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Sample records for arterial embolization therapy

  1. Hyperbaric oxygen therapy for the prevention of arterial gas embolism in food grade hydrogen peroxide ingestion.

    Science.gov (United States)

    Hendriksen, Stephen M; Menth, Nicholas L; Westgard, Bjorn C; Cole, Jon B; Walter, Joseph W; Masters, Thomas C; Logue, Christopher J

    2016-12-14

    Food grade hydrogen peroxide ingestion is a relatively rare presentation to the emergency department. There are no defined guidelines at this time regarding the treatment of such exposures, and providers may not be familiar with the potential complications associated with high concentration hydrogen peroxide ingestions. In this case series, we describe four patients who consumed 35% hydrogen peroxide, presented to the emergency department, and were treated with hyperbaric oxygen therapy. Two of the four patients were critically ill requiring intubation. All four patients had evidence on CT or ultrasound of venous gas emboli and intubated patients were treated as if they had an arterial gas embolism since an exam could not be followed. After hyperbaric oxygen therapy each patient was discharged from the hospital neurologically intact with no other associated organ injuries related to vascular gas emboli. Hyperbaric oxygen therapy is an effective treatment for patients with vascular gas emboli after high concentration hydrogen peroxide ingestion. It is the treatment of choice for any impending, suspected, or diagnosed arterial gas embolism. Further research is needed to determine which patients with portal venous gas emboli should be treated with hyperbaric oxygen therapy.

  2. Transcatheter arterial embolization as therapy of renal angiomyolipomas: The evolution in 15 years of experience

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    Chatziioannou, A.; Gargas, D. [University of Athens, Aretaieion Hospital, Radiology Department (Greece); Malagari, K. [University of Athens, Imaging and Research Unit, Evgenidion Hospital (Greece); Kornezos, I., E-mail: kornezos@gmail.com [University of Athens, Aretaieion Hospital, Radiology Department (Greece); Ioannidis, I.; Primetis, E. [University of Athens, Aretaieion Hospital, Radiology Department (Greece); Moschouris, H. [University of Athens, Imaging and Research Unit, Evgenidion Hospital (Greece); Gouliamos, A.; Mourikis, D. [University of Athens, Aretaieion Hospital, Radiology Department (Greece)

    2012-09-15

    Objective: This study aims at presenting the evolution of the embolization technique in treating renal angiomyolipomas (AMLs) either diagnosed in patients with acute bleeding or discovered accidentally. Methods: Ten patients with renal AMLs have been through thirteen selective transcatheter arterial embolizations for 15 years. Two patients had tuberous sclerosis complex (TSC) with bilateral tumors and were embolized twice. Four embolic materials were employed: PVA particles, Gianturco coils, microspheres and microcoils. Catheterization was achieved by means of 5F Cobra 2 catheters and coaxial microcatheter systems. Results: On an emergency basis, embolization was a first-line treatment. In one case, surgery was necessary; in two patients, a second embolization was performed. When treatment was preventive, a single embolization proved to be sufficient, as well. There was no significant deterioration of the serum creatinine levels in the post-embolization period. Conclusion: Selective arterial embolization is a rather safe and effective technique to treat AMLs both urgently and preventively. Different embolic materials can be employed. Microspheres and microcatheters stand for new promising materials.

  3. Partial Splenic Artery Embolization

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    Gh. Shadmani

    2010-05-01

    Full Text Available Background/Objective: Hypersplenism often accompanies chronic liver disease and splenomegaly is one of the four cardinal signs of hypersplenism, the other three being cytopenia, normal or hyperplastic bone marrow and response splenectomy. Surgical splenectomy is the traditional treatment."nIn the recent years, partial splenic embolization has been widely used in patients with hypersplenism and cirrhosis.This study was conducted to assess the safety and efficacy of partial splenic embolization using PVA (poly vinyl alcohol and steel coil in the management of hypersplenism."nPatients and Methods: Between Aban 1387 and Aban 1388, ten patients with hypersplenism related hematologic abnormalities (leukopenia, thrombocytopenia, variceal hemorrhage or other sequels underwent partial splenic embolization with PVA and coil. A comparison between pre-procedure and post-procedure lab data, endoscopy and splenic volumetery was done."nResults: All patients showed dramatic improvement in platelet and leukocyte counts. Platelet and leukocyte counts remained at an appropriate level during the follow up period. In one patient after one year progressive decline in the platelet count was noted, however the values remained significantly higher than before PSE (70000 vs 15000."nAlmost all patients had problems related to post embolization syndrome. In one patient severe pain was noted that lasted nearly ten days, in the other patients, pain was less severe. No significant complication (splenic abscess, pancreatitis, portal vein thrombosis developed in this study."nConclusion: The efficacy of PSE observed in our study confirms the results of previous studies in pa-tients with hypersplenism. This safe, fast method can be used bridging therapy for cirrhotic patients waiting for liver transplantation. Hematological response is related to the extension of embolization.

  4. Hemophilic Chronic Synovitis: Therapy of Hemarthrosis using Endovascular Embolization of Knee and Elbow Arteries

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    Galli, E., E-mail: emgalli1@yahoo.com.ar [CABA, Hospital de Agudos ' Juan A. Fernandez' (Argentina); Baques, A.; Moretti, N.; Candela, M. [CABA, Fundacion de la Hemofilia de Buenos Aires (Argentina); Caviglia, H. [CABA, Hospital de Agudos ' Juan A. Fernandez' (Argentina)

    2013-08-01

    PurposeCongenital hemophilia is a hereditary bleeding disorder that affects 1 in 5,000 males and is characterized by repetitive musculoskeletal bleeding episodes. Selective embolization of the knee and elbow arteries can prevent bleeding episodes. To evaluate the long-term efficacy of these procedures, we assessed the outcomes of 30 procedures performed in our center.MethodsWe performed 30 procedures in 27 hemophilic patients, including 23 knee, and 7 elbow procedures. To evaluate the efficacy of selective embolization of knee and elbow arteries in people with hemophilia, we analyzed the number of bleeding episodes during 12 months before the procedure compared with the amount of episodes that occurred 3, 6, and 12 months after embolization.ResultsTwenty-nine of 30 procedures were classified as successful. The median of 1.25 episodes per month (range 0-3) observed before the procedure was reduced to 0 (range 0-1.67; p < 0.001) at 3 months, 0.17 (range 0-1.67; p < 0.001) at 6 months, and 0.33 (range 0-1.67; p = 0.024) at 12 months. Three patients remained free of bleeding events for more than 6 months. Additionally, after the procedure there was a significant reduction in factor FVIII usage that sustained up to 12 months after the procedures. No serious adverse events were observed.ConclusionsSelective angiographic embolization of knee and elbow arteries is a feasible procedure that can prevent repetitive bleedings, which would translate in better joint outcomes for these patients.

  5. Bronchial artery embolization in hemoptysis

    Institute of Scientific and Technical Information of China (English)

    DAI Hong-xiu; YANG Ding-cai; LIU Wei-hong; TANG He-qing; LIU Ke-yong; ZHAO Xiao-hua; TAN Yi-qing; WANG Jun

    2005-01-01

    Massive hemoptysis is one of the most dreaded of all respiratory emergencies and can have a variety of underlying causes. It is mostly caused by bleeding from bronchial circulation. Bronchial artery embolization is now considered to be the treatment of choice for acute massive hemoptysis. Bronchial artery embolization (BAE) is a safe and effective nonsurgical treatment for patients with massive hemoptysis. However, nonbronchial systemic arteries can be a significant source of massive hemoptysis and a cause of recurrence after successful BAE. So knowledge of the bronchial artery anatomy, together with an understanding of the pathophysiologic features of massive hemoptysis, are essential for planning and performing BAE in affected patients. In addition, interventional radiologists should be familiar with the techniques, results, efficacy, safety and possible complications of BAE and with the characteristics of the various embolic agents. Bronchial arterial catheterisation in human via a percutaneous approach has been practiced for 32 years (1973) in the world and 20 years (1986) in China, initially for direct chemotherapy treatment for bronchial malignancies and then for the embolization of patients with massive haemoptysis. A review of clinical experience to evaluate technique,embolic materials,outcome and complications of BAE is presented.

  6. Pregnancy after uterine arterial embolization

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    Cláudio E. Bonduki

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. METHODS: A retrospective study of 187 patients treated with uterine arterial embolization for symptomatic uterine fibroids between 2005-2008 was performed. Uterine arterial embolization was performed using polyvinyl alcohol particles (500-900 mm in diameter. Pregnancies were identified using screening questionnaires and the study database. RESULTS: There were 15 spontaneous pregnancies. Of these, 12.5% were miscarriages (n = 2, and 87.5% were successful live births (n = 14. The gestation time for the pregnancies with successful live births ranged from 36 to 39.2 weeks. The mean time between embolization and conception was 23.8 months (range, 5-54. One of the pregnancies resulted in twins. The newborn weights (n = 14 ranged from 2.260 to 3.605 kg (mean, 3.072 kg. One (7.1% was considered to have a low birth weight (2.260 kg. There were two cases of placenta accreta (12.5%, treated with hysterectomy in one case [6.3%], one case of premature rupture of the membranes (PRM (6.3%, and one case of preeclampsia (6.3%. All of the patients were delivered via Cesarean section. CONCLUSION: In this study, there was an increased risk of Cesarean delivery. There were no other major obstetric risks, suggesting that pregnancy after uterine arterial embolization is possible without significant morbidity or mortality.

  7. Upper limb amputation due to a brachial arterial embolism associated with a superior mesenteric arterial embolism: a case report

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    Yamada Tsuyoshi

    2012-07-01

    Full Text Available Abstract Background Acute mesenteric ischemia due to an embolism of the superior mesenteric artery is associated with a high mortality rate. Over 20 percent of acute mesenteric embolism cases consist of multiple emboli, and the long-term prognosis depends on the incidence of subsequent embolic events at other sites. The incidence of emboli in the upper extremity associated with a superior mesenteric arterial embolism has rarely been described. The signs and symptoms of ischemic change in the upper limb can be masked by other circumstances, such as postoperative conditions or complications. In these cases, a late presentation or delayed diagnosis and treatment can result in limb loss. Case presentation We present a rare case of a 67-year-old Japanese woman with atrial fibrillation who developed an embolic occlusion of the brachial artery associated with a superior mesenteric arterial embolism. She developed gangrene in her right hand, which had progressed to the point that amputation was necessary by the time the gastrointestinal surgeon had consulted the Department of Orthopedic Surgery. The brachial arterial embolism diagnosis was delayed by the severe abdominal symptoms and shock conditions that followed the emergency enterectomy, resulting in amputation of the upper limb despite anticoagulation therapy. In this case, multiple infarctions of the spleen were also observed, indicating a shower embolism. Conclusions When treating a superior mesenteric arterial embolism in a patient with atrial fibrillation, the possibility of recurrent or multiple arterial thromboembolic events should be considered, even after the procedure is completed.

  8. Uterine artery embolization - inpatient and outpatient therapy: a comparison of cost, safety, and patient satisfaction

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    Baerlocher, M.O.; Asch, M.R.; Hayeems, E.Z.; Rajan, D.K. [Univ. of Toronto, Radiology Residency Training Program, Toronto, Ontario (Canada)]. E-mail: mark.baerlocher@utoronto.ca

    2006-04-15

    To determine whether uterine artery embolization (UAE) can be safely performed as an outpatient procedure without increased complications and readmission rates or decreased patient satisfaction rates and to determine the Canadian cost difference between performing UAE as an outpatient, compared with inpatient, procedure. We performed a retrospective chart review and patient survey of 2 groups of patients, 132 patients who underwent inpatient UAE and 20 patients who underwent outpatient UAE. Of these, 82 and 18, respectively, were successfully surveyed by telephone. Variables examined included presenting complaints, postprocedural symptoms, patient satisfaction, and readmission or complication rates. We also performed a detailed Canadian cost analysis comparing inpatient with outpatient UAE. We did not find any statistically significant difference between inpatient and outpatient UAE on any of the patient variables measured, including presenting complaints, postprocedural symptoms, patient satisfaction, and readmission or complication rates. We also found that outpatient UAE costs significantly less than inpatient UAE, primarily owing to decreased hospital overhead costs for overnight admission. In Ontario, inpatient UAE costs per patient totalled $3216.22, whereas outpatient costs totalled $2194.53 - a saving of $1021.69, which represents a 31.8% cost reduction. Given these results, we recommend that centres consider performing UAE as an outpatient procedure. A key enabling factor is the ability to have several hours of close nursing supervision of the patient postprocedure, prior to discharge. (author)

  9. Transcatheter embolization therapy of the gastrointestinal hemorrhage

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    Sim, Jae In; Park, Auh Whan; Ryeom, Hun Kyu; Kim, Yong Joo [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    1994-05-15

    To evaluate the effectiveness of transcatheter embolization for the treatment of massive gastrointestinal arterial bleeding. The study was based on retrospective analysis of twelve cases(8 men, 4 woman) including two patients with hemobilia in which transcatheter embolization was attempted for the control of massive gastrointestinal bleeding from March 1987 to October 1993. Clinical diagnoses of these patients were peptic ulcer(5), pseudoaneurysm formation(3) following percutaneous transhepatic biliary drainage or traffic accident, stomach cancer(1), typhoid fever(1), duodenal leiomyoma(1) and Osler-Weber-Rendu disease (1). Embolized vessels are as follows: gastroduodenal artery(6), left gastric artery(2), ileocolic artery(2), and hepatic artery(2). Embolization was effective in immediate control of bleeding in all patients. Although five of the six patients who had undergone embolization of the gastroduodenal artery developed rebleeding within 24 hour, only 2 required surgery and none showed serious complication. Embolization therapy is safe and effective initial treatment of choice for life-threatening massive gastrointestinal bleeding.

  10. Transarterial embolization of acute intercostal artery bleeding

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    Bae, Jae Ik; Park, Auh Whan; Lee, Seon Joo [Inje University College of Medicine, Busan (Korea, Republic of); Ko, Gi Young; Yoon, Hyun Ki [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Yoon, Chang Jin [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Shin, Tae Beom [Donga University College of Medicine, Busan (Korea, Republic of); Kim, Young Hwan [Kyimyung University School of Medicine, Daegu (Korea, Republic of)

    2005-09-15

    To report our experiences of transarterial embolization for acute intercostal artery bleeding. A retrospectively analysis of the causes, clinical manifestations, angiographic findings and transarterial embolization technique in 8 patients with acute intercostal artery bleeding, with a review of the anatomical basis. The causes of intercostal artery bleeding were iatrogenic and traumatic in 88 and 12% of cases, respectively. Active bleeding from the collateral intercostal or posterior intercostal arteries was angiographically demonstrated in 75 and 25% of cases, respectively. Transarterial embolization successfully achieved hemostasis in all cases. However, two patient with hypovolemic shock expired due to a massive hemothorax, despite successful transarterial embolization. Intercostal access should be performed through the middle of the intercostal space to avoid injury to the collateral intercostal artery. Transarterial embolization is an effective method for the control of intercostal artery bleeding.

  11. Systemic arterial air embolism after percutaneous lung biopsy

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    Hare, S.S., E-mail: samanjit@btinternet.com [Ottawa Hospital, Ontario (Canada); Gupta, A.; Goncalves, A.T.C.; Souza, C.A.; Matzinger, F.; Seely, J.M. [Ottawa Hospital, Ontario (Canada)

    2011-07-15

    Systemic arterial air embolism is a rarely encountered but much feared complication of percutaneous lung biopsy. We present a comprehensive review of iatrogenic air embolism post-lung biopsy, a complication that is often suboptimally managed. This review was inspired by our own institutional experience and we use this to demonstrate that excellent outcomes from this complication can be seen with prompt treatment using hyperbaric oxygen chamber therapy, after initial patient stabilization has been achieved. Pathophysiology, clinical features, and risk factors are reviewed and misconceptions regards venous versus arterial air embolism are examined. An algorithm is provided for radiologists to ensure suspected patients are appropriately managed with more favourable outcomes.

  12. Intra-arterial therapy for cardio embolic internal carotid artery terminus occlusion: The past and present status in real practice

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    Jung, Seung Guk; Jung, Cheol Kyu; KIm, Jae Hyoung; Choi, Byung Se; Kim, Beomn Joon; Han, Moon Ku; Bae, Hee Joon [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Kwon, Bae Ju [Dept. of Radiology, Myongji Hospital, Goyang (Korea, Republic of); Cha, Sang Hoon [Dept. of Radiology, Chungbuk National University College of Medicine, Daejeon (Korea, Republic of)

    2015-10-15

    There is little data on the effect of intra-arterial therapy (IAT) in acute cardioembolic internal carotid artery terminus (ICAT) occlusion that has poor prognosis. We determined procedural and clinical outcomes in patients with acute cardioembolic ICAT occlusion treated with different methods of IAT. On retrospective review of our registry, patients with cardioembolic ICAT occlusion were categorized as thrombolytic-based IAT group (TLG) and thrombectomy-based IAT group (TEG) according to the primary endovascular technique. Subsequently, procedural and clinical outcomes were compared. Fifty-five patients had cardioembolic ICAT occlusion and 18 patients were assigned to TLG and 37 patients to TEG. The rate of complete reperfusion was significantly higher and the groin puncture to reperfusion time was significantly shorter in TEG than those in TLG. There was a trend towards functional outcome at 3 months in the TEG group; however, it was not statistically significant (p = 0.06). Age, baseline Albert Stroke program early CT score and puncture to reperfusion time were factors affecting unfavorable outcome at 3 months, on multivariable analysis. Thrombectomy-based IAT has advantages over thrombolytic-based IAT in terms of the reduction of groin puncture to reperfusion time and improvement of the rate of complete reperfusion.

  13. Thrombolytic therapy in pulmonary embolism.

    LENUS (Irish Health Repository)

    Nagi, D

    2010-01-01

    Massive pulmonary embolism carries a high mortality. Potential treatment includes anticoagulation, thrombolytic therapy and embolectomy. We report a case of deep vein thrombosis leading to progressive massive pulmonary embolism despite appropriate anticoagulation, where thrombolysis with IVC filter placement resulted in a successful outcome.

  14. Permanent Cortical Blindness After Bronchial Artery Embolization

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    Doorn, Colette S. van, E-mail: cvandoorn@gmail.com; De Boo, Diederick W., E-mail: d.w.deboo@amc.uva.nl [Academic Medical Centre, Department of Radiology (Netherlands); Weersink, Els J. M., E-mail: e.j.m.weersink@amc.uva.nl [Academic Medical Centre, Department of Pulmonology (Netherlands); Delden, Otto M. van, E-mail: o.m.vandelden@amc.uva.nl; Reekers, Jim A., E-mail: j.a.reekers@amc.uva.nl; Lienden, Krijn P. van, E-mail: k.p.vanlienden@amc.uva.nl [Academic Medical Centre, Department of Radiology (Netherlands)

    2013-12-15

    A 35-year-old female with a known medical history of cystic fibrosis was admitted to our institution for massive hemoptysis. CTA depicted a hypertrophied bronchial artery to the right upper lobe and showed signs of recent bleeding at that location. Bronchial artery embolization (BAE) was performed with gelfoam slurry, because pronounced shunting to the pulmonary artery was present. Immediately after BAE, the patient developed bilateral cortical blindness. Control angiography showed an initially not opacified anastomosis between the embolized bronchial artery and the right subclavian artery, near to the origin of the right vertebral artery. Cessation of outflow in the bronchial circulation reversed the flow through the anastomosis and allowed for spill of embolization material into the posterior circulation. Unfortunately the cortical blindness presented was permanent.

  15. Permanent cortical blindness after bronchial artery embolization.

    Science.gov (United States)

    van Doorn, Colette S; De Boo, Diederick W; Weersink, Els J M; van Delden, Otto M; Reekers, Jim A; van Lienden, Krijn P

    2013-12-01

    A 35-year-old female with a known medical history of cystic fibrosis was admitted to our institution for massive hemoptysis. CTA depicted a hypertrophied bronchial artery to the right upper lobe and showed signs of recent bleeding at that location. Bronchial artery embolization (BAE) was performed with gelfoam slurry, because pronounced shunting to the pulmonary artery was present. Immediately after BAE, the patient developed bilateral cortical blindness. Control angiography showed an initially not opacified anastomosis between the embolized bronchial artery and the right subclavian artery, near to the origin of the right vertebral artery. Cessation of outflow in the bronchial circulation reversed the flow through the anastomosis and allowed for spill of embolization material into the posterior circulation. Unfortunately the cortical blindness presented was permanent.

  16. Penile angiography and superselective embolization therapy in arterial priapism; Penisangiographie und superselektive Embolisationstherapie bei high-flow Priapismus

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    Dinkel, H.P.; Triller, J. [Inst. fuer Diagnostische Radiologie, Inselspital, Univ. Bern (Switzerland); Hochreiter, W. [Urologische Klinik, Inselspital, Univ. Bern (Switzerland)

    2003-08-01

    Purpose: To report feasibility, benefit and complications of penile angiography and superselective penile embolization in arterial priapism. Materials and Methods: Four consecutive patients (aged 28, 29, 40 and 49 years), who underwent penile angiography for arterial priapism (high-flow priapism) within a four-year period, were identified by a keyword search of our radiology information system. One patient had sustained a direct penile trauma (severe blow to the erected penis) and three patients suffered from recurrent spontaneous priapism. All patients had previously undergone corporeal aspiration and noradrenaline injection to achieve detumescence. Two patients had one or several unsuccessful spongiocavernous shunt procedures. Results: In three of the four patients, superselective pudendal and penile angiography demonstrated pathologic arteriocavernous shunting. In two of the three patients, superselective embolization using a coaxial micro-catheter was attempted. In one of the two patients, the cavernous artery became spastic before embolization material was actually injected, inducing immediate and lasting detumescence. In the other patient, unilateral Gelfoam embolization led to immediate detumescence but the priapism recurred 12 hours after the procedure. A subsequent contralateral Gelfoam embolization was successful. Erectile function was preserved in all cases. No procedure-related complications occurred. Conclusion: Our experience supports the prevailing opinion found in the current literature that superselective coaxial embolization constitutes the treatment of choice in patients with high-flow priapism. Prognosis is good with high probability of preserving the erectile function. (orig.) [German] Ziel: Untersuchung der Interventionsmoeglichkeiten bei arteriellem (high-flow) Priapismus durch endovaskulaere superselektive Embolisation der Penisarterien. Methode: Alle innerhalb eines Vierjahreszeitraums (1/99-5/2002) wegen Priapismus zur Angiographie

  17. Arterial embolization in patients with renal carcinoma

    DEFF Research Database (Denmark)

    Christensen, S W; Berg, J; Brynitz, S;

    1989-01-01

    The literature concerning embolization of the renal artery in patients with renal cell carcinoma is reviewed. Based on this review it is concluded that the method is useful in this patient group as it will facilitate the surgical procedure if nephrectomy is performed afterwards. Used as a palliat......The literature concerning embolization of the renal artery in patients with renal cell carcinoma is reviewed. Based on this review it is concluded that the method is useful in this patient group as it will facilitate the surgical procedure if nephrectomy is performed afterwards. Used...

  18. Glue embolization of a ruptured celiac trunk pseudoaneurysm via the gastroduodenal artery

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    Schoder, M.; Cejna, M.; Hittmaier, K.; Lammer, J. [Department of Radiology, Division of Angiography and Interventional Radiology, University of Vienna, Vienna (Austria); Laengle, F. [Department of Surgery, Division of General Surgery, University of Vienna, Vienna (Austria)

    2000-08-01

    Percutaneous transcatheter embolization of splanchnic artery aneurysms is a minimally invasive and alternative therapy to conventional surgical intervention. Due to a high-grade stenosis at the origin of the celiac trunk, a retrograde approach to the celiac trunk pseudoaneurysm via the gastroduodenal artery was necessary. To prevent undesirable embolization into the peripheral left gastric artery initial occlusion of the central portion of the left gastric artery was performed with microcoils using a Tracker catheter. Complete occlusion of the celiac trunk itself and the short adjacent segments of the celiac artery was achieved by using a mixture of N-butyl-2-cyanoacrylate and ethiodized oil as the embolizing agent. (orig.)

  19. An intractable case of lower gastrointestinal hemorrhage due to radiation colitis. Usefulness of transcatheter arterial embolization

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    Inoue, Koichi; Koyama, Tukasa [Yoka Hospital, Hyogo (Japan); Sugamura, Kenji; Ogawa, Toshihide [Tottori Univ., Yonago (Japan). Faculty of Medicine

    2003-05-01

    We tried transcatheter arterial embolization for lower gastrointestinal hemorrhage due to radiation colitis. In this case, colostomy and endoscopic therapy were not effective. We succeeded in arresting the hemorrhage without any complications. Transcatheter embolization is a low-invasive and safe method of treatment. For prevention of inflammation and iatrogenic abscess formation, we repeated this therapy and we tried arterial injection of antibiotics and steroid. And so, this therapy is one of the effective methods. (author)

  20. Uterine artery embolization to treat uterine fibroids

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    Machan, L.; Martin, M. [Univ. of British Columbia Hospital, Dept. of Radiology, Vancouver, BC (Canada)

    2001-06-01

    The first reported application of uterine artery embolization, in 1979, was to treat life-threatening hemorrhage after a failed hysterectomy. Since then, uterine artery embolization has been used very successfully to control acute or delayed post-partum hemorrhage, post-surgical hemorrhage and hemorrhage from ectopic pregnancy, to treat uterine arteriovenous malformations and as prophylaxis before high-risk surgery, such as cesarean delivery in women with placenta previa. In contrast to these proven but underutilized applications, uterine embolization for fibroids has, in a short time, achieved significant notice in the lay press and is being widely offered. Ravina and colleagues, first reported uterine fibroid shrinkage after embolization for the treatment of acute bleeding. Since then, his group has performed over 100 procedures with up to a 6-year follow-up. The cumulative clinical success rate for the treatment of abnormal uterine bleeding due to fibroids is reported to be approximately 85% and for treatment of pain or pressure symptoms, about 75%. Six-month follow-up sonography reveals an average reduction of fibroid size of approximately 40%. However, to date, no studies have compared patients who undergo embolization with a nontreatment cohort or with surgical intervention. (author)

  1. Massive cerebral arterial air embolism following arterial catheterization

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    Yang, C.W. [Northwestem University Feinberg School of Medicine, Department of Radiology, Chicago, IL (United States); Yang, B.P. [Northwestern University Feinberg School of Medicine, Department of Neurological Surgery, Chicago, IL (United States)

    2005-12-01

    Microscopic cerebral arterial air embolism (CAAE) has been described in many patients undergoing cardiac surgery as well as other invasive diagnostic and therapeutic procedures. However, massive CAAE is rare. We report a 42-year-old woman who initially presented with thalamic and basal ganglia hemorrhages. Shortly after a radial arterial catheter was inserted, the patient suffered a generalized seizure and CT demonstrated intra-arterial air in bilateral cerebral hemispheres. (orig.)

  2. Peripheral arterial embolism. Report of hospitalized cases

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    Antonio Carlos Pereira Barretto

    2000-04-01

    Full Text Available OBJECTIVE: We analyzed the frequency of peripheral embolisms, the underlying heart disease,triggering factors, the sites of the emboli, and evolution of the patients. METHODS: We analyzed 29 cases of peripheral arterial embolism out of a total of 20,211 hospitalizations in a cardiology center in the city of São Paulo. The age was 51.89±18.66 years, and 15 were males. RESULTS: Embolism in the right lower limb occurred in 18 patients (62.0%,in the left lower 11(37.9% and right upper 3 (10.3% limbs, and in the left arm (1. Four patients had embolism in two limbs. The heart disease, mitral valvar heart disease (9 patients - 31.0%; infective endocarditis (7- 24.1%; dilated cardiomyopathy (6 - 20.6%; ischemic coronary heart disease (6 patients - 20.6%; and one patient with cor pulmonale. Atrial fibrillation was observed in 20 patients (68.9%, chronic in 12 patients (41.3% and acute in 8 (27.5%. All patients with mitral valvar heart disease had atrial fibrillation, chronic in 8 patients (88.8%; patients with cardiomyopathy and coronary heart disease, 4 in each group had atrial fibrillation, acute in 60% of the patients.Patients with infective endocarditis, 3 had staphylococcus and 2 Gram-negative bacteria. In the follow-up, 2 patients (6.8% required limbs amputation, and 5 (17.2% died due to embolism. CONCLUSION: Most of the time, embolism does not cause permanent complications. Our data highlight the importance of anticoagulation for patients acute atrial fibrillation in myocardial dysfunction and for patients with chronic atrial fibrillation in cases of mitral valvar heart disease to prevent peripheral embolism.

  3. Transcatheter hepatic artery embolization of liver cancer

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    Lee, Jong Tae; Yoo, Hyung Sik; Suh, Jung Ho [Yonsei University College of Medicine, Seoul (Korea, Republic of); Yun, Heun Yung [Indiana University Hospital, Bloomington (United States)

    1985-12-15

    From March 1985 to September 1985, transcatheter hepatic arterial embolization was performed in 17 primary hepatoma and 8 metastasis of liver in Department of Radiology, Yonsei University College of Medicine. Metastasis cancers of liver were one nasopharyngeal cancer, one small bowel leiomyosarcoma, one gall bladder cancer and 5 colon cancers. The used embolization materials were the followings: Gelfoam particles for one primary hepatoma, 95% absolute ethanol for 4 patients, lvalon (250-590 {mu} m) for 19 patients and autologous blood clots for one metastasis. The results were summarized as the follows: 1. The devascularization of tumor vessels in post-embolization hepatic angiogram was complete in 6 primary hepatoma and one metastasis and partial in 11 primary hepatoma and 7 metastasis. 2. In the follow-up CT evaluation 3 to 4 weeks after embolization, well necrotic density was revealed in 8 primary hepatoma and one metastasis. 3. The complications were fever with higher than 38 .deg. C (92%), abdominal pain (72%) and nausea or vomiting (40%). They were subsided within one to 7 days after embolization. 4. In liver function study, sGOT and sGPT were elevated in 96% of total cases and retuned to normal within 3 to 7 days. Alkaline phosphatase was elevated in 80% of total cases and retuned to normal within 15 to 30 days. LDH was variable. In 4 cases of absolute ethanol infusion, above liver enzymes were markedly elevated as 10 times or more as normal range.

  4. Uterine artery embolization for cervical ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Qiao Zhou, MD

    2015-12-01

    Full Text Available A 36-year-old woman with 3 prior C-sections is diagnosed with a caesarean scar ectopic pregnancy. Despite receiving intramuscular and transvaginal methotrexate injection 2 months before presentation, the beta human chorionic gonadotropin was recorded to be 73 mIU/mL at the time of encounter. The patient complained of vaginal bleeding with a significant drop in hematocrit from 40% to 33%. Transvaginal ultrasound confirmed retroplacental hemorrhage and because of the patient's desire to retain fertility, interventional radiology was consulted to perform an uterine artery embolization. The uterine artery embolization was successful in achieving hemostasis and resulted in a decrease of betaHCG to 46 on postprocedure day 1 to <1 mIU/mL by postoperative week 3.

  5. Transcatheter Arterial Embolization for Upper Gastrointestinal Nonvariceal Hemorrhage: Is Empiric Embolization Warranted?

    Energy Technology Data Exchange (ETDEWEB)

    Arrayeh, Elnasif; Fidelman, Nicholas, E-mail: nicholas.fidelman@ucsf.edu; Gordon, Roy L.; LaBerge, Jeanne M.; Kerlan, Robert K. [University of California San Francisco, Department of Radiology (United States); Klimov, Alexander; Bloom, Allan I. [Hadassah Hospital, Department of Radiology (Israel)

    2012-12-15

    Purpose: To determine whether transcatheter arterial embolization performed in the setting of active gastric or duodenal nonvariceal hemorrhage is efficacious when the bleeding source cannot be identified angiographically. Methods: Records of 115 adult patients who underwent visceral angiography for endoscopically documented gastric (50 patients) or duodenal (65 patients) nonvariceal hemorrhage were retrospectively reviewed. Patients were subdivided into three groups according to whether angiographic evidence of arterial hemorrhage was present and whether embolization was performed (group 1 = no abnormality, no embolization; group 2 = no abnormality, embolization performed [empiric embolization]; and group 3 = abnormality present, embolization performed). Thirty-day rates and duration of primary hemostasis and survival were compared.ResultsFor patients with gastric sources of hemorrhage, the rate of primary hemostasis at 30 days after embolization was greater when embolization was performed in the setting of a documented angiographic abnormality than when empiric embolization was performed (67% vs. 42%). The rate of primary hemostasis at 30 days after angiography was greater for patients with duodenal bleeding who either underwent empiric embolization (60%) or embolization in the setting of angiographically documented arterial hemorrhage (58%) compared with patients who only underwent diagnostic angiogram (33%). Patients with duodenal hemorrhage who underwent embolization were less likely to require additional invasive procedures to control rebleeding (p = 0.006). Conclusion: Empiric arterial embolization may be advantageous in patients with a duodenal source of hemorrhage but not in patients with gastric hemorrhage.

  6. Cerebellar hemorrhage after embolization of ruptured vertebral dissecting aneurysm proximal to PICA including parent artery

    Directory of Open Access Journals (Sweden)

    Akira Tamase

    2014-01-01

    Full Text Available Background: Some complications related to vertebral artery occlusion by endovascular technique have been reported. However, cerebellar hemorrhage after vertebral artery occlusion in subacute phase is rare. In this report, we describe a patient who showed cerebellar hemorrhage during hypertensive therapy for vasospasm after embolization of a vertebral dissecting aneurysm. Case Description: A 56-year-old female with a ruptured vertebral dissecting aneurysm proximal to the posterior inferior cerebellar artery developed cerebellar hemorrhage 15 days after embolization of the vertebral artery, including the dissected site. In this patient, the preserved posterior inferior cerebellar artery fed by retrograde blood flow might have been hemodynamically stressed during hypertensive and antiplatelet therapies for subarachnoid hemorrhage, resulting in cerebellar hemorrhage. Conclusion: Although cerebellar hemorrhage is not prone to occur in the nonacute stage of embolization of the vertebral artery, it should be taken into consideration that cerebellar hemorrhage may occur during hypertensive treatment.

  7. Embolization Therapy for Traumatic Splenic Lacerations

    Energy Technology Data Exchange (ETDEWEB)

    Dasgupta, Niloy; Matsumoto, Alan H., E-mail: ahm4d@virginia.edu; Arslan, Bulent; Turba, Ulku C.; Sabri, Saher; Angle, John F. [University of Virginia Health System, Division of Vascular and Interventional Radiology, Department of Radiology (United States)

    2012-08-15

    Purpose: This study was designed to evaluate the clinical success, complications, and transfusion requirements based on the location of and agents used for splenic artery embolization in patients with splenic trauma. Methods: A retrospective study was performed of patients with splenic trauma who underwent angiography and embolization from September 2000 to January 2010 at a level I trauma center. Electronic medical records were reviewed for demographics, imaging data, technical aspects of the procedure, and clinical outcomes. Results: Fifty patients were identified (34 men and 16 women), with an average age of 48 (range, 16-80) years. Extravasation was seen on initial angiography in 27 (54%) and was absent in 23 (46%). All 27 patients with extravasation were embolized, and 18 of 23 (78.2%) without extravasation were embolized empirically. Primary clinical success was similar (>75%) across all embolization locations, embolic agents, and grades of laceration treated. Of 45 patients treated, 9 patients (20%) were embolized in the main splenic artery, 34 (75.6%) in the splenic hilum, and 2 (4.4%) were embolized in both locations. Partial splenic infarctions developed in 47.3% treated in the splenic hilum compared with 12.5% treated in the main splenic artery. There were four (8.9%) mortalities: two occurred in patients with multiple critical injuries and two from nonbleeding etiologies. Conclusions: Embolization of traumatic splenic artery injuries is safe and effective, regardless of the location of treatment. Embolization in splenic hilar branches may have a higher incidence of infarction. The grade of laceration and agents used for embolotherapy did not impact the outcomes.

  8. Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes.

    Science.gov (United States)

    Loffroy, R; Favelier, S; Pottecher, P; Estivalet, L; Genson, P Y; Gehin, S; Cercueil, J P; Krausé, D

    2015-01-01

    Over the past three decades, transcatheter arterial embolization has become the first-line therapy for the management of acute nonvariceal upper gastrointestinal bleeding that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the treatment of bleeding for a variety of indications. Transcatheter arterial embolization is a fast, safe, and effective minimally invasive alternative to surgery, when endoscopic treatment fails to control acute bleeding from the upper gastrointestinal tract. This article describes the role of arterial embolization in the management of acute nonvariceal upper gastrointestinal bleeding and summarizes the literature evidence on the outcomes of endovascular therapy in such a setting.

  9. Complete hepatocellular carcinoma necrosis following sequential porto-arterial embolization

    Institute of Scientific and Technical Information of China (English)

    Stéphane Zalinski; Olivier Scatton; Bruto Randone; Olivier Vignaux; Bertrand Dousset

    2008-01-01

    Most patients with hepatocellular carcinoma (HCC) are not eligible for curative treatment, which is resection or transplantation. Two recent series have emphasized the potential benefits of preoperative arterio-portal embolization prior to surgical resection of such tumours. This preoperative strategy offers a better disease free survival rate and a higher rate of total tumor necrosis. In case of non resectable HCC it is now widely accepted that transarterial chemoembolization (TACE) leads to a better survival when compared to conservative treatment. Thus, the question remains whether combined portal vein embolization (PVE) may enhance the proven efficiency of TACE in patients with unresectable HCC. We herein report the case of a 56-year-old cirrhotic woman with a voluminous HCC unsuitable for surgical resection. Yet, complete tumour necrosis and prolonged survival could be achieved after a combined porto-arterial embolization. This case emphasizes the potential synergistic effect of a combined arterio-portal embolization and the hypothetical survival benefit of such a procedure, in selected patients, with HCC not suitable for surgery or local ablative therapy.

  10. Prognostic factors in bronchial arterial embolization for hemoptysis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eui Jong; Yoon, Yup; Oh, Joo Hyeong; Lim, Joo Won; Sung, Dong Wook [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1994-07-15

    To find the rebleeding factors in bronchial arterial embolization for treatment of hemoptysis, a retrospective study was performed. Medical records, angiographic findings and embolic materials of 35 patients who had undertaken arterial embolization for control of hemoptysis were reviewed. The period of follow-up for rebleeding was from 3 to 32 months after arterial embolization. We investigated the angiographic findings of extravasation, neovascularity, intervascular shunt, aneurysm and periarterial diffusion. Neovascularity was classified as mild(numerable neovascularity) and severe(innumerable). Rebleeding occurred in 15(43%) among 35 cases. Only two of 11 cases with no past episode of hemoptysis showed recurrence, while 9 of 15 cases who had more than three episodes did. Severe neovascularity were seen in 11 of 15 recurred cases, but seven of 20 non- recurred cases showed severe neovascularity. More than three angiographic findings representing hemoptysis were seen on 11(73%) among recurred 15 cases and seven(35%) among non- recurred 20 cases. The lesion was supplied by more than two different arteries on 8(54%) of the recurred cases, but only three(15%) of the non- recurred cases. Six of seven cases persistent neovascularity after arterial embolization were recurred. The history of repeated hemoptysis, severe neovascularity, variable angiographic findings, and post-embolization persistency of neovascularity were the factors related with the rebleeding after arterial embolization for hemoptysis. Careful and active arterial embolization are required on these conditions.

  11. Recurrent Hemarthrosis Following Knee Arthroplasty Treated with Arterial Embolization.

    Science.gov (United States)

    Weidner, Zachary D; Hamilton, William G; Smirniotopoulos, John; Bagla, Sandeep

    2015-11-01

    Recurrent hemarthrosis is an uncommon but troublesome complication following knee arthroplasty. This study reports the results for 13 patients with spontaneous recurrent hemarthrosis after knee arthroplasty treated with arterial embolization. The average interval between arthroplasty and embolization was 47 months (range, 2-103 months), and the average time from onset of hemarthrosis to embolization was 4.1 months (range, 1-11 months). Geniculate arterial embolization lead to resolution of hemarthrosis in 12 of 13 patients (92.3%). The one clinical failure likely represented a case of misdiagnosed periprosthetic joint infection. Two patients experienced transient cutaneous ischemia related to distal particulate embolization that resolved spontaneously. Selective geniculate arterial embolization is an effective and safe treatment modality for recurrent hemarthrosis after knee arthroplasty.

  12. Prostate Artery Embolization for Benign Prostatic Hyperplasia: Current Status.

    Science.gov (United States)

    Mirakhur, Anirudh; McWilliams, Justin P

    2017-02-01

    Prostate artery embolization has garnered much attention as a promising treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia. We aim to provide an up-to-date review of this minimally invasive technique, including discussion of potential benefits and technical challenges. Current evidence suggests it is a safe and effective option for patients with medication-refractory urinary obstructive symptoms who are poor surgical candidates or refuse surgical therapy. Larger, randomized studies with long-term follow-up data are needed for this technique to be formally established in the treatment paradigm for benign prostatic hyperplasia.

