Transarterial Embolization for Malignancy-Related Gastrointestinal Bleeding: Outcomes with and Without CT...

Area of Science:

• Interventional Radiology
• Gastroenterology
• Oncology

Background:

• Gastrointestinal (GI) bleeding in cancer patients often resists standard treatments.
• Transarterial embolization (TAE) is a key intervention, but its effectiveness based on pre-procedural CT findings is debated.

Purpose of the Study:

• To assess the efficacy and safety of TAE for malignancy-related GI bleeding.
• To compare outcomes in patients with and without CT-detected contrast extravasation.

Main Methods:

• Retrospective analysis of 40 patients undergoing TAE for malignancy-related GI bleeding (2012-2023).
• Patients were grouped based on pre-procedural CT: extravasation (n=25) vs. no extravasation (n=15).
• Key outcomes included technical/clinical success, 30-day mortality, overall survival (OS), and complications.

Main Results:

• High technical (100%) and clinical success (82.5%) rates for TAE.
• No significant difference in clinical success (84% vs. 80%) or 30-day mortality (5%) between groups.
• Overall survival was comparable; shock index > 1 independently predicted worse OS (HR 2.308, p=0.033).
• No major procedure-related complications were reported.

Conclusions:

• TAE demonstrates high technical success and similar short-term outcomes for malignancy-related GI bleeding, irrespective of CT extravasation.
• Hemodynamic instability, indicated by a high shock index, is a significant predictor of poorer overall survival.
• TAE is a safe and effective option for this patient population.