Clinical Outcomes of CTA-Assisted Transarterial Embolization in Emergency Patients With Urologic Tumours Complicated by Gross Haematuria: A Retrospective Cohort Study.

BACKGROUND: Gross haematuria constitutes a life-threatening complication of urologic tumours, demanding urgent and precise identification of the responsible bleeding vessels, along with immediate and effective haemostatic intervention to avert hemodynamic collapse. METHODS: This retrospective cohort study included 120 emergency patients with urologic tumours and gross haematuria between January 2020 and December 2023. All patients underwent preprocedural computed tomography angiography (CTA) to evaluation bleeding vessels and tumour blood supply, followed by transarterial embolization (TAE). Clinical characteristics, procedural outcomes, and follow-up data were analysed. RESULTS: Preprocedural CTA identified target vessels in 112 of 120 patients (93.3%). Postoperative complications occurred in 23 patients (19.2%) and were predominantly Clavien-Dindo grade I-II, including embolization syndrome (9.2%), transient recurrent haematuria (5.0%), and urinary tract infection (3.3%), all of which were managed conservatively. Multivariate Cox regression analysis identified tumour node metastasis (TNM) stage III-IV, multiple tumour foci, and hypovascular supply as independent risk factors for haematuria recurrence and poor overall survival rate (all p < 0.05). CONCLUSIONS: CTA-assisted TAE shows high immediate haemostatic efficacy and acceptable short-term safety, supporting its clinical feasibility as a rescue approach for urologic tumour-related gross haematuria. TNM stage III-IV, multiple foci, and hypovascular supply predict poorer outcomes. Prospective multicentre controlled studies are warranted.