  13. Tentorial artery embolization in tentorial dural arteriovenous fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Rooij, Willem Jan van; Sluzewski, Menno [St. Elisabeth Ziekenhuis, Department of Radiology, Tilburg (Netherlands); Beute, Guus N. [St. Elisabeth Ziekenhuis, Department of Neurosurgery, Tilburg (Netherlands)

    2006-10-15

    The tentorial artery is often involved in arterial supply to tentorial dural fistulas. The hypertrophied tentorial artery is accessible to embolization, either with glue or with particles. Six patients are presented with tentorial dural fistulas, mainly supplied by the tentorial artery. Two patients presented with intracranial hemorrhage, two with pulsatile tinnitus and one with progressive tetraparesis, and in one patient the tentorial dural fistula was an incidental finding. Different endovascular techniques were used to embolize the tentorial artery in the process of endovascular occlusion of the fistulas. All six tentorial dural fistulas were completely occluded by endovascular techniques, confirmed at follow-up angiography. There were no complications. When direct catheterization of the tentorial artery was possible, glue injection with temporary balloon occlusion of the internal carotid artery at the level of the tentorial artery origin was effective and safe. Different endovascular techniques may be successfully applied to embolize the tentorial artery in the treatment of tentorial dural fistulas. (orig.)

  14. TRANS-ARTERIAL EMBOLIZATION WITH N-BUTYL CYANOACRYLATE GLUE FOR RENAL BLEEDING: Case Report

    Directory of Open Access Journals (Sweden)

    Benny Young

    2014-08-01

    Full Text Available Background: The objectivity in management of renal bleeding is to preserve a significant renal parenchyma tissue and prevent associated morbidities like anemic shock or renal impairment from substantial nephron demise or obstructed uropathy. Trans-arterial embolization therapy by interventional radiology offers a high success rate with potential of reserving normal renal tissue. The selection material for renal arterial embolization largely depends on vasculature anatomy and end-point of procedure. N-butyl cyanoacrylate glue in our experience is applied in lesion supplied by small size of end-artery

  15. Hemoptysis and hemoperitoneum due to metastatic gestational choriocarcinma: bronchial artery embolization and superselective splenic artery embolization: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Tae Beom; Park, Byung Ho; Yoon, Seong Kuk; Kim, Chan Sung; Lee, Jin Hwa; Oh, Jong Young [Donga University School of Medicine, Pusan (Korea, Republic of); Seong, Chang Kyu; Kim, Yong Joo; Kim, Young Hwan [Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2003-01-01

    Gestational choriocarcinoma is easily disseminated hematogenously and its hypervascular nature places the patient at risk of significant hemorrhage both at the sites of metastatic lesion and in the uterus. In addition, its tends to give rise to pseudoaneurysm formation. Treatment of the condition by percutaneous embolization has been reported in several published articles, and hemoperitoneum secondary to rupture of splenic metastasis of gestational choriocarcinoma has also been reported, as has angiographic embolization. Hemoptysis resulting from pulmonary metastasis and treatment by means of embolization of the bronchial artery have not been reported, however. In this article, we describe a case of hemoptysis and hemoperitoneum due to pulmonary and splenic metastasis of gestational choriocarcinoma. Treatment of the condition involved embolization of the bronchial artery and superselective embolization of the splenic artery.

  16. Hypertension following Therapeutic Arterial Embolization: A Rare Complication

    Directory of Open Access Journals (Sweden)

    Ghansham Biyani

    2014-05-01

    Full Text Available Accelerated hypertension following therapeutic arterial embolization is a rare phenomenon. A patient of left upper limb chronic lymphedema was posted for shoulder disarticulation under general anaesthesia. Coil embolization of the left subclavian artery was done prior to surgery. Following the intervention, patient’s blood pressure increased by more than 30% of the base line value and was managed with antihypertensives for the next 3 hours to get the blood pressure optimised prior to taking the patient for surgery.

  17. Bronchial Artery Embolization for Massive Hemoptysis: a Retrospective Study

    Directory of Open Access Journals (Sweden)

    Ali Fani

    2013-05-01

    Full Text Available   Introduction: To assess the efficacy and safety of bronchial artery embolization in the treatment of massive hemoptysis.   Materials and Methods: A retrospective study on 46 patients (26 males and 20 females who were referred to the Razavi Hospital from April 2009 to May 2012 with massive hemoptysis and had bronchial artery embolization procedures. General characteristics of the patients including age, gender, etiology, and thorax computed tomograms, findings of bronchial angiographic, results of the embolization, complications related to bronchial artery embolization and clinical outcome during follow-up were reviewed. Results: The etiology included previous pulmonary tuberculosis in 20 cases, previous tuberculosis with bronchiectasis in 16 cases, bronchiectasis in 6 cases, and active pulmonary tuberculosis in one case. No identifiable causes could be detected in three patients. Moreover, massive hemoptysis was successfully and immediately controlled following the embolization procedure in all patients. One patient developed recurrent hemoptysis during one month following the procedure and was treated by re-embolization. No major procedure–related complication such as bronchial infarction was identified However none of the patientsexperienced neurological complications. Conclusion: Bronchial artery embolization is a safe and effective means of controlling massive hemoptysis and should be regarded as the first-line treatment for this condition.

  18. Emergency Transcatheter Arterial Embolization for Acute Renal Hemorrhage.

    Science.gov (United States)

    Wang, Hong Liang; Xu, Chun Yang; Wang, Hong Hui; Xu, Wei

    2015-10-01

    The aims of this study were to identify arteriographic manifestations of acute renal hemorrhage and to evaluate the efficacy of emergency embolization. Emergency renal artery angiography was performed on 83 patients with acute renal hemorrhage. As soon as bleeding arteries were identified, emergency embolization was performed using gelatin sponge, polyvinyl alcohol particles, and coils. The arteriographic presentation and the effect of the treatment for acute renal hemorrhage were analyzed retrospectively. Contrast extravasation was observed in 41 patients. Renal arteriovenous fistulas were found in 12 of the 41 patients. In all, 8 other patients had a renal pseudoaneurysm, 5 had pseudoaneurysm rupture complicated by a renal arteriovenous fistula, and 1 had pseudoaneurysm rupture complicated by a renal artery-calyceal fistula. Another 16 patients had tumor vasculature seen on arteriography. Before the procedure, 35 patients underwent renal artery computed tomography angiography (CTA). Following emergency embolization, complete hemostasis was achieved in 80 patients, although persistent hematuria was present in 3 renal trauma patients and 1 patient who had undergone percutaneous nephrolithotomy (justifying surgical removal of the ipsilateral kidney in this patient). Two-year follow-up revealed an overall effective rate of 95.18 % (79/83) for emergency embolization. There were no serious complications. Emergency embolization is a safe, effective, minimally invasive treatment for renal hemorrhage. Because of the diversified arteriographic presentation of acute renal hemorrhage, proper selection of the embolic agent is a key to successful hemostasis. Preoperative renal CTA plays an important role in diagnosing and localizing the bleeding artery.

  19. Hepatic arterial embolization in patients with neuroendocrine tumors

    Science.gov (United States)

    2014-01-01

    Liver metastases occur in 46-93% of patients with neuroendocrine neoplasms (NENs). Presence and extension of liver metastases are considered important prognostic factors, as they may significantly impair the patient’s quality of life, because of either tumor bulk or hormonal hypersecretion. Therapies for NEN liver metastases include surgical resection, liver transplantation, chemotherapy and biotherapy. Surgery is the gold standard for curative therapy, but in most of NEN patients with liver metastases, when surgery can not be applied, minimally invasive therapeutic approaches are adopted. They include trans-arterial embolization (TAE), trans-arterial chemoembolization (TACE), radiofrequency thermal ablation and new emerging techniques. TAE is based on selective infusion of particles in the branch of the hepatic artery supplying the tumor lesions. The goal of TAE is to occlude tumor blood vessels resulting in ischemia and necrosis. Many reports have shown that TAE can reduce tumor size and hormone output, resulting in palliation of symptoms without the use of cytotoxic drugs, resulting in better tolerability. This review will focus on TAE performance and safety in NEN patients with liver metastases. PMID:24887262

  20. Iatrogenic systemic air embolism treated with hyperbaric oxygen therapy

    DEFF Research Database (Denmark)

    Jørgensen, Thomas Bech; Sørensen, Allan Martini Ibsen; Jansen, Erik C.

    2008-01-01

    Air embolism is a rare and potentially severe complication of surgical and invasive procedures. Emboli large enough to produce symptoms require immediate treatment because of the risk of 'gas lock' in the right side of the heart and subsequent circulatory failure. If air is transmitted to the art...... to the arterial circulation through a shunt, it may cause cerebral emboli with neurological symptoms. We present two cases with venous air emboli and concurrent cerebral arterial emboli. Both patients were successfully treated with hyperbaric oxygen therapy Udgivelsesdato: 2008/4...

  1. Cerebral lipiodol embolism following transcatheter arterial chemoembolization for hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Cerebral lipiodol embolism (CLE) is an extremely rare complication of transcatheter arterial chemoembolization for hepatocellular carcinoma (HCC). The authors present a case of CLE that occurred after the second hepatic arterial chemoembolization for HCC, and attempt to introduce several plausible mechanisms of CLE, after reporting the clinical and radiological findings and reviewing the medical literature.

  2. Selective Uterine Artery Embolization for Management of Interstitial Ectopic Pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Seung Boo; Lee, Sang Jin; Joe, Hwan Sung; Goo, Dong Erk; Chang, Yun Woo [Soonchunhyang University Gumi Hospital, Gumi (Korea, Republic of); Kim, Dong Hun [Chosun University Hospital, Gwangju (Korea, Republic of)

    2007-04-15

    Interstitial pregnancy is defined as any gestation that develops in the uterine portion of the fallopian tubes lateral to the round ligament. Interstitial pregnancies account for 2-4% of all ectopic pregnancies and have been reported to have an associated 2% to 2.5% maternal mortality rate. The traditional treatment for interstitial pregnancy using surgical cornual resection may cause infertility or uterine rupture in subsequent pregnancies. Recently, the early identification of intact interstitial pregnancy has been made possible in many cases with high resolution transvaginal ultrasound as well as more sensitive assays for betahuman chorionic gonadotropin ({beta}-hCG). The treatment includes: hysteroscopic transcervical currettage, local and systemic methotrexate (MTX) therapy and prostaglandin or potassium chloride injection of the ectopic mass under sonographic guidance. We describe a case of successful treatment of interstitial pregnancy using uterine artery embolization, after failure of methotrexate treatment.

  3. Transcatheter arterial embolization in gastric cancer patients with acute bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Joo; Shin, Ji Hoon; Yoon, Hyun-Ki; Ko, Gi-Young; Gwon, Dong-Il; Song, Ho-Young; Sung, Kyu-Bo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Seoul (Korea)

    2009-04-15

    The safety and clinical effectiveness of transcatheter arterial embolization for bleeding associated with unresectable gastric cancer was evaluated. Twenty-three patients with bleeding from unresectable gastric cancer underwent transcatheter arterial embolization. Of the 23 patients, eight showed signs of active bleeding, such as contrast extravasation or pseudoaneurysm, seven showed only tumor staining, and the remaining eight patients showed negative angiographic findings. All embolization procedures were successful without procedure-related complications. In all eight active bleeding patients, immediate hemostasis was achieved. The overall clinical success rate was 52% (12/23). Recurrent bleeding within 1 month occurred in one (8%) in 12 patients with initial clinical success. One patient showed partial splenic infarction after embolization of the splenic artery for active bleeding from the short gastric artery. Overall 30-day mortality rate was 43% (10/23). The median overall survival period was 38 days. In patients with bleeding from unresectable gastric cancer, transcatheter arterial embolization was found to be safe and effective for achieving immediate hemostasis for active bleeding. Although the clinical success rate was not high, the recurrent bleeding rate was low at 1 month post procedure. (orig.)

  4. Use of adrenal arterial embolization in severe ACTH-dependent Cushing's syndrome.

    OpenAIRE

    Blunt, S B; Pirmohamed, M.; Chatterjee, V K; Burrin, J. M.; Allison, D J; Joplin, G. F.

    1989-01-01

    The management of a patient with severe Cushing's syndrome due to ectopic ACTH produced by a medullary carcinoma of the thyroid is described. Initial treatment with maximal adrenolytic medical therapy and two attempts at bilateral adrenal venous infarction had failed to control the disease, and she was at that time unfit for surgery. Subsequent use of bilateral adrenal arterial embolization enabled medical therapy to produce sufficient control of the Cushing's syndrome to allow bilateral adre...

  5. Hepatic artery pseudoaneurysm treated using stent-graft implantation and retrograde gastroduodenal artery coil embolization

    Energy Technology Data Exchange (ETDEWEB)

    Basile, Antonio; Patti, Maria Teresa [Ospedale Ferrarotto, Department of Diagnostic and Interventional Radiology, Catania (Italy); Ragazzi, Salvatore; Piazza, Diego [Ospedale Vittorio Emanuele, Department of Surgery I, Catania (Italy); Tsetis, Dimitrios [University Hospital of Heraklion, Medical School of Crete, Department of Radiology, Heraklion (Greece); Lupattelli, Tommaso [Multimedica Holding, Department of Interventional Radiology, Sesto S. Giovanni (Italy)

    2008-11-15

    Endovascular treatment options for visceral artery pseudoaneurysms depend on lesion location and size. Exclusion methods fall into two categories, embolization and stent placement, and these procedures aim to exclude the pseudoaneurysm from the circulation and if possible to maintain distal blood flow. Embolization of the afferent artery can be used in pseudoaneurysms that arise from a donor artery without collateral supply such as a visceral branch, whereas in the case of visceral arteries with well-established collateral supply, the embolization of both proximal and distal branches to the pseudoaneurysm is mandatory in preventing backflow from the collateral circulation. A direct embolization delivering coils or glue into the sac can also be performed if the aneurismal neck is narrow. Stent-graft placement represents another option to exclude the pseudoaneurysm, in the case of wide neck, reduced arterial tortuosity and large-diameter arteries. We present a case of common hepatic artery pseudoaneurysm involving the gastroduodenal artery origin treated by a combination of techniques. An hepatic stent-graft implantation plus retrograde embolization of the gastroduodenal artery through the pancreaticoduodenal anastomosis from the superior mesenteric artery was performed. (orig.)

  6. The efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury

    Energy Technology Data Exchange (ETDEWEB)

    Kwack, Kyu Sung; Kim, Young Ju; Lee, Myung Sub; Kim, Dong Jin; Hong, In Soo [Wonju Christian Hospital, College of Medicine, Yonsei University, Wonju (Korea, Republic of)

    2000-07-01

    To evaluate the efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury after blunt abdominal trauma. We retrospectively analyzed the results of transcatheter arterial embolization in 23 patients who suffered splenic injury after blunt abdominal trauma. Fourteen of the patients were male, and 9 were female; 13 were adults, and 10 were children. Transcatheter arterial embolization was performed in patients with hypotension, tachycardia, evidence of hemodynamic instability due, for example, to low levels of Hgb and Hct, or those who needed fluid therapy or blood transfusion. After embolization the patients' progress was monitored by CT scanning, abdominal sonography, or {sup 99m}Tc-sulfur colloid scintigraphy. The degree of splenic injury was classified according to the system devised by Mirvis et al.; nine cases were CT grade III, and 14 were grade IV. After demonstrating angiographically the site of contrast leakage, embolization was performed; for this, a coil only was used in 16 cases, gelfoam only in four, and both coil and gelfoam in three. There were three sites of vascular embolization: 16 procedures were performed in the proximal part of the main trunk of the splenic artery, four in a superselected branch of this same artery, and three in both the splenic artery and one of its superselected branches. Of the 23 cases, 18 recovered without splenectomy after embolization, three adult patients died from coexisting conditions (spinal or cerebral injuries, liver cirrhosis, or pelvic bone fracture) or complications (acute renal failure or disseminated intravascular coagulation). Due to co-existing pancreatic and mesenteric vessel injury, two of the adult patients who underwent TAE also underwent delayed surgery; intraoperatively, there was no evidence of splenic rebleeding. In all patients who did not undergo surgery, follow-up observation revealed a decreased volume of hemoperitoneum, increased uptake of

  7. Efficacy and Safety of Trans-Arterial Splenic Embolization

    Directory of Open Access Journals (Sweden)

    Ali Cadili

    2012-02-01

    Conclusions: Trans-arterial splenic embolization is a safe and effective procedure that does not lead to longterm compromise of splenic function. Complications and failures of this procedure, however, cannot be predicted based on either patient or procedure characteristics examined in this study. [Arch Clin Exp Surg 2012; 1(1.000: 22-26

  8. Geniculate artery embolization for recurrent postarthroplasty hemarthrosis of the knee

    Directory of Open Access Journals (Sweden)

    Moses Azubuike, BS

    2015-01-01

    Full Text Available Hemarthrosis after total knee arthroplasty is an uncommon condition. We present a unique case of recurrent hemarthrosis in a 93-year-old woman two years after an uneventful total knee arthroplasty and describe how we successfully treated her with selective angiographic embolization of the geniculate arteries.

  9. Geniculate artery embolization for recurrent postarthroplasty hemarthrosis of the knee

    OpenAIRE

    Moses Azubuike, BS; Ryan Mikus, MD; Poyan Rafiei, MD

    2016-01-01

    Hemarthrosis after total knee arthroplasty is an uncommon condition. We present a unique case of recurrent hemarthrosis in a 93-year-old woman two years after an uneventful total knee arthroplasty and describe how we successfully treated her with selective angiographic embolization of the geniculate arteries.

  10. Geniculate artery embolization for recurrent postarthroplasty hemarthrosis of the knee.

    Science.gov (United States)

    Azubuike, Moses; Mikus, Ryan; Rafiei, Poyan

    2015-01-01

    Hemarthrosis after total knee arthroplasty is an uncommon condition. We present a unique case of recurrent hemarthrosis in a 93-year-old woman two years after an uneventful total knee arthroplasty and describe how we successfully treated her with selective angiographic embolization of the geniculate arteries.

  11. Flow diverter assisted coil embolization of a very small ruptured ophthalmic artery aneurysm.

    Science.gov (United States)

    Dornbos, David; Pillai, Promod; Sauvageau, Eric

    2016-06-01

    Small ruptured aneurysms present a unique problem to endovascular therapy. We report a case in which a patient presented with subarachnoid hemorrhage and a very small ruptured ophthalmic artery aneurysm, for which endovascular therapy was preferred secondary to severe cardiac comorbidities. Due to the aneurysm size, a small 1.5 mm coil was needed, but presented a significant risk of migration. Conventional stent assisted coiling was considered suboptimal as the small coil could have easily migrated through the strut. We present a novel technique of flow diverter assisted coil embolization in which a coil was placed within the aneurysm and a pipeline embolization device was then partially deployed, jailing the microcatheter and coil mass. Once in place, the coil was detached, securing the aneurysm, and preventing coil migration. Through the use of a flow diverter, some degree of aneurysm protection would still be expected in the event of coil migration toward the ophthalmic artery origin.

  12. Transcatheter Arterial Embolization of Cystic Artery Pseudoaneurysm in Acalculous Cholecystitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyung Ook; Lee, Young Hwan [Dept. of Radiology, Daegu Catholic University College of Medicine, Daegu (Korea, Republic of); Kim, Young Hwan [Dept. of Diagnostic Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2011-04-15

    A pseudoaneurysm of the cystic artery is a rare complication of cholecystitis, and is manifested by hemobilia or hematemesis. An early diagnosis is required for the successful treatment by cholecystectomy and ligation of the cystic artery. Herein, we report a case of a pseudoaneurysm of the cystic artery diagnosed by color Doppler ultrasonography and CT, and successfully treated by transcatheter arterial embolization with N-butyl cyanoacrylate in a high-risk surgical patient.

  13. Arterial Emboli Complicating Cisplatin Therapy

    OpenAIRE

    Tait, Campbell D.; Rankin, Elaine M

    2012-01-01

    We report three cases of arterial emboli in patients with lung cancer treated with cisplatin chemotherapy. All three patients were managed without surgical intervention but subsequent oncological treatment was complicated by the sequelae of arterial emboli. We discuss the issues surrounding these patients and the importance of identifying patients at risk of arterial embolic phenomena with cisplatin treatment.

  14. Study on intraluminal embolization with microcoils treating traumatic pseudoaneurysms in common carotid artery in rabbits

    Institute of Scientific and Technical Information of China (English)

    刘云松; 马廉亭; 吴佐泉

    2004-01-01

    Objective: To evaluate the long-term effect of endovascular occlusion with microcoils on traumatic pseudoaneurysms (TPAs) in the common carotid artery in rabbits.Methods: TPAs in the right common carotid artery were surgically made in 16 rabbits. At 3-4 weeks after operation, the survived 12 models were randomly divided into a control group (n = 3 ) with no treatment and an experimental group (n = 9), in which TPAs were intraluminally embolized with microcoils and corresponding therapy was given. Three months after embolization, the TPAs were examined with digital subtraction angiography and pathology.Results: The 3 rabbits in the control group all died of rupture of TPA. Among the 9 TPAs occluded with microcoils, 4 were completely occluded, 4 were partially occluded, and 1 was excluded due to the microcoils migrating into the parent artery. Three months after embolization, the 4 TPAs which were completely occluded remained obliterated as determined by digital subtraction angiographic findings. The parent artery remained unobstructed and the structure of the TPAs were replaced by a mass of scar tissues. The 4 TPAs which were partially occluded remained unruptured and the microcoils were compressed.Conclusions: The lumen in TPA can be completely occluded by microcoils and the parent artery is unblocked.Partial occlusion of the lumen can also prevent the rupture of TPA.

  15. PREPARATION AND DRUG RELEASE CHARACTERISTICS OF PINGYANGMYCIN GELATIN MICROSPHERES FOR EMBOLIZATION THERAPY

    Institute of Scientific and Technical Information of China (English)

    吴红; 张镇西; 吴道澄; 于开涛; 李晓晔

    2003-01-01

    Objective: To prepare Pingyangmycin gelatin microspheres (PYM-GMS) for carotid artery embolization therapy and to study the release characteristics in vivo and in vitro. Methods: PYM-GMS was prepared by optical double-phase emulsified condensation polymerization. Through UV-spectrophotometer drug content and encapsulation rate were measured. The characteristics of drug release in vitro which could simulate the actual state in vivo were tested by HPLC. Three ways of vein drop, artery perfusion and artery embolization were contrasted. Under the supervision of X-ray, PYM-GMS were perfused into the external carotid artery of rabbits by superselective artery embolization. Blood samples were tested at different time and analyzed statistically. Results: The roundness of PYM-GMS was 1.02±0.005. The mean diameter was 85.6 (m, 78% of them ranging from 50(200 (m, which fitted the use of embolization. PYM content and encapsulation rate were 6.8% and 91.3% respectively. 70% of the drug was released in 3 h in the simulated environment in vivo and total drug was released after more than 6 h. After artery embolization with small dosage of PYM-GMS, the local drug concentration was 8 times higher than the blood drug concentration and the high level of local drug concentration was kept for more than 120 min. Conclusion: External carotid artery embolization with PYM-GMS, which significantly reduced the circulating drug level and employment dosage, could prolong the duration higher drug concentration and suit the purpose of targeted tumor therapy.

  16. Acute arterial embolism of left lower extremity caused by paradoxical embolism in Ebstein's anomaly

    Science.gov (United States)

    LI, Jun-Sheng; Ma, Jie; Yan, Zi-Xing; Cheng, Dong-Ming; Chang, Liang; Zhang, Hai-Chun; Liu, Jiang-Yan

    2017-01-01

    Abstract Introduction: Ebstein's anomaly is a benign and stable congenital heart disease for asymptomatic patients. Despite a low incidence of Ebstein's anomaly (EA), patients’ quality of life can be badly affected by EA without positive surgical intervention. Especially EA is associated with other congenital heart disease, such as the atrial septal defect, patent foramen ovale, and arterial embolism exclude other reasons, it is often considered to be the consequence of paradoxical embolism, and surgical intervention must be conducted. Case report: An 11-year-old girl falling off the bed suffered pain from left lower extremity. Echocardiographic evaluation revealed an EA, severe tricuspid regurgitation, and secundum atrial septal defect. Both left leg amputation and cardiac surgery were conducted after recovery. Under the condition of anesthesia cardiopulmonary bypass extracorporeal circulation, atrial septal defect repair and Cone reconstruction of the tricuspid valve were performed. Patient recovered well and left hospital smoothly. Discussion: EA is a rare and complex congenital cardiac malformation. There are about 80% to 90% of EA patients with combined atrial septal defect and patent foramen ovale. Sudden arterial occlusion is very rare especially in childhood. When thoracic roentgenoscopy, arterial blood gas analysis, coagulation test, and echocardiographic of lower extremity deep venous system are all normal, one should consider the possibility of a paradoxical embolism. If patients have the paradoxical embolism or worsening tricuspid regurgitation, the most suitable therapeutic regimen should be chosen according to patients’ condition. With surgical techniques and methods renewed continuously, cone reconstruction of the tricuspid valve has been confirmed in clinical trials, which can use its own tissues to form not only central bloodstream, but also the coaption between leaflet and leaflet. PMID:28151866

  17. Clinical Experience of Cesarean Scar Pregnancy on 12 Cases with Uterine Artery Embolism Combined Curettage Therapy%子宫动脉栓塞加清宫术治疗疤痕妊娠12例临床体会

    Institute of Scientific and Technical Information of China (English)

    李媛媛; 李宁; 徐上

    2014-01-01

    Objective: To discuss the effectiveniss on cesarean scar pregnancy with uterine artery embolism combined curettage therapy. Methods: The clinical data of 12 cases with cesarean scar pregnancy were analyzed retrospectively.Which included method of treatment,effect,prognosis and adverse reactions by bilateral artery catheterization,injection methotrexate and gelatin sponge. Results: 12 cases were successful hemostasis and retained the uterus.Then they underwent curettage after in a week, None of them occurred uterine infection and uterine cavity adherence. After 1~3 months,they had normal menstruation.The pathologic examination showed the chorionic tissues,There was no obvious difference compared with preoperative of blood routine and heptic and renal functions,the serum HCG and homones become normal range in 3 to 6 weeks.Conclusion: Uterine artery embolism combined curettage were micro-invasive,signiifcant effect,hige success rate and little side effects for the treatment of micro-invasive,signiifcant effect,hige success rate and little side effects.%目的:探讨子宫动脉栓塞加清宫术治疗剖宫产子宫疤痕妊娠(CSP)临床效果。方法:回顾性分析12例CSP患者的临床资料,内容包括患者采用双侧股动脉穿刺插管,灌注甲氨蝶呤+明胶海绵颗粒的治疗方法,治疗效果、预后情况及不良反应。结果:12例患者均成功栓塞,1周内行清宫术,无宫腔感染及黏连的发生,术后1~3月阴道出血停止,月经恢复正常,均成功的保留了生育功能,病理检查清除组织显示绒毛组织,不同程度变性、坏死。随访复查血常规及肝肾功能与术前无明显差异。激素水平及血尿HCG值3~6周内回复正常。结论:子宫动脉栓塞加清宫术治疗CSP具有微创、有效,不良反应及并发症小成功率高的优点。

  18. Splenic artery embolization: An alternative approach in a critically ill patient with autoimmune hemolytic anemia

    Directory of Open Access Journals (Sweden)

    Mine Durusu Tanrıöver

    2011-06-01

    Full Text Available Assessment of general health status and hematological parameters usually precedes the use of invasive diagnostic and therapeutic procedures in critically ill patients. Angiography can be effective and safe as a substitute for major surgical procedures, or as a bridging therapy in such cases. We present a critically ill patient with hemolytic anemia that underwent splenic artery embolization as a bridging therapy. We aimed to emphasize that minimally invasive approaches and multidisciplinary care can be utilized in the treatment of critically ill patients with accompanying hematological disease.

  19. Maghemite based silicone composite for arterial embolization hyperthermia.

    Science.gov (United States)

    Smolkova, Ilona S; Kazantseva, Natalia E; Makoveckaya, Kira N; Smolka, Petr; Saha, Petr; Granov, Anatoly M

    2015-03-01

    Maghemite nanoparticle based silicone composite for application in arterial embolization hyperthermia is developed. It possesses embolization ability, high heating efficiency in alternating magnetic fields and radiopaque property. The initial components of the composite are selected so that the material stays liquid for 20min, providing the opportunity for transcatheter transportation and filling of the tumour vascular system. After this induction period the viscosity increases rapidly and soft embolus is formed which is able to occlude the tumour blood vessels. The composite is thermally stable up to 225°C, displays rubber-elastic properties and has a thermal expansion coefficient higher than that of blood. Maghemite nanoparticles uniformly distributed in the composite provide its rapid heating (tens of °Cmin(-1)) due to Neel magnetization relaxation. Required X-ray contrast of composite is achieved by addition of potassium iodide.

  20. CT-Monitored Percutaneous Cryoablation of Uterine Fibroids after Uterine Artery Embolization

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE To investigate the effects of percutaneous cryoablation on uterine fibroids using computed tomographic (CT) guidance after uterine artery embolization.METHODS Twelve patients who failed to respond to uterine artery embolization were treated using percutaneous cryoablation. All patients had undergone previous uterine artery embolization an average of 1.2 years (0.7~1.6 years) ago. Two cases had abnormal bleeding, and the other 10 suffered from pressure and/or pelvic pain. Myoma diameters were 4 cm to 16.5 cm. By using CT guidance, 2.0, 2.4, 3.0 or 3.8 mm cryoprobes were placed into the fibroid, and two 15~20 min freezing processes were performed. Hemostasis was achieved only by pressing the incisions for several minutes.MR-imaging was performed before the procedure to measure the size and number of fibroid tumors, and follow- up MR-imaging determined the reduction of the lesions.RESULTS All patients were discharged within 48 h of treatment. Almost no hemorrhage was found in all of the cases. No bladder or bowel injury or significant postsurgery pain was reported. Ice spheres were readily visualized at CT. Beam-hardening artifact from the metal probes was present, but did not interfere with the procedure. Myomas regressed up to 76.3% after 12 months of treatment, and the primary symptoms improved in all treated women.CONCLUSION CT-monitored percutaneous cryoablation is an effective and minimally invasive therapy for symptom relief and fibroid shrinkage after the failure of uterine artery embolization.

  1. Acute stenting and thromboaspiration in basilar artery occlusions due to embolism from the dominating vertebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Nedeltchev, K.; Remonda, L.; Brekenfeld, C.; Ozdoba, C.; Schroth, G. [Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital, Freiburgstrasse 4, 3010, Bern (Switzerland); Do, D.D. [Institute of Angiology, University of Bern, Inselspital, Bern (Switzerland); Arnold, M.; Mattle, H.P. [Department of Neurology, University of Bern, Inselspital, Bern (Switzerland)

    2004-08-01

    Intra-arterial thrombolysis (IAT) is the only treatment that has demonstrated benefit in patients with acute basilar artery occlusions (ABAO). IAT may be difficult to perform when access to the occluded basilar artery (BA) is prevented by pathology of the vertebral arteries (VA). We report on two patients with ABAO due to embolism from the dominating VA. Catheter navigation through the occluded VA and thromboaspiration enabled access to the BA. Thromboaspiration alone or in addition to IAT resulted in a complete recanalization of the BA and a favorable clinical outcome. A stent was deployed at the site of the stenosis in the VA either prior to or immediately after BA recanalization. (orig.)

  2. Embolization of a giant pediatric, posttraumatic, skull base internal carotid artery aneurysm with a liquid embolic agent.

    Science.gov (United States)

    Reig, Adam S; Simon, Scott; Mericle, Robert A

    2009-11-01

    Many treatments for posttraumatic, skull base aneurysms have been described. Eight months after an all-terrain-vehicle accident, this 12-year-old girl presented with right-side Horner syndrome caused by a 33 x 19-mm internal carotid artery aneurysm at the C-1 level. We chose to treat the aneurysm with a new liquid embolic agent for wide-necked, side-wall aneurysms (Onyx HD 500). We felt this treatment would result in less morbidity than surgery and was less likely to occlude the parent artery than placement of a covered stent, especially in a smaller artery in a pediatric patient. Liquid embolic agents also appear to be associated with a lower chance of recanalization and lower cost compared with stent-assisted coil embolization. After the patient was treated with loading doses of aspirin, clopidogrel bisulfate, and heparin, 99% of the aneurysm was embolized with 9 cc of the liquid embolic agent. There were no complications, and the patient remained neurologically stable. Follow-up angiography revealed durable aneurysm occlusion after 1 year. The cost of Onyx was less than the cost of coils required for coil embolization of similarly sized intracranial aneurysms at our institution. Liquid embolic agents can provide a safe, efficacious, and cost-effective approach to treatment of select giant, posttraumatic, skull base aneurysms in pediatric patients.

  3. Evaluation of selective arterial embolization effect by chitosan micro-hydrogels in hindlimb sarcoma rodent models using various imaging modalities

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Tai Kyoung; Kwon, Jeong Il; Na, Kyung Sook [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of); and others

    2015-09-15

    Embolization is mainly used to reduce the size of locally advanced tumors. In this study, selective arterial catheterization with chitosan micro-hydrogels (CMH) into the femoral artery was performed and the therapeutic effect was validated using different imaging methods. Male SD rats (n = 18, 6 weeks old) were randomly assigned into three groups: Group 1 as control, Group 2 without any ligation of distal femoral artery, and Group 3 with temporary ligation of the distal femoral artery. RR1022 sarcoma cell lines were inoculated into thigh muscle. After 1 week, CMH was injected into the proximal femoral artery. Different imaging modalities were performed during a 3-week follow-up. The tumor size was significantly (P < 0.001) decreased in both Group 2 and Group 3 (P < 0.001) after selective arterial embolization therapy. 18F-FDG-PET/CT revealed decreased intensity of 18F-FDG uptake in tumors. The accumulation status of 125I-CMH near the tumor was verified by gamma camera. Appropriate selective arterial embolization therapy with CMH was.

  4. Interventional radiology in the management of visceral artery pseudoaneurysms: A review of techniques and embolic materials

    Energy Technology Data Exchange (ETDEWEB)

    Madhusudhan, Kumble Seetharama; Venkatesh, Hosur Ananthashayana; Gamanagatti, Shivanand; Garg, Pramod; Srivastava, Deep Narayan [All India Institute of Medical Sciences, New Delhi (India)

    2016-06-15

    Visceral artery pseudoaneurysms occur mostly as a result of inflammation and trauma. Owing to high risk of rupture, they require early treatment to prevent lethal complications. Knowledge of the various approaches of embolization of pseudoaneurysms and different embolic materials used in the management of visceral artery pseudoaneurysms is essential for successful and safe embolization. We review and illustrate the endovascular, percutaneous and endoscopic ultrasound techniques used in the treatment of visceral artery pseudoaneurysm and briefly discuss the embolic materials and their benefits and risks.

  5. Evaluation of Arterial Impairment after Experimental Gelatin Sponge Embolization in a Rabbit Renal Model

    OpenAIRE

    Oh, Jung Suk; Lee, Hae Giu; Chun, Ho Jong; Choi, Byung Gil; Choi, Yeong Jin

    2015-01-01

    Objective Arterial stenosis is a major obstacle for subsequent interventional procedures. We hypothesized that the stenosis is caused by gelatin sponge embolization and performed an experimental study in a rabbit renal model. Materials and Methods A total of 24 rabbits were embolized with porcine gelatin sponge particles injected into the renal arteries. Four rabbits were sacrificed on 1 day, 4 days, 1 week, 2 weeks, 3 weeks, and 4 weeks after embolization. Microscopic evaluations were perfor...

  6. Transcatheter Arterial Embolization of Arterial Esophageal Bleeding with the Use of N-Butyl Cyanoacrylate

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ji Hoon; Kim, Hyo Cheol; Chung, Jin Wook; Jae, Hwan Jun; Park, Jae Hyung [Seoul National University Hospita, Seoul (Korea, Republic of)

    2009-08-15

    To evaluate the clinical efficacy and safety of a transcatheter arterial embolization (TAE) with N-butyl cyanoacrylate (NBCA) for the treatment of arterial esophageal bleeding. Between August 2000 and April 2008, five patients diagnosed with arterial esophageal bleeding by conventional angiography, CT angiography or endoscopy, underwent a TAE with NBCA. We mixed NBCA with iodized oil at ratios of 1:1 to 1:4 to supply radiopacity and achieve a proper polymerization time. After embolization, we evaluated the angiographic and clinical success, recurrent bleeding, and procedure-related complications. The bleeding esophageal artery directly originated from the aorta in four patients and from the left inferior phrenic artery in one patient. Although four patients had an underlying coagulopathy at the time of the TAE, angiographic and clinical success was achieved in all five patients. In addition, no procedurerelated complications such as esophageal infarction were observed during this study. NBCA can be an effective and feasible embolic agent in patients with active arterial esophageal bleeding, even with pre-existing coagulopathy.

  7. Pharmacokinetics of Harmine Gelatin Microspheres after Embolization in Hepatic Artery

    Institute of Scientific and Technical Information of China (English)

    LI Yan; SUN Dianjia; BI Dianzhou; WEN Hao

    2002-01-01

    The preparation and properties of Harmine - gelatin microspheres ( HM - GMS) were reported. The characteristics of pharmacokinetics and embolization effects of HM - GMS in vivo were studied in dogs. The average diameter of the microspheres was 63. 0μm and the content was 6.09% of HM. In in vitro experiment, the release rate of drug demonstrated that the microspheres had sustained - release properties. The HM - GMS and HM solution were infused into the hepatic artery of dogs through a catheter for embolization, respectively. The plasma concentration of HM was determined by HPLC. The peak concentration of HM solution was 2.9 times as much as HM - GMS in circulating blood, while that of solution was 0.42 times as much as HM - GMS in hepatic vein. Angiograms revealed that the peripheral blood vessels decreased obviously in liver. Results showed that the HM - GMS probably can become a promising embolic agent for treatment of hepatic cancer. It could aid in the use of intensive chemotherapy with minimum systemic side effect.

  8. Therapeutic Effect of Transcatheter Arterial Embolization for Hypervascular Hepatocellular Carcinoma: Web-based Multicenter Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Baik, Jun Hyun [St. Vincent' s Hospital, The Catholic University of Korea, Seoul (Korea, Republic of); Song, Kyung Sup [St. Paul' s Hospital, The Catholic University of Korea, Seoul (Korea, Republic of); Han, Joon Koo [Seoul National University Hospital, Seoul (Korea, Republic of)

    2011-06-15

    To evaluate the therapeutic effect of transcatheter arterial embolization (TAE) as a first treatment course for hypervascular hepatocellular carcinoma (HCC), using nationwide web-based multicenter data in Korea. Eight hundred eighty eight HCC patients who were registered in the internet homepage of primary liver cancer registry (www.plcr.or.kr) from August 2003 to August 2005 were enrolled in this study, and they were investigated till February 2007. The patients were divided into three groups according to the following treatments after first TAE; TAE only, TAE + SL (any surgical resection, transplantation or percutaneous ablation followed), TAE + RC (any radiation therapy or chemotherapy followed). The clinical and tumor characteristics, embolization factors and survival periods were analyzed. The 5-year survival rates of the groups of TAE only, TAE + SL and TAE + RC were 21.6%, 57.4%, and 13.1%, respectively. In all cases and in the TAE only group, more selective and complete embolization increased survival rates. There were tendencies that as smaller tumor and the tumor in earlier stage, more selective and complete embolizations were performed in the TAE only group, and independent prognostic factors of this group were Child-Pugh classification, tumor size and Modified 4th UICC stage. This study is the first nationwide multicenter analysis for TAE using an online registration system in Korea. Selective and complete TAE increases patient's survival, and decisive combined treatment after TAE such as surgical resection, transplantation or percutaneous ablation increases patient's survival.

  9. Severe hypertension due to renal polar artery stenosis in an adolescent treated with coil embolization

    Energy Technology Data Exchange (ETDEWEB)

    Docx, Martine K. [Koningin Paola Kinderziekenhuis, Department of Paediatrics, Chronic Diseases and Hypertension, Antwerp (Belgium); Vandenberghe, Philippe [Koningin Paola Kinderziekenhuis, Department of Paediatric Cardiology, Antwerp (Belgium); Maleux, Geert [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); Gewillig, Marc [University Hospitals Leuven, Department of Paediatric Cardiology, Leuven (Belgium); Mertens, Luc [Hospital for Sick Children, Paediatric Cardiology, Toronto (Canada)

    2009-11-15

    A 12-year-old boy presented with severe arterial hypertension due to a severe subsegmental renal artery stenosis. Treatment consisted of selective embolization of the stenosed polar artery, which resulted in near normalization of the arterial pressures. Renal artery stenosis should always be considered, even in young adolescents, as a cause for arterial hypertension. Only selective angiography was able to demonstrate the subsegmental artery stenosis in this patient. (orig.)

