Preprocedural computed tomography angiography-guided transcatheter arterial embolization for managing esophageal
Xue-Jiao Yang1, Yong-Juan Wu2, Jing-Zhong Wang2
1Department of Respiratory and Critical Care Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
Insights
Computed tomography angiography (CTA)-guided transcatheter arterial embolization (TAE) effectively stops esophageal cancer bleeding. This minimally invasive procedure shows high success rates and manageable complications for patients with upper gastrointestinal tumor bleeding.
Area of Science:
- Interventional Radiology
- Gastroenterology
- Oncology
Background:
- Endoscopy is limited for upper gastrointestinal tumor bleeding.
- Esophageal cancer can cause significant hemorrhage.
Purpose of the Study:
- Evaluate computed tomography angiography (CTA)-guided transcatheter arterial embolization (TAE) for esophageal cancer bleeding.
- Assess the efficacy and safety of CTA-guided TAE in achieving hemostasis.
Main Methods:
- Retrospective case series of eight patients with esophageal cancer bleeding.
- Preprocedural CTA-guided TAE was performed.
- Technical and clinical success were evaluated.
Main Results:
- Seven of eight patients achieved technical and clinical success with CTA-guided TAE.
- Complications included mild discomfort; one patient died due to missed pseudoaneurysm.
- Recurrent hemorrhage occurred in five patients, leading to four deaths.
Conclusions:
- CTA-guided TAE is a successful method for controlling esophageal cancer bleeding.
- The procedure has high technical and clinical success rates.
- Complications are generally mild and manageable.
Objective:
While endoscopy is the first-line treatment for non-variceal upper gastrointestinal hemorrhage, its role in managing upper gastrointestinal tumor bleeding is limited. This study aims to evaluate the effect of computed tomography angiography (CTA)-guided transcatheter arterial embolization (TAE) in achieving hemostasis for esophageal cancer bleeding.
Methods:
A retrospective case series was conducted at our hospital, involving eight patients who underwent preprocedural CTA-guided TAE for esophageal cancer bleeding between August 2023 and August 2024.
Results:
Of the eight patients (seven males, mean age 67 ± 12.9 years) who underwent CTA-guided TAE for esophageal cancer bleeding, seven achieved both technical and clinical success. One patient failed to achieve embolization due to missed identification of a pseudoaneurysm in the superior thyroid artery, resulting in death from hemorrhage. Two patients experienced mild chest or neck discomfort, which resolved with conservative management. During follow-up, five patients experienced recurrent hemorrhage, with four dying and one successfully treated with a second TAE. One of the remaining two patients died from disease progression, and the other remained recurrence-free for 270 days.
Conclusion:
CTA-guided TAE demonstrates high technical and clinical success rates for achieving hemostasis in esophageal cancer bleeding with mild and manageable complications.
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