwent embolization between September 1997 and July 2001, using permanent coils in the anterior division of internal iliac artery bilaterally. RESULTS All patients had undergone conservative treatment before embolization for a mean of 2 days. The mean requirement for transfusion before embolization was 3.2 units. All patients except one were successfully embolized in a single setting with no complications. Bleeding was successfully controlled in one patient at the second attempt of embolization. There were minor complications, e.g. nausea, vomiting or fever, for a mean of 2 days, responding well to conservative treatment. At a mean follow‐up of 22 months, no patient had a recurrence of bleeding. CONCLUSION Internal iliac artery embolization is a feasible, effective and minimally invasive option in managing advanced pelvic urological malignancies presenting with intractable bleeding; it should be bilateral and permanent.

Unilateral Versus Bilateral Prostatic Arterial Embolization for Lower Urinary Tract Symptoms in Patients with Prostate Enlargement

“…It has proved to be a safe and effective technique to control refractory, lifethreatening bladder, or prostate bleeding. The procedure should be considered the treatment of choice, because it obviates the need for emergency surgery in severely ill patients [11][12][13][14][15][16]. Animal studies have reported that PAE is a safe technique, inducing PV reduction, prostatic infarction, and ablation without sexual dysfunction [17][18][19].…”

Prostatic Arterial Embolization to Treat Benign Prostatic Hyperplasia

“…Prostatic embolization to control severe hemorrhage has also been successfully performed in human subjects in different case series (19,20). Also, case reports in human subjects have shown that PAE is safe and can induce prostate volume reduction and relief of obstruction-related voiding symptoms (14,15).…”

The Effect of Transarterial Prostate Embolization in Hormone-induced Benign Prostatic Hyperplasia in Dogs: A Pilot Study

“…There have been reports on the effectiveness of transcatheter arterial embolization in controlling bleeding after prostatectomy or prostate biopsy and in pelvic malignancies (13)(14)(15)(16). DeMeritt et al (17) reported that transarterial prostate embolization was effective not only in controlling bleeding, but also in the relief of BPH-related bladder outlet obstruction.…”

“…Prostate embolization has been performed successfully in patients with bleeding after prostatic biopsy, transurethral prostatectomy, or pelvic urological malignancies (13)(14)(15)(16). In addition, there was a case report that transarterial prostate embolization using polyvinyl alcohol (PVA) was effective in reducing the prostate volume and relieving urinary symptoms in a patient with BPH (17).…”