Endovascular embolisation in acute arterial haemorrhage cases and hypervascular lesions: a single institution experience

Introduction Endovascular embolisation had played a major role in the acute management of acute arterial haemorrhage. It had proven benefits in acute upper and lower gastrointestinal haemorrhage, massive haemoptysis, bleeding visceral pseudoaneurysms and arteriovenous malformations. It also had played a major role in the preoperative embolisation of hypervascular lesions such as paraganglioma, meningioma, juvenile angiofibroma and other hypervascular lesions, with proven reduction in blood loss intraoperatively. Purpose of Study The purpose of this study is to evaluate our single institution experience in endovascular embolisation of acute arterial haemorrhage cases and preoperative embolisation of hypervascular lesions. Materials and Methods All cases which undergo endovascular embolisation from June 2009 until March 2011 were included in this series. Patient’s demography, preembolisation studies, embolisation studies and clinical followup post procedure were recorded. Results For a period of 22 months, there were a total of 10 cases of acute arterial haemorrhage and 4 cases of hypervascular lesions which undergo endovascular embolisation (n=14). The acute arterial haemorrhage cases ranging from lung lesions with haemoptysis, renal artery pseudoaneurysm, hepatic artery pseudoaneurysm, left gastric artery pseudoaneurysm, renal artery arteriovenous malformation and gluteal arteriovenous malformation. The hypervascular lesions include carotid body paraganglioma, parapharyngeal tumour, renal cell carcinoma, and renal cell carcinoma metastases. Various embolic materials were used ranging from glue, gelfoam, coils and PVA. All cases of acute arterial haemorrhage had cessation of haemorrhage immediately post embolisation. For preoperative embolisation of hypervascular lesions, all cases had marked reduction in the intraoperative blood loss. Conclusion In this limited series, endovascular embolisation had shown to be effective in controlling acute arterial haemorrhage and also reducing intraoperative blood loss in hypervascular lesions