Factors associated with in-hospital mortality following transcatheter arterial embolization for tumor hemorrhage in patients with cancer

Abstract

Introduction: Bleeding in cancer patients is a common and potentially serious complication associated with high morbidity and mortality. Transcatheter arterial embolization has emerged as an effective therapeutic strategy for controlling bleeding, especially in patients with advanced disease or limited treatment options. Materials and methods: A retrospective, observational, analytical cohort study was conducted in cancer patients with tumor hemorrhage treated with transcatheter arterial embolization using coils at SOLCA Guayaquil between March and November 2025. Clinical, procedure-related, and outcome variables were collected, including technical success, immediate control of bleeding, rebleeding, re-embolization, and mortality. A descriptive and comparative analysis was performed using Fisher’s exact test and the Mann–Whitney U test. Results: Twenty-six patients were included; the median age was 58 years, and 61.5% were female. Technical success was 100%, with immediate control of bleeding in 69.2% of cases. Re     bleeding occurred in      30.8%, and 15.4% required re-embolization. In-hospital mortality was 38.5%, and 30-day mortality was 42.3%. Higher mortality was observed among      patients with      shock, those receiving vasopressors, those without hemorrhage control, and those with rebleeding. Conclusions: Transcatheter arterial embolization is an effective strategy for controlling bleeding in cancer patients; however, rebleeding and baseline clinical status significantly influence outcomes and mortality. These findings highlight the importance of close follow-up and comprehensive evaluation in this population.