  10. Cortical blindness and ataxia complicating bronchial artery embolization for severe hemoptysis.

    Science.gov (United States)

    Peng, Guoping; Liang, Hui; Ruan, Lingxiang; Luo, Benyan

    2010-01-01

    Complications of bronchial artery embolization (BAE) are uncommon. A 37-year-old patient with pulmonary tuberculosis received bronchial artery embolization because of severe hemoptysis. The bilateral bronchial arteries and left internal mammary artery were embolized using a gelatin sponge, and the patient exhibited occipital blindness and ataxia after the second BAE. The dissolvable gelatin sponge possibly entered the posterior circulation, resulting in the multiple infarctions in the bilateral occipital lobes and cerebellum. Because of the bad prognosis and the difficulty for curability, this kind of complication should be recognized in a timely manner and carefully avoided by the interventional radiologists carrying out the BAE.

  11. Catheterization and embolization of a replaced left hepatic artery via the right gastric artery through the anastomosis: a case report

    Directory of Open Access Journals (Sweden)

    Miyazaki Masaya

    2011-08-01

    Full Text Available Abstract Introduction Conversion of multiple hepatic arteries into a single vascular supply is a very important technique for repeat hepatic arterial infusion chemotherapy using an implanted port catheter system. Catheterization of a replaced left hepatic artery arising from a left gastric artery using a percutaneous catheter technique is sometimes difficult, despite the recent development of advanced interventional techniques. Case presentation We present a case of a 70-year-old Japanese man with multiple hepatocellular carcinomas in whom the replaced left hepatic artery arising from the left gastric artery needed to be embolized. After several failed procedures, the replaced left hepatic artery was successfully catheterized and embolized with a microcatheter and microcoils via the right gastric artery through the anastomosis. Conclusion A replaced left hepatic artery arising from a left gastric artery can be catheterized via a right gastric artery by using the appropriate microcatheter and microguidewires, and multiple hepatic arteries can be converted into a single supply.

  12. Transcatheter Arterial Embolization of Renal VX-2 Carcinoma: Ethiodol-Ethanol Capillary Embolization Combined with Carboplatin

    Energy Technology Data Exchange (ETDEWEB)

    Konya, Andras; Pelt, Carolyn S. Van; Wright, Kenneth C. [The University of Texas MD Anderson Cancer Center, Hoston (United States); Choi, Byung Gil [The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-04-15

    We wanted to determine whether transcatheter Ethiodol-based capillary embolization in combination with carboplatin could improve the efficiency of a 1:1 Ethiodol-ethanol mixture (EEM) to ablate kidneys that been inoculated with VX-2 carcinoma. The right kidney in 34 New Zealand white rabbits were inoculated with fresh VX-2 tumor fragments. One week later, the kidneys were subjected to transarterial treatment (4-5 rabbits/group): Saline infusion (Group 1); carboplatin infusion (5 or 10 mg, Groups 2A and 2B); carboplatin- Ethiodol (CE) alone (Group 3) and followed by main renal artery occlusion with ethanol (RAO) (Group 4); carboplatin-EEM (C-EEM) followed by RAO (Group 5); carboplatin infusion followed by EEM plus RAO (Group 6); and EEM followed by RAO (Group 7). The animals were followed for up to 3-weeks. The treated kidneys were evaluated angiographically and macroscopically. The kidneys that showed successful embolization macroscopically were entirely cut into serial sections, and these were examined microscopically. Histologically, the kidneys were evaluated on the basis of the residual tumor found in the serial sections. The results obtained with carboplatin infusion alone (Groups 2A and 2B) and CE without RAO (Group 3) were similar to those of the control animals (Group 1). Kidneys from Groups 4-7 demonstrated macroscopically successful embolization with histologically proven complete renal parenchyma infarction; however, some residual tumor was evident in all but one animal. None of the Ethiodol-based modalities combined with locoregional carboplatin were more efficacious for tumor ablation than EEM alone.

  13. Direct Needle Puncture and Embolization of Splenic Artery Pseudoaneurysm in Case of Chronic Atrophic Calcific Pancreatitis

    Science.gov (United States)

    Shrivastava, Amit; Rampal, Jagadeesh Singh; Reddy, D. Nageshwar; Rao, Guduru Venkat

    2016-01-01

    Summary Background Gastro-Intestinal bleeding remains a frequent clinical dilemma and common cause of hospitalization, morbidity and mortality. Case Report We report a case of pseudo aneurysm of splenic artery developed after an episode of acute on chronic pancreatitis which was treated by direct percutaneous puncture of pseudoaneurysm and embolization by coils. Conclusions The aim was to preserve the main splenic artery and avoid the complications of splenic artery embolization like infarcts and abscess. PMID:27757174

  14. Post-traumatic hepatic artery pseudo-aneurysm combined with subphrenic liver abscess treated with embolization

    Institute of Scientific and Technical Information of China (English)

    Long Sun; Yong-Song Guan; Hua Wu; Wei-Min Pan; Xiao Li; Qing He; Yuan Liu

    2006-01-01

    A 23-year-old man with post-traumatic hepatic artery pseudo-aneurysm and subphrenic liver abscess was admitted. He underwent coil embolization of hepatic artery pseudo-aneurysm. The pseudo-aneurysm was successfully obstructed and subphrenic liver abscess was controlled. Super-selective trans-catheter coil embolization may represent an effective treatment for hepatic artery pseudo-aneurysm combined with subphrenic liver abscess in the absence of other therapeutic alternatives.

  15. Spontaneous healing of cervical pseudoaneurysm in vertebral artery dissection under anticoagulant therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, A.; Neff, W.; Schwartz, A. [Department of Neurology, Klinikum Mannheim, Medical Faculty, University of Heidelberg, Theodor-Kutzer-Ufer 1, D-68132 Mannheim (Germany)

    1998-04-01

    We report a 41-year-old woman with embolic stroke of the mid-pons attributed to embolism from vertebral artery dissection. Angiography revealed an occluded artery on one side and an incidental pseudoaneurysm of the midcervical portion of the vertebral artery on the other. After 3 months of warfarin therapy control angiography showed complete occlusion of the pseudoaneurysm. We discuss therapeutic choices and review the literature. (orig.) With 4 figs., 8 refs.

  16. Uterine Artery Embolization Versus Laparoscopic Uterine Artery Occlusion: The Outcomes of a Prospective, Nonrandomized Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Mara, Michal; Kubinova, Kristyna, E-mail: kristyna.kubinova@gmail.com [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic); Maskova, Jana [Aberdeen Royal Infirmary, Department of Radiology (United Kingdom); Horak, Petr [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic); Belsan, Tomas [Central Military Hospital, Department of Radiology (Czech Republic); Kuzel, David [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic)

    2012-10-15

    Purpose: To compare outcomes of two different types of occlusive therapy of uterine fibroids. Methods: Women with fibroid(s) unsuitable for laparoscopic myomectomy (LM) were treated with uterine artery embolization (UAE) or laparoscopic uterine artery occlusion (LUAO). Results: Before the procedure, patients treated with UAE (n = 100) had a dominant fibroid greater in size (68 vs. 48 mm) and a mean age lower (33.1 vs. 34.9 years) than surgically treated patients (n = 100). After 6 months, mean shrinkage of fibroid volume was 53 % after UAE and 39 % after LUAO (p = 0.063); 82 % of women after UAE, but only 23 % after LUAO, had complete myoma infarction (p = 0.001). Women treated with UAE had more complications (31 vs. 11 cases, p = 0.006) and greater incidence of hysteroscopically verified intrauterine necrosis (31 vs. 3 %, p = 0.001). Both groups were comparable in markers of ovarian functions and number of nonelective reinterventions. The groups did not differ in pregnancy (69 % after UAE vs. 67 % after LUAO), delivery (50 vs. 46 %), or abortion (34 vs. 33 %) rates. The mean birth weight of neonates was greater (3270 vs. 2768 g, p = 0.013) and the incidence of intrauterine growth restriction lower (13 vs. 38 %, p = 0.046) in post-UAE patients. Conclusion: Both methods are effective in the treatment of women with future reproductive plans and fibroids not suitable for LM. UAE is more effective in causing complete ischemia of fibroids, but it is associated with greater risk of intrauterine necrosis. Both methods have low rate of serious complications (except for a high abortion rate).

  17. [Embolism of the humeral artery originating in a thrombosed axillo-femoral bypass].

    Science.gov (United States)

    Barba, A; Escribano, J V; García-Alfageme, A

    1992-01-01

    A case of a patient, with acute arterial ischemia at the upper limb is reported. On this case, ischemia was caused by humeral arterial embolism. The embolic origin was focused on the proximal end of a thrombosed axillofemoral bypass. After a rude manipulation during surgical procedure, part of the thrombus, following the sanguineous current, occluded the humeral artery. Patient underwent an emergent surgery. Posterior course was good. Histology showed a re-epithelialized, ancient thrombus. Cardiologic studies and angiography showed no others embolic focuses.

  18. D-amphetamine improves cognitive deficits and physical therapy promotes fine motor rehabilitation in a rat embolic stroke model

    DEFF Research Database (Denmark)

    Rasmussen, Rune Skovgaard; Overgaard, K; Hildebrandt-Eriksen, E S

    2006-01-01

    BACKGROUND AND PURPOSE: The purpose of this study was to examine the effects of D-amphetamine (D-amph) and physical therapy separately or combined on fine motor performance, gross motor performance and cognition after middle cerebral artery thromboembolization in rats. METHODS: Seventy-four rats...... were trained in appropriate cognitive and motor behaviours. Thirteen animals were sham-operated and fifty-nine animals were embolized in the right carotid territory. Animals were randomly assigned to five groups: 1) SHAM (non-embolized, saline), 2) CONTROL (embolized, saline), 3) D-AMPH (embolized, D...... were allowed to voluntarily engage in suitable cognitive or motor behaviours in order to obtain food. Animals from all groups were re-tested during days 21-28 after surgery. RESULTS: No differences in infarct volumes were observed between the groups of embolized animals. When evaluating performances...

  19. Evaluation of arterial impairment after experimental gelatin sponge embolization in a rabbit renal model

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jung Suk; Lee, Hae Gi; Chun, Ho Jong; Choi, Byung Gil; Choi, Yeong Jin [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2015-02-15

    Arterial stenosis is a major obstacle for subsequent interventional procedures. We hypothesized that the stenosis is caused by gelatin sponge embolization and performed an experimental study in a rabbit renal model. A total of 24 rabbits were embolized with porcine gelatin sponge particles injected into the renal arteries. Four rabbits were sacrificed on 1 day, 4 days, 1 week, 2 weeks, 3 weeks, and 4 weeks after embolization. Microscopic evaluations were performed on hematoxylin-eosin and smooth muscle actin immunohistochemical stained sections. Gelatin sponge particles were mainly observed in the segmental and interlobar arteries. Transmural inflammation of the embolized arterial wall and mild thickening of the media were observed 1 week after embolization. Resorption of the gelatin sponge and organization of thrombus accompanied by foreign body reactions, were observed from 2 to 4 weeks after embolization. Microscopic images of the 3 weeks group showed vessel lumens filled mostly with organized thrombi, resulting in severe stenosis. Additionally, vessels showed a thickened intima that contained migrating smooth muscle cells and accompanying interruption of the internal elastic lamina. The migrating smooth muscle cells were distributed around the recanalized arterial lumen. Gelatin sponge embolization may induce arterial stenosis by causing organized thrombus and intimal hyperplasia, which consists of migrating smooth muscle cells and intimal collagen deposits.

  20. Superselective uterine arterial embolization with pingyangmycin-lipiodol emulsion for management of symptomatic uterine leiomyoma

    Institute of Scientific and Technical Information of China (English)

    单鸿; 黄明声; 关守海; 姜在波; 朱康顺; 李征然

    2004-01-01

    Background Uterine arterial embolization (UAE) is a safe and effective therapy for symptomatic uterine leiomyoma. This study was to assess the effectiveness and the feasibility of pingyangmycin-lipiodol emulsion (PLE) for the management of symptomatic uterine leiomyoma.Methods One hundred consecutive patients (aged 21-53 years, with 38 in average) with symptomatic uterine leiomyoma underwent superselective UAE with PLE. Clinical symptoms of the patients (including menorrhagia, bulk-related symptoms, and postprocedure-related abdominal pain) and the changes in uterine volume and tumor size after the embolization were analyzed. The patients were followed up for 8-21 months (mean, 15 months).Results Ninety-nine patients (99%, 99/100) were interviewed in their first menses circle after embolization, showing improvements in their abnormal bleeding and bulk-related symptoms to some extent. Imagiological results during follow-up showed a mean of 48% reduction in uterine volume at 6 months and a mean of 75% reduction in tumor size at 9 months. Eighty-three percent of the patients reported complete resolution of postprocedure pain within 7 days.Conclusions PLE is effective in the management of uterine leiomyoma, having superiority in alleviating postprocedure-related pain.

  1. Posterior Circulation Stroke After Bronchial Artery Embolization. A Rare but Serious Complication

    Energy Technology Data Exchange (ETDEWEB)

    Laborda, Alicia [Universidad de Zaragoza, Departamento de Pediatria, Radiologia y Medicina Fisica, Grupo de Investigacion en Tecnicas Minimamente Invasivas, GITMI (Spain); Tejero, Carlos [Hospital Clinico Universitario Lozano Blesa, Servicio de Neurologia (Spain); Fredes, Arturo, E-mail: fredesarturo@gmail.com [Universidad de Zaragoza, Hospital Quiron, Departamento de Pediatria, Radiologia y Medicina Fisica, Grupo de Investigacion en Tecnicas Minimamente Invasivas, GITMI (Spain); Cebrian, Luis; Guelbenzu, Santiago; Gregorio, Miguel Angel de, E-mail: mgregori@unizar.es [Universidad de Zaragoza, Departamento de Pediatria, Radiologia y Medicina Fisica, Grupo de Investigacion en Tecnicas Minimamente Invasivas, GITMI (Spain)

    2013-06-15

    Bronchial artery embolization (BAE) is the treatment of choice for massive hemoptysis with rare complications that generally are mild and transient. There are few references in the medical literature with acute cerebral embolization as a complication of BAE. We report a case of intracranial posterior territory infarctions as a complication BAE in a patient with hemoptysis due to bronchiectasis.

  2. Hepatic artery embolization for treatment of patients with hereditary hemorrhagic telangiectasia and symptomatic hepatic vascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Chavan, Ajay [Hannover Medical School, Department of Diagnostic Radiology, Hannover (Germany); Klinikum Oldenburg, Department of Radiology and Nuclear Medicine, Oldenburg (Germany); Caselitz, Martin; Wagner, Siegfried; Manns, Michael [Hannover Medical School, Department of Gastroenterology and Hepatology, Hannover (Germany); Gratz, Karl-Friedrich [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Lotz, Joachim; Kirchhoff, Timm; Galanski, Michael [Hannover Medical School, Department of Diagnostic Radiology, Hannover (Germany); Piso, Plinio [Hannover Medical School, Department of Abdominal and Transplantation Surgery, Hannover (Germany)

    2004-11-01

    At present there is no established therapy for treating patients with hereditary hemorrhagic telangiectasia (HHT) and symptomatic hepatic involvement. We present the results of a prospective study with 15 consecutive patients who were treated with staged hepatic artery embolization (HAE). Branches of the hepatic artery were selectively catheterized and embolized in stages using polyvinyl alcohol particles (PVA) and platinum microcoils or steel macrocoils. Prophylactic antibiotics, analgesics and anti-emetics were administered after every embolization. Clinical symptomatology and cardiac output were assessed before and after therapy as well as at the end of follow-up (median 28 months; range 10-136 months). Five patients had abdominal pain and four patients had symptoms of portal hypertension. The cardiac output was raised in all patients, with cardiac failure being present in 11 patients. After treatment, pain resolved in all five patients, and portal hypertension improved in two of the four patients. The mean cardiac output decreased significantly (P<0.001) from 12.57{+-}3.27 l/min pre-treatment to 8.36{+-}2.60 l/min at the end of follow-up. Symptoms arising from cardiac failure resolved or improved markedly in all but one patient. Cholangitis and/or cholecystitis occurred in three patients of whom two required a cholecystectomy. One patient with pre-existent hepatic cirrhosis died as a complication of the procedure. Staged HAE yields long-term relief of clinical symptoms in patients with HHT and hepatic involvement. Patients with pre-existing hepatic cirrhosis may be poor candidates for HAE. (orig.)

  3. Blunt renal trauma: comparison of contrast-enhanced CT and angiographic findings and the usefulness of transcatheter arterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Kitase, M.; Mizutani, M.; Tomita, H.; Kono, T.; Sugie, C.; Shibamoto, Y. [Nagoya City University, Nagoya, (Japan). Graduate School of Medical Sciences. Dept. of Radiology

    2007-07-15

    Full text: Background: The purpose of this study was to evaluate the role of contrast-enhanced CT and the usefulness of super selective embolization therapy in the management of arterial damage in patients with severe blunt renal trauma. Patients and Methods: Nine cases of severe renal trauma were evaluated. In all cases, we compared contrast enhanced CT findings with angiographic findings, and performed transcatheter arterial embolization (TAE) in six of them with microcoils and gelatin sponge particles. Morphological changes in the kidney and site of infarction after TAE were evaluated on follow-up CT Chronological changes in blood biochemistry findings after injury, degree of anemia and renal function were investigated. Adverse effects or complications such as duration of hematuria, fever, abdominal pain, renovascular hypertension and abscess formation were also evaluated. Results: The CT finding of extravasation was a reliable sign of active bleeding and useful for determining the indication of TAE. In all cases, bleeding was effectively controlled with super selective embolization. There was minimal procedure-related loss of renal tissue. None of the patients developed abscess, hypertension or other complications. Conclusions: In blunt renal injury, contrast-enhanced CT was useful for diagnosing arterial hemorrhage. Arterial bleeding may produce massive hematoma and TAE was a useful treatment for such cases. By using selective TAE for a bleeding artery, it was possible to minimize renal parenchymal damage, with complications of TAE rarely seen. (author)

  4. Can catheter-directed thrombolysis be applied to acute lower extremity artery embolism after recent cerebral embolism from atrial fibrillation?

    Energy Technology Data Exchange (ETDEWEB)

    Si, T.-G. [Department of interventional treatment, Tianjin medical university cancer Hospital and Institution, Tianjin (China); Guo, Z. [Department of interventional treatment, Tianjin medical university cancer Hospital and Institution, Tianjin (China)], E-mail: dr.guozhi@yahoo.com.cn; Hao, X.-S. [Department of interventional treatment, Tianjin medical university cancer Hospital and Institution, Tianjin (China)

    2008-10-15

    Purpose: To assess the feasibility and efficacy of catheter-directed thrombolysis with recombinant tissue plasminogen activator (rt-PA) for acute limb embolism in patients with recent cerebral embolism due to atrial fibrillation. Materials and methods: Eight patients (six men, two women; mean age 63.5 years) with acute embolic occlusion of two left common iliac arteries, four femoral arteries (three left; one right), and two right popliteal arteries were treated. All patients had a history of recent cerebral embolism (mean 6 days, range 5-15 days) and all had a history of atrial fibrillation (duration 5-10 years). Catheter-directed thrombolysis started a few hours (mean 6.2 h; range 3-10 h) after the onset of arterial embolism. Two 5 mg boluses of rt-PA were injected into the proximal clot through a 5 F end-hole catheter and, subsequently, two additional boluses of 5 mg rt-PA were injected into the emboli. In patients with residual emboli, infusion with rt-PA (1 mg/h) was continued. Percutaneous transluminal angioplasty was performed in three patients, and a stent was deployed in one patient. Results: Technical success was achieved in all patients. Clinical success rate was 87.5% (7/8). The one clinical failure was secondary to chronic occlusion of outflow runoff vessels. The mean duration of continuous rt-PA infusion was 3.6 h, the mean total dose of rt-PA administered was 23.6 mg (range 20-28 mg). There was no significant change in stroke scale scores during thrombolysis and no intracerebral haemorrhage was found at computed tomography (CT) after thrombolysis. Minor complications included haematomata at puncture sites (6/8), bleeding around the vascular sheath (2/8), and haematuria (1/8). During the follow-up period of 3-6 months, one patient suffered from recurrent cerebral embolism and died. Conclusions: Catheter-directed thrombolysis with rt-PA is an option for acute lower extremity arterial embolism in patients with recent cerebral embolism and a history of

  5. Embolization of Life-Threatening Arterial Rupture in Patients with Vascular Ehlers–Danlos Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Takuya, E-mail: okabone@gmail.com [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France); Frank, Michael, E-mail: michael.frank@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Rare Vascular Diseases Reference Center (France); Pellerin, Olivier, E-mail: olivier@pellerin.as; Primio, Massimiliano Di, E-mail: massimiliano.di.primio@gmail.com; Angelopoulos, Georgios, E-mail: giorginos78@msn.com [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France); Boughenou, Marie-Fazia, E-mail: marie-fazia.boughenou@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Anesthesia and Surgical Intensive Care Unit (France); Pagny, Jean-Yves, E-mail: jean-yves.pagny@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France); Messas, Emmanuel, E-mail: emmanuel.messas@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Rare Vascular Diseases Reference Center (France); Sapoval, Marc, E-mail: marc.sapoval2@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France)

    2013-05-09

    PurposeTo evaluate the safety and efficacy of transarterial embolization of life-threatening arterial rupture in patients with vascular Ehlers–Danlos syndrome (vEDS) in a single tertiary referral center.MethodsWe retrospectively analyzed transarterial embolization for vEDS performed at our institution from 2000 to 2012. The indication of embolization was spontaneous arterial rupture or pseudoaneurysm with acute bleeding. All interventions used a percutaneous approach through a 5F or less introducer sheath. Embolic agents were microcoils and glue in 3 procedures, glue alone in 2, and microcoils alone in 2.ResultsFive consecutive vEDS patients were treated by 7 embolization procedures (4 women, mean age 29.8 years). All procedures were successfully performed. Two patients required a second procedure for newly arterial lesions at a different site from the first procedure. Four of the five patients were still alive after a mean follow-up of 19.4 (range 1–74.7) months. One patient died of multiple organ failure 2 days after procedure. Minor procedural complications were observed in 3 procedures (43 %), all directly managed during the same session. Remote arterial lesions occurred after 3 procedures (43 %); one underwent a second embolization, and the other 2 were observed conservatively. Puncture site complication was observed in only one procedure (14 %).ConclusionEmbolization for vEDS is a safe and effective method to manage life-threatening arterial rupture.

  6. Left-sided portal hypertension: Successful management by laparoscopic splenectomy following splenic artery embolization

    Directory of Open Access Journals (Sweden)

    Damiano Patrono

    2014-01-01

    CONCLUSION: Splenic artery embolization may be a valuable adjunct in case of left-sided portal hypertension requiring splenectomy, allowing a safe dissection of the splenic vessels even by laparoscopy.

  7. Polyvinyl alcohol and gelatin sponge particle embolization of splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Yong-Song Guan; Long Sun; Xiang-Ping Zhou; Xiao Li; Ze-Jun Fei; Xiao-Hua Zheng; Qing He

    2005-01-01

    AIM: To assess the effectiveness of and complications associated with polyvinyl alcohol (PVA) and gelatin sponge particles embolization of splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis.METHODS: A 42-year-old man with splenic artery pseudoaneurysm formation secondary to chronic alcoholic pancreatitis was admitted. We used PVA and gelatin sponge partides embo lization of splenic artery pseudoaneurysm by superselective embolization techniques.RESULTS: The splenic artery pseudoaneurysm was successfully controlled with splenic embolization. The patient was discharged in 9 d with complete recovery. CONCLUSION: This case confirms that superselective transcatheter embolization by PVA and gelatin sponge particles may represent an effective treatment for pseudoaneurysm caused by chronic alcoholic pancreatitis in the absence of other therapeutic alternatives.

  8. Acquisition of endovascular skills for uterine artery embolization using a simulator

    DEFF Research Database (Denmark)

    McLucas, Bruce; Coats, Richard; Lönn, Lars Birger;

    2009-01-01

    This study addresses endovascular training using simulators for uterine artery embolization. A review of endovascular skill training for surgeons using simulators was performed. Surgeons possess varying levels of proficiency in endovascular techniques. A simulator will improve endovascular skills...

  9. Spontaneous Hepatic Rupture Associated with Preeclampsia: Treatment with Hepatic Artery Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Seung Boo; Goo, Dong Erk; Chang, Yun Woo; Kim, Yong Jae; Hwang, In Cheol; Han, Hyo Sang; Yoon, Jong Hyun; Lee, Tae Il [Soonchunhyang University Hospital, Gumi (Korea, Republic of)

    2010-02-15

    Spontaneous rupture of the liver due to preeclampsia is a rare condition of pregnant women, and it can be very dangerous if not treated. We report here on a case of successfully treating spontaneous liver rupture associated with preeclampsia by performing transcatheter hepatic arterial embolization. A 41-year-old woman with spontaneous rupture of the liver associated with preeclampsia was treated by hepatic arterial embolization

  10. Dextran Microsphere Hepatic Artery Embolization for Hepatoma: Pathological Assessment of Its Efficacy in Resected Cases

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To evaluate the therapeutic effect and the mechanism of dextran microsphere hepatic artery embolization for hepatoma. Methods Partial hepatectomy was performed in 11 patients with hepatoma pretreated with dextran microsphere hepatic artery embolization. All specimens were for histopathologic studies in order to observe the destiny of dextran microspheres and necrotic degree of the tumor. Results complete necrosis of the tumor was found in seven cases and incomplete necrosis of the tumor in the rest 4. Tumors in the later were near to areas rich in arterial collateral anastomoses. The extent of tumor necrosis was unrelated to the presence and thickness of tumor capsule and capsular invasions. Dextran microspheres could cause permanent embolization of distal arterioles. The microspheres were very biocompatible and cause little foreign body reaction. No inflammatory changes were seen both inside and outside of the embolized artery 191 days after embolization. Dextran microspheres were not absorbed and the vessel recanalization was also not seen. Dextran microsphere was not found in portal veins. Conclusion Some hepatomas distant from the collateral circulation of arteries could be cured with dextran microsphere hepatic artery embolization alone.

  11. Life-threatening autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura: successful seletive splenic artery embolization

    Directory of Open Access Journals (Sweden)

    matteo molica

    2016-04-01

    Full Text Available Selective splenic artery embolization (SSAE is a nonsurgical intervention characterized by the transcatheter occlusion of the splenic artery and/or its branch vessels using metallic coils or other embolic devices. It has been applied for the management of splenic trauma, hypersplenism with portal hypertension, hereditary spherocytosis, thalassemia and splenic hemangioma. We hereby describe a case of a patient affected by idiopathic thrombocytopenic purpura (ITP and warm auto-immune hemolytic anemia (AIHA both resistant to immunosuppressive and biological therapies, not eligible for a surgical intervention because of her critical conditions. She underwent SSAE and achieved a hematologic complete response within a few days without complications. SSAE is a minimally invasive procedure to date not considered a standard option in the management of AIHA and ITP. However, following the progressive improvement of the techniques, its indications have been extended, with a reduction in morbidity and mortality compared to splenectomy in patients with critical clinical conditions. SSAE was a lifesaving therapeutic approach for our patient and it may represent a real alternative for the treatment of resistant AIHA and ITP patients not eligible for splenectomy.

  12. Life-Threatening Autoimmune Hemolytic Anemia and Idhiopatic Thrombocytopenic Purpura. Successful Selective Splenic Artery Embolization

    Science.gov (United States)

    Molica, Matteo; Massaro, Fulvio; Annechini, Giorgia; Baldacci, Erminia; D’Elia, Gianna Maria; Rosati, Riccardo; Trisolini, Silvia Maria; Volpicelli, Paola; Foà, Robin; Capria, Saveria

    2016-01-01

    Selective splenic artery embolization (SSAE) is a nonsurgical intervention characterized by the transcatheter occlusion of the splenic artery and/or its branch vessels using metallic coils or other embolic devices. It has been applied for the management of splenic trauma, hypersplenism with portal hypertension, hereditary spherocytosis, thalassemia and splenic hemangioma. We hereby describe a case of a patient affected by idiopathic thrombocytopenic purpura (ITP) and warm auto-immune hemolytic anemia (AIHA) both resistant to immunosuppressive and biological therapies, not eligible for a surgical intervention because of her critical conditions. She underwent SSAE and achieved a hematologic complete response within a few days without complications. SSAE is a minimally invasive procedure to date not considered a standard option in the management of AIHA and ITP. However, following the progressive improvement of the techniques, its indications have been extended, with a reduction in morbidity and mortality compared to splenectomy in patients with critical clinical conditions. SSAE was a lifesaving therapeutic approach for our patient and it may represent a real alternative for the treatment of resistant AIHA and ITP patients not eligible for splenectomy. PMID:27158433

  13. Uterine artery embolization (UAE) for diffuse leiomyomatosis of the uterus: Clinical and imaging results

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Jieun [Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Shinchon-dong, Seodaemun-gu, Seoul 120-752 (Korea, Republic of); Kim, Man Deuk, E-mail: mdkim@yuhs.ac [Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Shinchon-dong, Seodaemun-gu, Seoul 120-752 (Korea, Republic of); Jung, Dae Chul; Lee, Myungsu; Lee, Mu Sook; Won, Jong Yun; Lee, Do Yun; Park, Sung Il; Lee, Kwang Hun [Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Shinchon-dong, Seodaemun-gu, Seoul 120-752 (Korea, Republic of)

    2012-10-15

    Purpose: The aim of the current study was to evaluate the efficacy of uterine artery embolization (UAE) in the management of diffuse uterine leiomyomatosis with mid-term follow-up. Materials and methods: All patients who underwent UAE between 2008 and 2010 for symptomatic fibroids were analyzed. Among 360 cases, a total of 7 patients with diffuse uterine leiomyomatosis diagnosed based on MRI were included in this retrospective study. Patient ages ranged from 29 to 38 (mean 32.7) years. The median follow-up period was 16 (range; 6–31) months. The embolic agent was non-spherical polyvinyl alcohol particles. All patients underwent follow-up MRI at 3 months after UAE. Uterine volumes were calculated using MRI. Menorrhagia symptom changes were assessed at mid-term follow-up. Results: There were no technical failures to catheterize the uterine artery and no adverse events requiring therapy after UAE. Contrast-enhanced MRI showed complete necrosis of the leiomyomatous nodules in 5 patients (71%) 3 months after embolization. Two patients (28%) showed mostly leiomyomatous nodules that were necrotized, some of which were still viable. All 7 patients with menorrhagia had improvement of symptoms at the mid-term follow-up. The initial mean uterine volume was 601.30 ± 533.92 cm{sup 3} and was decreased to a mean of 278.81 ± 202.70 cm{sup 3} at 3 months follow-up, for a mean uterus volume reduction rate of 50.1% (p < 0.05). One patient became pregnant 5 months after UAE treatment. Conclusion: UAE was a highly effective treatment for diffuse uterine leiomyomatosis with mid-term durability and may be a valuable alternative to hysterectomy.

  14. Treatment of Rare Gastric Variceal Bleeding in Acute Pancreatitis Using Embolization of the Splenic Artery Combined with Short Gastric Vein

    Directory of Open Access Journals (Sweden)

    Lixin Li

    2012-12-01

    Full Text Available In the acute stage of pancreatitis, sinistral portal hypertension is a rare reason for gastric variceal bleeding. Here we report a 20-year-old female patient with massive upper gastrointestinal hemorrhage 7 days after an episode of severe acute pancreatitis. Computed tomography showed gastric varices caused by splenic venous thrombosis. Emergency endoscopic examination was performed, however tissue adhesive utilized to restrain the bleeding was not successful. Although interventional therapy was controversial to treat the gastric variceal hemorrhage resulting from sinistral portal hypertension, the bleeding was successfully treated by embolization of the splenic artery combined with short gastric vein. Two weeks after the interventional the patient was discharged from our hospital without recurrence of bleeding. Embolization of the splenic artery combined with short gastric vein proved to be an effective emergency therapeutic method for gastric variceal bleeding caused by sinistral portal hypertension in the acute stage of pancreatitis.

  15. Geniculate artery embolization in the management of spontaneous recurrent hemarthrosis of the knee: case series.

    Science.gov (United States)

    Bagla, Sandeep; Rholl, Kenneth S; van Breda, Arina; Sterling, Keith M; van Breda, Arletta

    2013-03-01

    Spontaneous recurrent hemarthrosis after knee arthroplasty is reported to occur in 0.3%-1% of patients, likely secondary to hypertrophic vascular synovium. Five patients who underwent previous arthroplasty presented with spontaneous hemarthrosis. Selective arterial embolization was performed with spherical embolic particles (diameter range, 100-700 μm). Angiography demonstrated synovial hypervascularity with geniculate artery "tumor blush" appearance in all patients. Average time to resolution of effusion was 2.6 weeks, with no recurrences reported during follow-up (mean, 25.4 mo; range, 16-48 mo). Two patients experienced transient cutaneous ischemia. Selective geniculate artery embolization with spherical embolic particles is an effective treatment for spontaneous recurrent hemarthrosis of the knee.

  16. Post-Operative hemorrhage after myomectomy: Safety and efficacy of transcatheter uterine artery embolization

    Energy Technology Data Exchange (ETDEWEB)

    Wan, Alvin Yu Hon [Dept. of Radiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong (China); Shin, Ji Hoon; Yoon, Hyun Ki; Ko, Gi Young; Park, Sang Gik [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Seong, Nak Jong; Yoon, Chang Jin [Dept. of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam (Korea, Republic of)

    2014-06-15

    To evaluate the safety and clinical efficacy of transcatheter uterine artery embolization (UAE) for post-myomectomy hemorrhage. We identified eight female patients (age ranged from 29 to 51 years and with a median age of 37) in two regional hospitals who suffered from post-myomectomy hemorrhage requiring UAE during the time period from 2004 to 2012. A retrospective review of the patients' clinical data, uterine artery angiographic findings, embolization details, and clinical outcomes was conducted. The pelvic angiography findings were as follows: hypervascular staining without bleeding focus (n = 5); active contrast extravasation from the uterine artery (n = 2); and pseudoaneurysm in the uterus (n = 1). Gelatin sponge particle was used in bilateral uterine arteries of all eight patients, acting as an empirical or therapeutic embolization agent for the various angiographic findings. N-butyl-2-cyanoacrylate was administered to the target bleeding uterine arteries in the two patients with active contrast extravasation. Technical and clinical success were achieved in all patients (100%) with bleeding cessation and no further related surgical intervention or embolization procedure was required for hemorrhage control. Uterine artery dissection occurred in one patient as a minor complication. Normal menstrual cycles were restored in all patients. Uterine artery embolization is a safe, minimally invasive, and effective management option for controlling post-myomectomy hemorrhage without the need for hysterectomy.

  17. Selective Arterial Embolization in the Treatment of High Flow Priapism: Report of 5 Cases

    Directory of Open Access Journals (Sweden)

    H. Rokni Yazdi

    2005-06-01

    Full Text Available High flow priapism is a rare entity caused by a pathologic influx from lacerated arteries to the cavernous bodies. Transcatheter embolization of feeding arteries is the treatment of choice. We reviewed a series of 5 patients who un derwent transcatheter embolization in our hospital from 2000 to 2004. The mean age of patients was 32 years; dur ation of priapism was between one week and a year. All underwent bilateral pudendal artery ca theterization with No.5 French Cobra-II catheters. We did not microcatheters in our patien ts. Embolized materials were gel-foam, coils and polyvinyl alcohol microspheres. We could follow four of them for 6 to 40 months; one of the patients dropped out from our follow-up study. All the four patients had completed detumescence after a maximum of two days from embolization;none of them experienced signific ant complications and all returned to normal sexual function and remained symptom free thereafter (6-40 months. We noted no difference in complications and duration to restore erectile function and less recurrence rate with embolization of main br anch of pudendal artery instead of superselective embolization of arteriocavernous fistul a feeder artery with a microcatheter that is the method of choice for the treatment of high flow priapism, but due to small number of cases it needs further studies to be confirmed.

  18. Iatrogenic central retinal artery occlusion after carotid body tumor embolization and excision

    Directory of Open Access Journals (Sweden)

    Rangel, Carlos M.

    2017-03-01

    Full Text Available Objective: To report a case of iatrogenic central retinal artery occlusion after embolization and surgical resection of carotid body paraganglioma.Methods: Case report Results: One adult female patient presented with persistent unilateral visual loss after embolization with Embosphere and Contour microparticles of carotid body tumor. Fluorescein angiography revealed intraluminal microspheres in the central retinal artery ramifications. OCT revealed intraretinal spherical, hyporeflective particles with posterior shadowing. Conclusions: Central retinal artery occlusion should be assessed as a possible complication after surgical repair of head and neck paragangliomas.

  19. Anticoagulant-induced pseudothrombocytopenia occurring after transcatheter arterial embolization for hepatocellular carcinoma.

    Science.gov (United States)

    Yoshikawa, Takeshi; Nakanishi, Kayo; Maruta, Tsutomu; Takenaka, Daisuke; Hirota, Shozo; Matsumoto, Shinichi; Saigo, Katsuyasu; Ohno, Yoshiharu; Fujii, Masahiko; Sugimura, Kazuro

    2006-08-01

    Pseudothrombocytopenia (PTCP) is the in vitro phenomenon of anticoagulant-activated platelet agglutination that results in spuriously low platelet counts. We report the case of a 65-year-old man with EDTA- and sodium citrate-dependent PTCP occurring after transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) due to hepatitis C cirrhosis. Invasion of the portal and hepatic veins by HCC formed severe trans-tumoral arterio-venous shunts that were effectively treated by TAE. Two days after the therapy, PTCP was seen on blood count and continued for 4 months. The patient received unnecessary treatment for disseminated intravascular coagulation (DIC) until the diagnosis of PTCP was established. PTCP is a rare complication but should be considered after TAE for HCC; lack of recognition may lead the physician to misdiagnosis and patient mismanagement.

  20. Prostate Artery Embolization as a New Treatment for Benign Prostate Hyperplasia: Contemporary Status in 2016.

    Science.gov (United States)

    Noor, Amir; Fischman, Aaron M

    2016-07-01

    The gold standard treatment for benign prostate hyperplasia (BPH) is transurethral resection of the prostate (TURP) or open prostatectomy (OP). Recently, there has been increased interest and research in less invasive alternative treatments with less morbidity including prostate artery embolization (PAE). Several studies have shown PAE to be an effective alternative to TURP to treat lower urinary tract symptoms (LUTS) associated with BPH with decreased morbidity. Specifically, PAE has been advantageous in selected patient populations such as those with prostates too large for TURP or unsuitable surgical candidates, showing a promising potential for the future care of patients with BPH. Further studies are being done to demonstrate the clinical applications and advantages of this therapy in reduction of LUTS.

  1. Transcatheter bronchial artery embolization in the multimodality management of massive hemoptysis.

    Science.gov (United States)

    Metzdorff, M T; Vogelzang, R L; LoCicero, J; Otto, R

    1990-06-01

    To illustrate the potential role of transcatheter bronchial artery embolization (TBAE) in the multimodality management of massive hemoptysis, we describe a case in which TBAE was successfully employed as the definitive therapy. In recent years, the technique of TBAE has joined the armamentarium of managing methods for massive hemoptysis. While massive hemoptysis has traditionally been defined in terms of the volume of blood produced within a period of time, with a rate of 600 ml in 24 hours the most commonly used definition, a more functional definition has been proposed: bleeding into the tracheobronchial tree at a rate that poses a threat to life. It is the life-threatening nature of this symptom that often results in the early involvement of thoracic surgeons in the care of these patients.

  2. Glue embolization of ruptured anterior thalamoperforating artery aneurysm in patient with both internal carotid arteries occlusion.

    Science.gov (United States)

    Lee, Jae Il; Choi, Chang Hwa; Ko, Jun Kyeung; Lee, Tae Hong

    2011-05-01

    Thalamoperforating artery aneurysms are rarely reported in the literature. We report an extremely rare case of ruptured distal anterior thalamoperforating artery aneurysm which was treated by endovascular obliteration in a patient with occlusion of both the internal carotid arteries (ICAs) : A 72-year-old woman presented with severe headache and loss of consciousness. Initial level of consciousness at the time of admission was drowsy and the Glasgow Coma Scale score was 14. Brain computed tomography (CT) scan was performed which revealed intracerebral hemorrhage in right basal ganglia, subarachnoid hemorrhage, and intraventricular hemorrhage. The location of the aneurysm was identified as within the globus pallidus on CT angiogram. Conventional cerebral angiogram demonstrated occlusion of both the ICAs just distal to the fetal type of posterior communicating artery and the aneurysm was arising from right anterior thalamoperforating artery (ATPA). A microcatheter was navigated into ATPA and the ATPA proximal to aneurysm was embolized with 20% glue. Post-procedural ICA angiogram demonstrated no contrast filling of the aneurysm sac. The patient was discharged without any neurologic deficit. Endovascular treatment of ATPA aneurysm is probably a more feasible and safe treatment modality than surgical clipping because of the deep seated location of aneurysm and the possibility of brain retraction injury during surgical operation.

