Super-Selective Trans-Catheter Arterial Embolization (TAE) of the Vesical Arteries in the Management of Intractable Hematuria Secondary to Advanced Bladder and Prostate Cancers
BAUS ePoster online library. Alarayedh A. 06/22/21; 319010; p10-20
Disclosure(s): No conflict of interests to declare.
Dr. Ameer Alarayedh
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Abstract
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Introduction:
In frail patients intractable haematuria secondary to advanced malignancies is a clinical challenge. Super-selective TAE of the vesical arteries is a suitable minimally invasive option. We present our experience in this patient cohort.
Patients and Methods:
All patients who underwent TAE from January 2014 to December 2019 were included. Super-selective TAE of the superior and inferior vesical arteries was done using 300-500µ PVA particles. Demographic data, cancer stage, pre-embolization palliative treatment, chemotherapy and radiotherapy were recorded. Technical and clinical success, time to cessation of haematuria, recurrence of haematuria and complications were recorded. Data are presented as mean±standard deviation, and statistical significance is set at p <0.05.
Results:
From 2014-2019, 7 patients underwent 8 procedures. The average patients' age was 60.6±10.3 years. All presented with gross haematuria, 6 due to bladder cancer and 1 due to prostate cancer. The average time of haematuria clearance was 60 hours. The average haemoglobin levels at the time of the procedure, 1 month and 6 months post-embolization were 9.6±1.7g/dL, 10.6±1.5g/dL (p <0.05), and 9.6±0.9g/dL, respectively (p>0.05). Packed red blood cell requirements decreased from 7.3±2 units to 5±3.3 units after the procedure (p>0.05). The patients were followed up for an average of 13.6 months and 4 had a recurrence at an average of four months post-embolization.
Conclusion:
Super-selective TAE is an effective method in controlling intractable haematuria. The risks of major surgery and anaesthesia are omitted, and the procedure can be repeated as needed. Furthermore, post-embolization complications, using this technique, are minor and manageable.
In frail patients intractable haematuria secondary to advanced malignancies is a clinical challenge. Super-selective TAE of the vesical arteries is a suitable minimally invasive option. We present our experience in this patient cohort.
Patients and Methods:
All patients who underwent TAE from January 2014 to December 2019 were included. Super-selective TAE of the superior and inferior vesical arteries was done using 300-500µ PVA particles. Demographic data, cancer stage, pre-embolization palliative treatment, chemotherapy and radiotherapy were recorded. Technical and clinical success, time to cessation of haematuria, recurrence of haematuria and complications were recorded. Data are presented as mean±standard deviation, and statistical significance is set at p <0.05.
Results:
From 2014-2019, 7 patients underwent 8 procedures. The average patients' age was 60.6±10.3 years. All presented with gross haematuria, 6 due to bladder cancer and 1 due to prostate cancer. The average time of haematuria clearance was 60 hours. The average haemoglobin levels at the time of the procedure, 1 month and 6 months post-embolization were 9.6±1.7g/dL, 10.6±1.5g/dL (p <0.05), and 9.6±0.9g/dL, respectively (p>0.05). Packed red blood cell requirements decreased from 7.3±2 units to 5±3.3 units after the procedure (p>0.05). The patients were followed up for an average of 13.6 months and 4 had a recurrence at an average of four months post-embolization.
Conclusion:
Super-selective TAE is an effective method in controlling intractable haematuria. The risks of major surgery and anaesthesia are omitted, and the procedure can be repeated as needed. Furthermore, post-embolization complications, using this technique, are minor and manageable.
Introduction:
In frail patients intractable haematuria secondary to advanced malignancies is a clinical challenge. Super-selective TAE of the vesical arteries is a suitable minimally invasive option. We present our experience in this patient cohort.
Patients and Methods:
All patients who underwent TAE from January 2014 to December 2019 were included. Super-selective TAE of the superior and inferior vesical arteries was done using 300-500µ PVA particles. Demographic data, cancer stage, pre-embolization palliative treatment, chemotherapy and radiotherapy were recorded. Technical and clinical success, time to cessation of haematuria, recurrence of haematuria and complications were recorded. Data are presented as mean±standard deviation, and statistical significance is set at p <0.05.
Results:
From 2014-2019, 7 patients underwent 8 procedures. The average patients' age was 60.6±10.3 years. All presented with gross haematuria, 6 due to bladder cancer and 1 due to prostate cancer. The average time of haematuria clearance was 60 hours. The average haemoglobin levels at the time of the procedure, 1 month and 6 months post-embolization were 9.6±1.7g/dL, 10.6±1.5g/dL (p <0.05), and 9.6±0.9g/dL, respectively (p>0.05). Packed red blood cell requirements decreased from 7.3±2 units to 5±3.3 units after the procedure (p>0.05). The patients were followed up for an average of 13.6 months and 4 had a recurrence at an average of four months post-embolization.
Conclusion:
Super-selective TAE is an effective method in controlling intractable haematuria. The risks of major surgery and anaesthesia are omitted, and the procedure can be repeated as needed. Furthermore, post-embolization complications, using this technique, are minor and manageable.
In frail patients intractable haematuria secondary to advanced malignancies is a clinical challenge. Super-selective TAE of the vesical arteries is a suitable minimally invasive option. We present our experience in this patient cohort.
Patients and Methods:
All patients who underwent TAE from January 2014 to December 2019 were included. Super-selective TAE of the superior and inferior vesical arteries was done using 300-500µ PVA particles. Demographic data, cancer stage, pre-embolization palliative treatment, chemotherapy and radiotherapy were recorded. Technical and clinical success, time to cessation of haematuria, recurrence of haematuria and complications were recorded. Data are presented as mean±standard deviation, and statistical significance is set at p <0.05.
Results:
From 2014-2019, 7 patients underwent 8 procedures. The average patients' age was 60.6±10.3 years. All presented with gross haematuria, 6 due to bladder cancer and 1 due to prostate cancer. The average time of haematuria clearance was 60 hours. The average haemoglobin levels at the time of the procedure, 1 month and 6 months post-embolization were 9.6±1.7g/dL, 10.6±1.5g/dL (p <0.05), and 9.6±0.9g/dL, respectively (p>0.05). Packed red blood cell requirements decreased from 7.3±2 units to 5±3.3 units after the procedure (p>0.05). The patients were followed up for an average of 13.6 months and 4 had a recurrence at an average of four months post-embolization.
Conclusion:
Super-selective TAE is an effective method in controlling intractable haematuria. The risks of major surgery and anaesthesia are omitted, and the procedure can be repeated as needed. Furthermore, post-embolization complications, using this technique, are minor and manageable.
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