Embolization Of Vesical Arteries Research Articles

Selective Vesical Artery Embolization in Refractory BK Virus Hemorrhagic Cystitis

AbstractIn hematopoietic stem cell transplantation (HSCT) recipients, BK virus-related hemorrhagic cystitis is a well-known complication. It increases the risk of death and morbidity of HSCT recipients with simultaneous increase in healthcare cost burden, as a result of prolonged hospital admissions. There are many conservative therapeutic strategies available for the treatment that are effective in treatment of milder forms of hemorrhagic cystitis. Vesical artery embolization is one of the nonsurgical bailout procedure in patient's refractory to medical therapy with added advantage of avoidance of high-risk definitive surgical procedure of cystectomy or urinary diversion in these critical immunosuppressed patients.

Superselective vesical artery embolisation of bleeding associated with bladder cancer

Superselective vesical artery embolization is used in the control of bleeding due to bladder cancer. However, there are few studies with a small number of patients. The current study aimed to investigate the efficacy, complications, and short-mid-term results of super-selective transarterial embolization in the treatment of persistent hematuria associated with bladder cancer. A retrospective examination was made of 13 patients with bladder cancer-related persistent hematuria who were applied with selective vesical artery embolization in the interventional radiology unit. The patients were evaluated in terms of the success of the treatment, the patients' need for additional interventional procedures, and the complications related to the procedure. Superselective superior vesical artery embolization was applied to a total of 13 patients with a mean age of 78.85±11.76 years and a median follow-up of 181 days. The time without bleeding was determined as a median of 159 days (min: 15, max:1410 days). The short-term clinical success was calculated as 84.6%. In the long-term follow-up of the patients in this study, the clinical success was determined to be 76.9% and no major complications were observed in any patient. Superselective embolization of vesical arteries is an effective and reliable treatment method for bladder cancer-related bleeding with high clinical success rates and low complication rates.

Superselective vesical artery embolization versus intravesical formalin for intractable hematuria in patients with bladder cancer

ObjectiveIntractable hematuria is a leading critical problem occurring in patients with advanced stage bladder cancer (BCa) that are not suitable for radical cystectomy. The present study, for the first time in the literature, aimed to compare the effectiveness of intravesical formalin (IF) and superselective vesical artery embolization (SVAE) in the management of intractable and life-threatening hematuria in BCa patients. MethodsThe retrospective study included 40 BCa patients who underwent SVAE or IF treatment due to intractable hematuria after failure of other methods. Patients were divided into two groups based on the procedures administered: SVEA Group (n = 24) and IF Group (n = 16). ResultsThe success rate at first-line therapy was 50% (12/24) in SVAE Group and 82% (13/16) in IF Group (p = 0.046). Based on the success rates at first- and second-line therapies, the overall success rate in SVAE Group was 75% and this rate was similar to that of IF Group (p = 0.439). Complication rate was significantly higher in IF patients than in SVAE patients (37.5% vs. 8.3; p = 0.024), whereas duration of postoperative hospital stay was significantly longer in SVAE Group (15.8 vs. 6 days; p = 0.041). ConclusionThe advantages of IF appear to include shorter postoperative hospital stays and higher success rates at a single session, while the advantages of SVAE seem to include non-requirement of spinal/general anesthesia, easy repeatability, and low complication rates. In the management of patients with intractable hematuria, patients’ general condition, comorbidities, and anesthesia-related risks should be taken into consideration.

Embolización vesical supraselectiva versus formalina intravesical para la hematuria intratable en pacientes con cáncer de vejiga

ObjectiveIntractable hematuria is a leading critical problem occurring in patients with advanced stage bladder cancer (BCa) that are not suitable for radical cystectomy. The present study, for the first time in the literature, aimed to compare the effectiveness of intravesical formalin (IF) and superselective vesical artery embolization (SVAE) in the management of intractable and life-threatening hematuria in BCa patients. MethodsThe retrospective study included 40 BCa patients who underwent SVAE or IF treatment due to intractable hematuria after failure of other methods. Patients were divided into two groups based on the procedures administered: SVEA Group (n=24) and IF Group (n=16). ResultsThe success rate at first-line therapy was 50% (12/24) in SVAE Group and 82% (13/16) in IF Group (p=0.046). Based on the success rates at first- and second-line therapies, the overall success rate in SVAE Group was 75% and this rate was similar to that of IF Group (p=0.439). Complication rate was significantly higher in IF patients than in SVAE patients (37.5% vs. 8.3; p=0.024), whereas duration of postoperative hospital stay was significantly longer in SVAE Group (15.8 vs. 6 days; p=0.041). ConclusionThe advantages of IF appear to include shorter postoperative hospital stays and higher success rates at a single session, while the advantages of SVAE seem to include non-requirement of spinal/general anesthesia, easy repeatability, and low complication rates. In the management of patients with intractable hematuria, patients’ general condition, comorbidities, and anesthesia-related risks should be taken into consideration.