  3. Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-Year Single-Centre Experience

    Energy Technology Data Exchange (ETDEWEB)

    Raupach, J., E-mail: janraupach@seznam.cz; Lojik, M., E-mail: miroslav.lojik@fnhk.cz; Chovanec, V., E-mail: chovanec.v@seznam.cz; Renc, O., E-mail: ondrejrenc@seznam.cz [Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic); Strýček, M., E-mail: m.strycek@gmail.com [Faculty of Medicine at Charles University (Czech Republic); Dvořák, P., E-mail: petr.dvorak@fnhk.cz; Hoffmann, P., E-mail: hoffmpet@fnhk.cz [Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic); Guňka, I., E-mail: gunka@email.cz; Ferko, A., E-mail: a.ferko@seznam.cz [Faculty of Medicine at Charles University and University Hospital, Department of Surgery (Czech Republic); Ryška, P., E-mail: ryska@fnhk.cz [Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic); Omran, N., E-mail: nidal81@gmail.com [Faculty of Medicine at Charles University and University Hospital, Department of Cardiac Surgery (Czech Republic); Krajina, A., E-mail: krajina@fnhk.cz; Čabelková, P., E-mail: pavla.cabelkova@fnhk.cz [Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic); Čermáková, E., E-mail: cermakovae@lfhk.cuni.cz [Faculty of Medicine at Charles University, Computer Technology Center (Czech Republic); Malý, R., E-mail: malyr@volny.cz [Faculty of Medicine at Charles University and University Hospital, Department of Medicine (Czech Republic)

    2016-02-15

    PurposeRetrospective evaluation of 12-year experience with endovascular management of acute mesenteric ischemia (AMI) due to embolic occlusion of the superior mesenteric artery (SMA).Materials and methodsFrom 2003 to 2014, we analysed the in-hospital mortality of 37 patients with acute mesenteric embolism who underwent primary endovascular therapy with subsequent on-demand laparotomy. Transcatheter embolus aspiration was used in all 37 patients (19 women, 18 men, median age 76 years) with embolic occlusion of the SMA. Adjunctive local thrombolysis (n = 2) and stenting (n = 2) were also utilised.ResultsWe achieved complete recanalization of the SMA stem in 91.9 %. One patient was successfully treated by surgical embolectomy due to a failed endovascular approach. Subsequent exploratory laparotomy was performed in 73.0 % (n = 27), and necrotic bowel resection in 40.5 %. The total in-hospital mortality was 27.0 %.ConclusionPrimary endovascular therapy for acute embolic SMA occlusion with on-demand laparotomy is a recommended algorithm used in our centre to treat SMA occlusion. This combined approach for the treatment of AMI is associated with in-hospital mortality rate of 27.0 %.

  4. Splenic Arterial Embolization in the Treatment of Severe Portal Hypertension Due to Pancreatic Diseases: The Primary Experience in 14 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Qi, E-mail: wqtjmu@gmail.com; Xiong, Bin, E-mail: herrxiong@126.com; Zheng, ChuanSheng, E-mail: hqzcsxh@sina.com; Liang, Ming, E-mail: whliangming@163.com; Han, Ping, E-mail: cjr.hanping@vip.163.com [Huazhong University of Science and Technology, Department of Radiology, Union Hospital, Tongji Medical College (China)

    2016-03-15

    ObjectiveThis retrospective study reports our experience using splenic arterial particle embolization and coil embolization for the treatment of sinistral portal hypertension (SPH) in patients with and without gastric bleeding.MethodsFrom August 2009 to May 2012, 14 patients with SPH due to pancreatic disease were diagnosed and treated with splenic arterial embolization. Two different embolization strategies were applied; either combined distal splenic bed particle embolization and proximal splenic artery coil embolization in the same procedure for acute hemorrhage (1-step) or interval staged distal embolization and proximal embolization in the stable patient (2-step). The patients were clinically followed.ResultsIn 14 patients, splenic arterial embolization was successful. The one-step method was performed in three patients suffering from massive gastric bleeding, and the bleeding was relieved after embolization. The two-step method was used in 11 patients, who had chronic gastric variceal bleeding or gastric varices only. The gastric varices disappeared in the enhanced CT scan and the patients had no gastric bleeding during follow-up.ConclusionsSplenic arterial embolization, particularly the two-step method, proved feasible and effective for the treatment of SPH patients with gastric varices or gastric variceal bleeding.

  5. Inflammatory response in patients undergoing uterine artery embolization as compared to patients undergoing conventional hysterectomy

    DEFF Research Database (Denmark)

    Brøchner, A C; Mygil, B; Elle, B;

    2009-01-01

    : To investigate whether uterine artery embolization generates a reduced inflammatory response as compared with conventional hysterectomy. MATERIAL AND METHODS: 40 women, 20 in each group, entered this prospective, non-randomized study. The two groups were comparable concerning age, comorbidity, and body......-mass index (BMI). RESULTS: We found a significant difference between the inflammatory responses in women undergoing embolization compared with the inflammatory response in women having an abdominal hysterectomy. Women undergoing embolization were subjected to a much smaller inflammatory burden, their total...... morphine consumption was lower, and their return to work was faster than women subjected to conventional hysterectomy. CONCLUSION: Uterine artery embolization generates a reduced inflammatory response compared with conventional hysterectomy....

  6. Predictive factors for pelvic magnetic resonance in response to arterial embolization of a uterine leiomyoma

    Directory of Open Access Journals (Sweden)

    Eduardo Zlotnik

    2014-03-01

    Full Text Available OBJECTIVE: Minimally invasive methods are used as alternatives to treat leiomyomas and include uterine artery embolization, which has emerged as a safe, effective method. This study aims to evaluate the magnetic resonance imaging predictors for a reduction in leiomyoma volume in patients undergoing uterine artery embolization. METHODS: This prospective longitudinal study was performed at a university hospital. We followed 50 symptomatic premenopausal women with uterine leiomyomas who underwent uterine artery embolization. We examined 179 leiomyomas among these patients. Magnetic resonance imaging was performed one month before and six months after uterine artery embolization. Two radiologists who specialized in abdominal imaging independently interpreted the images. Main Outcome Measures: The magnetic resonance imaging parameters were the uterus and leiomyomas volumes, their localizations, contrast perfusion pattern and node-to-muscle ratio. RESULTS: Six months after treatment, the average uterine volume reduction was 38.91%, and the leiomyomas were reduced by 55.23%. When the leiomyomas were submucosal and/or had a higher node-to-muscle ratio in the T2 images, the volume reduction was even greater (greater than 50%. Other parameters showed no association. CONCLUSIONS: We conclude that symptomatic uterine leiomyomas in patients undergoing uterine artery embolization exhibit volume reductions greater than 50% by magnetic resonance imaging when the leiomyomas are submucosal and/or had a high node-to-muscle ratio in the T2 images.

  7. Expulsion of dominant submucosal fibroids after uterine artery embolization

    Energy Technology Data Exchange (ETDEWEB)

    Radeleff, Boris, E-mail: Boris_radeleff@med.uni-heidelberg.d [Department of Diagnostic and Interventional Radiology, University of Heidelberg (Germany); Eiers, Michael; Bellemann, Nadine; Ramsauer, Stefanie [Department of Diagnostic and Interventional Radiology, University of Heidelberg (Germany); Rimbach, Stefan [Department of Gynecology, University of Konstanz (Germany); Kauczor, Hans-Ulrich [Department of Diagnostic and Interventional Radiology, University of Heidelberg (Germany); Richter, Goetz M. [Department of Diagnostic and Interventional Radiology, University of Heidelberg (Germany); Clinic of Diagnostic and Interventional Radiology, Katharinenhospital, Stuttgart (Germany)

    2010-07-15

    Purpose: Purpose of this study was to evaluate the frequency, probability, and factors associated with expulsion of submucosal fibroids after uterine artery embolization (UAE) in addition to the technical and clinical results at 1-year follow-up. Materials and methods: We determined the preinterventional volume of each dominant submucosal fibroid using the commonly used ellipsoid formula and a 3D volumetry in the MRI to define a threshold value in milliliters that indicates the probability for a fibroid expulsion. Assessment of fibroid expulsion was done by MRI at 3-month intervals for a year. Assessment of clinical mid term success was achieved by applying questionnaires at 1-year follow-up. Results: Technical success was observed in all 20 patients (mean age of 41.4 {+-} 5.6 years; range: 29.2-51.1 years). Two (10%) minor and one (5%) major complications occurred. 10/20 dominant submucosal fibroids were completely expelled during the follow-up. Using 3D MRI volumetry the preinterventional mean volume of the later expelled fibroids was 56.8 {+-} 57.0 ml (range 2.3-198.0 ml) and the mean volume of non-expelled fibroids was 123.8 {+-} 147.3 ml (range 24.0-531.8 ml). This difference was statistically significant, but weak (p = 0.0494). Fibroids with a volume equal or less than the threshold value (66.0 ml) were 73% likely to be expelled and fibroids larger than 66.0 ml were 78% likely not to be expelled. All 20 patients demonstrated a significant reduction in the fibroid related symptoms. Conclusion: In our study the complication rate was low despite increased rates of fibroid expulsion (50%); simultaneously the rate of treatment satisfaction was very high. Patients with a dominant submucosal fibroid under 66.0 ml should be informed about the probability of fibroid expulsion and the accompanying symptoms.

  8. Pulmonary embolism caused by a carbon dioxide blower during off-pump coronary artery bypass grafting.

    Science.gov (United States)

    Hirata, Naoyuki; Kanaya, Noriaki; Yamazaki, Yutaka; Sonoda, Hajime; Namiki, Akiyoshi

    2010-02-01

    We report a rare case of pulmonary embolism (PE) caused by a carbon dioxide (CO2) blower during off-pump coronary artery bypass grafting (OPCAB). When the anastomosis of the right internal thoracic artery to left anterior descending artery was performed, the operator tore the right ventricle outflow track (RVOT) that was adjacent to the left anterior descending artery. Immediately after the anastomosis and repair of the torn RVOT with CO2 blower, the systolic pulmonary artery pressure (PAP) increased from 28 to 64 mmHg, and end-tidal CO2 decreased from 32 to 12 mmHg. Because transesophageal echocardiograph (TEE) showed numerous gas bubbles in the main pulmonary artery, we diagnosed PE caused by invasion of CO2 gas bubbles via the torn RVOT. Although a CO2 blower is useful to enhance visualization of the anastomosis during OPCAB, it should not be used for the venous system because it may cause CO2 embolism.

  9. A Preliminary Observation of Weight Loss Following Left Gastric Artery Embolization in Humans

    Directory of Open Access Journals (Sweden)

    Andrew J. Gunn

    2014-01-01

    Full Text Available Background/Objectives. Embolization of the left gastric artery (LGA, which preferentially supplies the gastric fundus, has been shown to produce weight loss in animal models. However, weight loss after LGA embolization in humans has not been previously established. The aim of this study was to evaluate postprocedural weight loss in patients following LGA embolization. Subjects/Methods. A retrospective analysis of the medical records of patients who underwent LGA embolization for upper gastrointestinal (GI bleeding was performed. Postprocedural weight loss in this group was compared to a control group of patients who had undergone embolization of other arteries for upper GI bleeding. Results. The experimental group (N=19 lost an average of 7.3% of their initial body weight within three months of LGA embolization, which was significantly greater than the 2% weight loss observed in the control group (N=28 (P=0.006. No significant differences were seen between the groups in preprocedural body mass index (BMI, age, postprocedural care in the intensive care unit, history of malignancy, serum creatinine, or left ventricular ejection fraction. Conclusions. The current data suggest that body weight in humans may be modulated via LGA embolization. Continued research is warranted with prospective studies to further investigate this phenomenon.

  10. Stent-assisted coil embolization of a recurrent posterior cerebral artery aneurysm following surgical clipping.

    Science.gov (United States)

    Takeshita, Tomonori; Nagamine, Tomoaki; Ishihara, Kohei; Kaku, Yasuhiko

    2017-02-01

    Posterior cerebral artery (PCA) aneurysms are rare, and direct surgery of these is considered difficult. Coil embolization of PCA aneurysms is becoming popular. However, it is difficult to completely obliterate the aneurysm while preserving the flow of the parent artery in large or giant PCA aneurysms with a wide neck with this technique. We report a case of a large and wide-necked PCA aneurysm with multiple recurrences following successful surgical clipping and coil embolization. A 77-year-old man with a large unruptured right PCA (P2) aneurysm was successfully treated by surgical clipping. Postoperative digital subtraction angiography (DSA) showed complete aneurismal occlusion. Four years afterward, the aneurysm recurred and grew toward the contralateral. Surgical retreatment of this complicated aneurysm was considered difficult, with a substantial risk of complications. Therefore, the aneurysm was treated with an endovascular procedure. Because simple coil embolization was not expected to achieve satisfactory obliteration of the aneurysm with preservation of parent artery patency, we used stent-assisted coil embolization. The patient tolerated the treatment well. On DSA obtained six months after the first endovascular treatment, coil compaction and recanalization of the aneurysm were detected. A second coil embolization was successfully performed without any complications. The aneurysm was stable during the next six-month follow-up. Stent-assisted coil embolization may be feasible and effective for such postoperatively complicated aneurysms.

  11. Uterine Artery Pseudoaneurysm in the Setting of Delayed Postpartum Hemorrhage: Successful Treatment with Emergency Arterial Embolization

    Directory of Open Access Journals (Sweden)

    Ankur M. Sharma

    2011-01-01

    Full Text Available Postpartum hemorrhage is a major cause of maternal mortality. Though uncommon, uterine artery pseudoaneurysm can follow uterine dilatation and curettage (D + C and needs to be considered in the differential diagnosis. This 30-year-old G1P1 woman presented with right upper quadrant pain and vaginal bleeding. She was afebrile but her white blood count was significantly increased (22.2×109 /L. One week prior, she had undergone a Cesarean delivery which was complicated by hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP, fetal dystocia, and chorioamnionitis. Uterine dilatation and curettage (D & C and placement of a Bakri intrauterine balloon, performed for suspected retained products of conception, failed to control her postpartum bleeding. The patient wished to have a hysterectomy only as a last resort in order to preserve fertility. Emergency uterine artery angiography revealed a left uterine artery pseudoaneurysm and contrast extravasation. The patient was successfully treated with selective embolization. Computed tomography (CT later revealed dehiscence of her uterine Cesarean section incision with an intra-abdominal fluid collection. This collection was drained. She also developed disseminated intravascular coagulopathy (DIC syndrome as well as multiple pulmonary emboli which were both successfully treated. We discuss this unique case of uterine artery pseudoaneurysm with associated uterine dehiscence.

  12. Splenic artery embolization in a woman with bleeding gastric varices and splenic vein thrombosis: a case report

    Directory of Open Access Journals (Sweden)

    Schmid Roland M

    2010-08-01

    Full Text Available Abstract Introduction Gastric variceal bleeding due to splenic vein thrombosis is a life-threatening situation and is often difficult to manage by endoscopy. In the worst cases, an emergency splenectomy may be required to stop variceal bleeding. Case presentation We report the case of a 60-year-old Caucasian woman with bleeding gastric varices secondary to splenic vein thrombosis treated by splenic artery embolization. Successful embolization was performed by depositing coils into the splenic artery resulting in cessation of variceal bleeding. After embolization there was no recurrence of bleeding. Conclusion Splenic artery embolization can be an effective and definite treatment for variceal bleeding secondary to splenic vein thrombosis.

  13. Pregnancy after Uterine Artery Embolization: A Case Report in a Woman with Leiomyomata

    Directory of Open Access Journals (Sweden)

    Helena Isabel Lopes

    2015-01-01

    Full Text Available Background. Several pregnancies have been reported after embolization of uterine artery. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids but its safety in women desiring future childbearing is not well established. Case Report. We present a 40-year-old woman with leiomyomata who became pregnant after previously undergone uterine artery embolization for three times. The placenta was previa and the fetus was in transverse position. She had a cesarean delivery of an appropriately grown fetus at 37 weeks, which was followed by uterine atony requiring hysterectomy. Conclusion. Although pregnancy-related outcomes remain understudied, the available reports evidence that pregnancies after uterine artery embolization may be at significantly increased risk for postpartum hemorrhage, cesarean delivery, abnormal placentation, and malpresentation. In patients who are undergoing this type of treatment and contemplating pregnancy, the possibility of adverse complications should be taken in consideration and women should be appropriately advised.

  14. Severe gastric variceal bleeding successfully treated by emergency splenic artery embolization.

    Science.gov (United States)

    Sankararaman, Senthilkumar; Velayuthan, Sujithra; Vea, Romulo; Herbst, John

    2013-06-01

    Bleeding from gastric varices due to splenic vein obstruction is extremely rare in children, but it can be catastrophic. Reported herein is the case of a teenager with splenic vein thrombosis and chronic decompensated liver disease from autoimmune hepatitis who presented with massive gastric variceal bleeding. Standard medical management did not control the bleeding. Due to decompensated liver disease and continuous active bleeding, emergency partial splenic artery embolization was preferred over splenectomy or a shunt procedure. Bleeding was successfully controlled by partial splenic artery embolization by decreasing the inflow of blood into the portal system. It is concluded that emergency partial splenic artery embolization is a safer alternative life-saving procedure to manage severe gastric variceal bleeding due to splenic vein obstruction in a patient with high surgical risk. To our knowledge, only one other patient with similar management has been reported in the pediatric age group.

  15. Low-pressure pulmonary artery aneurysm presenting with pulmonary embolism: a case series

    Directory of Open Access Journals (Sweden)

    Papoulidis Pavlos

    2011-04-01

    Full Text Available Abstract Introduction Pulmonary artery aneurysm is an uncommon disorder with severe complications. The diagnosis is often difficult, since the clinical manifestations are non-specific and the treatment is controversial, as the natural history of the disease is not completely understood. Case presentation We describe the cases of two patients with pulmonary artery aneurysms. The first patient was a 68-year-old Caucasian man with an idiopathic low-pressure pulmonary artery aneurysm together with a pulmonary embolism. The patient preferred a conservative approach and was stable at the 10-month follow-up visit after being placed on anti-coagulant treatment. The second patient was a 66-year-old Caucasian woman with a low-pressure pulmonary artery aneurysm also presented together with a pulmonary embolism. The aneurysm was secondary to pulmonary valve stenosis. She received anti-coagulants and, after stabilization, underwent percutaneous balloon valvuloplasty. Conclusion Pulmonary embolism may be the initial presentation of a low-pressure pulmonary artery aneurysm. No underlying cause for pulmonary embolism was found in either of our patients, suggesting a causal association with low-pressure pulmonary artery aneurysm.

  16. Internal Iliac Artery Embolization during an Endovascular Aneurysm Repair with Detachable Interlock Microcoils

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Woo ChuL; Jeon, Yong Sun; Hong, Kee Chun; Cho, Soon Gu; Park, Jae Young [Inha University Hospital, Inha University School of Medicine, Incheon (Korea, Republic of); Kim, Jang Yong [Dept. of Vascular and Endovascular Surgery, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of)

    2014-10-15

    The purpose of this study was to evaluate the effectiveness of detachable interlock microcoils for an embolization of the internal iliac artery during an endovascular aneurysm repair (EVAR). A retrospective review was conducted on 40 patients with aortic aneurysms, who had undergone an EVAR between January 2010 and March 2012. Among them, 16 patients were referred for embolization of the internal iliac artery for the prevention of type II endoleaks. Among 16 patients, 13 patients underwent embolization using detachable interlock microcoils during an EVAR. Computed tomographic angiographies and clinical examinations were performed during the follow-up period. Technical success, clinical outcome, and complications were reviewed. Internal iliac artery embolizations using detachable interlock microcoils were technically successful in all 13 patients, with no occurrence of procedure-related complications. Follow-up imaging was accomplished in the 13 cases. In all cases, type II endoleak was not observed with computed tomographic angiography during the median follow-up of 3 months (range, 1-27 months) and the median clinical follow-up of 12 months (range, 1-27 months). Two of 13 (15%) patients had symptoms of buttock pain, and one patient died due to underlying stomach cancer. No significant clinical symptoms such as bowel ischemia were observed. Internal iliac artery embolization during an EVAR using detachable interlock microcoils to prevent type II endoleaks appears safe and effective, although this should be further proven in a larger population.

  17. Splenic artery embolization with Ankaferd blood stopper in a sheep model

    Science.gov (United States)

    Koç, Osman; Acar, Kadir; Özbek, Orhan; Güler, İbrahim; Sarıtaş, Kadir; Erdem, Tuba Bera; Solak, Yalçın; Toy, Hatice; Küçükapan, Ahmet; Özbek, Seda; Gaipov, Abduzhappar; Haznedaroğlu, İbrahim C.

    2016-01-01

    PURPOSE Splenic artery embolization is a minimally invasive therapeutic procedure utilized in a number of disorders. Ankaferd blood stopper (ABS) is a novel hemostatic agent with a new mechanism of action independent of clotting factors. We aimed to investigate the safety and efficiency of ABS for splenic artery embolization in a sheep model. METHODS Seven adult female sheep were included in the study. Selective celiac angiography was performed using a 5F diagnostic catheter and then a 2.7F hydrophilic coating microcatheter was advanced coaxially to the distal part of the main splenic artery. Under fluoroscopic guidance, 6 mL mixture composed of half-and-half ABS and contrast agent was slowly injected. Fluoroscopy was used to observe the deceleration and stagnation of the flow. Control celiac angiograms were obtained immediately after the embolization. After the procedure, the animals were observed for one day and then sacrificed with intravenous sodium thiopental. RESULTS Technical success rate was 100%. None of the animals died or experienced a major systemic adverse event during the procedure. All of the spleens appeared dark on macroscopic examination due to excessive thrombosis. Microscopically, the majority of the splenic sinusoids (90%–95%) were necrotic. CONCLUSION In our study, splenic artery embolization by ABS was found to be safe and effective in the shortterm. Further studies are needed to better understand the embolizing potential of this novel hemostatic agent. PMID:27306661

  18. Uterine artery embolization: the only life saving measure in some obstetric cases

    Directory of Open Access Journals (Sweden)

    Asha N. Gokhale

    2015-12-01

    Full Text Available Uterine artery embolization is a highly specialised and efficacious method that can be used prophylactically to reduce obstetric haemorrhage. Its use in modern obstetrics is currently limited to morbidly adherent placenta and acreta. This report presents a case where uterine artery embolization has been used as the primary treatment for obstetric haemorrhage in a patient with high risk for PPH where surgical management would not have been possible. We aim at highlighting the benefits of this procedure in terms of reduced surgical blood loss, morbidity and fertility preservation. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 2093-2095

  19. The histology of prostate tissue following prostatic artery embolization for the treatment of benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    George Camara-Lopes

    2013-04-01

    Full Text Available Objective Prostatic artery embolization (PAE for the treatment of patients with symptomatic benign prostatic hyperplasia (BPH is believed to be a safe procedure with a low risk of adverse side effects. Artery embolization is a viable treatment option in patients who are refractory to the classic noninvasive treatments. Knowledge of the histological characteristics of prostate tissue following the procedure is still limited. In this study, we describe the microscopic aspects of the prostate following PAE for BPH. Materials and Methods Two patients underwent transurethral resections of the prostate (TURP after PAE. Embolizations were performed under local anesthesia with an initial pelvic angiography to evaluate the iliac vessels and the prostate arteries using a 2.8 French microcatheter. The prostate was embolized with 300-500µm Microspheres (Embosphere®, using complete blood stasis as the end point. The prostate tissues were analyzed histologically to characterize the effects of the embolization. Results The embolic material within the prostate tissue was easily identified as homogeneous, bright eosin-red spheroids filling the vessel lumens. Ischemic necrosis surrounded or not by chronic inflammatory reactions containing macrophages were considered as a result of the artery embolization. Also, some aspects related to the healing process were observed being fibrotic nodules surrounded by glands with squamous metaplasia of the epithelial lining the most important. In the remaining sections, due to the precocious surgical intervention, the classic findings of BPH were still present with the glandular and stromal hyperplasia associated with nonspecific chronic prostatitis. Conclusions This is the first description of prostate histology in BPH patients treated by PAE, a new procedure that is being used increasingly as a therapeutic intervention. The recognition of the changes caused by this new modality of treatment has become a very important

  20. Venous Fragment Embolism to the Pulmonary Artery: A Rare Occurrence - Case Report and Literature Review of Venous Fragment Embolization to the Pulmonary Artery

    Science.gov (United States)

    2009-09-01

    approx 8x9mm. Angiography revealed a left popliteal artery aneurysm and left popliteal vein disruption. Whether the fragment originated from the...complications such as hemorrhage at insertion site, cardiac dysrhythmias, and ruptured aortic aneurysm . Technique failure requiring venotomy can occur...embolization in childhood: report of a case, literature review, and recommendations for management. J Pediatr Surg. 1990 Dec;25(12):1292-4. 28 Shannon FL

  1. Development of biodegradable radiopaque microsphere for arterial embolization-a pig study

    Institute of Scientific and Technical Information of China (English)

    Yi-Sheng; Liu; Xi-Zhang; Lin; Hong-Ming; Tsai; Hung-Wen; Tsai; Guan-Cheng; Chen; Syuan-Fong; Chen; Jui-Wen; Kang; Chen-Miao; Chou; Chiung-Yu; Chen

    2015-01-01

    AIM: To develop a new type of calibrated, biodegradable, and imaging detectable microsphere and evaluated its embolization safety and efficacy on pig’s liver and spleen. METHODS: Six kinds of pharmaceutical excipient were combined and atomized to form our microsphere. Twenty-four male Lanyu pigs weighing 25-30 kg were used. The arteries of spleen and liver were embolized with Gelfoam, Embosphere, or our microsphere. The serum biochemical tests, computed tomography(CT), liver perfusion scan, and tissue microscopy examination were done to evaluate the safety and efficacy of embolization. RESULTS: Radiopaque microspheres with a size ranging from 300 to 400 μm were produced. Embolization of hepatic and splenic artery of pigs with our microsphere significantly reduced the blood flow of liver and resulted in splenic infarction. The follow-up CT imaging and the microscopic examination showed intraarterial degradation of Gelfoam and microsphere. The blood testsdemonstrated insignificant changes with regards to liver and renal functions. CONCLUSION: Our microspheres, with the unique characteristics, can be used for transcatheter arterial embolization with effects equivalent to or better than Gelfoam and Embosphere in pigs.

  2. Pilot study of transcatheter arterial ethanol embolization under closed renal circuit for large renal cell carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Murata, Satoru; Tajima, Hiroyuki; Onozawa, Shiro; Kumita, Shinichiro [Nippon Medical School, Department of Radiology/Center for Advanced Medical Technology, Tokyo (Japan); Kondo, Yukihiro [Nippon Medical School, Department of Urology, Tokyo (Japan); Nomura, Kazuhiro [Tokyo Labor-Welfare Hospital, Tokyo (Japan)

    2008-07-15

    The safety of a new technique, designated ''transcatheter arterial embolization (TAE) with aspiration via a balloon-occluded renal drainage vein'' (TAE-ABOD), for the management of large renal cell carcinomas (RCCs). The subjects were 25 patients with RCC who underwent a total of 27 sessions of TAE-ABOD. This TAE-ABOD technique incorporates two procedures: balloon occlusion of renal drainage vein and infusion of absolute ethanol into the tumor-feeding arteries during aspiration of blood via a balloon catheter, thereby reducing leakage of absolute ethanol into the systemic circulation. Our primary endpoint was to establish a safe regimen for high-dose ethanol injection therapy, and our secondary endpoint was to assess global survival of the patients. The administered dose of ethanol ranged from 0.2 to 0.5 ml/kg [median: 0.34 (SD: 0.10) ml/kg], increased in a stepwise manner. The systemic ethanol concentration was measurable in 14 patients, and was less than 0.1 mg/ml in 12 and from 0.1 to less than 0.2 mg/ml in two. There were no major complications such as renal failure or renal abscess. TAE-ABOD can safely deliver a high dose of absolute ethanol for the treatment of large RCCs. (orig.)

  3. Preoperative arterial embolization in heterotopic ossification: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Balzer, J. [Dept. of Radiology, University of Frankfurt (Germany); Wolff, J.D. [Dept. of Cardiothoracic Surgery, University of Frankfurt (Germany); Skripitz, R. [Dept. of Orthopaedic Surgery, University of Frankfurt (Germany)

    2001-06-01

    We report a case of preoperative embolization in a 64-year-old patient suffering from total stiffness of the right hip joint due to heterotopic ossification following brain injury and pertrochanteric fracture of the right femur. A previous attempt of operative treatment could not be performed successfully due to bleeding complications. After the embolization of the correlating hypervascularisation, the surgical procedure was redone and finished with good result and minimal bleeding complications during the operation and a tolerable drop of the haemoglobin concentration postoperatively. (orig.)

  4. Mortality in trauma patients with active arterial bleeding managed by embolization or surgical packing

    DEFF Research Database (Denmark)

    Froberg, Lonnie; Helgstrand, Frederik; Clausen, Caroline

    2016-01-01

    OBJECTIVE: Exsanguination due to coagulopathy and vascular injury is a common cause of death among trauma patients. Arterial injury can be treated either by angiography and embolization or by explorative laparotomy and surgical packing. The purpose of this study was to compare 30-day mortality...... and blood product consumption in trauma patients with active arterial haemorrhage in the abdominal and/or pelvic region treated with either angiography and embolization or explorative laparotomy and surgical packing. MATERIAL AND METHODS: From January 1(st) 2006 to December 31(st) 2011 2,173 patients......-one patients received angiography and embolization, and 35 patients underwent exploratory laparotomy and surgical packing. Gender, age, initial oxygen saturation, pulse rate and respiratory rate, ISS and Probability of Survival were comparable in the two groups. CONCLUSION: A significant increased risk of 30...

  5. Cerebral Arterial Air Embolism Associated with Mechanical Ventilation and Deep Tracheal Aspiration

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    S. Gursoy

    2012-01-01

    Full Text Available Arterial air embolism associated with pulmonary barotrauma has been considered a rare but a well-known complication of mechanical ventilation. A 65-year-old man, who had subarachnoid hemorrhage with Glasgow coma scale of 8, was admitted to intensive care unit and ventilated with the help of mechanical ventilator. Due to the excessive secretions, deep tracheal aspirations were made frequently. GCS decreased from 8–10 to 4-5, and the patient was reevaluated with cranial CT scan. In CT scan, air embolism was detected in the cerebral arteries. The patient deteriorated and spontaneous respiratory activity lost just after the CT investigation. Thirty minutes later cardiac arrest appeared. Despite the resuscitation, the patient died. We suggest that pneumonia and frequent tracheal aspirations are predisposing factors for cerebral vascular air embolism.

  6. Short-Term Effects of Ankaferd Hemostat for Renal Artery Embolization: An Experimental Study

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    Ozbek, Orhan, E-mail: orhan.ozbek@gmail.com [Selcuk University, Department of Radiology, Meram School of Medicine (Turkey); Acar, Kadir [Selcuk University, Division of Hematology, Department of Internal Medicine, Meram School of Medicine (Turkey); Koc, Osman [Selcuk University, Department of Radiology, Meram School of Medicine (Turkey); Saritas, Kadir [Afyon Kocatepe University, Department of General Surgery, Veterinary Faculty (Turkey); Toy, Hatice [Selcuk University, Department of Pathology, Meram School of Medicine (Turkey); Solak, Yalcin [Selcuk University, Division of Nephrology, Department of Internal Medicine, Meram School of Medicine (Turkey); Ozbek, Seda [Selcuk University, Department of Radiology, Selcuklu School of Medicine (Turkey); Kucukapan, Ahmet; Guler, Ibrahim [Selcuk University, Department of Radiology, Meram School of Medicine (Turkey); Gaipov, Abduzhappar; Turk, Suleyman [Selcuk University, Division of Nephrology, Department of Internal Medicine, Meram School of Medicine (Turkey); Haznedaroglu, Ibrahim Celaleddin [Hacettepe University, Division of Hematology, Department of Internal Medicine, Faculty of Medicine (Turkey)

    2013-04-15

    Renal artery embolization (RAE) is a minimally invasive therapeutic technique that is utilized in a number of disorders. Ankaferd is a novel hemostatic agent with a new mechanism of action independent of clotting factors. We used Ankaferd for RAE in a sheep model. Seven adult female sheep were included in the study. Selective renal arteriogram using 5-F diagnostic catheter was performed to make sure that each kidney was fed by a single renal artery and the animal had normal renal vasculature. Coaxial 2.7-F microcatheter was advanced to the distal main renal artery. Under fluoroscopic guidance, 2 mL of Ankaferd mixed with 2 mL of nonionic iodinated contrast agent was slowly injected. Fluoroscopy was used to observe the deceleration of flow and stagnation. Control renal angiograms were performed just after embolization. After the procedure, the animals were observed for 1 day and then sacrificed with intravenous sodium thiopental. The technical success was observed in seven of the seven animals.. After embolization procedure, none of the animals died or experienced a major systemic adverse event. On macroscopic examination of the embolized kidneys, thrombus at the level of main renal artery formed after Ankaferd embolization was more compact compared with the thrombi that was not Ankaferd-associated, which was observed elsewhere. Microscopically, majority of the renal tubular cells (80-90 %) were necrotic, and there was epithelial cell damage in a small portion of the cells (10-20 %). RAE was safe and effective in the short-term with Ankaferd in studied animals. Further studies should be conducted to better delineate the embolizing potential of this novel hemostatic agent.

  7. Percutaneous transhepatic venous embolization of pulmonary artery aneurysm in Hughes-Stovin syndrome

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    Kim, Kyung Ah; Kim, Man Deuk; Oh, Do Yun; Park, Pil Won [Bundang CHA General Hospital, Pochon CHA University, Seongnam (Korea, Republic of)

    2007-08-15

    Hughes-Stovin syndrome is an extremely rare entity. We present a case of a 42-year-old man, who developed deep vein and inferior vena cava (IVC) thrombosis, repeated internal bleeding and pulmonary artery aneurysms (PAAs). The patient presented with massive hemoptysis and with PAAs of a 2.5 cm maximum diameter. We describe the successful percutaneous transhepatic venous embolization of the PAAs due to occluded common vascular pathways to the pulmonary artery.

  8. Significance of transcatheter arterial embolization in the treatment of pseudoaneurysm complicating pancreatitis

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    Kim, Sang Gyee; Joo, Jung Hyun; Kim, Young Cheol; Kim, Jae Kyu; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam Univ. School of Medicine, Kwangju (Korea, Republic of); Oh, Hee Yeon [Namkwang Hospital, Kwangju (Korea, Republic of)

    1998-11-01

    To evaluate the significance of transcatheter arterial embolization(TAE) of pseudoaneurysm complicating pancreatitis. This study was based on a retrospective analysis of eight cases, in which TAE for control of pseudoaneurysm complicating pancreatitis was attempted. All patients were males, and were aged between 35 and 65(mean, 47) years. Seven had a history of episodes of chronic pancreatitis and one case was the result of acute pancreatitis. All patients underwent diagnostic angiography and superselective embolization. Arteries in which pseudoaneurysm had occurred were the gastroduodenal (n=3D5), inferior pancreaticoduodenal (n=3D1), superior mesenteric artery root (n=3D1), and the celiac axis (n=3D1). Six cases were treated successfully without complications, but in two, embolization failed due to a wide aneurysmal neck arising from the superior mesenteric artery root and celiac axis. In four successful cases, pseudoaneurysms were completely resolved within three to six months of embolization. One of the other two remained as a pseudocyst, while in the other, also a pseudocyst, surgery was performed. Because TAE in patients with pseudoaneurysm complicating pancreatitis has a high success rate, and also leads to absolute resorption of a pseudocyst, TAE is the preferred pre-surgical treatment mode.=20.

  9. Strategy for endovascular coil embolization of a penetrating vertebral artery injury

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    Hiroki Uchikawa

    2015-01-01

    Conclusion: This is the rare documentation of a patient whose penetrating VAI was treated by simultaneous coil embolization and foreign body removal. Imaging studies confirmed the patency and perfusion of the intracranial artery. Our treatment strategy produced a good outcome in this unusual patient.

  10. Ovarian thrombosis and uterine synechiae after arterial embolization for a late postpartum haemorrhage

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    Françoise Vendittelli

    2015-01-01

    Conclusions: This case teaches us that one rare complication can hide another! It is important to consider the diagnosis of subinvolution of the placental bed in cases of late PPH and to know the complications associated with vascular artery embolization in order to provide the most rapid and least invasive treatment.

  11. Stent-grafting combined with transcatheter embolization for a ruptured isolated hypogastric artery aneurysm

    Institute of Scientific and Technical Information of China (English)

    DONG Zhi-hui; FU Wei-guo; GUO Da-qiao; XU Xin; CHEN Bin; JIANG Jun-hao; YANG Jue; SHI Zheng-yu; WANG Yu-qi

    2006-01-01

    @@ Rupture of isolated hypogastric artery aneurysm (HAA) is rarely encountered and is associated with a high mortality rate. Conventional surgery can not achieve distal control easily and may cause substantial blood loss, yielding high operative morbidity and mortality. On March 17, 2005, we treated a patient with such a disease successfully by using endovascular stent-grafting combined with transcatheter embolization.

  12. Successful Control of Liver Metastases From Pancreatic Solid-Pseudopapillary Neoplasm (SPN) Using Hepatic Arterial Embolization

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    Violari, Elena G., E-mail: eviolari@live.com; Brody, Lynn A.; Covey, Anne M.; Erinjeri, Joseph P.; Getrajdman, George I.; Sofocleous, Constantinos T. [Memorial Sloan-Kettering Cancer Center, Department of Radiology, Interventional Radiology Service (United States); Reidy, Diane L. [Memorial Sloan-Kettering Cancer Center, Department of Medicine, Gastrointestinal Oncology Service (United States); Jarnagin, William R. [Memorial Sloan-Kettering Cancer Center, Department of Surgery, Hepatopancreatobiliary Service (United States); Brown, Karen T. [Memorial Sloan-Kettering Cancer Center, Department of Radiology, Interventional Radiology Service (United States)

    2015-04-15

    No systemic agents that are known to be effective for the treatment of solid-pseudopapillary neoplasm (SPN) are available. We report the prolonged and sustained control of metastatic pancreatic SPN to the liver using hepatic arterial embolization (HAE), where a total of 13 HAE sessions were performed over a 6-year period.

  13. Endovascular therapy of ruptured distal anterior choroidal artery aneurysm associated with moyamoya pattern collateralization secondary to middle cerebral artery occlusion

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    Hidenori Oishi

    2013-01-01

    Full Text Available We report a case of a ruptured distal anterior choroidal artery (AChoA aneurysm associated with moyamoya pattern collateralization secondary to the middle cerebral artery occlusion. Patient was successfully treated with the coil embolization of the distal AChoA. This case supports the feasibility and efficacy of the endovascular therapy for the distal AChoA aneurysms in patients with MCA occlusion with moyamoya pattern collateralization.

