Maria Tsitskari MD, Presenter: Nothing to Disclose

Lazaros Reppas BS, Abstract Co-Author: Nothing to Disclose

Dimitrios Filippiadis MD, PhD, Abstract Co-Author: Nothing to Disclose

Kostantinos Palialexis, Abstract Co-Author: Nothing to Disclose

Chrisostomos Kostantos, Abstract Co-Author: Nothing to Disclose

Elias Brountzos MD, Abstract Co-Author: Nothing to Disclose

We evaluated the outcomes of embolization treatment for intractable bladder bleeding after failed conservative treatment.

We retrospectively studied the records of 1 woman and 10 men with a mean age of 76 years referred between February 2008 and March 2014 for bladder embolization after failed conventional therapy. The underlying pathologies included bladder cancer in 9 patients, prostate cancer in 1 and metastatic osteosarcoma of the urinary bladder in 1 case. Embolization was feasible in 10 out 11 patients. It consisted of superselective embolizaion of the superior or inferior vesical arteries with particles or glue in 10 patients, and selective proximal gelfoam sponge particle occlusion of the anterior division of the internal iliac artery in 1 patient. Clinical bleeding control and post-embolization angiography findings were used to assess outcomes.  

The technical success rate was 90% (10 of 11 cases). In the one patient embolization was not possible, due to severe tortuosity of the iliac arteries. Bleeding was controlled after the first procedure in 8 patients, and after a repeat procedure in 2. Non target embolization of the buttocks ant the anterior abdominal wall was encountered in 1 patient. Late bleeding recurrence was reported in 2 of the 10 survivors. Mean post-embolization follow up was 30 months. During follow up 4 patients died, due to underlying conditions.

Selective vesical artery embolization is effective for the control of refractory, life threatening bladder bleeding

Selective angiographic embolization is safe and effective to control refractory, life threatening bladder bleeding. This procedure should be considered the treatment of choice since it usually obviates the need for emergency surgery in these severely ill patients

Tsitskari, M, Reppas, L, Filippiadis, D, Palialexis, K, Kostantos, C, Brountzos, E, Embolization Treatment for Intractable Bladder Bleeeding-Clinical Efficacy and Safety.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014357.html