Mesane ve prostat kanseri olan yaşlı ve komorbid hastalarda dirençli hematüride minimal invaziv bir yöntem, transkateter bilateral süperselektif arter embolizasyonu

Objective: In this article, we aimed to share our experience with superselective vesical and prostatic artery embolization applied by transarterial microcatheter method as a treatment option for recurrent resistant hematuria due to bladder and prostate cancer in elderly and comorbid patients. Materials and Methods: Bilateral transarterial microcatheter method was used for superselective vesical or prostatic artery embolization in 10 patients whose follow-up treatment was continued in our clinic with macroscopic hematuria due to bladder and prostate cancer diagnoses and could not be treated with other palliative and radical surgical methods due to comorbidity and high surgical operative risk. Before and after embolization treatment; hemoglobin (Hb) and hematocrit (Hct) values of the patients, the amount of transfusion of blood and blood products, postoperative complications, urethral foley catheter removal times and patient satisfaction were evaluated. The patients were followed up with controls intermittently for an average of 15 months. Results: The mean age of the patients included in the study was 77.5 (69-86) years. The average hemoglobin value before and after the embolization procedure was 8,16 mg/dL and 9,48 mg/dL, respectively. The average hematocrit value before and after the embolization procedure was 25,5 and 30,4 , respectively. The average amount of blood products (erythrocyte suspension) transfusion was 2.1 (1-3) units before the procedure, and there was no need for blood transfusion in the follow-up after the procedure. The urethral catheters of all patients were removed on the 5th day (3-7 days) after the urine color became completely clear. There were no major complications, recurrent urethral catheterization or mortality, morbidity related to the treatment after the embolization procedure. Conclusion: Superselective vesical and prostatic artery embolization treatment applied by transarterial microcatheter method is an effective and reliable alternative in the case of resistant hematuria due to bladder or prostate cancer that cannot be controlled with other palliative methods due to the high risk of anesthesia in elderly patients with comorbidities. Keywords: persistent hematuria, bladder cancer, superselective vesical artery embolization

Superselective Vesical Artery Embolization for Intractable Hemorrhagic Cystitis Following Hematopoietic Stem Cell Transplantation: A Single-Center Retrospective Study in 26 Patients.

To evaluate the safety and efficacy of superselective vesical artery embolization (SVAE) in the treatment of intractable hemorrhagic cystitis (HC) following hematopoietic stem cell transplantation (HSCT). From January 2010 to December 2018, 26 patients with hematologic malignancy who underwent SVAE for treatment of intractable HC following HSCT were retrospectively reviewed. SVAE was performed with 300-500μm gelatin-sponge particles initially. Technical success was defined as achieving bilateral SVAE for all the prominent vesical arteries. Therapeutic efficacy was defined as: Complete response (CR): macroscopic hematuria completely disappeared on more than 2 consecutive days after SVAE; Partial response (PR): macroscopic hematuria reduced after SVAE or briefly disappeared after SVAE but reappeared soon within 2days; No response: no response to SVAE or hematuria aggravated after SVAE; Recurrence: macroscopic hematuria relapsed on follow-up after achieving an initial CR. Adverse events were also registered. There was a mean follow-up of 11.4months (range, 0.5-83.7). The mean interval for the onset of HC after HSCT was 39.7 ± 19.0days, and mean duration of hematuria before embolization was 14.9 ± 15.7days. SVAE was technically successful in all patients. After embolization, macroscopic hematuria regressed within 48h for all patients. The mean urine erythrocyte counts dropped from 14,213.2 ± 20,999.0/uL before SVAE to 6072.9 ± 12,720.7/uL on 3d after SVAE (P = 0.002) and 3720.2 ± 8988.9/uL on 7d after SVAE (P = 0.001), respectively. Hematuria completely disappeared prior to discharge in 23 (88.5%) patients (including 20 with one embolization and 3 with 2 embolizations) and remainder 3 patients had PR. No major procedure-related complications were noted, except for post-embolization syndrome in 8 patients, which resolved with symptomatic treatment. On follow-up monthly, hematuria recurrence was seen in 4/23 patients (17.4%) and was managed conservatively in 2 patients and with repeat embolization in the remainder 2 patients. For fragile patients with hematologic malignancy, SVAE is safe and effective to treat HC following HSCT, even though repeat embolization may be required to achieve a sustained complete remission of the hematuria.

Superselective vesical artery embolization for intractable bladder hemorrhage related to pelvic malignancy.

Intractable bladder hemorrhage from pelvic malignancy can be potentially life-threatening and its management can be a challenging clinical problem. To evaluate safety, efficacy, and clinical outcome of superselective vesical artery embolization for the control of intractable bladder hemorrhage from pelvic malignancy. Between January 2010 and September 2018, 20 patients underwent superselective vesical artery embolization for intractable hematuria secondary to pelvic malignancy arising from or invading the bladder. Treatment details and clinical outcomes were obtained. There were 12 men and 8 women (mean age = 77 years). Bilateral embolization was performed in 10 patients and unilateral approach in 10 patients. Two patients died within four days after embolization due to underlying heart failure and systemic metastasis, respectively. The remaining 18 patients had a follow-up of >30 days. Bleeding was controlled after the first embolization in 17/18 patients and after a repeat embolization in the remaining one patient. The mean follow-up period of 18 patients was 10.6 months (range = 1-77 months). Late recurrent hemorrhage (≥ 30 days after embolization) was reported in 6 (33.3%) patients. Five of these six patients underwent repeat embolization. There were no major complications related to embolization. Palliative superselective vesical artery embolization is a feasible, effective, and safe procedure to control intractable hematuria in patients with pelvic malignancy.

