Transcatheter therapy of intravisceral bleeding

Intravisceral bleeding is a life-threatening situation demanding fast and active steps to control, unless it stops spontaneously as in a few lucky patients. A surgical approach is a major intervention with its associated procedural risks when the site is in organs other than the spleen. The transcatheter approach helps in precise location and embolization of the bleeding site; it is a more practical approach that has been known for the past 2 decades to be effective and provide good long-term results. However, the transcatheter approach has been reported in fewer than 200 cases in the literature. Our small series of 43 cases shows initial success of 95% and a fatal early recurrence of only 2.4%. Non-hemorrhagic etiology (sepsis, head injury, etc.) was the major cause of early death (14.6%) among the successfully embolized cases. Long-term follow-up shows recurrence (4.8%) only in the group of chronic etiology. Transcatheter embolization of intravisceral bleeding with Gel-Foam and/or poly-vinyl alcohol particles is a swift, effective and precise method of treatment without major operational hazards.