The initial experience of selective x-ray endovascular chemoembolization of bladder arteries in combined treatment of patients with metastatic bladder cancer, which was complicated by refractory macrohematuria in «Feofaniya» clinical hospital

Abstract

The objective of study is retrospective analysis, estimate and publish the initial experience of selective chemoembolization of the bladder arteries in the combined treatment of a patient with metastatic bladder cancer complicated by refractory macrohematuria. Material and methods. In the course of the work the results of treatment of metastatic bladder cancer with the use of X-ray endovascular selective chemoembolization of the bladder arteries in the conditions of the «Feofaniya» clinical hospital were studied. Simmons/Sidewinder 3 and UFE Type 1 (Terumo) catheters with an outer diameter of 5 F were used during the intervention. Vascular chemoembolization was performed with LifePearl (Terumo) microspheres with a diameter of 200±50 nm in a volume of 2 ml, which were saturated with the chemotherapeutic agent Doxorubicin “Ebeve” at a dose of 50 mg. The results were studied immediately and after three months. Results. According to control intraoperative angiography all arterial branches feeding the tumor were excluded from the blood supply. After the intervention, the patient retained an independent act of urination, the need for catheterization of the bladder or other methods urine derivation after surgery did not arise. Three months later, according to the results of the control examination, signs of regression of the bladder tumor were revealed while maintaining the reservoir potential of the bladder. No recurrences of macrohematuria occurred during the follow-up period. Conclusions. The technique of X-ray endovascular selective chemoembolization seems promising to us, and the initial experience of its use motivates the further introduction of such operations in patients with locally advanced or metastatic (mostly hypervascular) neoplasias of different localizations. In addition, this process is actualized by the possibility of effective and minimally invasive prevention of the occurrence or cessation of existing tumor-associated bleeding, which in this work is successfully illustrated by the example of refractory macrohematuria.