Systemic embolization in oncological patients with pulmonary bleeding

The OBJECTIVE was to evaluate the effectiveness and safety of systemic embolization in cancer patients with pulmonary bleeding.METHODS AND MATERIALS. A retrospective single-center study of medical records of patients treated at the Ryazan Regional Clinical Hospital in the period 2020–2022 was conducted. The inclusion criteria were patients over 18 years of age with a breast cancer complicated by PB who underwent bronchial angiography. A total of 65 patients were selected. The PB signs during contrast enhancement of systemic vessels were divided into direct and indirect. After identifying the pathology of systemic vessels, they were embolized. The study evaluated the hospital-based effectiveness of hemostasis (immediate clinical success), the technical success of endovascular treatment, late clinical success (no recurrence of PB within a month), early (within a month) and late PB recurrences (more than a month), postoperative complications, and postoperative mortality.RESULTS. In our study, the sensitivity of the X-ray endovascular method in cancer patients with PB was 87.7 %. Bronchial arteriography was completed by embolization of the affected vessels in 53 cases during the primary X-ray endovascular examination and in 3 cases during the repeated examination. Thus, the technical success rate was 86.2 %. The immediate clinical success rate was 100 %. The late clinical success rate was 92.4 %. The rate of early recurrences (within a month) of PB in cancer patients did not exceed 7.5 %. Of the 50 cancer patients who underwent systemic embolization for PB, two patients (3.8 %) had PB recurrence within a year due to bronchial artery revascularization. Hyperthermia was a common postoperative symptom after systemic embolization in 25 (47.2 %) patients. In two (3.8 %) patients, the treatment was complicated by bronchial destruction and hemorrhagic stroke, which accounted for the 3.8 % mortality rate.CONCLUSIONS. Systemic embolization is the effective and safe method of treatment of pulmonary bleeding in cancer patients. This method has a high technical and clinical success and, due to the improvement of endovascular techniques, minimizes postoperative complications and lethality.