Endovascular Management of Severe Arterial Haemorrhage After Radical Prostatectomy: A Case Series
Male
Prostatectomy
Endovascular Procedures
Prostate
Contrast Media
Prostatic Neoplasms
Hemorrhage
Middle Aged
Embolization, Therapeutic
3. Good health
Radiographic Image Enhancement
03 medical and health sciences
Postoperative Complications
Treatment Outcome
0302 clinical medicine
Humans
Neoplasm Recurrence, Local
Tomography, X-Ray Computed
Aged
Extravasation of Diagnostic and Therapeutic Materials
Retrospective Studies
DOI:
10.1007/s00270-017-1715-0
Publication Date:
2017-06-07T15:52:09Z
AUTHORS (7)
ABSTRACT
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).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.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).The endovascular management of arterial haemorrhage after RP is safe and effective, without post-embolization ischaemic events.
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