S.V. Golovko, O.F. Savitsky, A.A. Kobirnichenko, I.L. Troitskyi, O.I. Kulyk

Applying of transcatheter arterial embolization for bleedeing from lower urinary tracts

In the article efficiency and results of applying of transcatheter arterial embolization for refractory bleeding from lower urinary tracts, in case of inefficiency of conservative haemostatic treatment, is analyzed. We’ve analyzed case reports of 24 male patients in the age from 62 to 87 years, who in general underwent 26 angiographic procedures by selective arterial embolization technique for severe refractory bleeding from lower urinary tracts in the urology clinic of Main Military Medical Clinical Center from 2010 to 2013 year. Bleeding from the urinary bladder was observed in 19 patients, and from the prostate in 6 patients. After retrograde percutaneous catheterization of the femoral artery, selective angiography of internal iliac arteries was performed, with subsequent superselective catheterization and embolization of urocystic or prostatic branches. For embolization we used haemostatic agent “Galetamp”, embolizing tris-acryl-gelatinous microspheres Embosphere, and n-butyl-2-cyanoacryl surgical glue. Evaluation of results was performed clinically and by control angiographies. Bleeding was stopped in 19 patients from 24 on the average during 3 days (from 2 to 5 days), showing 79,2% of clinical success. In the rest 5 patients bleeding continued (3), or recurred (2) during 1 month, but less intensively than before the procedure, and was controlled after a repeat embolization. Performed research proves, that transcatheter arterial embolization is efficient and safe for control of bleeding from the lower urinary tracts and for achieving stable haemostasis in old-aged patients with inoperable cancer of the urinary bladder or prostate, and decompensated concomitant pathology.