  14. Role and Effectiveness of Percutaneous Arterial Embolization in Hemodynamically Unstable Patients with Ruptured Splanchnic Artery Pseudoaneurysms

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    Dohan, Anthony, E-mail: anthony.dohan@lrb.aphp.fr [Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Department of Abdominal and Interventional Imaging (France); Eveno, Clarisse, E-mail: clarisse.eveno@lrb.aphp.fr [Université Paris-Diderot, Sorbonne Paris Cité (France); Dautry, Raphael, E-mail: raphael.dautry@lrb.aphp.fr; Guerrache, Youcef, E-mail: docyoucef05@yahoo.fr [Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Department of Abdominal and Interventional Imaging (France); Camus, Marine, E-mail: marine.camus@lrb.aphp.fr [Université Paris-Diderot, Sorbonne Paris Cité (France); Boudiaf, Mourad, E-mail: mourad.boudiaf@lrb.aphp.fr [Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Department of Abdominal and Interventional Imaging (France); Gayat, Etienne, E-mail: etienne.gayat@lrb.aphp.fr [Université Paris-Diderot, Sorbonne Paris Cité (France); Dref, Olivier Le, E-mail: olivier.ledref@lrb.aphp.fr; Sirol, Marc, E-mail: marc.sirol@lrb.aphp.fr; Soyer, Philippe, E-mail: philippe.soyer@lrb.aphp.fr [Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Department of Abdominal and Interventional Imaging (France)

    2015-08-15

    PurposeTo assess the role and effectiveness of percutaneous arterial embolization (TAE) in patients with hemodynamic instability due to hypovolemic shock secondary to ruptured splanchnic artery pseudoaneurysms (SAPA).Materials and MethodsSeventeen patients (11 men, 6 women; mean age, 53 years) with hemodynamic instability (systolic blood pressure <90 mmHg) due to hypovolemic shock secondary to ruptured SAPA were treated by TAE. Clinical files, multidetector row computed tomography angiography, and angiographic examinations along with procedure details were reviewed.ResultsSeventeen SAPAs were present, predominantly located on gastroduodenal or pancreatic arteries (9/17; 53 %). Angiography showed extravasation of contrast medium from SAPA in 15/17 patients (88 %). Technical success rate of TAE was 100 %. TAE was performed using metallic coils in all patients (100 %), in association with gelatin sponge in 5/17 patients (29 %). TAE allowed controlling the bleeding and returning to normal hemodynamic status in 16/17 patients (94 %). In 1/17 patient (6 %), surgery was needed to definitively control the bleeding. The mortality and morbidity rate of TAE at 30 days were 0 and 12 %, respectively. Morbidity consisted in coil migration in 1/17 patient (6 %) and transient serum liver enzyme elevation in 1/17 patient (6 %).ConclusionTAE is an effective and safe treatment option for ruptured SAPA in hemodynamically unstable patients, with a success rate of 94 %. Our results suggest that TAE should be the favored option in patients with hemodynamic instability due to ruptured SAPA.

  15. Radiological Findings of Prostatic Arterial Anatomy for Prostatic Arterial Embolization: Preliminary Study in 55 Chinese Patients with Benign Prostatic Hyperplasia.

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    Guodong Zhang

    Full Text Available To describe the prostatic arterial supply using Cone-beam computed tomography (CT and digital subtraction angiography (DSA before prostatic arterial embolization (PAE for benign prostatic hyperplasia (BPH.In a retrospective study from January 2012 to January 2014, 55 male patients (110 hemipelves with BPH who underwent PAE were evaluated by Cone-beam CT in addition to pelvic DSA during embolization planning. Each hemipelvis was evaluated regarding the number of prostatic arteries (PA and their origins, diameters, territorial perfusion, and anastomoses with adjacent arteries.A total of 114 PAs were identified in 110 hemipelves. There was one PA in 96.4% of the hemipelves (n=106, and two independent PAs in the other 3.6% (n=4. The PA was found to originate from the anterior trunk of the internal iliac artery in 39.5% of cases (n=45 , from the superior vesical artery in 32.6% (n=37, and from the internal pudendal artery in 27.9% of cases (n=32. Extra-prostatic anastomoses between PA and adjacent arteries were found in 39.1% of hemipelves (n=43. Intra-prostatic anastomoses between PAs and contra-lateral prostatic branches were found in 61.8% of hemipelves (n=68. In 67.3% of our study population (n=37, the prostate was dominantly supplied via a unilateral PA.The prostatic vascularization is complex with frequent anatomic variations. Knowledge of the vascular anatomy of the prostate may provide indications for planning PAE and avoiding nontarget embolization.

  16. Asparagus polysaccharide and gum with hepatic artery embolization induces tumor growth and inhibits angiogenesis in an orthotopic hepatocellular carcinoma model.

    Science.gov (United States)

    Weng, Ling-Ling; Xiang, Jian-Feng; Lin, Jin-Bo; Yi, Shang-Hui; Yang, Li-Tao; Li, Yi-Sheng; Zeng, Hao-Tao; Lin, Sheng-Ming; Xin, Dong-Wei; Zhao, Hai-Liang; Qiu, Shu-Qi; Chen, Tao; Zhang, Min-Guang

    2014-01-01

    Liver cancer is one of leading digestive malignancies with high morbidity and mortality. There is an urgent need for the development of novel therapies for this deadly disease. It has been proven that asparagus polysaccharide, one of the most active derivates from the traditional medicine asparagus, possesses notable antitumor properties. However, little is known about the efficacy of asparagus polysaccharide as an adjuvant for liver cancer chemotherapy. Herein, we reported that asparagus polysaccharide and its embolic agent form, asparagus gum, significantly inhibited liver tumor growth with transcatheter arterial chemoembolization (TACE) therapy in an orthotopic hepatocellular carcinoma (HCC) tumor model, while significantly inhibiting angiogenesis and promoting tumor cell apoptosis. Moreover, asparagine gelatinous possessed immunomodulatory functions and showed little toxicity to the host. These results highlight the chemotherapeutic potential of asparagus polysaccharide and warrant a future focus on development as novel chemotherapeutic agent for liver cancer TACE therapy.

  17. Coil embolization of internal mammary artery injured during central vein catheter and cardiac pacemaker lead insertion

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    Chemelli, A.P. [Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck (Austria)], E-mail: Andreas.Chemelli@i-med.ac.at; Chemelli-Steingruber, I.E. [Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck (Austria); Bonaros, N. [Department of Cardiovascular Surgery, Innsbruck Medical University (Austria); Luckner, G. [Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University (Austria); Millonig, G. [Department of Gastroenterology and Hepatology, Innsbruck Medical University (Austria); Seppi, K. [Department of Neurology, Innsbruck Medical University (Austria); Lottersberger, C.; Jaschke, W. [Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck (Austria)

    2009-08-15

    Purpose: This study describes several cases of endovascular coil embolization of the proximal internal mammary artery injured by blind approach to the subclavian vein for central venous catheter or pacemaker lead insertion. Materials and methods: We conducted a retrospective analysis of five patients with iatrogenic arterial lesions of the internal mammary artery (IMA). The lesions occurred in three patients from a puncture of the subclavian vein during insertion of a central venous catheter and in two patients from a puncture of the subclavian vein for insertion of a pacemaker lead. Four patients had acute symptoms of bleeding with mediastinal hematoma and hematothorax and one patient was investigated in a chronic stage. A pseudoaneurysm was detected in all five patients. All four acute and hemodynamic unstable patients required hemodynamic support. Results: In all patients, embolization was performed using a coaxial catheter technique, and a long segment of the IMA adjacent distally and proximally to the source of bleeding was occluded with pushable microcoils. In one patient, additional mechanically detachable microcoils were used at the very proximal part of the IMA. Microcoil embolization of the IMA was successful in all patients, and the source of bleeding was eliminated in all patients. Conclusion: Transarterial coil embolization is a feasible and efficient method in treating acute bleeding and pseudoaneurysm of the IMA and should be considered if mediastinal hematoma or hemathorax occurs after blind puncture of the subclavian vein.

  18. Pre-operative renal artery embolization and suprarenal IVC filter placement for prevention of fat embolization in renal angiomyolipoma with venous extension.

    Science.gov (United States)

    Cornman-Homonoff, Joshua; Li, David; Schiffman, Marc

    2017-01-26

    Though generally considered benign, angiomyolipomas can invade through the renal vein into the inferior vena cava, putting patients at risk of catastrophic pulmonary fat embolization. Venous invasion is thus an indication for surgical resection but is thought to increase the risk of adverse operative outcomes including intraoperative hemorrhage and embolization of fat and/or tumor thrombus. We report a novel approach to mitigating these complications illustrated in the case of a 43-year-old woman with IVC-invasive renal AML who underwent successful radical nephrectomy after concurrent pre-operative renal artery embolization and placement of a retrievable suprarenal IVC filter.

  19. Thrombolytic Therapy by Tissue Plasminogen Activator for Pulmonary Embolism.

    Science.gov (United States)

    Islam, Md Shahidul

    2017-01-01

    Clinicians need to make decisions about the use of thrombolytic (fibrinolytic) therapy for pulmonary embolism (PE) after carefully considering the risks of major complications from bleeding, and the benefits of treatment, for each individual patient. They should probably not use systemic thrombolysis for PE patients with normal blood pressure. Treatment by human recombinant tissue plasminogen activator (rt-PA), alteplase, saves the lives of high-risk PE patients, that is, those with hypotension or in shock. Even in the absence of strong evidence, clinicians need to choose the most appropriate regimen for administering alteplase for individual patients, based on assessment of the urgency of the situation, risks for major complications from bleeding, and patient's body weight. In addition, invasive strategies should be considered when absolute contraindications for thrombolytic therapy exist, serious complications arise, or thrombolytic therapy fails.

  20. Embolization of bronchial artery of anomalous origin: Management of two cases presenting with hemoptysis

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    Saikat Sengupta

    2007-01-01

    Full Text Available Life-threatening hemoptysis is one the most challenging condition encountered in critical care. Bronchial artery embolization (BAE has become an established procedure, in the management of massive and recurrent hemoptysis. Bronchial arteries have variable anatomy. The reported prevalence of bronchial arteries with an anomalous origin ranges from 8.5 -35%. We are describing two patients who presented with hemoptysis and were effectively managed with bronchial artery embolization. Both these patients had anomalous origin of bronchial artery from the internal mammary artery, one from the Right Internal Mammary Artery (RIMA and one from the Left Internal Mammary Artery (LIMA. The procedures were performed under general anesthesia. In the first case a double lumen endobronchial tube was used while in the second case, the patient was managed without tracheal intubation. The first patient was dyspnoeic; saturation was poor and was unable to maintain her airway probably due to profuse blood in her airways. We used a double lumen tube in her to isolate the diseased lung from the healthier lung. We gave her muscle relaxants and mechanical ventilation so that a stable lung field could be provided during embolization. The second patient was quite stable and comfortable while breathing room air. We decided not to interfere with his airway. A back-up plan and preparation for urgent airway control and lung isolation was done inside the catheterization laboratory.From the management point of view, an unstable patient with life-threatening hemorrhage needs airway control and lung isolation. A stable patient with minimum to moderate bleeding may be managed safely under general anesthesia with the patient spontaneously breathing.

  1. Incidence, risk factors, treatment and prognosis of popliteal artery embolization in the superficial femoral artery interventions.

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    Weiwei Wu

    Full Text Available OBJECTIVE: Percutaneous transluminal angioplasty and stenting (PTA + stent has gained acceptance as a primary treatment modality for the superficial femoral artery (SFA diseases. Popliteal artery embolization (PAE is a severe complication in SFA interventions. The purpose of this study was to evaluate the incidence, risk factors, treatment and prognosis of PAE in primary SFA PTA + stent. METHODS: Chronic SFA arteriosclerosis cases that underwent primary PTA + stent were reviewed from a retrospectively maintained database. Runoff vessels were evaluated in all cases before and after the interventions for PAE detection. The primary patency, secondary patency and limb salvage rates were calculated using Kaplan-Meier analysis and compared using log-rank analysis. Cox multivariate regression was performed to evaluate predictors of patency and limb salvage rates. RESULTS: There were 436 lesions treated in 388 patients with 10 PAE events (2.3% in total. PAE rate was significantly higher in Transatlantic Inter-Society Consensus (TASC C/D group compared with TASC A/B group (OR = 8.91, P = .002, in chronic total occlusion (CTO lesions compared with stenotic lesions (P<.0001, and in group with history of cerebral ischemic stroke (OR = 6.11, P = .007. PAE rates were not significantly affected by age, sex, smoking, hypertension, diabetes, hyperlipidemia and runoff status. The binary logistic regression showed that only the TASC C/D was an independent predictor of PAE (P = .031. The 12-month and 24-month primary patency, secondary patency and limb salvage rates in PAE group showed no significant differences comparing with non-PAE group. CONCLUSIONS: PAE is a rare event in primary SFA PTA + stent. TASC C/D lesion, CTO and cerebral ischemic stroke history are risk factors for PAE. PAE is typically reversible by comprehensive techniques. If the popliteal flow is restored in time, PAE has no significant effect on long-term patency and limb

  2. Arterial embolization for iatrogenic life-threatening bleeding from subcutaneous hypervascular tumor in prone position

    Institute of Scientific and Technical Information of China (English)

    Seiji Morita; Tomoatsu Tsuji; Toru Sawamoto; Hiromichi Aoki; Naoya Miura; Hiroyuki Otsuka; Sadaki Inokuchi

    2010-01-01

    Performing angiography in the prone position is a difficult technique; however it is useful in some emergency situation. We experienced a 60 years old male who was performed lipoma excision on his back in his family doctor's clinic. Since massive arterial bleeding could not be controlled with manual astriction, he transferred to our hospital in prone position with hemodynamic instability. Operating field was not kept because of massive bleeding; there-fore surgical treatment was impossible. We planed emer-gency arterial embolization (AE) in prone position. Hence we chose the left radial artery for vascular access. The left subclavicle arteriography showed many major and minor feeding arteries from left subclavicular and axillary arteries and a massive extravasation of the contrast medium. Three major feeding arteries were performed AE with gelatin sponge and steel coils. After AE, massive bleeding was controlled.He could discharge from our hospital on the 5th hospital day without any complication. Arterial embolization for lifethreatening bleeding from subcutaneous hypervascular tumor in the prone position is first report to our knowledge,and it is extremely rare. However we thought that this tech-nique is useful for patients who could not turn in the supine position, e.g. massive bleeding during renal biopsy and penetrating trauma from back.

  3. Selective uterine artery embolization: a new therapeutic approach in a patient with low-risk gestational trophoblastic disease.

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    Carlini, Laura; Villa, Antonella; Busci, Luisa; Trezzi, Gaetano; Agazzi, Roberto; Frigerio, Luigi

    2006-07-01

    We report a case of persistent gestational trophoblastic disease (GTD) in which a selective uterine artery embolization instead of invasive surgery achieved both the control of pelvic hemorrhage and of disease.

  4. Evaluation of tumor blood flow after feeder embolization in meningiomas by arterial spin-labeling perfusion magnetic resonance imaging.

    Science.gov (United States)

    Kawaji, Hiroshi; Koizumi, Shinichiro; Sakai, Naoto; Yamasaki, Tomohiro; Hiramatsu, Hisaya; Kanoko, Yusuke; Kamiya, Mika; Yamashita, Shuhei; Takehara, Yasuo; Sakahara, Harumi; Namba, Hiroki

    2013-10-01

    Preoperative embolization changes the amount of blood flow and pattern of flow distribution in meningioma. Tumor blood flow was investigated in eight meningioma patients before and after embolization using arterial spin-labeling (ASL) perfusion imaging. Although blood flow was significantly reduced in the whole tumor after embolization, changes in flow distribution patterns varied from one case to another. The findings suggest that evaluation of post-embolization tumor blood flow by ASL perfusion imaging would be useful in the surgical planning of meningioma.

  5. Ischemia induced by coronary steal through a patent mammary artery side branch: a role for embolization.

    Science.gov (United States)

    Moreno, Nuno; da Silva Castro, Alexandra; Pereira, Adriana; Silva, João Carlos; Almeida, Pedro Bernardo; Andrade, Aurora; Maciel, Maria Júlia; Pinto, Paula

    2013-06-01

    Non-occlusion of the internal mammary artery side branches may cause ischemia due to flow diversion after coronary artery bypass grafting. The authors present the case of a 67-year-old man with recurrent angina after undergoing myocardial revascularization with a left internal mammary artery to left anterior descending bypass. He presented with impaired anterior wall myocardial perfusion in the setting of a patent left internal mammary artery side branch. Effective percutaneous treatment was carried out through coil embolization, with improved flow and clinical symptoms, confirmed through ischemia testing. Coronary steal through a patent mammary artery side branch is a controversial phenomenon and this type of intervention should be considered only in carefully selected patients.

  6. Use of Ethanol in the Trans-Arterial Lipiodol Embolization (TAELE of Intermediated-Stage HCC: Is This Safer than Conventional Trans-Arterial Chemo-Embolization (c-TACE?

    Directory of Open Access Journals (Sweden)

    Francesco Somma

    Full Text Available To evaluate safety and efficacy of Trans-Arterial Ethanol-Lipiodol Embolization (TAELE compared with conventional Trans-Arterial Chemo-Embolization (cTACE in the treatment of small intermediate-HCC (BCLC-Stage B.A random sample of 87 patients (37.93% male; 62.07% female; age range, 36-86 years with documented small intermediate-HCC and treated with TAELE (mixture 1:1 of Ethanol and Lipiodol or cTACE (mixture of 50mg-Epirubicin and 5cc-Lipiodol were retrospectively studied in an institutional review board approved protocol. The two procedures were compared with χ2-test, χ2-test with Yates correction, McNemar's exact test, ANOVA test and log-rank test.TAELE and cTACE therapies were performed in 45 and 42 patients, respectively. Thirty days after the procedure, a Multi-Detector Computed Tomography (MDCT showed no significant difference in the number of patients with partial and complete response between the two groups (p-value = 0.958, according to mRECIST. Contrary, significant differences were found in tumor-devascularization, lesion-reduction and post-embolization syndrome occurrence (p-value = 0.0004, p-value = 0.0003 and p-value = 0.009, respectively. Similar survival was observed during 36-month follow-up (p-value = 0.884.Compared to cTACE, TAELE showed a better toxicity profile with similar 36-month survival and similar one-month anti-tumor effects, which makes it better tolerated by patients, especially in case of more than one treatment.

  7. Impact of spontaneous fibroid expulsion of uterine leiomyoma on pregnancy outcome after uterine arteries embolization

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    Medvediev M.V.

    2015-09-01

    Full Text Available Uterine leiomyoma (UL is common benign tumor of female genitals. Uterine artery embolization (UAE is widely used method of organ-sparing UL treatment. Safe ty of this procedure for future fertility and labor is controversial. We present a case of pregnancy in woman who previously underwent uterine artery embolization. During 12-months’ follow-up period patient periodically noted vaginal di¬scharge. No signs of UL have been found on ultrasound in 12 months of follow-up. Normal pregnancy occurred 1.5 years after UAE procedure which ended in normal labor without complications. Most authors report increased risk of pregnancy complications such as postpartum hemorrhage, preterm delivery, malpresentation after UAE. Our point of view is that a lot of pregnancy complications are possibly associated with persistence of necrotic leiomyoma tissue in uterine wall after UAE. Presented case allowed to draw preliminary conclusions that complete disappearance of UL nodule after UAE could improve pregnancy outcomes.

  8. Abdominal Skin Rash After TACE Due to Non-Target Embolization of Hepatic Falciform Artery.

    Science.gov (United States)

    Nagpal, Prashant; Bhalala, Mitesh; Vidholia, Aditi; Sao, Rahul; Sharma, Nisha; Mehta, Dhruv; McCabe, Sam; Bodin, Roxana

    2016-04-01

    Transcatheter arterial chemoembolization (TACE) is a well-recognized procedure for management of hepatocellular carcinoma. We present a 54-year-old man who presented with a periumbilical maculopapular skin rash that developed after an otherwise uneventful TACE procedure. A retrospective review of imaging was consistent with non-target embolization of the hepatic falciform artery (HFA). He was treated with oral non-steroidal antiinflammatory medication for 3 weeks with improvement, but had slight skin induration and an excoriated papule at 6-month follow-up. Non-target embolization of HFA is very rare, but clinicians and interventionalists should be aware of this complication, especially in patients predisposed to enlargement of HFA.

  9. Clinical Analysis of Pulmonary Lipiodol Embolism in Patients with Hepatic Carcinoma after Transcatheter Arterial Chemoembolization

    OpenAIRE

    2015-01-01

    Objective:To explore the clinical manifestations, therapeutic methods and preventive measures of pulmonary lipiodol embolism (PLE) induced by transcatheter arterial chemoembolization (TACE) so as to improve the cognition and management of PLE. Methods:A total of 2 613 patients with hepatic cancer without history of pulmonary disease who were treated with TACE in our hospital from Sept., 2004 to Mar., 2013 were selected. The clinical manifestations, therapeutic methods and preventing measures ...

  10. Radiodermitis After Prostatic Artery Embolization: Case Report and Review of the Literature

    Energy Technology Data Exchange (ETDEWEB)

    Laborda, Alicia, E-mail: alaborda@unizar.es [Universidad de Zaragoza, Group of Research in Minimally Invasive Techniques (GITMI), Facultad de Veterinaria (Spain); Assis, Andre Moreira De, E-mail: andre.maa@gmail.com [University of Sao Paulo Medical School, Interventional Radiology and Endovascular Surgery Department, Radiology Institute (Brazil); Ioakeim, Ignatios, E-mail: ignacio.ioakim@hotmail.es; Sánchez-Ballestín, María, E-mail: mirisanba@gmail.com [Universidad de Zaragoza, Group of Research in Minimally Invasive Techniques (GITMI), Facultad de Veterinaria (Spain); Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br [University of Sao Paulo Medical School, Interventional Radiology and Endovascular Surgery Department, Radiology Institute (Brazil); Gregorio, Miguel Angel De, E-mail: mgregori@unizar.es [Universidad de Zaragoza, Group of Research in Minimally Invasive Techniques (GITMI), Facultad de Veterinaria (Spain)

    2015-06-15

    Prostate artery embolization (PAE) is a technically demanding new treatment option for benign prostatic hyperplasia. We present a case of radiation-induced dermitis in a 63-year-old patient after a technically successful PAE, due to high radiation exposure (KAP: 8,023,949 mGy cm{sup 2}) and long fluoroscopy time (72 min). Anatomical and technical aspects are discussed, as well as recommendations to decrease radiation exposure in these procedures.

  11. Splenic artery embolization for the treatment of bleeding gastric varices secondary to splenic vein thrombosis.

    Science.gov (United States)

    Stone, Patrick A; Phang, David; Richmond, Bryan; Gill, Gurpreet; Campbell, John E

    2014-04-01

    Splenic vein thrombosis can lead to gastric varices. Subsequent upper gastrointestinal bleeding may ensue related to the change in venous outflow to the portal system. Vascular surgeons are infrequently asked to assist in the management of this entity. However, with many vascular surgeons providing diverse endovascular-based interventions, understanding catheter-based solutions is imperative. This report presents a case in which arterial embolization was used to treat gastric variceal bleeding.

  12. Arterial embolization for traumatic lethal lateral abdomi-nal wall hemorrhage in a liver cirrhosis patient

    Institute of Scientific and Technical Information of China (English)

    Seiji Morita; Tomoatsu Tsuji; Takeshi Yamagiwa; Hiroyuki Otsuka; Sadaki Inokuchi

    2009-01-01

    @@ B lood loss due to abdominal wall hemorrhage is generally managed conservatively. Further, abdominal wall hemorrhage rarely develops into a life-threatening condition. However, it is difficult to sur-gically achieve hemostasis. We report the case of a liver cirrhosis patient with life-threatening abdominal wall hemorrhage that developed as a result of a minor trauma and was successfully treated with arterial embolization (AE).

  13. Postpartum Hemorrhage Resulting from Pelvic Pseudoaneurysm: A Retrospective Analysis of 588 Consecutive Cases Treated by Arterial Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Dohan, Anthony, E-mail: anthony.dohan@lrb.aphp.fr; Soyer, Philippe, E-mail: philippe.soyer@lrb.aphp.fr; Subhani, Aqeel, E-mail: drsubhani07@gmail.com [Hopital Lariboisiere, Assistance Publique-Hopitaux de Paris, Department of Abdominal and Interventional Imaging (France); Hequet, Delphine, E-mail: delphine.hequet@gmail.com [Universite Paris-Diderot (France); Fargeaudou, Yann, E-mail: yannfargeaudou4@hotmail.com [Hopital Lariboisiere, Assistance Publique-Hopitaux de Paris, Department of Abdominal and Interventional Imaging (France); Morel, Olivier, E-mail: olivier.morel17@gmail.com [Maternite Universitaire de Nancy, Universite Henri Poincare Nancy 1 (France); Boudiaf, Mourad, E-mail: mourad.boudiaf@lrb.aphp.fr [Hopital Lariboisiere, Assistance Publique-Hopitaux de Paris, Department of Abdominal and Interventional Imaging (France); Gayat, Etienne, E-mail: etienne.gayat@9online.fr [Hopital Lariboisiere, Assistance Publique-Hopitaux de Paris, Department of Anesthesiology and Intensive Care Medicine (France); Barranger, Emmanuel, E-mail: emmanuel.barranger@lrb.aphp.fr [Universite Paris-Diderot (France); Dref, Olivier Le, E-mail: olivier.ledref@lrb.aphp.fr; Sirol, Marc, E-mail: marc.sirol@lrb.aphp.fr [Hopital Lariboisiere, Assistance Publique-Hopitaux de Paris, Department of Abdominal and Interventional Imaging (France)

    2013-10-15

    Objective: This study was designed to determine the incidence of arterial pseudoaneurysm in patients presenting with postpartum hemorrhage (PPH), to analyze the angiographic characteristics of pseudoaneurysms that cause PPH, and to evaluate the effectiveness of pelvic arterial embolization for the treatment of this condition.Study designEighteen women with pelvic arterial pseudoaneurysm were retrieved from a series of 588 consecutive patients with PPH treated by arterial embolization. Clinical files, angiographic examinations, and procedure details were reviewed. Results: The incidence of pseudoaneurysm was 3.06 % (18/588; 95 % confidence interval (CI): 1.82-4.8 %). A total of 20 pseudoaneurysms were found; 15/20 (75 %) were located on the uterine arteries. Angiography revealed extravasation of contrast material from pseudoaneurysm indicating rupture in 9 of 18 (50 %) patients. Arterial embolization was performed using gelatin sponge alone in 12 of 18 (67 %) patients or in association with metallic coils in 5 of 18 (28 %) patients or n-butyl-2-cyanoacrylate in 1 of 18 (6 %) patients. Arterial embolization allowed controlling the bleeding in all patients after one or two embolization sessions in 17 of 18 (94 %) and 1 of 18 patients (6 %) respectively, without complications, obviating the need for further surgery. Conclusions: Pseudoaneurysm is rarely associated with PPH. Arterial embolization is an effective and safe procedure for the treatment of PPH due to uterine or vaginal artery pseudoaneurysm. Our results suggest that gelatin sponge is effective for the treatment of ruptured pseudoaneurysms, although we agree that our series does not contain sufficient material to allow drawing definitive conclusions with respect to the most effective embolic material.

  14. Therapeutic embolization of renal artery to control severe hypertension due to renal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Cotroneo, A.R.; Patane, D.; De Cinque, M.; Falappa, P.; Doglietto, G.

    1987-05-01

    In a young patient with a post-traumatic renal hematoma, severe systemic hypertension, secondary to the activation of the renin-angiotensin axis, developed. Because of persistent hypertension, after 3 months of drug therapy, selective percutaneous embolization of the damaged vessels was performed. One year after procedure, the patient is normotensive without drugs.

  15. Aortic Branch Artery Pseudoaneurysms Associated with Intramural Hematoma: When and How to Do Endovascular Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Ferro, Carlo; Rossi, Umberto G., E-mail: urossi76@hotmail.com; Seitun, Sara [IRCCS San Martino University Hospital, IST, National Institute for Cancer Research, Department of Radiology and Interventional Radiology (Italy); Scarano, Flavio; Passerone, Giancarlo [IRCCS San Martino University Hospital, IST, National Institute for Cancer Research, Department of Cardiac Surgery (Italy); Williams, David M. [University of Michigan Medical Center, Department of Radiology, Division of Vascular and Interventional Radiology (United States)

    2013-04-15

    To describe when and how to perform endovascular embolization of aortic branch artery pseudoaneurysms associated with type A and type B intramural hematoma (IMH) involving the descending thoracic and abdominal aorta (DeBakey I and III) that increased significantly in size during follow-up. Sixty-one patients (39 men; mean {+-} standard deviation age 66.1 {+-} 11.2 years) with acute IMH undergoing at least two multidetector computed tomographic examinations during follow-up for 12 months or longer were enrolled. Overall, 48 patients (31 men, age 65.9 {+-} 11.5) had type A and type B IMH involving the descending thoracic and abdominal aorta (DeBakey I and III). Among the 48 patients, 26 (54 %; 17 men, aged 64.3 {+-} 11.4 years) had 71 aortic branch artery pseudoaneurysms. Overall, during a mean follow-up of 22.1 {+-} 9.5 months (range 12-42 months), 31 (44 %) pseudoaneurysms disappeared; 22 (31 %) decreased in size; two (3 %) remained stable; and 16 (22 %) increased in size. Among the 16 pseudoaneurysms with increasing size, five of these (three intercostal arteries, one combined intercostobronchial/intercostal arteries, one renal artery), present in five symptomatic patients, had a significant increase in size (thickness >10 mm; width and length >20 mm). These five patients underwent endovascular embolization with coils and/or Amplatzer Vascular Plug. In all patients, complete thrombosis and exclusion of aortic pseudoaneurysm and relief of back pain were achieved. Aortic branch artery pseudoaneurysms associated with type A and type B IMH involving the descending thoracic and abdominal aorta (DeBakey I and III) may be considered relatively benign lesions. However, a small number may grow in size or extend longitudinally with clinical symptoms during follow-up, and in these cases, endovascular embolization can be an effective and safe procedure.

  16. Renal Artery Embolization of Perirenal Hematoma in Hemorrhagic Fever with Renal Syndrome: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hee Seok; Lee, Yong Seok; Lim, Ji Hyon; Kim, Kyung Soo; Yoon, Yup [Dongguk University College of Medicine, Goyang (Korea, Republic of); Hwang, Jae Cheol [Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan (Korea, Republic of)

    2007-08-15

    Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure. Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings. We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization. Hemorrhagic fever with renal syndrome (HFRS) is an acute infectious disease caused by hantavirus. HFRS is clinically characterized by fever, renal failure and hemorrhage in organs such as lung, kidney, spleen and the pituitary gland. Renal medullary hemorrhage is a well-known complication in the kidney, but spontaneous rupture of the kidney and perirenal hematoma in HFRS is rare, and patients showing continuous bleeding and massive perirenal hematoma have often been surgically treated. We report here on a case of HFRS complicated by massive perirenal hematoma, and the patient was treated with transcatheter arterial embolization. In summary, spontaneous rupture of the kidney and perirenal hematoma is a rare complication of HFRS. We report here on a case of HFRS that caused massive perirenal hematoma, and this was treated with superselective renal artery embolization.

  17. Delayed cerebral lipiodol embolism after transcatheter arterial chemoembolization of hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    WU Jian-jun; CHAO Ming; ZHANG Guang-qiang; LI Bin

    2009-01-01

    @@ Transcatheter arterial chemoembolization (TACE) has been an effective mean in treating hepatocellular carcinoma for nearly 30 years.The reported complications associated with TACE mainly include acute hepatic failure (accounting for 0.26%),liver abscess (0.22%),multiple intrahepatic aneurysms (0.17%),hepatic artery occlusion (1.52%),spontaneous rupture of tumor (0.15%),gallbladder infarction (0.3%),perforation of duodenum (0.05%),acute renal failure (0.05%),pulmonary embolism (0.17%),femoral nerve injury (0.15%),etc.1,2

  18. Supplementary inferior phrenic artery embolization in the interventional treatment of hemoptysis

    Institute of Scientific and Technical Information of China (English)

    LIU Feng-yong; WANG Mao-qiang; FAN Qing-sheng; DUAN Feng; WANG Zhi-jun; SONG Peng

    2009-01-01

    Background Transcatheter bronchial artery embolization (BAE) is widely used for the treatment of hemoptysis and the immediate success rate is high, but there are still some hemorrhage recurrences. One of the common reasons for failure of BAE is collateral branches as blood supply. The inferior phrenic artery (IPA) is one of the most common collateral branches that is scarcely reported. Our purpose was to observe manifestations of IPA supplying to hemoptysis and evaluate the efficacy and safety of IPA embolization.Methods Angiography during interventional treatment of 178 hemoptysis patients in the past 7 years confirmed that IPA hemorrhage resulted in hemoptysis in 25 patients (26-67 years old) who had: lung cancer (11 patients), bronchiectasis (11 patients), chronic lung inflammation (2 patients), and pulmonary tuberculosis (1 patient). Among the 25 patients, 7 patients had twice interventional operations within one week and 6 patients still experienced intraoperative hemoptysis after conventional embolization of the bronchial artery, the internal thoracic artery, and the intercostal artery, then had the second interventional operation immediately. The total number of cases were 191. Selective embolization of the IPA was performed using polyvinyl alcohol microspheres, gelatin sponge particles, and microcoil. The safety and clinical significance of IPA embolization were evaluated. The Pearson χ2 test and Fisher's exact probability test were used in this study.Results Selective IPA angiography showed increased diameter of the IPA, disorganization of the branches, and varying degrees of angiogenesis. In 11 cases, contrast material was seen in vessels supplying the tumor and in the tumor. In 9 cases, contrast material had leaked into the area supplied by the IPA; in 8 cases, non-specific flake-like deposits of contrast material were seen; and in 14 cases, abnormal communication or shunt was visualized. Lesions were closely related to the pleura in 25 patients

  19. The dynamic study of the pulmonary artery obstruction degree and the right ventricular function in massive pulmonary embolism on CT pulmonary angiography

    Institute of Scientific and Technical Information of China (English)

    Jianguo Wang; Yulin Guo; Xiaojuan Guo; Min Liu; Youmin Guo; Chen Wang; Yuanhua Yang; Zhenguo Zhai; Li Zhu; Hongxia Ma

    2008-01-01

    Objective: To analyze the value of CTPA in assessing the dissolve of embolus and the function of the fight ventricle dynamically.Methods:Twenty-three cases of massive pulmonary embolism were analyzed retrospectively. The pulmonary artery obstruction index and the fight ventricular function parameters were collected and analyzed on CTPA before thrombolytic therapy, 24 hours and 14 days after therapy, respectively. Results:The pulmonary artery obstruction index decreased gradually, and there was significant difference before therapy, 24 hours and 2 weeks after therapy. Twenty-four hours after therapy, the maximal short axes diameter and the maximal transverse area of fight ventricle(RVd, RVs) decreased significantly, the maximal short axes diameter and the maximal transverse area of left ventricle(LVd, LVs) increased significantly, and the RVd/LVd, RVs/LVs decreased apparently. The pulmonary artery symbolic pressure before and 24 hours after therapy were apparently different. There was no significant difference between azygos vein, the super vena cava, the main pulmonary artery and vein reflux before and after therapy. Conclusion:CTPA can evaluate the pulmonary artery obstruction degree and right ventricular function dynamically.

  20. Appendicular arterial tumor embolization in two cats with pulmonary carcinoma.

    Science.gov (United States)

    Ibarrola, Patricia; German, Alexander J; Stell, Anneliese J; Fox, Richard; Summerfield, Nuala J; Blackwood, Laura

    2004-10-01

    A 13-year-old neutered male Persian cat and an 11-year-old neutered female Persian cat were examined because of an acute onset of lameness. In both cats, conscious proprioception and reflexes were diminished in the affected limb. In 1 cat, no blood flow was detected in the left brachial artery with a Doppler ultrasonic flow detector, whereas blood flow in the right brachial artery was easily documented. In the other cat, the right femoral pulse was not palpable. Neither cat had any echocardiographic evidence of cardiac disease. In both cats, treatment was primarily supportive. One cat died, and the other was euthanatized. At necropsy, lung lobe consolidation was seen. Microscopically, there was multifocal infiltration of the lung parenchyma with cuboidal to columnar neoplastic epithelial cells. Neoplastic epithelial cells of similar morphology were identified in nodular masses in sections of muscle, and intravascular tumor emboli were identified obliterating small and large arterioles. Immunohistochemical staining of pulmonary and muscular tissue for pan-cytokeratin antigen revealed intense cytoplasmic staining of neoplastic cells. Staining for factor VIII-related antigen confirmed that clusters of neoplastic cells represented intravascular emboli. Clinical signs in the cats were attributed to arterial occlusion by tumor emboli.

  1. Embolization of the Middle Meningeal Artery Effectively Treats Refractory Chronic Subdural Hematoma: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Gobran Alfotih

    2014-10-01

    Full Text Available Chronic subdural hematoma (CSDH formation mechanism is very complex, and has not entirely understood. It represents a frequent type of intracranial hemorrhage, and is very common disease in Neurosurgery practice, especially in older patients. Various surgical treatments have been proposed for the treatment of CSDH. The rate of recurrence in CSDH after surgery ranges from 5% to 30%, repeated surgery must be considered. But in some cases subdural collections are still persistent. Endovascular embolization of the middle meningeal artery (MMA is an option for treatment of refractory CSDH. We review all cases that were treated with embolization to assess the effect of this intervention. Our review revealed 6 papers with a total enrollment of 14 patients were treated with MMA embolization for refractory chronic subdural hematoma without any postoperative complication or recurrence. In this study we suggest MMA embolization as an alternative for treatment of non-curable CSDH, especially for old people with systematic diseases, who cannot tolerate repeat surgery.

  2. Transcatheter Arterial Embolization of Nonvariceal Upper Gastrointestinal Bleeding with N-Butyl Cyanoacrylate

    Energy Technology Data Exchange (ETDEWEB)

    Jae, Hwan Jun; Chung, Jin Wook; Jung, Ah Young; Lee, Whal; Park, Jae Hyung [Seoul National University Hospital, Institute of Radiation Medicine, Seoul (Korea, Republic of)

    2007-02-15

    To evaluate the clinical efficacy and safety of transcatheter arterial embolization (TAE) with N-Butyl Cyanoacrylate (NBCA) for nonvariceal upper gastrointestinal bleeding. Between March 1999 and December 2002, TAE for nonvariceal upper gastrointestinal bleeding was performed in 93 patients. The endoscopic approach had failed or was discarded as an approach for control of bleeding in all study patients. Among the 93 patients NBCA was used as the primary embolic material for TAE in 32 patients (28 men, four women; mean age, 59.1 years). The indications for choosing NBCA as the embolic material were: inability to advance the microcatheter to the bleeding site and effective wedging of the microcatheter into the bleeding artery. TAE was performed using 1:1 1:3 mixtures of NBCA and iodized oil. The angiographic and clinical success rate, recurrent bleeding rate, procedure related complications and clinical outcomes were evaluated. The angiographic and clinical success rates were 100% and 91% (29/32), respectively. There were no serious ischemic complications. Recurrent bleeding occurred in three patients (9%) and they were managed with emergency surgery (n = 1) and with a successful second TAE (n = 2). Eighteen patients (56%) had a coagulopathy at the time of TAE and the clinical success rate in this group of patients was 83% (15/18). TAE with NBCA is a highly effective and safe treatment modality for nonvariceal upper gastrointestinal bleeding, especially when it is not possible to advance the microcatheter to the bleeding site and when the patient has a coagulopathy.

  3. Intra-arterial tirofiban infusion for thromboembolic complication during coil embolization of ruptured intracranial aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Dae, E-mail: aronnn@naver.com [Department of Radiology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 425 Sindaebang-dong, Dongjak-gu, Seoul 156-707 (Korea, Republic of); Lee, Jong Young, E-mail: gen78@naver.com [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Seo, Jung Hwa, E-mail: jhseo34@gmail.com [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Kang, Hyun-Seung, E-mail: hsk4428@yahoo.com [Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Kim, Jeong Eun, E-mail: eunkim@snu.ac.kr [Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Jung, Keun Hwa, E-mail: jungkh@gmail.com [Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Han, Moon Hee, E-mail: hanmh@snuh.org [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of)

    2012-10-15

    Introduction: Intra-arterial (IA) thrombolytic intervention for acute thrombosis has been challenged due to the risk of bleeding during the endovascular treatment of ruptured aneurysms. We present the results of IA tirofiban infusion for thromboembolic complications during coil embolization in patients with ruptured intracranial aneurysms. Methods: Thromboembolic events requiring thrombolytic intervention occurred in 39 (10.5%) cases during coil embolization of 372 consecutive ruptured intracranial aneurysms. Maximal aneurysm diameters of 39 patients (mean age, 54.7 ± 13.2 years; 23 female, 16 male) ranged from 2.1 to 13.1 mm (mean, 6.6 ± 3.0 mm). The anterior communicating artery was the most common site (n = 13), followed by the middle cerebral artery (n = 9) and the posterior communicating artery (n = 7). In this series, we used intracranial stents in 10 patients during the procedure. Superselective IA tirofiban infusion through a microcatheter was performed to resolve thrombi and emboli. We assessed the efficacy and safety of IA tirofiban infusion in patients with ruptured aneurysms. Results: Intraarterially administered tirofiban doses ranged from 0.25 to 1.25 mg (mean, 0.71 ± 0.26 mg). Effective thrombolysis or recanalization was achieved in 34 patients (87.2%), and three patients (7.7%) suffered distal migration of clots with partial recanalization. The rest (5.1%) had no recanalization. Nonconsequent intracerebral hemorrhage occurred in two patients (5.1%) after the procedure. Thromboemboli-related cerebral infarction developed in eight patients, and only two patients remained infarction related disabilities. Conclusion: IA tirofiban infusion seems to be efficacious and safe for thrombolysis during coil embolization in patients with ruptured intracranial aneurysms.

