title: Bleeding after percutaneous radiofrequency ablation: Successful treatment with transcatheter embolization.
abstract: OBJECTIVE
  This knowledge will provide an ability to earlier detect bleeding complications after radiofrequency ablation (RFA), to manage these complications appropriately with endovascular procedures and minimize the sequelae.
  
  
  METHODS
  From 2002 to 2005, 96 patients with 150 hepatic tumours underwent 126 RFA sessions. Fifty-eight patients had HCC, 34 had liver colorectal metastases and 4 had cholangiocellular carcinoma. Sixty-one patients were men and 35 were women (mean age 69.82 years, age range 39-89). The lesions number ranged from 1 to 7 per patients (mean 1.6 nodules) with a mean diameter of 28.5 mm (range 80-10 mm). Seventy-seven patients underwent a single ablative session, 13 patients underwent 2 sessions, 4 patients underwent 3 sessions and 2 patients underwent 4 sessions. The number of tumours treated in each ablative session was 1 in 106, 2 in 18 and 4 in 2 patients.
  
  
  RESULTS
  Two cases of serious haemorrhages occurred after the procedures in two patients treated for liver metastases. An endovascular embolization was proposed for both patients using polyvinyl-alcohol and micro-coils. The absence of bleeding was first confirmed during angiography and then by CT performed the day after the angiographic procedure.
  
  
  CONCLUSIONS
  Transarterial embolization (TAE) represents the treatment of choice in the management of iatrogenic bleeding after RFA since it is minimally invasive, have a high success rate and a low incidence of complications compared to the more complex and dangerous surgical or laparoscopic options in patients who are often haemodynamically unstable and therefore at high anaesthetic and surgical risk.
authors.affiliation: Vascular and Interventional Radiology, Department of Radiology, University of Insubria, 21100 Varese, Italy. gcarraf@tin.it
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Carrafiello
authors.forename: Domenico
authors.initials: D
authors.lastname: Laganà
authors.forename: Andrea
authors.initials: A
authors.lastname: Ianniello
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Craparo
authors.forename: Chiara
authors.initials: C
authors.lastname: Recaldini
authors.forename: Domenico
authors.initials: D
authors.lastname: Lumia
authors.forename: Gianlorenzo
authors.initials: G
authors.lastname: Dionigi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cuffari
authors.forename: Carlo
authors.initials: C
authors.lastname: Fugazzola
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation; D018281:Cholangiocarcinoma / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000473:pathology; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000628:therapy*; D014057:Tomography, X-Ray Computed