Transcatheter Arterial Embolization (TAE) of Cancer-Related Bleeding-Reference-Cited by-同舟云学术

Transcatheter Arterial Embolization (TAE) of Cancer-Related Bleeding

Published:2023-07-18 Issue:7 Volume:59 Page:1323
ISSN:1648-9144
Container-title:Medicina
language:en
Short-container-title:Medicina

Author:

Minici Roberto¹^ORCID,Guzzardi Giuseppe²^ORCID,Venturini Massimo³⁴,Fontana Federico³⁴^ORCID,Coppola Andrea³^ORCID,Spinetta Marco²^ORCID,Piacentino Filippo³^ORCID,Pingitore Armando¹,Serra Raffaele⁵^ORCID,Costa Davide⁶^ORCID,Ielapi Nicola⁷^ORCID,Guerriero Pasquale⁸⁹^ORCID,Apollonio Biagio¹⁰,Santoro Rita¹¹^ORCID,Brunese Luca⁹¹²,Laganà Domenico¹¹³^ORCID,

Affiliation:

1. Radiology Unit, Dulbecco University Hospital, 88100 Catanzaro, Italy

2. Radiology Unit, Maggiore della Carità University Hospital, 28100 Novara, Italy

3. Diagnostic and Interventional Radiology Unit, ASST Settelaghi, Insubria University, 21100 Varese, Italy

4. School of Medicine and Surgery, Insubria University, 21100 Varese, Italy

5. Vascular Surgery Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Dulbecco University Hospital, 88100 Catanzaro, Italy

6. Department of Law, Economics and Sociology, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy

7. Department of Public Health and Infectious Disease, Sapienza University of Rome, 00185 Rome, Italy

8. Radiology Unit, Santobono-Pausilipon Hospital, 80129 Naples, Italy

9. Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy

10. Radiology Unit, San Timoteo Hospital, 86039 Termoli, Italy

11. Haemophilia and Thrombosis Center, Dulbecco University Hospital, 88100 Catanzaro, Italy

12. Scientific Committee of the Italian National Institute of Health (Istituto Superiore di Sanità, ISS), 00161 Rome, Italy

13. Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy

Abstract

Background and Objectives: Roughly 10% of cancer patients experience an episode of bleeding. The bleeding severity can range from occasional trivial bleeds to major bleeding. The treatment for the bleeding may vary, depending on the clinical condition and anatomical site, and may include various strategies, among which TAE is a cornerstone of major bleeding management. However, the existing literature on tumor hemorrhages is inconsistent. The objective of this multicenter retrospective cohort study was to evaluate the effectiveness and safety of arterial embolization in the treatment of tumor hemorrhages in patients with solid cancers. Materials and Methods: The data for patients with solid cancers undergoing TAE for the management of tumor hemorrhages from January 2020 to May 2023 were gathered. Results: A total of 92 patients with cancer-related bleeding were treated between January 2020 and May 2023. No bleeding was detected by X-ray angiography (XA) in 12 (13%) cases; therefore, a blind embolization was performed. The most common bleeding site was the liver (21.7%). A total of 66 tumor hemorrhages were spontaneous. The most commonly used embolic agent was polyvinyl alcohol (PVA) particles (30.4%). Technical success was achieved in 82 (89.1%) cases, with an 84.8% clinical success rate related to 14 cases of rebleeding. Proximal embolization was performed for 19 (20.7%) patients. Complications were recorded for 10 (10.9%) patients. The 30-day bleeding-related mortality was 15.2%. The technical success, clinical success, proximal embolization rate, and 30-day rebleeding were worse in the subset of patients undergoing TAE with coils. Conclusions: Transcatheter arterial embolization (TAE) represents a viable and potentially life-saving therapeutic approach in the management of tumor hemorrhages, demonstrating a notable effectiveness and safety. The TAE of bleeding tumors using coils resulted in a higher rate of non-superselective proximal embolization, with a trend toward lower clinical success rates and higher rebleeding episodes.

Publisher

MDPI AG

Subject

General Medicine

Link

https://www.mdpi.com/1648-9144/59/7/1323/pdf

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