Early Outcomes of Empiric Embolization of Tumor-related Gastrointestinal Hemorrhage in Patients with Advanced Malignancy

Tandberg, Daniel J.; Smith, Tony P.; Suhocki, Paul V.; Pabon‐Ramos, Waleska M.; Nelson, Rendon C.; Desai, Sima S.; Branch, Stanley; Kim, Charles Y.

doi:10.1016/j.jvir.2012.08.011

Cited by 24 publications

(16 citation statements)

References 22 publications

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“…Evidence from a single retrospective study showed empirical embolisation for tumour bleeding had a clinical success rate of 68%, increasing to 98% in the context of acute bleeding 93. However, a further study including unspecified empiric embolisation showed only a 23% rebleeding risk but a 30-day mortality of 31% versus a mortality of 9% for embolisation where there was active extravasation 90…”

Section: Therapymentioning

confidence: 99%

Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology

Oakland

Chadwick

East

et al. 2019

Gut

243

241

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This is the first UK national guideline to concentrate on acute lower gastrointestinal bleeding (LGIB) and has been commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG). The Guidelines Development Group consisted of representatives from the BSG Endoscopy Committee, the Association of Coloproctology of Great Britain and Ireland, the British Society of Interventional Radiology, the Royal College of Radiologists, NHS Blood and Transplant and a patient representative. A systematic search of the literature was undertaken and the quality of evidence and grading of recommendations appraised according to the GRADE(Grading of Recommendations Assessment, Development and Evaluation) methodology. These guidelines focus on the diagnosis and management of acute LGIB in adults, including methods of risk assessment and interventions to diagnose and treat bleeding (colonoscopy, computed tomography, mesenteric angiography, endoscopic therapy, embolisation and surgery). Recommendations are included on the management of patients who develop LGIB while receiving anticoagulants (including direct oral anticoagulants) or antiplatelet drugs. The appropriate use of blood transfusion is also discussed, including haemoglobin triggers and targets.

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Section: Therapymentioning

confidence: 99%

Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology

Oakland

Chadwick

East

et al. 2019

Gut

243

241

View full text Add to dashboard Cite

show abstract

“…Reports regarding the efficacy of TAE in treatment of tumoral GI bleeding are limited especially with such variability of tumor pathology and affected GI part. Nevertheless, as Tandberg et al [21] reported in a study that included 26 patients, a 68% clinical success rate at 30 days following embolization for GI bleeding due to primary and secondary GI neoplasms. Lee et al [22] and Meehan et al [23] reported 52% and 40% clinical success rates in 23 and 10 patients at 30 days following embolization performed to manage bleeding from gastric adenocarcinoma.…”

Section: Discussionmentioning

confidence: 94%

Trans-arterial embolization of malignant tumor-related gastrointestinal bleeding: technical and clinical efficacy

Elmokadem

Abdelsalam

El-Morsy

et al. 2019

Egypt J Radiol Nucl Med

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Background: Gastrointestinal (GI) tract bleeding is a major cause of mortality among patients with GI malignancies. We aimed to assess the technical and clinical efficacy of trans-arterial embolization (TAE) as a symptomatic treatment of tumor-related GI bleeding. This study was conducted for patients with GI bleeding secondary to histopathologically proven different GI malignancies. Fourteen patients underwent trans-arterial embolization. Patients were followed up clinically for any complications or episodes of recurrent bleeding. Results: Fourteen patients were included (9 males and 5 females) with mean age 55.5 years (range 42-69 years). All procedures were technically successful with post-procedural hemorrhage control and no immediate complication. The 30-day post-procedural clinical success rate was 78.4%. Three repeated clinically successful TAE sessions were done for recurrent bleeding. The median post-procedural follow-up duration was 241 days. The 30-day mortality rate was 7.1%, while the overall mortality rate was 35.7%. Conclusion: Trans-arterial embolization of tumor-related GI bleeding controlled hemorrhage with acceptable clinical success rate and without complication in this small group of patients.

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“…Specifically, gastrointestinal hemorrhage, either directly related to tumoral bleeding or as a consequence of cancer treatments, is a common problem for patients with advanced stage cancer [77]. Common primary tumors which result in gastrointestinal hemorrhage include adenocarcinoma, lymphoma and GI stromal tumors (GISTs); metastatic tumors including melanoma and renal-cell carcinoma (RCC) [78]. Active hemorrhage into the urinary tract resulting in hematuria can also occur as a result from involvement of the urinary tract from RCC [79].…”

Section: Trans-arterial Embolization For Uncontrolled Hemorrhagementioning

confidence: 99%

“…For the setting of uncontrolled gastrointestinal hemorrhage because of tumor involvement very limited reported patient outcomes exist with two studies reporting on 10 patients and 26 patients, by Meehan et al and Tandberg et al, respectively [78,82]. These studies demonstrated relative safety and efficacy of the procedure though QOL metrics were not reported.…”

Section: Trans-arterial Embolization For Uncontrolled Hemorrhagementioning

confidence: 99%

The role of interventional oncology in the palliative care of cancer patients

Hussaini

Kang

et al. 2016

Expert Review of Quality of Life in Cancer Care

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Interventional oncologists have expertise in delivery of state of the art, minimally invasive, imageguided procedures. As such, interventional oncologists are well-suited to provide palliative options for cancer patients, who often have complex comorbidities precluding them from more invasive options. The broad spectrum of procedures developed into clinical practice highlight the integral role of interventional oncology in the palliation of cancer patients. This review will focus on several of the more common procedures performed by interventional oncologists to provide symptomatic relief: 1. Tunneled peritoneal or pleural catheter placement for fluid drainage; Peritoneovenous shunt placement for fluid drainage; 2. Ablation with focus on metastatic bone ablation for pain control; 3. Neurolysis with focus on celiac neurolysis for pain control; 4. Decompressive gastrostomies or cecostomies for gastric and bowel obstruction; 5. Transarterial embolization for uncontrolled hemorrhage. A description of each procedure and its relative efficacy in providing palliation will be summarized. ARTICLE HISTORY

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Early Outcomes of Empiric Embolization of Tumor-related Gastrointestinal Hemorrhage in Patients with Advanced Malignancy

Cited by 24 publications

References 22 publications

Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology

Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology

Trans-arterial embolization of malignant tumor-related gastrointestinal bleeding: technical and clinical efficacy

The role of interventional oncology in the palliative care of cancer patients

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