Prophylactic embolization of the left gastric artery before neoadjuvant chemotherapy in gastric cancer patients

Transarterial embolization (TAE) is an effective method of hemostasis, but the prophylactic use of this procedure in patients with a high risk of bleeding remains poorly studied. Objective. To evaluate the clinical efficacy and safety of the left gastric artery TAE in patients with resectable gastric cancer and a history of gastrointestinal bleeding before neoadjuvant polychemotherapy (NAPCT). Material and methods. A single-center retrospective non-randomized study was conducted. Treatment results were analyzed in 14 patients (mean age 65±9 years) with resectable gastric cancer and a history of tumor bleeding, who underwent prophylactic embolization of the left gastric artery using microcoils or microspheres before NAPCT at the S.S. Yudin City Clinical Hospital from 2022 to 2024. The technical success of the procedure, the presence of bleeding recurrence and the tumor regression grade (TRG) were assessed. Results. TAE was technically successful in 12 patients (85.7%), of which 10 patients did not experience bleeding recurrence during NAPCT. Radical surgery was possible after successful TAE and NAPCT in 8 patients. There were 4 mild complications: post-embolization syndrome — 3, hematoma — 1. TRG according to Mandard classification constituted 1 — 1 case, 3 — 5 cases, 4 — 2 patients. Conclusion. Prophylactic embolization of the left gastric artery before NAPCT in patients with gastric cancer and tumor bleeding history is a clinically effective and safe procedure that can reduce the risk of bleeding recurrence and improve the tolerability of chemotherapy. However, further studies are needed to clarify the indications and evaluate the long-term results.