  4. Arterial embolization hyperthermia using As2O3 nanoparticles in VX2 carcinoma-induced liver tumors.

    Directory of Open Access Journals (Sweden)

    Hui Yu

    Full Text Available BACKGROUND: Combination therapy for arterial embolization hyperthermia (AEH with arsenic trioxide (As(2O(3 nanoparticles (ATONs is a novel treatment for solid malignancies. This study was performed to evaluate the feasibility and therapeutic effect of AEH with As(2O(3 nanoparticles in a rabbit liver cancer model. The protocol was approved by our institutional animal use committee. METHODOLOGY/PRINCIPAL FINDINGS: In total, 60 VX(2 liver-tumor-bearing rabbits were randomly assigned to five groups (n = 12/group and received AEH with ATONs (Group 1, hepatic arterial embolization with ATONs (Group 2, lipiodol (Group 3, or saline (Group 4, on day 14 after tumor implantation. Twelve rabbits that received AEH with ATONs were prepared for temperature measurements, and were defined as Group 5. Computed tomography was used to measure the tumors' longest dimension, and evaluation was performed according to the Response Evaluation Criteria in Solid Tumors. Hepatic toxicity, tumor necrosis rate, vascular endothelial growth factor level, and microvessel density were determined. Survival rates were measured using the Kaplan-Meier method. The therapeutic temperature (42.5°C was obtained in Group 5. Hepatotoxicity reactions occurred but were transient in all groups. Tumor growth was delayed and survival was prolonged in Group 1 (treated with AEH and ATONs. Plasma and tumor vascular endothelial growth factor and microvessel density were significantly inhibited in Group 1, while tumor necrosis rates were markedly enhanced compared with those in the control groups. CONCLUSIONS: ATON-based AEH is a safe and effective treatment that can be targeted at liver tumors using the dual effects of hyperthermia and chemotherapy. This therapy can delay tumor growth and noticeably inhibit tumor angiogenesis.

  5. Cerebral Embolism Associated with Left Atrial Myxoma That Was Treated with Thrombolytic Therapy

    Directory of Open Access Journals (Sweden)

    Naoto Kohno

    2012-01-01

    Full Text Available We present a case of cerebral embolism associated with a left atrial myxoma that was treated with intravenous thrombolytic therapy. A 79-year-old right-handed man with no history of neurological or psychiatric illnesses was referred to our hospital because of confusion. He had been self-supported in the activity of daily living and could enjoy gardening until just before his admission. He had aphasia, left conjugate deviation, right hemiparesis, and right pathological reflexes. His NIHSS score was 24. Cranial DWI showed hyperintense lesions in the left middle cerebral artery territory, and MRA revealed left middle cerebral artery occlusion. We started treatment with the recombinant tissue plasminogen activator alteplase intravenously 3 h after the onset. However, the therapy was ineffective, and the NIHSS score was 25 on the second day. A transthoracic echocardiogram and heart MRI showed a left atrial myxoma. However, surgery was contraindicated because of the patient’s poor general condition. Although intravenous recombinant tissue plasminogen activator is a reasonable treatment for stroke patients, even with a cardiac myxoma, we cannot always expect good effects, especially if the emboli are parts of the tumor itself. In this case, we could not perform an endovascular mechanical embolectomy; however, we speculate that mechanical embolus retrieval in cerebral ischemia might be effective in such cases.

  6. Bronchial artery and non-bronchial systemic artery embolization for the treatment in patients with hemoptysis: analysis of efficacy of gelfoam single use

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Seok Kyun; Kim, Jae Kyu; Yoon, Woong; Kim, Yun Hyeon; Park, Jin Gyoon; Kang, Heoung Keun [Chonnam National University Hospital School of Medicine, Gwangju (Korea, Republic of)

    2003-07-01

    To investigate the efficacy of Gelfoam single use for the management of hemoptysis by analyzing patients with recurrence in embolized artery and other artery, respectively. Between 1992 and 2000, 131 patients (104 men and 27 women, mean age: 54.4 years) with hemoptysis underwent BAE using gelatin sponge only. After puncturing the femoral artery using the Seldinger method, angiographies of the thoracic aorta, the bronchial arteries, the intercostal arteries, and the systemic collaterals which were suspected of bleeding focus and embolization were performed. Gelfoam was used 1 x 3 mm and 2 x 3 mm or 2 x 5mm by the diameter of feeding arteries. The cumulative hemoptysis control rate and recurrence rate were analyzed from the previously embolized vessels. Hemoptysis were recurred among 34 of 131 patients. Twenty-two patients had a recurrence from the same vessels and 12 from the different ones. Using the Kaplan-Meier method, the cumulative hemoptysis control rate was obtained in the patients with a recurrence from the same vessels: 88.8% in 1 month, 79.9% in 1 year, and 77.3% in 2 year. The reasons for recurrences of the same lesions are as follows; due to the tortuosity of the vessel (n=3); partial embolization through the common trunk formation between bronchial and anterior spinal artery (n=3); by vessel spasms or autogenous thrombus (n=2); due to the contrast media hypersensitivity (n=1). These 9 patients were not treated successfully. In the remaining 13 cases, hemoptysis were recurred due to recanalization of embolized vessels. Among 161 procedure, complications consisted of fever (n=8), dyspnea (n=8), mild chest discomfort (n=7), lower back pain (n=1), and transient lower leg paralysis (n=1), which were improved within several days. There was no serious complication in this study. Bronchial artery embolization using Gelfoam alone maybe effective and safe to control hemoptysis.

  7. Electroconvulsive therapy and anticoagulation after pulmonary embolism: a case report

    Directory of Open Access Journals (Sweden)

    Julio Cesar Lazaro

    2014-07-01

    Full Text Available Introduction Electroconvulsive therapy (ECT is considered the most effective treatment for catatonia regardless its underlying condition. The rigid fixed posture and immobility observed in catatonia may lead to several clinical complications, of which, pulmonary embolism (PE is one of the most severe. The rapid improvement of the psychiatric condition in catatonia-related PE is essential, since immobility favors the occurrence of new thromboembolic events and further complications. In that scenario, ECT should be considered, based on a risk-benefit analysis, aiming at the faster resolution of the catatonia. Methods Case report and literature review. Results A 66-years-old woman admitted to the psychiatric ward with catatonia due to a depressive episode presented bilateral PE. Clinically stable, but still severely depressed after a trial of antidepressants, she was treated with ECT in the course of full anticoagulation with enoxaparin. After five ECT sessions, her mood was significantly better and she was walking and eating spontaneously. She did not present complications related either to PE or to anticoagulation. After the eighth ECT session, she evolved with hypomania, which was managed with oral medication adjustments. The patient was completely euthymic at discharge. Conclusion The case we presented provides further evidence to the anecdotal case reports on the safety of ECT in the course of concomitant full anticoagulant therapy after PE, and illustrates how, with the proper precautions, the benefits of ECT in such condition might outweigh its risks.

  8. Massive retroperitoneal hemorrhage from a giant renal angiomyolipoma treated by selective arterial embolization with an Amplatzer Vascular Plug II

    OpenAIRE

    Teichgräber, Ulf KM; de Bucourt, Maximilian

    2012-01-01

    We report on a 36-year-old Caucasian woman who presented to the emergency department with post-traumatic retroperitoneal bleeding diagnosed by computed tomography. After clinical stabilization of the patient, selective arterial embolization was performed. The angiomyolipoma's feeding artery was successfully treated with an 8-mm Amplatzer Vascular Plug Type II. The upper pole of the left kidney, which was supplied by a separate upper renal artery, was conserved. Consequently, the renal angiomy...

  9. Embolization for the treatment of unilateral A1 segment anterior communicating artery aneurysm: a report of 48 cases

    Directory of Open Access Journals (Sweden)

    Qing-dong GUO

    2011-10-01

    Full Text Available Objective To summarize the experience and method of endovascular treatment of unilateral A1 segment anterior communicating artery aneurysm with detachable coils.Methods Forty-eight patients with unilateral A1 anterior communicating artery aneurysm(23 males and 25 females,age ranged from 32 to 72 years with mean of 53.4,hospitalized in Xijing hospital from Jan.2009 to Apr.2010 were involved in present study.All of the aneurysms were measured with rotational digital subtraction angiography(RDSA and image post-processing techniques,and they were embolized with Guglielmi detachable coils(GDCs.The patency of the parent arteries was monitored by catheterization in both carotid arteries in the process of treatment.Stent-assisted,balloon remodeling,microcatheter and microwire assisted techniques were used in the treatment of wide-necked aneurysm to keep patency of parent arteries.Cerebral angiography was performed in 38 cases 6 months after the operation to observe the patency of embolized aneurysms and anterior communicating arteries.Results Of the 48 cases,total occlusion was achieved in 39(81.3%,more than 90% occlusion was achieved in 6(12.5%,and 3(6.3% with less than 90% occlusion;1 had hemorrhage during embolization,3 had anterior communicating artery occlusion,and 2 had contralateral internal carotid artery compensation after anterior communicating artery occlusion.No re-bleeding was found during the 6 months follow-up period.Cerebral angiography showed total occlusion of aneurysms and patency of anterior communicating arteries in 38 cases during re-examination.Conclusion The anterior communicating arteries should be kept patent in embolization treatment of the major unilateral blood supply anterior communicating artery aneurysms,and it is helpful to use microcatheter or microwire assisted techniques.

  10. Liver microcirculation after hepatic artery embolization with degradable starch microspheres in vivo

    Institute of Scientific and Technical Information of China (English)

    Jian Wang; Satoru Murata; Tatsuo Kumazaki

    2006-01-01

    AIM: To observe the dynamic changes of liver microcirculation in vivo after arterial embolization with degradable starch microspheres (DSM).METHODS: DSM were injected into the proper hepatic artery through a silastic tube inserted retrogradely in gastroduodenal artery (GDA) of SD rats. Fluorescent microscopy was used to evaluate the dynamic changes of blood flow through the terminal portal venules (TPVs), sinusoids and terminal hepatic venules (THVs).The movements of DSM debris were also recorded. Six hours after injection of DSM, percentages of THVs with completely stagnant blood flow were recorded.RESULTS: Two phases of blood flow change were recorded. In phase one: after intra-arterial injection of DSM, slow or stagnant blood flow was immediately recorded in TPVs, sinusoids and THVs. This change was reversible, and blood flow resumed completely. In phase two: after phase one, blood flow in TPVs changed again and three patterns of blood flow were recorded. Six hours after DSM injection, 36.9% ± 9.2% of THVs were found with completely stagnant blood flow.CONCLUSION: DSM can stop the microcirculatory blood flow in some areas of liver parenchyma. Liver parenchyma supplied by arteries with larger A-P shunt is considered at a higher risk of total microcirculatory blood stagnation after injection of DSM through hepatic artery.

  11. [Cerebral vasospasm after coil embolization for unruptured internal carotid artery aneurysm: case report].

    Science.gov (United States)

    Ogata, Atsushi; Suzuyama, Kenji; Koga, Hisao; Takase, Yukinori; Matsushima, Toshio

    2010-01-01

    A 38-year-old woman was admitted to our hospital with a 3-day history of severe headache associated with some nausea and vomiting. MRI did not show any evidence of subarachnoid hemorrhage, but MRA and CTA showed an aneurysm on the paraclinoid region of the right internal carotid artery. She was successfully treated by coil embolization. MRA taken 7 days after the treatment showed marked vasospam. Fortunately, her therapeutic course was uneventful and she was discharged without any neurological deficits. Vasospasm without subarachnoid hemorrhage is a rare event. Here, we review the literature and discuss potential mechanisms for vasospasm in the absence of subarachnoid hemorrhage.

  12. Sudden cardiovascular collapse caused by carbon dioxide embolism during endoscopic saphenectomy for coronary artery bypass grafting

    Institute of Scientific and Technical Information of China (English)

    CHEN Xin-chun; TANG Xiao-yang; JIANG Yi-fan; PAN Yan-bing; FU Cheng-zhang

    2006-01-01

    @@ Endoscopic vein harvesting (EVH) for coronary artery bypass grafting (CABG) has gained increasing acceptance as a less invasive alternative to conventional open vein harvesting. With this procedure, carbon dioxide (CO2) is insufflated to create a subcutaneous tunnel to facilitate the harvest of the great saphenous vein. The technique seems to be safe because there are no adverse hemodynamic consequences or systemic CO2 absorption during EVH.1,2 We report a case of massive right heart gas embolism which occurred during a routine EVH performance of the saphenous vein.

  13. Transcatheter Arterial Embolization for Postpartum Hemorrhage with Disseminated Intravascular Coagulation: Outcome Assessment

    Energy Technology Data Exchange (ETDEWEB)

    An, Eun Jung; Kim, Young Hwan; Kwon, Bo Ra; Kim, See Hyung [Dept. of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2011-12-15

    We evaluated the efficacy and predictors of clinical outcome after transcatheter arterial embolization (TAE) for treatment of postpartum hemorrhage with disseminated intravascular coagulation (DIC). Of 127 patients who underwent TAE for postpartum hemorrhage, 46 progressed to DIC (group 1), 81 showed normal range hematological parameters (group 2). We retrospectively evaluated etiology, embolization methods and the efficacy of TAE for intergroup comparison Pearson Chi-Square test and logistic regression model. Overall TAE failed to control bleeding in 9 patients in spite of technical success. Lower bleeding control rate was found in group 2 (82.6%) relative to group 1 (98.8%, p = 0.001). And embolization methods were not statistically different between two groups no statistically significant predictors associated with failed hemostasis except the amount of transfusion in group 1. Although bleeding control rate is lower in postpartum hemorrhage with DIC than without DIC, we believe that TAE with correction of DIC is an effective method for postpartum hemorrhage with DIC.

  14. Successful treatment of combined vaginal and broad ligament hematoma using pelvic pressure pack and arterial embolization

    Institute of Scientific and Technical Information of China (English)

    Ma Runmei; Lao Terence T; Feng Yukun; Zhao Wei; Huang Jianqiang; Liang GuoHua; Li Hongyu; Chen Zhuo

    2005-01-01

    Objective:To assess using the pelvic pressure pack as temporizing treatment for combined vaginal and broad ligament hematoma before selective arterial embolization could be undertaken.Methods:A 29-year-old woman was transferred because of a 10cm right upper vaginal hematoma found shortly after the spontaneous delivery of a 3400g infant at term.Following evacuation of the clots,the patient's condition deteriorated with the appearance of a painful right pelvic mass,displacing the uterus.At laparotomy,the hematoma extended between the folds of the broad ligament into the pelvic sidewall.After evacuation of the clots,hemostasis failed despite subtotal hysterectomy.Eventually a pressure pack created from joined gauze rolls was used to fill up the pelvic cavity and achieved hemostasis before abdominal closure.When the vaginal pack was removed 30 hours later,vaginal bleeding recurred,and bilateral hypogastric embolization was performed with Gianturco coils.Results:The patient was successfully treated by this way and discharged uneventfully.Conclusion:In combined vaginal and broad ligament hematoma,pelvic pressure pack can be used to ensure maternal survival until definitive treatment with angiographic embolization.

  15. New therapies for arterial hypertension.

    Science.gov (United States)

    Pagliaro, Beniamino; Santolamazza, Caterina; Rubattu, Speranza; Volpe, Massimo

    2016-03-01

    Arterial hypertension is the most common chronic disease in developed countries and it is the leading risk factor for stroke, ischemic heart disease, congestive heart failure, chronic renal failure and peripheral artery disease. Its prevalence appears to be about 30-45% of the general population. Recent European guidelines estimate that up to 15-20% of the hypertensive patients are not controlled on a dual antihypertensive combination and they require three or more different antihypertensive drug classes to achieve adequate blood pressure control. The guidelines confirmed that diuretics, beta-blockers, calcium-channel blockers, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are suitable for the initiation and maintenance of antihypertensive treatment, either as monotherapy or in combination therapy. Very few antihypertensive agents have reached the market over the last few years, but no new therapeutic class has really emerged. The long-term adherence to cardiovascular drugs is still low in both primary and secondary prevention of cardiovascular diseases. In particular, the issue of compliance is persistently high in hypertension, despite the fixed-dose combination therapy. As a consequence, a cohort of high-risk hypertensive population, represented by patients affected by refractory and resistant hypertension, can be identified. Therefore, the need of controlling BP in high-risk patients may be addressed, in part, by the development of new drugs, devices and procedures that are designed to treat hypertension and comorbidities. In this review we will comprehensively discuss the current literature on recent therapeutic advances in hypertension, including both medical therapy and interventional procedures.

  16. Cerebral lipiodol embolism following transcatheter arterial chemoembolization for hepatocellular carcinoma: a report of two cases and literature review

    Institute of Scientific and Technical Information of China (English)

    LI Zhi; NI Rui-fang; BUSIREDDY Kiran Kumar Reddy; JIN Yong-hai; ZHAO Xin; LI Ming-ming; YANG Chao

    2011-01-01

    Cerebral lipiodol embolism (CLE) is an extremely rare complication of transcatheter arterial chemoembolization for hepatocellular carcinoma.To our knowledge,only 11 cases have been previously reported.We recently encountered two cases of CLE in our clinical work.Reviewing the 11 cases in the literature and the two cases in our report indicates that large dose lipiodol infusion and absence of particulate embolization should be avoided.The presence of a right-to-left shunt and inferior phrenic artery injection seems to increase the risk of CLE.More caution should be taken in these situations.

  17. Superselective embolization of the inferior vesical artery for the treatment of intractable hematuria from pelvic malignancy: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Jung; Jeon, Eui Yong [Hallym Univ. Sacred Heart Hospital/Hallym Univ. College of Medicine, Anyang, (Korea, Republic of); Choi, Sun Young [Ewha Womans Univ. Seoul (Korea, Republic of); Han, Kum Hyun [Inje Univ. Ilsan Paik Hospital/Inje Univ. College of Medicine, Goyang (Korea, Republic of)

    2012-05-15

    Intractable hematuria in from pelvic malignancy can be managed with conservative treatment in most patients. However, when treatment fails, surgical intervention may be required. Unfortunately, in most cases, the general condition of most patients is unfavorable for major surgery, with many patients having an inoperable status. We present two cases where intractable hematuria was successfully controlled by bilateral embolization of the inferior vesical artery with polyvinyl alcohol particles. Hematuria did not recur during the subsequent period and no complication was observed. Thus, bilateral embolization of the inferior vesical artery should be considered as an alternative method for the treatment of massive intractable hematuria caused by pelvic malignancy.

  18. Transarterial Embolization of Arterial Bleeding in Patients with Pelvic Bone Fractures

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ji Soo; Kwak, Hyo Sung; Han, Young Min [Chonbuk National University Hospital, Jeonju (Korea, Republic of)

    2009-11-15

    This study was designed to evaluate the usefulness of transcatheter arterial embolization (TAE) in hemodynamically unstable patients with a pelvic bone fracture. From November 2004 to July 2007, we retrospectively reviewed 211 patients with pelvic bone fractures. Of these patients, 24 patients with CT findings of active bleeding or hemodynamic instability underwent pelvic angiography. There were 13 female and 11 male patients, with an age range from 21 to 92 years (mean age, 58.3 years). To evaluate arterial injuries, angiography was performed, followed by TAE using coils, gelfoams and N-butyl-2-cyanoacrylate. The evaluation of risk factors between patients who were still alive and patients who had expired was performed statistically by use of the Student's t test and chisquared analysis. A total of 28 TAE procedures were performed in 24 patients and 50 injured arteries were occluded. Six patients (25%) died due to hypovolemic shock within 47 hours. Five of the patients were hemodynamically unstable (BP below 76/56 mmHg) prior to the angiographic procedure and one patient had a pseudoaneurysm located at the superior mesenteric artery. Dopamine usage and blood pressure before the procedure for patients showed a statistically significant difference between patients were still alive and patients who had expired (p = 0.01, p = 0.001). TAE is a safe and effective treatment for an arterial injury of a pelvic bone fracture. The outcome of patients with a hemodynamically unstable state before TAE is poor.

  19. Axillary artery transection and bilateral pulmonary embolism after anterior shoulder dislocation: case report

    Directory of Open Access Journals (Sweden)

    Leclerc Betty

    2017-01-01

    Full Text Available Introduction: Anterior shoulder dislocation can be associated with vascular and neurological complications. However, axillary artery injury associated with shoulder dislocation is rare and extremely rare without bone fracture. An early diagnosis of these complications allows predicting long-term functional outcomes. Methods: This article reports the case of a 66-year-old patient who presented an anterior shoulder dislocation after a ski fall without any neurological dysfunction or pulse deficit. Results: The first reduction attempts were unsuccessful and during the new attempt, we observed a hematoma. A CT scan showed a disruption of the axillary artery and a bilateral pulmonary embolism. Conclusion: Neurovascular injury must be systematically sought before and after reduction, and a multidisciplinary approach is always necessary.

  20. Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications

    Energy Technology Data Exchange (ETDEWEB)

    Soyer, Philippe, E-mail: philippe.soyer@lrb.aphp.fr; Dohan, Anthony, E-mail: anthony.dohan@lrb.aphp.fr; Dautry, Raphael, E-mail: raphael-dautry@yahoo.fr; Guerrache, Youcef, E-mail: docyoucef05@yahoo.fr [Hôpital Lariboisière-AP-HP, Department of Abdominal and Interventional Imaging (France); Ricbourg, Aude, E-mail: aude.ricbourg@lrb.aphp.fr [Hôpital Lariboisière-AP-HP, Department of Obstetrics and Gynecology (France); Gayat, Etienne, E-mail: etienne.gayat@lrb.aphp.fr [Diderot-Paris 7, Université-Sorbonne Paris-Cité (France); Boudiaf, Mourad, E-mail: mourad.boudiaf@lrb.aphp.fr; Sirol, Marc, E-mail: marc.sirol@lrb.aphp.fr; Ledref, Olivier, E-mail: olivier.ledref@lrb.aphp.fr [Hôpital Lariboisière-AP-HP, Department of Abdominal and Interventional Imaging (France)

    2015-10-15

    Postpartum hemorrhage (PPH) is a potentially life-threatening condition, which needs multidisciplinary management. Uterine atony represents up to 80 % of all causes of PPH. Transcatheter arterial embolization (TAE) has now a well-established role in the management of severe PPH. TAE allows stopping the bleeding in 90 % of women with severe PHH, obviating surgery. Pledgets of gelatin sponge as torpedoes are commonly used for safe TAE, and coils, glue, and microspheres have been primarily used in specific situations such as arterial rupture, pseudoaneurysm, and arteriovenous fistula. TAE is a minimally invasive procedure with a low rate of complications, which preserves future fertility. Knowledge of causes of PPH, potential risks, and limitations of TAE is essential for a timely decision, optimizing TAE, preventing irreversible complications, avoiding hysterectomy, and ultimately preserving fertility.

  1. Blunt splenic injury in a child with situs inversus totalis treated with transcatheter arterial embolization

    Directory of Open Access Journals (Sweden)

    Naoki Hashizume

    2016-10-01

    Full Text Available We report the first case of blunt splenic rupture in a child with situs inversus totalis treated with transcatheter arterial embolization (TAE. A 12-year-old girl fell roughly 4 feet onto the pavement while riding her bicycle. Contrast-enhanced computed tomography revealed situs inversus totalis, a massive hemorrhage in the abdominal cavity, and a ruptured spleen with extravasation. Arteriography showed that the internal organs were located opposite their normal positioning. TAE was carried out with gelfoam and a micro coils at the branch of the upper lobe of the splenic artery. TAE is effective for blunt splenic injury with extravasation in a child with situs inversus. In TAE, there is no technical difference about situs inversus excepted mirror image of abdominal vascular formation.

  2. Prostatic Artery Embolization for Enlarged Prostates Due to Benign Prostatic Hyperplasia. How I Do It

    Energy Technology Data Exchange (ETDEWEB)

    Carnevale, Francisco C., E-mail: fcarnevale@uol.com.br [University of Sao Paulo Medical School, Interventional Radiology Unit (Brazil); Antunes, Alberto A., E-mail: antunesuro@uol.com.br [University of Sao Paulo Medical School, Division of Urology (Brazil)

    2013-12-15

    Prostatic artery embolization (PAE) has emerged as an alternative to surgical treatments for benign prostatic hyperplasia (BPH). Patient selection and refined technique are essential for good results. Urodynamic evaluation and magnetic resonance imaging are very important and technical limitations are related to elderly patients with tortuous and atherosclerotic vessels, anatomical variations, difficulty visualizing and catheterizing small diameter arteries feeding the prostate, and the potential risk of bladder and rectum ischemia. The use of small-diameter hydrophilic microcatheters is mandatory. Patients can be treated safely by PAE with low rates of side effects, reducing prostate volume with clinical symptoms and quality of life improvement without urinary incontinence, ejaculatory disorders, or erectile dysfunction. A multidisciplinary approach with urologists and interventional radiologists is essential to achieve better results.

  3. Percutaneous uterine artery embolization for the treatment of symptomatic fibroids: current status

    Energy Technology Data Exchange (ETDEWEB)

    Lupattelli, Tommaso; Basile, Antonio; Garaci, Francesco Giuseppe; Simonetti, Giovanni

    2005-04-01

    Uterine artery embolization (UAE) is increasingly being used as an alternative treatment to hysterectomy for symptomatic fibroids. Symptoms of pelvic pressure, urinary frequency and menorrhagia are controlled in 73-98% of patients who undergo UAE. At the 1-year follow-up, the uterus may shrink by up to 55% but re-growth of fibroid may however occur. The rate of major complications and amenorrhoea following this procedure is low, ranging in most series from 1 to 3.5% and 1 to 7%, respectively. Nevertheless, the rate of amenorrhoea in women over 45 seems to be higher. In order to completely block the arterial supply to the fibroid, UAE is typically performed in both uterine arteries. Different embolic agents are used such as polyvinyl alcohol, gelfoam and more recently gelatine tris-acryl microspheres. After UAE, perfusion of the uterus is maintained. Uterine function is therefore conserved and although women who become pregnant after UAE seem to be at risk for malpresentation, pre-term birth, cesarean delivery and postpartum hemorrhage, successful pregnancies after UAE have been reported in some series. A major technical problem with UAE remains the possible presence of fibroid blood supply from other sources, such as the ovarian arteries or other pelvic branches, which can lead to failure of the procedure. In conclusion, although randomized trials are still underway, UAE appears a good option for those patients who wish to conserve their fertility or when surgery is contra-indicated. However, to evaluate the long-term effects of UAE longer follow up is required.

  4. Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Okuno, Yuji, E-mail: how-lowlow@yahoo.co.jp [Edogawa Hospital, Department of Orthopedic Surgery (Japan); Korchi, Amine Mohamed, E-mail: amine.korchi@gmail.com [Geneva University Hospitals, Department of Diagnostic and Interventional Radiology (Switzerland); Shinjo, Takuma, E-mail: shin.takuma@a7.keio.jp [Keio University, Institute for Integrated Sports Medicine, School of Medicine (Japan); Kato, Shojiro, E-mail: shojiro7@yahoo.co.jp [Edogawa Hospital, Department of Orthopedic Surgery (Japan)

    2015-04-15

    PurposeOsteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief. We hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis.MethodsTranscatheter arterial embolization for mild to moderate knee osteoarthritis using imipenem/cilastatin sodium or 75 μm calibrated Embozene microspheres as an embolic agent has been performed in 11 and three patients, respectively. We assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores.ResultsAbnormal neovessels were identified within soft tissue surrounding knee joint in all cases by arteriography. No major adverse events were related to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month, and to 6.3 ± 6.0 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range 4–19 months).ConclusionTranscatheter arterial embolization for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function.

  5. Transient Ischemic Rectitis as a Potential Complication after Prostatic Artery Embolization: Case Report and Review of the Literature

    Energy Technology Data Exchange (ETDEWEB)

    Moreira, Airton Mota, E-mail: motamoreira@gmail.com [University of Sao Paulo Medical School, Division of Interventional Radiology, Department of Radiology (Brazil); Marques, Carlos Frederico Sparapan, E-mail: sparapanmarques@gmail.com [University of Sao Paulo Medical School, Colorectal Surgery Division, Department of Gastroenterology (Brazil); Antunes, Alberto Azoubel, E-mail: antunesuro@uol.com.br [University of Sao Paulo Medical School, Department of Urology (Brazil); Nahas, Caio Sergio Rizkallah, E-mail: caionahas@usp.br; Nahas, Sergio Carlos, E-mail: sergionahas@uol.com.br [University of Sao Paulo Medical School, Colorectal Surgery Division, Department of Gastroenterology (Brazil); Gregorio Ariza, Miguel Angel de, E-mail: mgregori@unizar.es [University of Zaragoza, Division of Minimally Invasive Image Guided Surgery (Spain); Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br [University of Sao Paulo Medical School, Division of Interventional Radiology, Department of Radiology (Brazil)

    2013-12-15

    Prostatic artery embolization (PAE) is an alternative treatment for benign prostatic hyperplasia. Complications are primarily related to non-target embolization. We report a case of ischemic rectitis in a 76-year-old man with significant lower urinary tract symptoms due to benign prostatic hyperplasia, probably related to nontarget embolization. Magnetic resonance imaging revealed an 85.5-g prostate and urodynamic studies confirmed Inferior vesical obstruction. PAE was performed bilaterally. During the first 3 days of follow-up, a small amount of blood mixed in the stool was observed. Colonoscopy identified rectal ulcers at day 4, which had then disappeared by day 16 post PAE without treatment. PAE is a safe, effective procedure with a low complication rate, but interventionalists should be aware of the risk of rectal nontarget embolization.

  6. Arterial embolism

    Science.gov (United States)

    ... nih.gov/pubmed/21963765 . Read More Acute kidney failure Atrial fibrillation or flutter Atrial myxoma Blood clots Gas gangrene Heart attack Necrosis Platelet count Septic shock Stroke Transient ischemic attack Review Date 5/5/ ...

  7. Transcatheter coil embolization of multiple coronary artery-to-left ventricle fistulas: report of a rare case

    Institute of Scientific and Technical Information of China (English)

    LI Ruo-gu; JIANG Bei; WU Wei-hua; FANG Wei-yi; SHI Hong-yu; QU Xin-kai; CHEN Hui; QIU Xin-biao; XU Ying-jia; DONG Jia-lin; GUAN Shao-feng

    2008-01-01

    @@ Coronary artery fistula (CAF) is uncommon but remains the most frequent hemodynamically significant congenital coronary artery anomaly,1 The majority of fistula is single and drains into the right heart, only 3.5% into the left ventricle.2 A large fistula requires closure to prevent complications such as myocardial ischemia resulting from coronary steal, congestive heart failure, endocarditis and potential aneurysmal dilatation and rupture.3-5 Here we presented a rare case of CAF with multiple origins involving left anterior descending artery (LAD), left circumflex branch (LCX) and right coronary artery (RCA), and draining into the left ventricle, which was successfully closed by coil embolization.

  8. Giant hepatic artery aneurysm associated with immunoglobulin G4-related disease successfully treated using a liquid embolic agent

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Michele; Virgilio, Edoardo; Laurino, Florindo; Orgera, Gianluigi; Mene, Paolo; Pirozzi, Nicola; Ziparo, Vincenzo; Cavallini, Marco [St. Andrea Hospital, Rome (Italy)

    2015-08-15

    The occurrence of a giant hepatic artery aneurysm (GHAA) in a patient with systemic vasculitis is very rare. Herein, we describe our endovascular treatment experience of a GHAA associated with immunoglobulin G4-related disease (IgG4-RD) consisting primarily of a liquid embolic injection and deployment of a vascular plug.

  9. Bullet embolism of pulmonary artery: a case report; Embolia pulmonar por projetil de arma de fogo: relato de caso

    Energy Technology Data Exchange (ETDEWEB)

    Yamanari, Mauricio Gustavo Ieiri; Mansur, Maria Clara Dias; Kay, Fernando Uliana; Silverio, Paulo Rogerio Barboza; Jayanthi, Shri Krishna; Funari, Marcelo Buarque de Gusmao, E-mail: mauriciogustavo91@yahoo.com.br [Universidade de Sao Paulo (IHC-FMUSP), SP (Brazil). Faculdade de Medicina. Hospital das Clinicas

    2014-03-15

    The authors report the case of a patient victim of gunshots, with a very rare complication: venous bullet embolism from the left external iliac vein to the lingular segment of the left pulmonary artery. Diagnosis is made with whole-body radiography or computed tomography. Digital angiography is reserved for supplementary diagnosis or to be used as a therapeutic procedure. (author)

  10. Heated lipiodol as an embolization agent for transhepatic arterial embolization in VX2 rabbit liver cancer model

    Energy Technology Data Exchange (ETDEWEB)

    Cao Wei [Department of Interventional Radiology, Tangdu Hospital, Fourth Military Medical University, No.1 Xinshi Road, Shaanxi Province, Xi' an 710038 (China)], E-mail: zjfurong2008@126.com; Wan Yi [Department of Health Statistics, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Liang Zhihui [Department of Radiology, Bethune International Peace Hospital, Shijiazhuang, Hebei Province 050082 (China); Duan Yunyou; Liu Xi [Department of Ultrasonography, Tangdu Hospital, Fourth Military Medical University, No. 1 Xinshi Road, Xi' an 710038 (China); Wang Zhimin; Liu Yiyong; Zhu Jia; Liu Xiongtao [Department of Interventional Radiology, Tangdu Hospital, Fourth Military Medical University, No.1 Xinshi Road, Shaanxi Province, Xi' an 710038 (China); Zhang Hongxin [Department of Interventional Radiology, Tangdu Hospital, Fourth Military Medical University, No.1 Xinshi Road, Shaanxi Province, Xi' an 710038 (China)], E-mail: cawe-001@163.com

    2010-02-15

    Purpose: To evaluate the therapeutic effect of heated (60 deg. C) lipiodol via hepatic artery administration in a rabbit model of VX2 liver cancer. Materials and methods: Thirty male New Zealand white rabbits were randomly divided into three groups with 10 rabbits assigned to each group. VX2 carcinoma cells were surgically implanted into the left hepatic lobe. The tumors were allowed to grow for 2 weeks, and studies were performed until the diameter of the tumors detected by ultrasonograph reached 2-3 cm. Under anesthesia, trans-catheter hepatic arterial embolization was performed and doxorubicin-lipiodol (37 deg. C) (1 mL), lipiodol (60 deg. C) (1 mL) or control (physiological saline (37 deg. C) (1 mL)) solution was injected into the hepatic arteries of animals in the three groups. One week later, the volume of the tumor was measured by ultrasonograph again. The serum of all rabbits was collected before injection and at 4 and 7 days after injection, and the level of aspartate aminotransferase (AST) was checked. The survival period of the three groups of rabbits after treatment was also recorded. During the last course of their disease, the rabbits were given analgesics to relieve suffering. Results: The tumor growth rate in the lipiodol (60 deg. C) group (0.92 {+-} 0.21, tumor volume from 1811 {+-} 435 to 1670 {+-} 564 mm{sup 3}) was significantly lower than that in the control group (3.48 {+-} 1.17, tumor volume from 1808 {+-} 756 to 5747 {+-} 1341 mm{sup 3}) (P < 0.05) and in the doxorubicin-lipiodol (37 deg. C) group (1.69 {+-} 0.26, tumor volume from 1881 {+-} 641 to 2428 {+-} 752 mm{sup 3}) (P < 0.05). Consequently, the survival period of the animals in the lipiodol (60 deg. C) group (41.0 {+-} 3.0 days) was significantly greater than that in the doxorubicin-lipiodol (37 deg. C) group (38.0 {+-} 2.5 days) (P < 0.05). On the other hand, there was no statistically significant difference in serum AST levels between the lipiodol (60 deg. C) group (148.2 {+-} 11

  11. Splenic artery embolization for the treatment of refractory ascites after liver transplantation.

    Science.gov (United States)

    Quintini, Cristiano; D'Amico, Giuseppe; Brown, Chase; Aucejo, Federico; Hashimoto, Koji; Kelly, Dympna M; Eghtesad, Bijan; Sands, Mark; Fung, John J; Miller, Charles M

    2011-06-01

    Refractory ascites (RA) is a challenging complication after orthotopic liver transplantation. Its treatment consists of the removal of the precipitating factors. When the etiology is unknown, supportive treatment can be attempted. In severe cases, transjugular intrahepatic portosystemic shunts, portocaval shunts, and liver retransplantation have been used with marginal results. Recently, splenic artery embolization (SAE) has been described as an effective procedure for reducing portal hyperperfusion in patients undergoing partial or whole liver transplantation. Here we describe our experience with SAE for the treatment of RA. Between June 2004 and June 2010, 6 patients underwent proximal SAE for RA. Intraoperative flow measurements, graft characteristics, embolization portal vein (PV) velocities before and after SAE, and spleen/liver volume ratios were collected and analyzed. The response to treatment was assessed with imaging (ultrasound/computed tomography) and on the basis of clinical outcomes (weight changes, diuretic requirements, and the time to ascites resolution). The PV velocity decreased significantly for each patient after the embolization (median = 66.5 cm/second before SAE and median = 27.5 cm/second after SAE, P patients experienced a significant postprocedural weight loss (mean = 88.1 ± 28.4 kg before SAE and mean = 75.8 ± 28.4 kg after SAE, P patients experienced a complete resolution of ascites after a median time of 49.5 days (range = 12-295 days). No patient presented with postembolization complications. In conclusion, SAE was effective in reducing the PV velocity immediately after the procedure. Clinically, this translated into a dramatic weight loss, a reduction of diuretic use, and a resolution of ascites. SAE appears to be a safe and effective treatment for RA.

  12. 呼吸放松联合音乐疗法改善肝癌动脉化疗栓塞病人术中焦虑情绪及疼痛的研究%Breathing relaxed music therapy to improve liver artery chemotherapy embolism patients anxiety and pain research

    Institute of Scientific and Technical Information of China (English)

    杨涛涛; 孙敬梅; 张春婷; 莫庆国

    2015-01-01

    Purpose Breathing relaxed music therapy to improve liver artery chemotherapy embolism patient anxiety and observe the effect of pain. Evaluation method 60 patients with liver cancer interventional surgery in the operating room,the control group accepted routine nursing intervention operation,the experimental group on the basis of conventional nursing care to give music combination breathing relaxation therapy. Observed two groups of intraoperatie state anxiety and pain of patients, (SaS) and (VaS) for two groups of patients for anxiety,pain.Results The experimental group after intervention and SaS score of VaS scores were lower than control group (P< 0.01) difference was statistically significant;Conclusion Breathing relaxed joint music therapy can reduce patient tension,relieve pain,improve the patients tolerated.%目的:呼吸放松联合音乐疗法改善肝癌动脉化疗栓塞病人术中焦虑情绪及疼痛的效果观察。评价方法:选择肝动脉化疗栓塞手术的患者60例,平均分为实验组和对照组,对照组予以介入手术常规护理,实验组在基础护理上增加呼吸放松联合音乐疗法。观察两组病人术中焦虑状态及疼痛情况,采用焦虑自评量表(SaS)和疼痛视觉模拟量表(VaS)对两组病人的焦虑、疼痛情况进行比较。结果:干预后实验组病人的SaS评分及VaS分值均低于对照组(P<0.01)差异有统计学意义;结论:呼吸放松联合音乐疗法可减轻病人紧张情绪,缓解疼痛,提高病人手术的耐受性。

  13. Combined treatment of hepatocellular carcinoma with partial splenic embolization and transcatheter hepatic arterial chemoembolization

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To prospectively evaluate the efficacy and safety of partial splenic embolization (PSE) combined with transcatheter hepatic arterial chemoembolization (TACE)in treatment of hepatocellular carcinoma (HCC).METHODS: Fifty patients suffering from primary HCC associated with hypersplenism caused by cirrhosis were randomly assigned to 2 groups: group A receiving PSE combined with TACE (n = 26) and group B receiving TACE alone (n = 24). Follow-up examinations included calculation of peripheral blood cells (leukcytes,platelets and red blood cells) and treatment-associated complications.RESULTS: Prior to treatment, there was no significant difference in sex, age, Child-Pugh grade, tumor diameter,mass pathology type and peripheral blood cell counts between the 2 groups. After treatment, leukocyte and platelet counts were significantly higher in group A during the 3-mo follow-up period (P < 0.05), but lower in group B (P < 0.05). Severe complications occurred in 3 patients (11.5%) of group A and in 19 patients (79.2%) of group B (P < 0.05), and there was no significant difference in symptoms of post-embolization syndrome,including abdominal pain, fever, mild nausea and vomiting between the 2 groups (P > 0.05).CONCLUSION: PSE combined with TACE is more effective and safe than TACE alone for patients with HCC associated with hypersplenism caused by cirrhosis.

