RANKING OF EMBOLIZATION TREATMENT IN ACUT E HEMORRHAGES

137 arteries of 95 patients were treated by transcatheter embolization for massive haemorrhage using Ethibloc, Gelfoam, wire coils and Tissu col (Fibrinogen + Thrombin). The bleeding was secondary to trauma in 2 3 patients, to neoplasms in 16 patients and to vascular malformations or chronic inflammatory processes in 41 cases. 15 patients were treate d for iatrogenic bleeding following surgery. Bleeding was referred to haemoptysis (n = 27), pelvic (n = 24), renal (n = 16) or gastrointesti nal haemorrhage (n = 13) as well as several other diseases (n = 15). M ost patients were poor surgical candidates. The overall bleeding contr ol rate was 89.5 % with a incidence of recurrent bleeding in 14 out of 95 patients (14.7 %) treated by reembolization or surgery. 6 patients died (6.3 %) due to intractable haemorrhage, 4 patients (4.2 %) died of complications related to embolization procedure (4 x bowel infarcti on!) and 33 patients (34.7 %) died of procedure-unrelated causes such as myocardial infarction, trauma, malignancy or other underlying disea ses. 58 patients (61.1 %) are still alive (follow-up 16.2 +/- 4.8 mont hs). Significant complications (5.3 %) included bowel necrosis (4 x) a nd ischaemia of the spinal cord with incomplete paralysis in one patie nt. One patient suffered thrombosis of the common iliac artery due to angiography. On the basis of our results, peripheral embolization usin g Ethibloc can be recommended as palliative treatment for devascularis ation of bleeding tumours. Satisfactory results are obtained in haemop tysis, renal and pelvic haemorrhage, but gastrointestinal bleeding sho uld not be occluded by means of Ethibloc because of its considerable r isk of bowel infarction.