Re: Superselective Vesical Artery Embolization in the Management of Intractable Hematuria Secondary to Hemorrhagic Cystitis.

Re: Superselective Vesical Artery Embolization in the Management of Intractable Hematuria Secondary to Hemorrhagic Cystitis.

4:03 PM Abstract No. 371 Superselective vesical artery embolization for intractable bladder hemorrhage related to pelvic malignancy

4:03 PM Abstract No. 371 Superselective vesical artery embolization for intractable bladder hemorrhage related to pelvic malignancy

Superselective vesical artery embolization in the management of intractable hematuria secondary to hemorrhagic cystitis.

To evaluate the efficacy and outcome of superselective vesical arterial embolization in the management of severe intractable hematuria secondary to hemorrhagic cystitis. We retrospectively reviewed the medical records of nine patients with severe intractable hematuria treated with superselective vesical artery embolization at our institution between March 2003 and February 2015. There were six males and three females with a mean age of 56.1years. Seven patients had transitional cell carcinoma (TCC) of urinary bladder and had undergone transurethral resection of bladder tumor and pelvic radiotherapy. One patient had synchronous renal pelvis and bladder TCC. One patient had aortoarteritis and was receiving cyclophosphamide therapy and another patient had carcinoma cervix post-pelvic radiotherapy. Following the failure of conservative management, superselective vesical artery catheterization and embolization was performed with 300-500-μ PVA particles in all patients. Coil embolization of inferior gluteal artery followed by particle embolization of vesical arteries was done in one patient in whom superior, inferior vesical and inferior gluteal arteries were arising as a trifurcation. The technical success rate was 100% with complete cessation of hematuria within 48h in all patients. No significant complications were noted, except for post-embolization syndrome in onepatient, which improved on symptomatic treatment. During a mean follow-up period of 14.45months (ranging from 3-28months), one patient had mild recurrent hematuria (at 2months) which resolved spontaneously. Superselective vesical artery embolization is a safe and effective procedure in controlling intractable life-threatening hematuria in a select group of patients who have failed conventional treatment protocols. This procedure may be considered as the treatment of choice since it usually obviates the need for emergency surgery in these severely ill patients.

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

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

Successful treatment of severe hemorrhagic cystitis with selective vesical artery embolization

Successful treatment of severe hemorrhagic cystitis with selective vesical artery embolization

Transcatheter Arterial Embolization of Vesical Artery in the Treatment of Invasive Bladder Cancer

Transcatheter arterial embolization was performed in a total of 70 patients with invasive bladder cancer from October 1980 to December 1987. It was performed as a part of multidisciplinary treatment in patients with invasive bladder cancer. Microencapsulated mitomycin C, gelatin sponge and lipiodol (iodized oil) were used as the embolic material. As a result, reduction of tumor size was noted in 56.7%, but there was no embolic materials-related significant difference. Stage reduction was noted in 72.7% of patients where pathological stages were confirmed by operation. Hemostatic effects were noted in 76.5%. The symptoms of side effects included fever, leukocytosis, urinary frequency and pain, but none of them was severe. The results of the present study indicate that embolization of the vesical artery is useful in the treatment of bladder cancer.

217 - Transcatheter Arterial Embolization of Vesical Artery in the Management of Bladder Cancer and Intractable Bladder Hemorrhage

No AccessJournal of Urology1 Jun 1987Transcatheter Arterial Embolization of Vesical Artery in the Management of Bladder Cancer and Intractable Bladder Hemorrhage Seiichiro Ozono, Eigoro Okajima, Yoshihiko Hirao, Hisashi Matsuki, Shoji Takahashi, and Hajime Ohishi Seiichiro OzonoSeiichiro Ozono More articles by this author , Eigoro OkajimaEigoro Okajima More articles by this author , Yoshihiko HiraoYoshihiko Hirao More articles by this author , Hisashi MatsukiHisashi Matsuki More articles by this author , Shoji TakahashiShoji Takahashi More articles by this author , and Hajime OhishiHajime Ohishi More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)75367-0AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Transcatheter Arterial Embolization of Vesical Artery in the Management of Bladder Cancer and Intractable Bladder Hemorrhage." The Journal of Urology, 137(6), p. 158A © 1987 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 137Issue 6June 1987Page: 158A Advertisement Copyright & Permissions© 1987 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Seiichiro Ozono More articles by this author Eigoro Okajima More articles by this author Yoshihiko Hirao More articles by this author Hisashi Matsuki More articles by this author Shoji Takahashi More articles by this author Hajime Ohishi More articles by this author Expand All Advertisement Loading ...