  14. Intractable Postpartum Bleeding: A Comparison of the Retrospective Analysis of Angiographic Findings and Transcatheter Arterial Embolization According to Delivery Pattern

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Eun Jung; Kim, Young Hwan; Kim, Si Hyung; Choi, Jin Soo; Park, Jun Cheol; Kwon, Sang Hun; Jo, Chi Heum; Cha, Soon Do [Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2008-12-15

    We evaluated the technical aspect and efficacy of transcatheter arterial embolization (TAE) in cases of intractable postpartum bleeding by comparing the angiographic findings women patients according to their delivery pattern. Between July of 2003 and March of 2008, 55 female patients were enrolled in this study. Of the 55 patients, 36 underwent a vaginal delivery (group 1), whereas 19 underwent a cesarean section delivery (group 2). We retrospectively evaluated the angiographic findings and the embolization technique between groups, using a Pearson Chi-Square test. Medical records and telephone interview findings were also reviewed to evaluate the efficacy of TAE and the outcome of fertility. Significantly greater positive angiographic findings were found in group 2 (63.2%) relative to group 1 (30.6%). For positive angiographic findings, except for AVM, the embolization was performed using coil or glue with gelfoam. For the negative angiographic findings or AVM, the gelfoam was the only embolic agent used. In all patients except for one, bleeding stopped after embolization. Major complications occurred in 2 patients only, and included uterine synechia and perforation. All patients except for one recovered after menstruation. In total, four patients became pregnant and one patient delivered a healthy infant. Positive angiographic findings requiring embolization with coil or glue, as well as gelfoam, were more commonly encountered in group 2 than in group 1. Based on the outcome of the study group, TAE is a safe and effective treatment for intractable postpartum bleeding and is also useful for preserving fertility.

  15. Should children be SCUBA diving?: Cerebral arterial gas embolism in a swimming pool.

    Science.gov (United States)

    Johnson, Valerie; Adkinson, Cheryl; Bowen, Mariya; Ortega, Henry

    2012-04-01

    Cerebral arterial gas embolism (CAGE) is a well-known serious complication of self-contained breathing apparatus (SCUBA) diving. Most serious complications of SCUBA diving occur in adults because most of SCUBA divers are adults. However, young age is an independent risk factor for injury in SCUBA diving and shallow-water SCUBA diving is the riskiest environment for CAGE. We present a case of a 10-year-old boy who developed CAGE while taking SCUBA diving lessons in a university swimming pool. This case illustrates the potential danger of SCUBA diving for children who lack understanding of the physics of diving as well as the often unappreciated risk of shallow-water SCUBA diving. Our intent is to educate providers of primary care to children, so that they may appropriately advise parents about SCUBA diving, and to educate providers of emergency care to children, so that they will recognize this uncommon but serious emergency condition.

  16. Treatment of uterine fibroids for abnormal uterine bleeding: myomectomy and uterine artery embolization.

    Science.gov (United States)

    Al-Mahrizi, Sharifa; Tulandi, Togas

    2007-12-01

    Uterine myoma is a common benign tumour in women and most cases do not require treatment. Excessive uterine bleeding is usually due to a submucous myoma or an intramural myoma that is encroaching into the uterine cavity. After eliminating endometrial malignancy, perimenopausal women could be managed expectantly or with gonadotrophin-releasing hormone agonist until menopause. Hysteroscopic myomectomy is highly effective in controlling menorrhagia that is related to submucous myoma. Concomitant endometrial ablation improves menorrhagia; however, the subsequent hysterectomy rate remains the same. For those with an intramural myoma, abdominal myomectomy results in good bleeding control. It could also be done by laparoscopic approach; however, the surgeon should have expertise in laparoscopic suturing and the uterine incision should be properly sutured. In women who have completed their family, hysterectomy remains the most effective treatment for excessive uterine bleeding. Compared with uterine artery embolization (UAE), it is associated with better improvement in pelvic pain. Nevertheless, UAE is a good alternative to hysterectomy.

  17. Predictors of long-term clinical outcome of patients with acute massive pulmonary embolism after thrombolytic therapy

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Objective To assess the in-hospital clinical course and the long-term evolution of acute massive pulmonary embolism after thrombolytic therapy and to identify predictors of adverse clinical outcome.Methods A total of 260 patients hospitalized from January 1989 to October 1998 were retrospectively reviewed and followed up for 3.9 to 8.4 years. Baseline characteristics and variables pre- and post-thrombolysis were identified. Particular attention was paid to the clinical events, including death, recurrent thromboembolism, chronic thromboembolic pulmonary hypertension, and major bleeding attributable to the use of anticoagulants. Kaplan-Meier event-free survival curves were generated. Univariate analysis by means of the log-rank test was used to test each candidate variable for association with clinical outcome. Multivariate analysis with the Cox proportional hazard model was used to determine independent predictors of the long-term outcome.Results The in-hospital mortality rate was 8.5%, with 68.2% due to pulmonary embolism itself, and the follow-up mortality rate was 31.7%, with 29.2% due to recurrent embolism. Factors associated with an adverse outcome in univariate analysis were: (1) prior thromboembolic diseases; (2) duration of anticoagulant therapy 50 mmHg after thrombolysis; and (6) greater than 30% obstruction of pulmonary vasculature identified by pulmonary ventilation/perfusion scintigraphy before hospital discharge. Multivariate analysis identified three independent predictors of poor long-term outcome for patients with acute massive pulmonary embolism after thrombolysis; which were: (1) Doppler recording of pulmonary artery systolic pressure >50 mmHg, with relative risk of 3.78 and a 95% confidence interval of 2.70 to 4.86; (2) echocardiographic evidence of right ventricular dysfunction/dilatation (relative risk: 2.18; 95% confidence interval: 1.48 to 2.88); and (3) greater than 30% obstruction of pulmonary vasculature documented by lung scan (relative

  18. Analysis of the Quality of Information Obtained About Uterine Artery Embolization From the Internet

    Energy Technology Data Exchange (ETDEWEB)

    Tavare, Aniket N. [British Medical Association House, British Medical Journal Group (United Kingdom); Alsafi, Ali, E-mail: ali.alsafi03@imperial.ac.uk; Hamady, Mohamad S. [St. Mary' s Hospital, Imaging Department (United Kingdom)

    2012-12-15

    Purpose: The Internet is widely used by patients to source health care-related information. We sought to analyse the quality of information available on the Internet about uterine artery embolization (UAE). Materials and Methods: We searched three major search engines for the phrase 'uterine artery embolization' and compiled the top 50 results from each engine. After excluding repeated sites, scientific articles, and links to documents, the remaining 50 sites were assessed using the LIDA instrument, which scores sites across the domains of accessibility, usability, and reliability. The Fleisch reading ease score (FRES) was calculated for each of the sites. Finally, we checked the country of origin and the presence of certification by the Health On the Net Foundation (HONcode) as well as their effect on LIDA and FRES scores.ResultsThe following mean scores were obtained: accessibility 48/60 (80%), usability 42/54 (77%), reliability 20/51 (39%), total LIDA 110/165 (67%), and FRES 42/100 (42%). Nine sites had HONcode certification, and this was associated with significantly greater (p < 0.05) reliability and total LIDA and FRES scores. When comparing sites between United Kingdom and United States, there was marked variation in the quality of results obtained when searching for information on UAE (p < 0.05). Conclusion: In general, sites were well designed and easy to use. However, many scored poorly on the reliability of their information either because they were produced in a non-evidence-based way or because they lacking currency. It is important that patients are guided to reputable, location-specific sources of information online, especially because prominent search engine rank does not guarantee reliability of information.

  19. Hyperbaric programs in the United States: Locations and capabilities of treating decompression sickness, arterial gas embolisms, and acute carbon monoxide poisoning: survey results.

    Science.gov (United States)

    Chin, Walter; Jacoby, Laura; Simon, Olivia; Talati, Nisha; Wegrzyn, Gracelene; Jacoby, Rachelle; Proano, Jacob; Sprau, Susan E; Markovitz, Gerald; Hsu, Rita; Joo, Ellie

    2016-01-01

    Hyperbaric oxygen therapy is the primary treatment for arterial gas embolism, decompression sickness and acute carbon monoxide poisoning. Though there has been a proliferation of hyperbaric centers throughout the United States, a scarcity of centers equipped to treat emergency indications makes transport of patients necessary. To locate and characterize hyperbaric chambers capable of treating emergency cases, a survey of centers throughout the entire United States was conducted. Using Google, Yahoo, HyperbaricLink and the UHMS directory, a database for United States chambers was created. Four researchers called clinicians from the database to administer the survey. All centers were contacted for response until four calls went unreturned or a center declined to be included. The survey assessed chamber readiness to respond to high-acuity patients, including staff availability, use of medical equipment such as ventilators and intravenous infusion devices, and responding yes to treating hyperbaric emergencies within a 12-month period. Only 43 (11.9%, N = 361) centers had equipment, intravenous infusion pumps and ventilators, and staff necessary to treat high-acuity patients. Considering that a primary purpose of hyperbaric oxygen therapy is the treatment of arterial gas embolism and decompression sickness, more hyperbaric centers nationwide should be able to accommodate these emergency cases quickly and safely.

  20. Inadvertent Complication of a Pipeline Embolization Device for Treatment with Vertebral Artery Dissecting Aneurysm : Distal Tip Fracture of Delivery Wire.

    Science.gov (United States)

    Park, Jung Soo; Kwak, Hyo Sung; Lee, Jong Myong

    2016-09-01

    Use of the Pipeline embolization device (PED) has increased based on studies about its safety and effectiveness, and new reports that describe peri- or postprocedural complications are now emerging. We report a rare periprocedural device-related complication that occurred during endovascular treatment with the pipeline embolization device for a dissecting aneurysm on the vertebral artery. A 55-year old woman was admitted due to left medullary infarction, and angiography showed a fusiform dilatation in the left vertebral artery that was suspicious for dissecting aneurysm. Endovascular treatment with PED was planned. Under general anesthesia, the procedure was performed without significant problems and a PED was deployed in an appropriate position. However, in the final step of the procedure, the distal tip of the PED delivery wire became engaged within a small branch of the posterior cerebral artery and fractured. Fortunately, imaging studies after the procedure revealed neither hemorrhagic nor ischemic stroke, and the patient recovered without neurological morbidities except initial symptoms.

  1. Percutaneous Retrieval of an Embolized Kyphoplasty Cement Fragment From the Pulmonary Artery: A Case Report and Literature Review

    Science.gov (United States)

    Lamparello, Nicole A.; Jaswani, Vijay; DeSousa, Keith; Shapiro, Maksim; Kovacs, Sandor

    2016-01-01

    We present a case of a 41-year-old man with symptomatic pulmonary cement embolism following percutaneous vertebral augmentation, which was successfully retrieved via a percutaneous endovascular approach, a novel technique with only two prior cases reported. Cement leakage, including venous embolization of cement into the cardiopulmonary circulation, is a known potential complication following percutaneous kyphoplasty and vertebroplasty. While many patients with pulmonary cement embolism are asymptomatic and likely go undiagnosed, others experience respiratory distress and hemodynamic compromise requiring surgical and medical intervention. The optimal management for pulmonary cement embolism must be tailored to fit each individual patient, dependent upon the acuity of the clinical presentation, coexisting patient comorbidities, and the risks of systemic anticoagulation. In our patient, cement migration was visualized in real-time during vertebral augmentation. Endovascular retrieval by our Interventional Radiology section obviated the need for anticoagulation therapy or more invasive open surgical procedures. PMID:27761188

  2. Acute Myocardial Infarction Due to Coronary Artery Embolism in a 22-Year-Old Woman with Mitral Stenosis with Atrial Fibrillation Under Warfarinization: Successful Management with Anticoagulation.

    Science.gov (United States)

    Sinha, Santosh Kumar; Jha, Mukesh Jitendra; Razi, Mahmadula; Chaturvedi, Vikash; Erappa, Yatish Besthenahalli; Singh, Shravan; Mishra, Vikas; Khanra, Dibbendhu; Singh, Karandeep

    2017-04-07

    BACKGROUND Coronary artery embolization is an exceedingly rare cause of myocardial infarction, but a few cases in association with prosthetic mechanical valves have been reported. We report a case of embolic myocardial infarction caused by a thrombus in the left atrium with deranged coagulation profile in a patient with critical mitral stenosis under warfarinization. CASE REPORT A 22-year-old woman was taken to the catheterization lab for early coronary intervention in lieu of non-ST elevation myocardial infarction. Electrocardiography showed T↓ in V1 to V4, and atrial fibrillation with controlled ventricular rate. Coronary angiography showed total occlusion of the mid-left anterior descending artery with thrombus. After upstream treatment with tirofiban, the apparent thrombus was dislodged distally while passing a BMW wire. No abnormalities were seen by intravascular ultrasound study. Echocardiography revealed critical mitral stenosis, and left atrial clot with mild left ventricular dysfunction. Coagulation profile revealed sub-therapeutic international normalized ratio levels. The sequential angiographic images, normal intravascular ultrasound study, and presence of atrial fibrillation are confirmatory of coronary embolism as the cause of myocardial infarction. Anticoagulation and treatment of acute coronary syndrome were initiated and she was referred for closed mitral valvulotomy. CONCLUSIONS Coronary artery thromboembolism as a nonatherosclerotic cause of acute coronary syndrome is rare. The treatment consists of aggressive anticoagulation, antiplatelet therapy, and interventional options, including simple wiring when possible. In this context, primary prevention in the form of patient education on optimal anticoagulation with oral vitamin K antagonist and medical advice about imminent thromboembolic risks are of extreme importance.

  3. Resection of hilar cholangiocarcinoma with left hepatectomy after pre-operative embolization of the proper hepatic artery

    DEFF Research Database (Denmark)

    Yasuda, Yoshikazu; Larsen, Peter N; Ishibashi, Toshimitsu

    2010-01-01

    Right or right-extended hepatectomy including the caudate lobe is the most common treatment for hilar cholangiocarcinoma (HC). A 5-year survival of up to 60% can be achieved using this procedure if R0-resection is obtained. However, for some patients a left-sided liver resection is necessary to o......-operative embolization of the proper hepatic artery in an effort to induce development of arterial collaterals thus allowing the resection of the proper and right hepatic artery without vascular reconstruction....

  4. Perigraft Plug Embolization of the Internal Iliac Artery and Implantation of a Bifurcated Stentgraft: One Treatment Option for Insufficient Tubular Stentgraft Repair of a Common Iliac Artery Aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Goltz, Jan Peter, E-mail: janpeter.goltz@uksh.de; Loesaus, Julia; Frydrychowicz, Alex; Barkhausen, Jörg [University Hospital of Schleswig-Holstein, Department for Radiology and Nuclear Medicine (Germany); Wiedner, Marcus [University Hospital of Schleswig-Holstein, Clinic for Surgery (Germany)

    2016-02-15

    We report an endovascular technique for the treatment of type Ia endoleak after a plain tubular stentgraft had been implanted for a large common iliac artery aneurysm with an insufficient proximal landing zone and without occlusion of the hypogastric in another hospital. CT follow-up showed an endoleak with continuous sac expansion over 12 months. This was classified as type Ia by means of dynamic contrast-enhanced MRI. Before a bifurcated stentgraft was implanted to relocate the landing zone more proximally, the still perfused ipsilateral hypogastric artery was embolized to prevent a type II endoleak. A guidewire was manipulated alongside the indwelling stentgraft. The internal iliac artery could then be selectively intubated followed by successful plug embolization of the vessel’s orifice despite the stentgraft being in place.

  5. Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 2, Insights into the Technical Rationale.

    Science.gov (United States)

    Sun, Fei; Crisóstomo, Verónica; Báez-Díaz, Claudia; Sánchez, Francisco M

    2016-02-01

    Rationale of prostatic artery embolization (PAE) in the treatment of symptomatic benign prostatic hyperplasia is conventionally believed to include two parts: shrinkage of the enlarged prostate gland as a result of PAE-induced ischemic infarction and potential effects to relax the increased prostatic smooth muscle tone by reducing the number and density of α1-adrenergic receptor in the prostate stroma. This review describes new insights into the likely mechanisms behind PAE, such as ischemia-induced apoptosis, apoptosis enhanced by blockage of androgens circulation to the embolized prostate, secondary denervation following PAE, and potential effect of nitric oxide pathway immediately after embolization. Studies on therapeutic mechanisms in PAE may shed light on potentially new treatment strategies and development of novel techniques.

  6. Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 2, Insights into the Technical Rationale

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Fei, E-mail: feisun@ccmijesususon.com; Crisóstomo, Verónica, E-mail: crisosto@ccmijesususon.com; Báez-Díaz, Claudia, E-mail: cbaez@ccmijesususon.com; Sánchez, Francisco M., E-mail: msanchez@ccmijesususon.com [Jesús Usón Minimally Invasive Surgery Centre (Spain)

    2016-02-15

    Rationale of prostatic artery embolization (PAE) in the treatment of symptomatic benign prostatic hyperplasia is conventionally believed to include two parts: shrinkage of the enlarged prostate gland as a result of PAE-induced ischemic infarction and potential effects to relax the increased prostatic smooth muscle tone by reducing the number and density of α{sub 1}-adrenergic receptor in the prostate stroma. This review describes new insights into the likely mechanisms behind PAE, such as ischemia-induced apoptosis, apoptosis enhanced by blockage of androgens circulation to the embolized prostate, secondary denervation following PAE, and potential effect of nitric oxide pathway immediately after embolization. Studies on therapeutic mechanisms in PAE may shed light on potentially new treatment strategies and development of novel techniques.

  7. Prognosis following transcatheter arterial embolization for 121 patients with unresectable hepatocellular carcinoma with or without a history of treatment

    Institute of Scientific and Technical Information of China (English)

    Atsushi Hiraoka; Seishi Kumano; Hiroaki Tanaka; Yoshimasa Yamashita; Norio Horiike; Teruhito Mochizuki; Morikazu Onji; Teru Kumagi; Masashi Hirooka; Takahide Uehara; Kiyotaka Kurose; Hidehito Iuchi; Yoichi Hiasa; Bunzo Matsuura; Kojiro Michitaka

    2006-01-01

    AIM: To retrospectively evaluate the prognosis of patients with hepatocellular carcinoma (HCC) with or without a history of therapy for HCC following transcatheter arterial embolization (TAE).METHODS: One hundred and twenty-one patients with HCC treated with TAE from 1992 to 2004 in our hospital were enrolled in this study. Eighty-four patients had a history of treatment for HCC, while 37 did not. At the time of entry, patients with extra-hepatic metastasis,portal vein tumor thrombosis, or Child-Pugh class C were excluded. TAE was repeated when recurrence of HCC was diagnosed by elevated tumor markers, or ultrasonography or dynamic computed tomography findings. RESULTS: Tumor size was larger and the number of tumors was fewer in patients without past treatment (P< 0.01). However, there were no differences in tumor node metastasis (TNM) stage or survival rate between the 2 groups. A bilobular tumor and high level of α-fetoprotein (AFP) (>100 ng/mL) were factors related to a poor prognosis in patients with a history of HCC. CONCLUSION: The prognosis following TAE is similar between HCC patients with and without past treatment.Early diagnosis of HCC or recurrent HCC and obtaining good local control against HCC before entry to a repeated TAE course can improve prognosis.

  8. HEMODYNAMIC INSIGNIFICANT CAROTID ARTERIES STENOSIS AND RISK OF EMBOLIC STROKE IN PATIENTS WITH ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    V. V. Semenova

    2009-01-01

    Full Text Available Aim. To assess a risk of vascular embolism in patients with ischemic heart disease (IHD and hemodynamic insignificant asymptomatic carotid stenosis.Material and methods. 100 patients with IHD were examined. Ultrasound scanning of the main cranial arteries and transcranial Dopplerography was performed in all patients as well as lipid spectrum, fibrinogen level and blood D-diameter concentration were evaluated.Results. 165 carotid atherosclerotic plaques (AP were detected in patients with IHD independently on angina severity. In IHD patients with nonhomogeneous hypoechogenic AP microembolic signals (MES were revealed in 44,78%, with nonhomogeneous hyperechogenic AP - in 25%, with homogeneous hypoechogenic AP - in 4,16% of patients. MES were not recorded in patients with homogeneous hyperechogenic AP. There were not relations between MES and parameters of lipid spectrum as well as fibrinogen and Ddiameter plasma levels.Conclusion. Thus, during transcranial dopplerographic monitoring MES were recorded in the third part (27,9% of IHD patients with hemodynamically insignificant carotid arteries stenosis. MES were predominantly observed in patients with nonhomogeneous AP especially with hypoechogenic components.

  9. Risk Factors related to hemorrhage necessitating renal artery embolization after percutaneous nephrostomy

    Energy Technology Data Exchange (ETDEWEB)

    Byon, Jung Hee; Han, Young Min; Jin, Gong Yong; Song, Ji Soo [Chonbuk National University Hospital and Medical School, Jeonju (Korea, Republic of)

    2015-12-15

    To investigate risk factors related to severe bleeding necessitating renal artery embolization (RAE) after percutaneous nephrostomy (PCN). 36 patients who underwent RAE from January 2005 to June 2014 were retrospectively reviewed. Among them, 10 patients underwent embolization because of severe bleeding after PCN (bleeding group). From 1762 patients who underwent PCN in the same period, we selected 21 patients who underwent PCN without bleeding after the procedure (non-bleeding group). We investigated possible related risk factors, such as the presence of underlying diseases, activated partial thromboplastin time (aPTT), prothrombin time (PT), platelet count, puncture site, procedure time, size of the kidney, distance from skin to renal cortex, maximum caliber of the indwelling catheter, parenchymal thickness, and grade of hydronephrosis. We used Fisher's exact test and independent t test for data analyses. We classified hydronephrosis as either 'mild hydronephrosis,' or 'moderate or severe hydronephrosis.' The frequency of mild hydronephrosis was 80.0% (8/10) in the bleeding group and 33.3% (7/21) in the non-bleeding group (p = 0.023). There were no significant differences between the two groups in the incidence of underlying diseases. Similarly, other risk factors (PT, aPTT, platelet count, procedure time, distance from skin to renal cortex, maximum caliber of the indwelling catheter, kidney size, and parenhcymal thickness) also did not differ significantly between the two groups. Mild hydronephrosis is a risk factor for severe bleeding necessitating RAE after PCN. Therefore, when performing PCN, careful attention should be paid to patients with mild hydronephrosis.

  10. Study of the Impact of Uterine Artery Embolization (UAE) on Endometrial Microvessel Density (MVD) and Angiogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Tan Guosheng; Xiang Xianhong; Guo Wenbo; Zhang Bing; Chen Wei; Yang Jianyong, E-mail: kerisgz@126.com [The First Affiliated Hospital of Sun Yat-sen University, Department of Interventional Radiology (China)

    2013-08-01

    PurposeTo investigate the influence of uterine artery embolization (UAE) on endometrial microvessel density (MVD) and angiogenesis.MethodsSixty female guinea pigs were divided into two groups, the control group (n = 15) and the UAE treatment group (n = 45). In the UAE group, tris-acryl gelatin microspheres were used to generate embolization. Animals were further divided into three subgroups, A1, A2, and A3 (n = 15 for each subgroup), with uterine specimens collected at 7-15, 16-30, and 31-45 days after UAE, respectively. Immunostaining for factor VIII and CD105 was performed to identify total endometrial MVD (MVD{sub FVIII}) and CD105-positive angiogenesis (MVD{sub CD105}) at the indicated time points after UAE.ResultsQuantitative analysis revealed that MVD{sub FVIII} significantly decreased in the A1 (11.40 {+-} 2.76, p < 0.05) and A2 (15.37 {+-} 3.06, p < 0.05) groups compared to the control group (19.40 {+-} 2.50), and was restored to normal in the A3 group (18.77 {+-} 2.69). UAE caused a temporal up-regulation of MVD{sub CD105}-positive angiogenesis in the A1 group (9.33 {+-} 2.37, p < 0.05) and the A2 group (11.63 {+-} 1.56, p < 0.05) compared to the control group (7.12 {+-} 1.67), and the MVD{sub CD105} value returned to normal in the A3 group (8.07 {+-} 1.97).ConclusionUAE caused a temporal decrease in endometrial MVD that reversed over time as a result of the increase of CD105-positive angiogenesis. Although the UAE-induced reduction of endometrial MVD was reversible, its long-term effect on endometrial receptivity still needs further study.

  11. Combined application of distal and proximal embolic protection devices in endovascular stenting for severe carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Zhi-hua DU

    2011-09-01

    Full Text Available Objective To analyze and summarize methods and experiences of combined application of distal and proximal embolic protection devices(EPD in endovascular stenting for severe carotid artery stenosis.Methods Five patients with severe stenosis of the common carotid artery or with extracranial segment of the internal carotid artery diagnosed through digital subtraction angiography(DSA from March to July 2010 were involved in the present study.All patients received carotid angioplasty and stenting(CAS,with a combination of distal and proximal EPD via the percutaneous femoral artery approach.Results The operation failed in one patient,whereas technical success with no intraoperative complication was achieved in four patients.The symptoms disappeared or improved in the four cases that achieved technical success.The follow-up duration was one to three months,and no cerebral ischemia was found.Conclusion CAS with the combined application of distal and proximal EPD in some special cases of carotid artery stenosis may surmount the shortage of single EPD,reduce the risk of intraoperative embolization,decrease the time of intraoperative endovascular inflow occlusion,and reduce high-risk operations.CAS may be used as an individualized treatment strategy for patients with carotid artery stenosis.

  12. Clinical Analysis of Pulmonary Lipiodol Embolism in Patients with Hepatic Carcinoma after Transcatheter Arterial Chemoembolization

    Directory of Open Access Journals (Sweden)

    Wen-jin JIANG

    2015-03-01

    Full Text Available Objective:To explore the clinical manifestations, therapeutic methods and preventive measures of pulmonary lipiodol embolism (PLE induced by transcatheter arterial chemoembolization (TACE so as to improve the cognition and management of PLE. Methods:A total of 2 613 patients with hepatic cancer without history of pulmonary disease who were treated with TACE in our hospital from Sept., 2004 to Mar., 2013 were selected. The clinical manifestations, therapeutic methods and preventing measures of the 9 patients who were accompanied with PLE were observed to analyze the pre-operative hepatic computed tomography (CT and chest X-ray, intra-operative contrast examination, dosage of lipiodol and chemotherapeutic drugs, clinical manifestation and therapeutic progression as well as the postoperative follow-up.Results: Nine patients accompanied by PLE had different-severity cough, hemoptysis and progressive dyspnea, and chest X-ray and/or CT showed flaky high-density radiography. After treated with oxygen inhalation, bronchus expansion and inflammation alleviation, 8 patients were improved but 1 died. Of the 8 patients, 2 were given ventilator to assist breath, and the clinical symptoms of 8 patients disappeared within 3-15 d. The re-examined chest X-ray showed normal after 20-60 d follow-up observation. Additionally, 6 patients were with nidus diameter ≥10 cm, 6 with hepatic artery-vein fistula and 7 with lipiodol dosage ≥20 mL.Conclusion: PLE often occurs in patients with giant hepatic carcinoma accompanied by hepatic artery-vein fistula, whose lipiodol dosage is ≥20 mL. Accurate and correct management during operation can effectively reduce the development of PLE.

  13. Clinical Analysis of Pulmonar y Lipiodol Embolism in Patients with Hepatic Carcinoma after Transcatheter Arterial Chemoembolization

    Institute of Scientific and Technical Information of China (English)

    JIANG Wen-jin; WANG Li-gang; SONG Xue-peng; ZHENG Yan-bo; LIU Xiao-gang; SUN Bo-lin

    2015-01-01

    Objective:To explore the clinical manifestations, therapeutic methods and preventive measures of pulmonary lipiodol embolism (PLE) induced by transcatheter arterial chemoembolization (TACE) so as to improve the cognition and management of PLE. Methods:A total of 2 613 patients with hepatic cancer without history of pulmonary disease who were treated with TACE in our hospital from Sept., 2004 to Mar., 2013 were selected. The clinical manifestations, therapeutic methods and preventing measures of the 9 patients who were accompanied with PLE were observed to analyze the pre-operative hepatic computed tomography (CT) and chest X-ray, intra-operative contrast examination, dosage of lipiodol and chemotherapeutic drugs, clinical manifestation and therapeutic progression as well as the postoperative follow-up. Results:Nine patients accompanied by PLE had different-severity cough, hemoptysis and progressive dyspnea, and chest X-ray and/or CT showed flaky high-density radiography. After treated with oxygen inhalation, bronchus expansion and inlfammation alleviation, 8 patients were improved but 1 died. Of the 8 patients, 2 were given ventilator to assist breath, and the clinical symptoms of 8 patients disappeared within 3~15 d. The re-examined chest X-ray showed normal after 20~60 d follow-up observation. Additionally, 6 patients were with nidus diameter ≥10 cm, 6 with hepatic artery-vein ifstula and 7 with lipiodol dosage≥20 mL. Conclusion:PLE often occurs in patients with giant hepatic carcinoma accompanied by hepatic artery-vein ifstula, whose lipiodol dosage is ≥20 mL. Accurate and correct management during operation can effectively reduce the development of PLE.

  14. Ghrelin Suppression and Fat Loss after Left Gastric Artery Embolization in Canine Model

    Energy Technology Data Exchange (ETDEWEB)

    Bawudun, Dilmurat [Xinjiang Medical University, Department of Interventional Radiology, First Affiliated Hospital (China); Xing Yan; Liu Wenya, E-mail: wenyaliu2002@hotmail.com; Huang Yujie [Xinjiang Medical University, Imaging Center, First Affiliated Hospital (China); Ren Weixin [Xinjiang Medical University, Department of Interventional Radiology, First Affiliated Hospital (China); Ma Mei [Xinjiang Medical University, Animal Research Center, First Affiliated Hospital (China); Xu Xiaodong [Xinjiang Medical University, Department of Interventional Radiology, First Affiliated Hospital (China); Teng Gaojun [Southeast University, Department of Radiology, Zhong-da Hospital (China)

    2012-12-15

    Purpose: To evaluate the effects of left gastric artery embolization (LGAE) on plasma ghrelin levels, abdominal fat, and body weight in beagles. Methods: The institutional animal care and use committee approved this study. Fifteen healthy adult beagles (12 male and three female animals) were randomly divided into three experimental groups: LGAE was proceeded with mixed emulsion of bleomycin A{sub 5} hydrochloride and lipiodol (group A), and polyvinyl alcohol particles (group B). Transcatheter saline injections in the left gastric artery were performed as a control. Weight and fasting plasma ghrelin levels were obtained at baseline and at weekly intervals for 8 weeks after the procedure in all animals. All animals were scanned and measured by multidetector computed tomography at baseline and at week 8 for evaluation of abdominal fat. Results: In LGAE-treated animals, plasma ghrelin and body weight significantly decreased compared to control animals (group A: P = 0.007 and P = 0.000; group B: P = 0.004 and P = 0.000, respectively). Subcutaneous fat size was also significantly reduced (P = 0.011 and P = 0.027 for groups A and B, respectively). The decreasing percentage in ghrelin levels at week 6 (peak of recovery) of LGAE-treated animals were negatively correlated with the size of area supplied by left gastric artery (r = -0.693, P = 0.026). Conclusion: LGAE could suppress the plasma concentration of ghrelin, which results in subcutaneous fat size reduction and weight loss. Compensatory ghrelin production might occur in the remnant gastric fundus after LGAE.

  15. Trisacryl Gelatin Microembolism and Metastases in the Lung after Renal Artery Embolization and Nephrectomy for Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Andres Borja Alvarez

    2015-01-01

    Full Text Available This is the first report, to our knowledge, of widespread, histologically confirmed trisacryl gelatin pulmonary microembolism after renal artery embolization (RAE. In addition, this is the first report of lung involvement by both metastatic renal cell carcinoma (RCC and an embolic agent used for RAE. The patient was a 63-year-old woman who recently presented with both dyspnea on exertion and productive cough. Her past medical history included clear cell RCC, which was treated with preoperative trisacryl gelatin microsphere RAE and right nephrectomy 9 years earlier. Computed tomography of the chest showed multiple lung nodules, a mass-like density in the left lower lobe, and mediastinal and hilar lymphadenopathy. Wedge resections of the lung showed multiple foci of metastatic RCC and extensive involvement of the muscular pulmonary arteries by trisacryl gelatin microspheres.

  16. Acute arterial occlusion - kidney

    Science.gov (United States)

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidney can often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury or trauma to ...

  17. Study on Treatment of Primary Hepatic Carcinoma by Arterial Perfusion Embolization with Zedoary Turmeric Oil

    Institute of Scientific and Technical Information of China (English)

    程剑华; 常纲; 吴万垠; 杨志钢; 孟凡喆; 徐凯; 李柳宁; 朱迪盈; 陈春泳; 罗海英

    2001-01-01

    To evaluate the effect, side-effect and prospect of hepatic arterial perfusion embolization (HAPE) with Zedoary turmeric oil (ZTO) in treating primary hepatic carcinoma (PHC).Methods: Clinical study was carried out by administration of 1-3 ml ZTO through arterial catheter to induce embolism in 32 patients of PHC, and compared with 32 patients treated by hepatic arterial perfusion embolization with chemical agents (HAPE-C) in the control group. The Chinese herbal medicine was given orally to both groups according to Syndrome Differentiation of TCM. In the experimental study, transplantation hepatic carcinoma model was established in 40 rats. They were randomly divided into the treated group and the control group, 20 in each group, and were perfused with 10 mg/kg ZTO and 0.2-0.3 ml normal saline respectively to observe the effect of treatment.Results: The effect of treatment in the ZTO group was CR in 1 case and PR in 13 cases, the total effective rate being 43.75%, with AFP negative reversed in 7 cases, titer decreased in 7; while in the control group it was PR in 10 cases, the total effective rate being 31.25%, AFP negative reversed in 5, titer decreased in 2, and the difference of therapeutic effect between the two groups was insignificant (P>0.05). The post-perfusion thrombotic syndrome occurrence, with the symptoms of fever, abdominal pain, vomiting, etc. in the two groups was similar, but no bone marrow inhibition occurred in the ZTO group, which was different from the control group (P<0.01, P<0.05). The mean survival time, median survival time, 1-, 2-, 3- and 4-year survival rate in the ZTO group was 13.84 months, 10 months, 37.5%, 18.87%, 9.70% and 6.4% respectively, and in the control group, 8.03 months, 6 months, 15.6%, 6.27%, 0% and 0% respectively, the mean survival time, median survival time and 1-year survival rate in the ZTO group were significantly superior to those in the control group (P<0.05). Experimental study showed that the effect in the

  18. A New Flow Control Technique Using Diluted Epinephrine in the N-butyl-2-cyanoacrylate Embolization of Visceral Artery Pseudoaneurysms Secondary to Chronic Pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Morishita, Hiroyuki, E-mail: hmorif@koto.kpu-m.ac.jp [Japan Red Cross Kyoto Daiichi Hospital, Department of Diagnostic Radiology (Japan); Yamagami, Takuji [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science (Japan); Takeuchi, Yoshito [National Cancer Center, Division of Diagnostic Radiology (Japan); Matsumoto, Tomohiro; Asai, Shunsuke; Masui, Koji [Japan Red Cross Kyoto Daiichi Hospital, Department of Diagnostic Radiology (Japan); Sato, Hideki [Japan Red Cross Kyoto Daiichi Hospital, Department of Gastroenterology (Japan); Taniguchi, Fumihiro [Japan Red Cross Kyoto Daiichi Hospital, Department of Surgery (Japan); Sato, Osamu [Japan Red Cross Kyoto Daiichi Hospital, Department of Diagnostic Radiology (Japan); Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science (Japan)

    2012-08-15

    Although n-butyl-2-cyanoacrylate (NBCA) has been used as an effective liquid embolization material, its indication for pseudoaneurysms has seemingly been limited because of the technical difficulties of using NBCA, such as reflux to the parent artery and causing significant infarction. Thus, considerable skill in using NBCA or a device to control blood flow during its polymerization is required to achieve embolization without severe complications. We report our new technique for controlling blood flow using diluted epinephrine in transcatheter arterial NBCA embolization of five pseudoaneurysms in four cases secondary to hemosuccus pancreaticus.

  19. Segmental embolization of the gastroduodenal artery in a case of a perforated pseudoaneurysm and gastrointestinal bleeding; Segmentembolisation der Arteria gastroduodenalis bei perforiertem Pseudoaneurysma und gastrointestinaler Massivblutung

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, R. [Inst. fuer Diagnostische Radiologie der Friedrich-Alexander-Univ. Nuernberg-Erlangen (Germany); Inst. fuer Diagnostische und Interventionelle Radiologie der Herz- und Gefaessklinik GmbH, Bad Neustadt an der Saale (Germany); Cavallaro, A.; Bautz, W. [Inst. fuer Diagnostische Radiologie der Friedrich-Alexander-Univ. Nuernberg-Erlangen (Germany)

    2004-07-01

    We present the history of a woman suffering from an extensive gastrointestinal bleeding due to liver cirrhosis and chronic pancreatitis. Selective angiogram of the celiac artery revealed a pseudoaneurysm of the gastroduodenal artery caused by inflammatory wall penetration. The life-threatening hemorrhage was completely stopped by embolization with three stainless steel coils after microcatheter engagement of the gastroduodenal artery. The particularity of this case is the restricted embolization of the aneurysm vessel segment, so the collateral circulation of the gastroduodenal and pancreaticoduodenal artery could be preserved. (orig.)

  20. Effect of Transcatheter Embolization by Autologous Fat Particles in the Treatment of Coronary Artery Perforation During Percutaneous Coronary Intervention

    Institute of Scientific and Technical Information of China (English)

    Li-Yun He; Jiang-Li Han; Li-Jun Guo; Fu-Chun Zhang; Ming Cui; Wei Gao

    2015-01-01

    Background:Coronary artery perforation (CAP) is a rare but severe complication of percutaneous coronary intervention (PCI).The aim of our study was to evaluate the effect and safety of transcatheter embolization by autologous fat particles in the treatment of CAP.Methods:Once the CAP was confirmed,a little autologous subcutaneous fatty tissue was obtained from the groin of the patient and then was made into 1 mm× 1 mm fat particles.The perforated vessel was embolized by fat particles via a micro-catheter.There were eight patients undergoing transcatheter embolization by autologous fat particles in the treatment of CAP during PCI in Peking University Third Hospital from February 2009 to June 2014,and the clinical data of these patients were collected and analyzed retrospectively.Results:The lesion morphology of the patients was classified based on the American College of Cardiology/American Heart Association Task Force classification,there were one patient with Class B2 lesion and seven patients with Class C lesions (there were five patients with chronic total occlusion lesions).According to the Ellis classification of CAP,there were six patients with Class Ⅱ perforations and two patients with Class Ⅲ perforations.The causes of perforation included that seven patients induced by guide wire and one patient by balloon predilation.Three patients had pericardial effusion.All of the eight patients with CAP underwent transcatheter embolization by autologous fat particles.Coronary angiography confirmed that all of them were embolized successfully.There was no severe complication after the procedure.The coronary angiography of one patient at l week and another patient at 2 years after the embolization showed that the embolized arteries had recanalized.The median follow-up time was 20.3 months (8.8-50.2 months),the event-free survival rate was 100%.Conclusions:Transcatheter embolization by autologous fat particles was an effective,safe,cheap,and easy way to treat the

  1. Effect of internal carotid artery reperfusion in combination with Tenecteplase on clinical scores and hemorrhage in a rabbit embolic stroke model.

    Science.gov (United States)

    Lapchak, Paul A

    2009-10-19

    In the present study, we used a modification of the rabbit small clot embolic stroke model (RSCEM), a multiple infarct ischemia model to achieve reperfusion (REP) through the internal carotid artery (ICA) following small clot embolization. We determined if increasing regional cortical blood flow (RCBF) following an embolic stroke is beneficial to neurological outcome. We compared this to cerebral reperfusion induced by the administration of the thrombolytic Tenecteplase (TNK, 1.5 mg/kg, IV bolus) in the presence or absence of REP. In this study, we also measured the incidence of ICH following REP and thrombolytic treatment. Following embolization, RCBF was reduced to 48-55% of baseline. When REP was induced by removal of a CCA ligature, RCBF initially increased to 185% of baseline. REP (P(50)=1.18+/-0.43 mg) had no effect on embolization-induced behavior measured 24 h following embolization compared to control (P(50)=1.01+/-0.48 mg). However, TNK treatment (2-hours post-embolization) in the absence or presence of REP (initiated 2 h following embolization) significantly (p0.05) group compared to either the control group (5.5%) or TNK group (10%). This study show that reperfusion of ICA can increase RCBF following embolization, but this is not associated with improved neurological outcome measured using quantal analysis. However, TNK administration significantly increased behavioral outcome when given 2 h following embolization; an increase that is not affected by combining TNK with REP.

  2. Safety and efficacy of splenic artery embolization for portal hyperperfusion in liver transplant recipients: a 5-year experience.

