Transcatheter Arterial Embolization to Control Bleeding from Malignant Tumors

Abstract

Tumor bleeding occurs in 6％ to 10％ of all malignant tumors. Tumor hemorrhage may not only delay treatment of the primary lesion, but also lead to a poor prognosis. Endoscopic hemostasis, which is often selected as the first-line treatment modality, has been reported to be associated with a high success rate. However, in patients who are not suitable candidates for endoscopic therapy, in a critical hemodynamic state, or with recurrent bleeding after endoscopic hemostasis, transcatheter arterial embolization (TAE) could be used as a reliable hemostatic measure. The advantage of TAE is its availability to a wide clinical spectrum of patients; it is performed under local anesthesia, so that it can be used in patients who are in poor general condition or in a critical hemodynamic state. Moreover, TAE can even be performed when there is no active bleeding, as empiric embolization. Successful hemostasis with TAE can be achieved with selection of the appropriate embolic material and finding the proper balance between the degree of devascularization and degree of maintenance of vascularity, depending on the tolerance for ischemia of each organ.