Erschienen in:
07.06.2017 | Clinical Investigation
Endovascular Management of Severe Arterial Haemorrhage After Radical Prostatectomy: A Case Series
verfasst von:
Lawrence Bonne, Patrick Gillardin, Liesbeth De Wever, Els Vanhoutte, Steven Joniau, Raymond Oyen, Geert Maleux
Erschienen in:
CardioVascular and Interventional Radiology
|
Ausgabe 11/2017
Einloggen, um Zugang zu erhalten
Abstract
Purpose
The aim of this study is to assess the safety, effectiveness and long-term outcome of endovascular management of arterial haemorrhage after radical prostatectomy (RP).
Materials and Methods
Ten patients who received endovascular treatment for refractory bleeding after RP between January 2008 and December 2016 were retrospectively identified. Contrast-enhanced computed tomography (CT) was performed and followed by catheter-directed treatment by means of transarterial embolization (TAE) or stent graft placement. Follow-up included analysis of bleeding recurrence, embolization-related adverse events and tumour recurrence.
Results
Contrast-enhanced CT and catheter-directed angiography showed pelvic contrast extravasation in nine patients. Nine patients were successfully treated with TAE of the internal pudendal, superior and/or inferior vesical or (the anterior division or main branch of) the internal iliac arteries using microparticles in two patients, coils in two patients, a combination of microparticles and coils in three patients, glue in one patient and Gelfoam in one patient. The remaining patient was treated with stent graft placement in the external iliac artery, which was most likely injured during robot-assisted lymphadenectomy. One patient developed a puncture site pseudoaneurysm. No other complications related to the endovascular procedures occurred, in particular no pelvic ischaemic complications were identified. Mean follow-up period was 45 months (range 22–80).
Conclusions
The endovascular management of arterial haemorrhage after RP is safe and effective, without post-embolization ischaemic events.