    Science.gov (United States)

    Presser, Naftali; Quintini, Cristiano; Tom, Cynthia; Wang, Weiping; Liu, Qiang; Diago-Uso, Teresa; Fujiki, Masato; Winans, Charles; Kelly, Dympna; Aucejo, Federico; Hashimoto, Koji; Eghtesad, Bijan; Miller, Charles

    2015-04-01

    Severe portal hyperperfusion (PHP) after liver transplantation has been shown to cause intrahepatic arterial vasoconstriction secondary to increased adenosine washout (hepatic artery buffer response). Clinically, posttransplant PHP can cause severe cases of refractory ascites and hydrothorax. In the past, we reported our preliminary experience with the use of splenic artery embolization (SAE) as a way to reduce PHP. Here we present our 5-year experience with SAE in orthotopic liver transplantation (OLT). Between January 2007 and December 2011, 681 patients underwent OLT at our institution, and 54 of these patients underwent SAE for increased hepatic arterial resistance and PHP (n=42) or refractory ascites/hepatic hydrothorax (n=12). Patients undergoing SAE were compared to a control group matched by year of embolization, calculated Model for End-Stage Liver Disease score, and liver weight. SAE resulted in improvements in hepatic artery resistive indices (0.92±0.14 and 0.76±0.10 before and after SAE, respectively; Pspleen/liver volume ratios were correlated with patients requiring SAE versus matched controls (P=0.002 and P=0.001, respectively). Among the 54 patients undergoing SAE, there was 1 case of postsplenectomy syndrome. No abscesses, significant infections, or bleeding was noted. We thus conclude that SAE is a safe and effective technique able to improve HAF parameters in patients with elevated portal venous flow and its sequelae.

  3. Uterine Artery Embolization for Symptomatic Uterine Fibroids: a Prospective Study on 102 Patients in Iran

    Directory of Open Access Journals (Sweden)

    M. Shakiba

    2005-06-01

    Full Text Available Background/Objectives : To evaluate the safety, efficacy an d complication rate of uterine artery embolization in symptomatic fibroid patients in Iran. Patients and Methods: A hundred and two patients aged 20-48 years (mean age: 35.7 ±6.4 years with symptomatic fibroids entered th e study from September 2001 to November 2004. The most common presenting symptom was increased menstrual bleeding, which occurred in 74.5% of all patients. Urinary symptoms occurred in 43%, and bulk-related symptoms were seen in 63.7 % of our patients. We performed bilateral UAE (uterine artery em bolization using PVA (pol yvinyl alcohol particles (500-710 micron and assessed the patients before UAE and at regular follow- ups at 1, 3, 6 and 12-month intervals by questionnaires / interviews and ultrasound. MRI without gadolinium (Gd-DTPA injection was done before emboliz ation and at 6 and 12 months after the procedure. Results: By Friedman test, sequential follow-up (up to 12 months showed that the vaginal bleeding severity significantly decreased (p <0.0001, with menorrhagia resolving in 59.4% of patients at 1 month, and in 69% at 12 months. The mean uterus volume decreased 38.5 ±30% after 12 months .The paired t-test showed that dominant fibroid volume changed from 273.7±439.2 cm3 to 112.1±141.6 cm3 at month 6 (n=58, p=0.001 and from 246.1±314.5 cm3 to 70.1±73.5 cm3 at month 12 (n=41, p<0.0001 . The initial size of the fibroids did not affect the success rate. Conclusion: The study showed the high efficacy of UAE in controlling fibroid related symptoms, with only few complications.

  4. Efficacy of Prophylactic Uterine Artery Embolization before Obstetrical Procedures with High Risk for Massive Bleeding

    Science.gov (United States)

    Ko, Heung Kyu; Ko, Gi Young; Gwon, Dong Il; Kim, Jin Hyung; Han, Kichang; Lee, Shin-Wha

    2017-01-01

    Objective To evaluate the safety and efficacy of prophylactic uterine artery embolization (UAE) before obstetrical procedures with high risk for massive bleeding. Materials and Methods A retrospective review of 29 female patients who underwent prophylactic UAE from June 2009 to February 2014 was performed. Indications for prophylactic UAE were as follows: dilatation and curettage (D&C) associated with ectopic pregnancy (cesarean scar pregnancy, n = 9; cervical pregnancy, n = 6), termination of pregnancy with abnormal placentation (placenta previa, n = 8), D&C for retained placenta with vascularity (n = 5), and D&C for suspected gestational trophoblastic disease (n = 1). Their medical records were reviewed to evaluate the safety and efficacy of UAE. Results All women received successful bilateral prophylactic UAE followed by D&C with preservation of the uterus. In all patients, UAE followed by obstetrical procedure prevented significant vaginal bleeding on gynecologic examination. There was no major complication related to UAE. Vaginal spotting continued for 3 months in three cases. Although oligomenorrhea continued for six months in one patient, normal menstruation resumed in all patients afterwards. During follow-up, four had subsequent successful natural pregnancies. Spontaneous abortion occurred in one of them during the first trimester. Conclusion Prophylactic UAE before an obstetrical procedure in patients with high risk of bleeding or symptomatic bleeding may be a safe and effective way to manage or prevent serious bleeding, especially for women who wish to preserve their fertility. PMID:28246515

  5. Emergent Uterine Arterial Embolization Using N-Butyl Cyanoacrylate in Postpartum Hemorrhage with Disseminated Intravascular Coagulation

    Science.gov (United States)

    Kasai, Michi; Kasai, Junko; Seki, Kazuo; Sekikawa, Zenjiro; Torimoto, Izumi; Takebayashi, Shigeo; Hirahara, Fumiki

    2017-01-01

    Although it is widely accepted that uterine artery embolization (UAE) is an effective therapeutic strategy for postpartum hemorrhage (PPH), no consensus has been reached regarding the efficacy of UAE in patients with PPH with disseminated intravascular coagulation (DIC). This single-center retrospective cohort study included patients treated with UAE using NBCA for PPH between 2010 and 2015. The patients were divided into DIC and non-DIC groups, according to the obstetrical DIC score and the overt DIC diagnostic criteria issued by the International Society of Thrombosis and Haemostasis (ISTH), and their clinical outcomes were compared. There were 28 patients treated with UAE using NBCA. Complete hemostasis was achieved by UAE in 19 of 28 patients. In eight of nine patients with unsuccessful hemostasis, surgical hemostatic interventions were performed after UAE, and hemostasis was achieved in seven patients. UAE using NBCA showed no significant intergroup differences in complete hemostasis according to the presence or absence of DIC based on obstetrical DIC score (70% versus 62.5%, P = 1.000) or ISTH DIC score (54.5% versus 76.5%, P = 0.409). UAE using NBCA may be a useful first-choice treatment for PPH with DIC.

  6. Diffusion-weighted MR imaging of uterine leiomyomas following uterine artery embolization

    Energy Technology Data Exchange (ETDEWEB)

    Sutter, Olivier; Shotar, Eimad; Guerrache, Youcef; Place, Vinciane; Oprea, Raluca; Le Dref, Olivier; Boudiaf, Mourad [Hopital Lariboisiere, AP-HP, Department of Body and Interventional Imaging, Paris (France); Soyer, Philippe; Dohan, Anthony [Hopital Lariboisiere, AP-HP, Department of Body and Interventional Imaging, Paris (France); Universite Paris-Diderot, Sorbonne Paris Cite, Paris (France); UMR INSERM 965, Hopital Lariboisiere, Paris (France); Dautry, Raphael; Sirol, Marc [Hopital Lariboisiere, AP-HP, Department of Body and Interventional Imaging, Paris (France); Universite Paris-Diderot, Sorbonne Paris Cite, Paris (France); Ricbourg, Aude [Hopital Lariboisiere-AP-HP, Department of Obstetrics and Gynecology, Paris (France)

    2016-10-15

    To test whether variations in apparent diffusion coefficient (ADC) values of uterine leiomyomas after uterine artery embolization (UAE) may correlate with outcome and assess the effects of UAE on leiomyomas and normal myometrium with magnetic resonance imaging (MRI). Data of 49 women who underwent pelvic MRI before and after UAE were retrospectively reviewed. Uterine and leiomyoma volumes, ADC values of leiomyomas, and normal myometrium were calculated before and after UAE. By comparison with baseline ADC values, a significant drop in leiomyoma ADC was found at 6-month post-UAE (1.096 x 10{sup -3} mm{sup 2}/s vs. 0.712 x 10{sup -3} mm{sup 2}/s, respectively; p < 0.0001), but not at 48-h post-UAE. Leiomyoma devascularization was complete in 40/49 women (82 %) at 48 h and in 37/49 women (76 %) at 6 months. Volume reduction and leiomyoma ADC values at 6 months correlated with the degree of devascularization. There was a significant drop in myometrium ADC after UAE. Perfusion defect of the myometrium was observed at 48 h in 14/49 women (28.5 %) in association with higher degrees of leiomyoma devascularization. Six months after UAE, drop in leiomyoma ADC values and volume reduction correlate with the degree of leiomyoma devascularization. UAE affects the myometrium as evidenced by a drop in ADC values and initial myometrial perfusion defect. (orig.)

  7. Interest of uterine artery embolization with gelatin sponge particles prior to myomectomy for large and/or multiple fibroids

    Energy Technology Data Exchange (ETDEWEB)

    Butori, Noemie [Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Tixier, Herve; Filipuzzi, Laurence; Mutamba, William [Department of Gynecology and Obstetrics, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Guiu, Boris; Cercueil, Jean-Pierre [Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Douvier, Serge; Sagot, Paul [Department of Gynecology and Obstetrics, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Krause, Denis [Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Loffroy, Romaric, E-mail: romaric.loffroy@chu-dijon.fr [Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France)

    2011-07-15

    Purpose: To evaluate the efficacy of pre-myomectomy uterine artery embolization with gelatin sponge particles to reduce operative blood loss and facilitate removal of fibroids. Materials and methods: This retrospective study included 33 women (mean age, 36 years; range, 24-45 years), of whom at least 18 wished to preserve fertility. They presented with at least one large myoma (mean diameter, 90 mm; range, 50-150 mm) and had undergone preoperative uterine artery embolization with resorbable gelatin sponge by unilateral femoral approach between December 2001 and November 2008. Clinical, radiological and surgical data were available for all patients. Mean haemoglobin levels before and after surgery were compared with Student's t-test. Results: No complication or technical failure of embolization occurred. The myomectomies were performed during laparotomy (25 cases) or laparoscopy (8 cases). Dissection of fibroids was easier (mean, 3 per patient; range, 1-11), with a mean operating time of 108 {+-} 50 min (range, 30-260 min). Bloodless surgery was the rule with a mean estimated peroperative blood loss of 147 {+-} 249 mL (range, 0-800 mL). Mean pre-(12.9 {+-} 1.3 g/dL) and post-therapeutic (11.4 {+-} 1.2 g/dL) haemoglobin levels were not statistically different (p > 0.05). There was no need for blood transfusion. None of the patients required hysterectomy. The mean duration of hospital stay was 7.5 {+-} 1.3 days (range, 3-12 days). Conclusion: Preoperative uterine artery embolization is effective in reducing intraoperative blood loss and improves the chances of performing conservative surgery. It should be considered a useful adjunct to myomectomy in women at high hemorrhagic risk or who refuse blood transfusion.

  8. Transarterial embolization for serious renal hemorrhage following renal biopsy.

    Science.gov (United States)

    Zeng, Dan; Liu, Guihua; Sun, Xiangzhou; Zhuang, Wenquan; Zhang, Yuanyuan; Guo, Wenbo; Yang, Jianyong; Chen, Wei

    2013-01-01

    The goal of this study is to evaluate the feasibility and efficacy of percutaneous transarterial embolization for the treatment of serious renal hemorrhage after renal biopsy. Nine patients with renal hemorrhage had frank pain and gross hematuria as main symptoms after renal biopsy. Intrarenal arterial injuries and perinephric hematoma were confirmed by angiography in all cases. The arterial injuries led to two types of renal hemorrhage, Type I: severe renal injure or intrarenal renal artery rupture (n=5), with contrast medium spilling out of the artery and spreading into renal pelvis or kidney capsule in angiography; Type II, pseudo aneurysm or potential risk of intrarenal artery injure (n=4), where contrast medium that spilled out of intraartery was retained in the parenchyma as little spots less than 5 mm in diameter in angiography. Transcatheter superselective intrarenal artery embolization was performed with coils or microcoils (Type I intrarenal artery injure) and polyvinyl alcohol particles (Type II injure). The intrarenal arterial injuries were occluded successfully in all patients. Light or mild back or abdominal pain in the side of the embolized kidney was found in three patients following embolization procedures and disappeared 3 days later. Serum creatinine and perinephric hematoma were stable, and gross hematuresis stopped immediately (n=4) or 3-5 days (n=3) after embolization. In conclusions, transcatheter superselective intrarenal artery embolization as a minimally invasive therapy is safe and effective for treatment of serious renal hemorrhage following percutaneous renal biopsy.

  9. Temporary Arterial Embolization of Liver Parenchyma with Degradable Starch Microspheres (EmboCept{sup ®}S) in a Swine Model

    Energy Technology Data Exchange (ETDEWEB)

    Pieper, Claus C., E-mail: claus.christian.pieper@ukb.uni-bonn.de; Meyer, Carsten, E-mail: Carsten.Meyer@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany); Vollmar, Brigitte, E-mail: brigitte.vollmar@med.uni-rostock.de [University of Rostock, Institute for Experimental Surgery (Germany); Hauenstein, Karlheinz, E-mail: karlheinz.hauenstein@med.uni-rostock.de [University of Rostock, Department of Diagnostic and Interventional Radiology (Germany); Schild, Hans H., E-mail: Hans.Schild@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany); Wilhelm, Kai E., E-mail: Kai.Wilhelm@ek-bonn.de [Johanniter Hospital, Evangelische Kliniken Bonn (Germany)

    2015-04-15

    BackgroundThis study aimed to evaluate the embolic properties, time to reperfusion, and histologic changes in temporary embolization of liver tissue with degradable starch microspheres (DSM) in a swine model.MethodsIn four adult minipigs, DSMs were injected into the right or left hepatic artery on the lobar level until complete stasis of the blood flow was detectable angiographically. The time required to complete angiographically determined reperfusion was noted. The animals were killed 3 h after complete reperfusion, and samples were taken from the liver. Histologic examinations of the embolized liver parenchyma and untreated tissue were performed.ResultsHepatic arterial embolization using DSMs was technically successful in all cases, with complete blood flow stasis shown by control angiography. A single vial of DSMs (450 mg/7.5 ml) was sufficient to embolize a whole liver lobe in all cases. Angiography showed complete reconstitution of hepatic arterial perfusion after a mean time to reperfusion of 32 ± 6.1 min (range, 26–39 min). Hematoxylin and eosin staining showed no histologically detectable differences between untreated tissue and parenchyma embolized with DSMs except for mild sinusoidal congestion in one case. Indirect in situ DNA nick end labeling staining (TUNEL) showed only single positive hepatocytes, indicating apoptosis.ConclusionTemporary embolization of the hepatic artery using DSMs is feasible with complete reperfusion after 30 min in pigs. Even after complete arterial blood flow stasis, no extensive tissue damage to the embolized liver parenchyma was observed at histologic examinations in this short-term study.

  10. Effect of low-molecular-weight heparin and urokinase on pulmonary arteries involved in pulmonary embolism

    Institute of Scientific and Technical Information of China (English)

    WU Jun-ping; SUN Xin; WU Qi; DU Zhong-zhen; LI Li; WU Qian; SUN Hong-fen

    2013-01-01

    Background Pulmonary embolism (PE) is a common and often fatal disease.Early after pulmonary thromboembolism,inflammation and associated intimal hyperplasia occur within the pulmonary arteries,similar to what is observed with chronic thromboembolic pulmonary hypertension.This study tested the hypothesis that thrombolytic and anticoagulant agents would have anti-inflammatory effects or inhibit intimal hyperplasia of involved pulmonary arteries.Methods Seventy-two male New Zealand white rabbits were randomly divided into two groups (54 rabbits in the PE group and 18 in the sham group).Experimental PE was induced in 54 rabbits by femoral vein injection of autologous blood clots and confirmed with pulmonary angiography,and other 18 rabbits underwent sham operations.Fifty-four rabbits in the PE group were randomly divided into three groups:a control group (treated with normal saline),a low-molecularweight heparin (LMWH) group (treated with LMWH),and a urokinase (UK) group (treated with UK).Arterial blood gas was analyzed at 2,7,and 28 days (n=6 per time point by random group division),then lung tissues were removed and were analyzed for pro-inflammatory cytokines and chemokines,and were stained for intimal hyperplasia.Results The overall survival of rabbits undergoing PE was 100%.PE distribution detected on digital signal angiography (DSA) and histopathology was shown in 67% of rabbits (36/54) in the bilateral low lobar pulmonary arteries (PAs).The results showed that alveolar-arterial partial pressure of oxygen (PO2) difference (PA-aO2) significantly increased and PO2 decreased in the control group compared with the sham group.Compared with controls,the UK group had a decreased level of PA-aO2 on day 2 (P <0.05),however,there was no significant difference in the LMWH group.Compared with controls,the LMWH group had a decreased level of monocyte chemoattractant protein-1 (MCP-1) in affected tissue and serum samples on days 7 and 28 (P <0.05),and the UK group had

  11. Midterm Results after Uterine Artery Embolization Versus MR-Guided High-Intensity Focused Ultrasound Treatment for Symptomatic Uterine Fibroids

    Energy Technology Data Exchange (ETDEWEB)

    Froeling, V., E-mail: vera.froeling@charite.de; Meckelburg, K., E-mail: katrin.meckelburg@charite.de; Scheurig-Muenkler, C., E-mail: christian.scheurig-muenkler@charite.de; Schreiter, N. F., E-mail: nils.schreiter@charite.de; Kamp, J., E-mail: julia.kamp@charite.de; Maurer, M. H., E-mail: martin.maurer@charite.de; Beck, A., E-mail: alexander.beck@charite.de; Hamm, B., E-mail: bernd.hamm@charite.de; Kroencke, T. J., E-mail: Thomas.kroencke@charite.de [Charite-Universitaetsmedizin Berlin, Department of Radiology (Germany)

    2013-12-15

    Purpose: To compare the rate of reintervention and midterm changes in symptom severity (SS) and Total health-related quality of life (HRQoL) scores after uterine artery embolization (UAE) and magnetic resonance-guided high-intensity focused ultrasound (MR-g HIFU) for symptomatic uterine fibroids. Methods: Eighty women (median age 38.3 years), equally eligible for MR-g HIFU and UAE who underwent one of both treatments between 2002 and 2009 at our institution, were included. The primary end point of the study was defined as the rate of reintervention after both therapies. The secondary outcome was defined as changes in SS and Total HRQoL scores after treatment. SS and Total HRQoL scores before treatment and at midterm follow-up (median 13.3 months) were assessed by the uterine fibroid symptom and quality-of-life questionnaire (UFS-QoL) and compared. Results: The rate of reintervention was significantly lower after UAE than after MR-g HIFU (p = 0.002). After both treatments, SS and Total HRQoL scores improved significantly from baseline to follow-up (UAE: p < 0.001, p < 0.001; MR-g HIFU: p = 0.002, p < 0.001). Total HRQoL scores were significantly higher after UAE than after MR-g HIFU (p = 0.032). Changes in the SS scores did not differ significantly for both treatments (p = 0.061). Conclusion: UAE and MR-g HIFU significantly improved the health-related quality of life of women with symptomatic uterine fibroids. After UAE, the change in Total HRQoL score improvement was significantly better, and a significantly lower rate of reintervention was observed.

  12. TEE monitoring for RA-horizontal paradoxical arterial air embolism during sitting-position surgery

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    A 36-year-old woman suffered meningioma in her right cerebellopontine angle.Air embolisms often complicate sitting-position surgeries.Because TEE guides the localization of central venous catheters and promptly locates air embolisms promptly enough for effective treatment,TEE is an effective monitoring method for sitting-position surgeries.

  13. Carotid-cavernous fistula caused by laceration of persistent fetal trigeminal artery treated with single catheter coil embolization

    Directory of Open Access Journals (Sweden)

    Benjamin L Brown

    2012-01-01

    Full Text Available We present the endovascular treatment of traumatic carotid-cavernous fistula from persistent fetal trigeminal artery (PFTA laceration. To date, there are six such cases of traumatic PFTA-cavernous fistulas reported in the literature. These injuries can pose a unique challenge in that rupture of a PFTA in its course through the cavernous sinus may produce a fistula feeding from both anterior and posterior circulations. Previously, these have been treated with dual catheter coil embolization from the carotid and basilar systems. We utilize a single catheter technique accessing the cavernous sinus through the origin of the PFTA on the internal carotid. Both anterior and posterior fistula components may be embolized through this single access. This represents a simple yet safe treatment option.

  14. 血管内栓塞治疗基底动脉顶端动脉瘤%Endovascular Embolization of Basilar Artery Apex Aneurysms

    Institute of Scientific and Technical Information of China (English)

    阮玉山; 卢桂花; 罗昱; 谭源福; 张超元; 肖绍文

    2011-01-01

    Objective To evaluate the therapeutic effect of endovascular embolization for basilar artery apex aneurysms.Methods A retrospective analysis was performed on 17 patients with posterior circulation aneurysms who underwent endovascular embolization between July 2000 and December 2010. In the patients, 6 cases received the treatment in 2 days after acute bleeding stage, 11 cases were treated at 3 to 10 days post-hemorrhage. Three cases with wide necked intracranial aneurysm received the interventional therapy by self expanding stent (Neuroform) and separable detachable coil. The separable detachable coils were occluded in the aneurysms in 14 cases. Glasgow outcome scale (GOS) was conducted to evaluate the outcomes afterwards. Results Complete embolization ( 100% ) was achieved in 10 cases, 3 aneurysms were 95% embolized, and 3 were 90% embolized. Perforation during embolization occurred in one patient who died in the next day. No re-bleeding case but 2 cases of recurrence were found during a follow-up of 6 -36 months (mean, 15 months) post-embolization. According to GOS, good outcome was achieved in 12 cases, mild disability ( being able to look after themselves in daily life) in 3, and severe disability in 1. Conclusion Endovascular embolization is a minimally invasive, relatively safe and effective method for posterior circulation aneurysms.%目的 评价血管内栓塞治疗基底动脉顶端动脉瘤的疗效.方法 回顾性分析2000年7月~2010年12月血管内栓塞治疗17例基底动脉顶端动脉瘤的临床资料.6例在出血2天内、11例在出血3~10天内进行血管内栓塞治疗.应用Neuroform支架辅助弹簧圈栓塞宽颈动脉瘤3例,弹簧圈栓塞14例.结果 17例中成功栓塞16例,其中10例100%栓塞,3例95%栓塞,3例90%栓塞,术中动脉瘤破裂1例(弹簧罔栓塞,次日死亡).出院时格拉斯哥预后评分(GOS),恢复良好12例;中度病残,但生活能自理3例;重度病残,生活不能自理1例.16例随访6

  15. Transretroperitoneal CT-guided Embolization of Growing Internal Iliac Artery Aneurysm after Repair of Abdominal Aortic Aneurysm: A Transretroperitoneal Approach with Intramuscular Lidocaine Injection Technique

    Energy Technology Data Exchange (ETDEWEB)

    Park, Joon Young, E-mail: pjy1331@hanmail.net; Kim, Shin Jung, E-mail: witdd2@hanmail.net; Kim, Hyoung Ook, E-mail: chaos821209@hanmail.net [Chonnam National University Hospital, Department of Radiology (Korea, Republic of); Kim, Yong Tae, E-mail: mono-111@hanmail.net [Chonnam National University Hwasun Hospital, Department of Radiology (Korea, Republic of); Lim, Nam Yeol, E-mail: apleseed@hanmail.net; Kim, Jae Kyu, E-mail: kjkrad@jnu.ac.kr [Chonnam National University Hospital, Department of Radiology (Korea, Republic of); Chung, Sang Young, E-mail: sycpvts@jnu.ac.kr; Choi, Soo Jin Na, E-mail: choisjn@jnu.ac.kr; Lee, Ho Kyun, E-mail: mhaha@hanmail.net [Chonnam National University Hospital, Department of Surgery (Korea, Republic of)

    2015-02-15

    This study was designed to evaluate the efficacy and safety of CT-guided embolization of internal iliac artery aneurysm (IIAA) after repair of abdominal aortic aneurysm by transretroperitoneal approach using the lidocaine injection technique to iliacus muscle, making window for safe needle path for three patients for whom CT-guided embolization of IIAA was performed by transretroperitoneal approach with intramuscular lidocaine injection technique. Transretroperitoneal access to the IIAA was successful in all three patients. In all three patients, the IIAA was first embolized using microcoils. The aneurysmal sac was then embolized with glue and coils without complication. With a mean follow-up of 7 months, the volume of the IIAAs remained stable without residual endoleaks. Transretroperitoneal CT-guided embolization of IIAA using intramuscular lidocaine injection technique is effective, safe, and results in good outcome.

  16. Transretroperitoneal CT-guided embolization of growing internal iliac artery aneurysm after repair of abdominal aortic aneurysm: a transretroperitoneal approach with intramuscular lidocaine injection technique.

    Science.gov (United States)

    Park, Joon Young; Kim, Shin Jung; Kim, Hyoung Ook; Kim, Yong Tae; Lim, Nam Yeol; Kim, Jae Kyu; Chung, Sang Young; Choi, Soo Jin Na; Lee, Ho Kyun

    2015-02-01

    This study was designed to evaluate the efficacy and safety of CT-guided embolization of internal iliac artery aneurysm (IIAA) after repair of abdominal aortic aneurysm by transretroperitoneal approach using the lidocaine injection technique to iliacus muscle, making window for safe needle path for three patients for whom CT-guided embolization of IIAA was performed by transretroperitoneal approach with intramuscular lidocaine injection technique. Transretroperitoneal access to the IIAA was successful in all three patients. In all three patients, the IIAA was first embolized using microcoils. The aneurysmal sac was then embolized with glue and coils without complication. With a mean follow-up of 7 months, the volume of the IIAAs remained stable without residual endoleaks. Transretroperitoneal CT-guided embolization of IIAA using intramuscular lidocaine injection technique is effective, safe, and results in good outcome.

  17. Prophylactic Embolization of the Cystic Artery Prior to Radioembolization of Liver Malignancies—An Evaluation of Necessity

    Energy Technology Data Exchange (ETDEWEB)

    Powerski, Maciej, E-mail: maciej.powerski@med.ovgu.de; Busse, Anke, E-mail: anke.busse@med.ovgu.de; Seidensticker, Max, E-mail: max.seidensticker@med.ovgu.de; Fischbach, Frank, E-mail: frank.fischbach@med.ovgu.de; Seidensticker, Ricarda, E-mail: ricarda.seidensticker@med.ovgu.de; Strach, Katharina, E-mail: katharina.strach@med.ovgu.de; Dudeck, Oliver, E-mail: oliver.dudeck@med.ovgu.de; Ricke, Jens, E-mail: jens.ricke@med.ovgu.de; Pech, Maciej, E-mail: maciej.pech@med.ovgu.de [Otto-von-Guericke University, Department of Radiology and Nuclear Medicine (Germany)

    2015-06-15

    PurposePrior to radioembolization (RE) of hepatic tumors, many centers prophylactically occlude the cystic artery (CA) during evaluation angiography (EVA) to prevent radiation-induced cholecystitis. There is no conclusive evidence for the protective effect of CA embolization and it bears the risk of inducing ischemic cholecystitis. The aim of this study is to evaluate the justification for CA embolization by comparing clinical and morphologic imaging parameters between patients undergoing coil occlusion of the cystic artery (COCA) and those with uncoiled CA (UCCA).Materials and MethodsRetrospective comparison of 37 patients with UCCA versus 68 patients with COCA in terms of clinical findings (CRP, leukocyte count, body temperature, upper abdominal pain) and morphologic imaging parameters associated with cholecystitis (gallbladder (GB) wall thickness, free fluid in GB bed, bremsstrahlung SPECT) after EVA, after RE, and at 6-week follow-up.ResultsAt none of the 3 time points (EVA, RE, 6-week follow-up) was there any significant difference in CRP, leukocyte count, body temperature, or upper abdominal pain between the UCCA and COCA group. There was also no significant difference between the two groups with regard to GB wall thickness, fluid in the GB bed, and bremsstrahlung in SPECT. One patient of the UCCA group and two patients of the COCA developed cholecystitis requiring treatment.ConclusionComparison of clinical and imaging findings between patients with and without CA embolization prior to RE identified no predictors of radiogenic or ischemic cholecystitis after RE. Our study provides no evidence for a benefit of prophylactic CA embolization before RE.

  18. The Treatment of Selective Renal Arterial Embolization for Kidney Hemorrhage After Mini-invasive Percutaneous Nephrolithotomy (MPCNL)%超选择性肾动脉栓塞治疗MPCNL术后肾出血

    Institute of Scientific and Technical Information of China (English)

    周小明; 张伟东

    2011-01-01

    目的 研究MPCNL术后肾出血的介入止血方法和效果.方法 2008年4月至2009年10月间经MPCNL治疗上尿路结石后肾出血患者15例,行超选择性肾动脉栓塞治疗术,回顾性分析其临床资料.结果 本组患者治疗后效果满意,一次栓塞成功14例(93.3%),1例栓塞后另一血管分支再出血,经第二次栓塞血止.结论 介入方法治疗MPCNL术后肾出血具有安全、有效、创伤小、预后好、恢复快等优点,是MPCNL术后肾出血的首选手术方法之一.%Objective Kidney hemorrhage after mini-invasive percutaneous nephrolithotomy (MPCNL), however, including renal artery branch injuries, often require surgical intervention and result in partial or total nephrectomy. Nonoperative management of kidney hemorrhage after MPCNL following complete radiographic assessment has become an accepted if not preferred therapeutic option. In this article, we will study the methods and treatment effects of selective renal arterial embolization on kidney hemorrhage after MPCNL. Methods From April 2008 to October 2009, 15 cases with nephrorrhagia after MPCNL underwent interventional therapy of selective renal arterial embolization. Results Overall, 14 of 15 patients had prompt hemostasis documented either on the post-embolization angiogram or by clinical assessment. In 1 patient, bleeding was recurred and another transcatheter embolization was required. The technical successful rate with single session was 93. 3% (14/15). There was no complication occurred after the selective renal arterial embolization. Conclusion The angiography with transcatheter embolization techniques provides a safe and effective means of managing renal artery branch injuries secondary to MPCNL.

  19. Role of splenic artery embolization in management of traumatic splenic injuries: a prospective study.

    Science.gov (United States)

    Parihar, Mohan Lal; Kumar, Atin; Gamanagatti, Shivanand; Bhalla, Ashu Seith; Mishra, Biplab; Kumar, Subodh; Jana, Manisha; Misra, Mahesh C

    2013-10-01

    The objective of our study was to evaluate the role of splenic artery embolization (SAE) in the management of traumatic splenic injuries. From September 2008 to September 2010, a total of 67 patients underwent nonoperative management (NOM) for blunt splenic injuries. Twenty-two patients were excluded from the study because of associated significant other organ injuries. Twenty-five patients underwent SAE followed by NOM (group A) and 20 patients underwent standard NOM (group B). Improvement in clinical and laboratory parameters during hospital stay were compared between two groups using Chi-square test and Mann-Whitney test. SAE was always technically feasible. The mean length of the total hospital stay was lower in the group A patients (5.4 vs. 6.6 day, [P = 0.050]). There was significant increase in hemoglobin and hematocrit levels and systolic blood pressure (SBP) in group A patients after SAE, whereas in group B patients there was decrease in hemoglobin and hematocrit levels and only slight increase in SBP (pre- and early posttreatment relative change in hemoglobin [P = 0.002], hematocrit [P = 0.001], and SBP [P = 0.017]). Secondary splenectomy rate was lower in group A (4 % [1/25] vs. 15 % [3/20] [P = 0.309]). No procedure-related complications were encountered during the hospital stay and follow-up. Minor complications of pleural effusion, fever, pain, and insignificant splenic infarct noted in 9 (36 %) patients. SAE is a technically feasible, safe, and effective method in the management of splenic injuries. Use of SAE as an adjunct to NOM of splenic injuries results improvement in hemoglobin, hematocrit levels, and SBP. SAE also reduces secondary splenectomy rate and hospital stay.

  20. Unilateral Versus Bilateral Prostatic Arterial Embolization for Lower Urinary Tract Symptoms in Patients with Prostate Enlargement

    Energy Technology Data Exchange (ETDEWEB)

    Bilhim, Tiago, E-mail: tiagobilhim@hotmail.com [Universidade Nova de Lisboa (UNL), Departamento Universitario de Anatomia, Faculdade de Ciencias Medicas (FCM) (Portugal); Pisco, Joao; Rio Tinto, Hugo; Fernandes, Lucia [Interventional Radiology, Saint Louis Hospital (Portugal); Campos Pinheiro, Luis [Universidade Nova de Lisboa (UNL), Departamento Universitario de Urologia, Faculdade de Ciencias Medicas (FCM) (Portugal); Duarte, Marisa; Pereira, Jose A. [Interventional Radiology, Saint Louis Hospital (Portugal); Oliveira, Antonio G. [Universidade Nova de Lisboa (UNL), Biostatistics Department, Faculdade de Ciencias Medicas (FCM) (Portugal); O' Neill, Joao [Universidade Nova de Lisboa (UNL), Departamento Universitario de Anatomia, Faculdade de Ciencias Medicas (FCM) (Portugal)

    2013-04-15

    This study was designed to compare baseline data and clinical outcome between patients with prostate enlargement/benign prostatic hyperplasia (PE/BPH) who underwent unilateral and bilateral prostatic arterial embolization (PAE) for the relief of lower urinary tract symptoms (LUTS). This single-center, ambispective cohort study compared 122 consecutive patients (mean age 66.7 years) with unilateral versus bilateral PAE from March 2009 to December 2011. Selective PAE was performed with 100- and 200-{mu}m nonspherical polyvinyl alcohol (PVA) particles by a unilateral femoral approach. Bilateral PAE was performed in 103 (84.4 %) patients (group A). The remaining 19 (15.6 %) patients underwent unilateral PAE (group B). Mean follow-up time was 6.7 months in group A and 7.3 months in group B. Mean prostate volume, PSA, International prostate symptom score/quality of life (IPSS/QoL) and post-void residual volume (PVR) reduction, and peak flow rate (Qmax) improvement were 19.4 mL, 1.68 ng/mL, 11.8/2.0 points, 32.9 mL, and 3.9 mL/s in group A and 11.5 mL, 1.98 ng/mL, 8.9/1.4 points, 53.8 mL, and 4.58 mL/s in group B. Poor clinical outcome was observed in 24.3 % of patients from group A and 47.4 % from group B (p = 0.04). PAE is a safe and effective technique that can induce 48 % improvement in the IPSS score and a prostate volume reduction of 19 %, with good clinical outcome in up to 75 % of treated patients. Bilateral PAE seems to lead to better clinical results; however, up to 50 % of patients after unilateral PAE may have a good clinical outcome.

  1. Hybrid treatment of bullet embolism at the abdominal aortic bifurcation, complicated with thoracoabdominal aorta pseudoaneurysm and common iliac artery occlusion: case report

    Directory of Open Access Journals (Sweden)

    Patrick Bastos Metzger

    2014-03-01

    Full Text Available Embolization due to a firearm projectile entering the bloodstream is a rare event that is unlikely to be suspected during initial treatment of trauma patients. We describe and discuss a case of bullet embolism of the abdominal aortic bifurcation, complicated by a pseudoaneurysm of the thoracoabdominal aorta and occlusion of the right common iliac artery, but successfully treated using a combination of endovascular methods and conventional surgery.

  2. Acute embolic occlusion of the right common iliac artery after revision total hip arthroplasty treated with catheter-directed thrombolysis and balloon angioplasty: A case report

    Directory of Open Access Journals (Sweden)

    Hongqi Yang

    2015-07-01

    Full Text Available Methods: A 63-year-old woman with atrial fibrillation presented clinical symptoms and signs of acute ischemia in the right lower extremity on the 17th postoperative day after revision total hip arthroplasty of the left hip for aseptic loosening of femoral component. Aspirin was discontinued 7 days before surgery. Both computed tomography angiography and digital subtraction angiography demonstrated complete occlusion of the right common iliac artery. An emergency catheter-directed thrombolysis with urokinase combined with balloon angioplasty was performed to obtain complete patency of the right common iliac artery. Results: The patient received anticoagulation and antiplatelet therapy postoperatively and was fine at the 2-year follow-up. Conclusions: This case demonstrated that catheter-directed thrombolysis combined with balloon angioplasty could be an efficacious, minimally invasive approach for the treatment of acute embolic occlusion of the common iliac artery. Preoperative anticoagulation for patients undergoing total hip arthroplasty with long-term use of aspirin for atrial fibrillation needs further investigation.

  3. Efficacy and Safety of Thrombolytic Therapy in Acute Submassive Pulmonary Embolism: Follow-Up Study

    Science.gov (United States)

    Sinha, Santosh Kumar; Sachan, Mohit; Goel, Amit; Singh, Karandeep; Mishra, Vikas; Jha, Mukesh Jitendra; Kumar, Ashutosh; Abdali, Nasar; Asif, Mohammad; Razi, Mahamdula; Pandey, Umeshwar; Thakur, Ramesh; Varma, Chandra Mohan; Krishna, Vinay

    2017-01-01

    Background Thrombolysis in acute submassive pulmonary embolism (PE) remains controversial. So we studied impact of thrombolytic therapy in acute submassive PE in terms of mortality, hemodynamic status, improvement in right ventricular function, and safety in terms of major and minor bleeding. Method A single-center, prospective, randomized study of 86 patients was conducted at LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, India. Patients received thrombolysis (single bolus of tenecteplase) with unfractionated heparin (UFH, group I) or placebo with UFH (group II). Result Mean age of patients was 54.35 ± 12.8 years with male dominance (M:F = 70%:30%). Smoking was the most common risk factor seen in 29% of all patients, followed by recent history of immobilization (25%), history of surgery or major trauma within past 1 month (15%), dyslipidemia (10%) and diabetes mellitus (10%). Dyspnea was the most common symptom in 80% of all patients, followed by chest pain in 55% and syncope in 6%. Primary efficacy outcome occurred significantly better in group I vs. group II (4.5% vs. 20%; P = 0.04), and significant difference was also found in hemodynamic decompensation (4.5% vs. 20%; P = 0.04), the fall in mean pulmonary artery systolic pressure (PASP) (28.8% vs. 22.5%; P = 0.03), improvement in right ventricular (RV) function (70% vs. 40%; P = 0.001) and mean hospital stay (8.1 ± 2.5 vs. 11.1 ± 2.14 days; P = 0.001). There was no difference in mortality and major bleeding as safety outcome but increased minor bleeding occurred in group I patients (16% vs. 12%; P = 0.04). Conclusion Patients with acute submassive PE do not derive overall mortality benefit, recurrent PE and rehospitalization with thrombolytic therapy but had improved clinical outcome in form of decrease in hemodynamic decompensation, mean hospital stay, PASP and improvement of RV function with similar risk of major bleed but at cost of increased minor bleeding. PMID:28090232

  4. Establishment of a rhesus monkey model of middle cerebral artery ischemia and reperfusion using a microcatheter embolization method

    Institute of Scientific and Technical Information of China (English)

    Jie Yang; Xiaoqi Huang; Hongxia Li; Li Wang; Jingqiu Cheng; Jian Guo; Hongbo Zheng; Muke Zhou; Li He; Wenying Cao; Li Xiao; Jiachuan Duan; Qiyong Gong

    2010-01-01

    Nonhuman primates are closest to humans in terms of lineage,and middle cerebral artery ischemia/reperfusion responses of nonhuman primates are most similar to ischemic stroke in humans.Therefore,nonhuman primates could be utilized to simulate the process of ischemic stroke in the human.Few studies,however,have reported the use of endovascular technology to establish a rhesus monkey stroke model.In the present study,seven adult,male,rhesus monkeys were selected and,following anesthesia,a microcatheter was inserted into one side of the middle cerebral artery via the femoral artery to block blood flow,thereby resulting in middle cerebral artery occlusion.After 2 hours,the microcatheter was withdrawn to restore the middle cerebral artery blood flow and to establish ischemia/reperfusion.Results from angiography and magnetic resonance angiography confirmed occlusion and reopening of the middle cerebral artery.Magnetic resonance imaging revealed the existence of ischemic brain lesions,and neurological examination showed sustained functional deficits following surgery.The rhesus monkey middle cerebral artery ischemia/reperfusion models established by microcatheter embolization had the advantage of non—craniotomy invasion and reproducibility.The scope and degree of ischemic damage using this model was controllable.Therefore,this nonhuman primate model is an ideal model for cerebral ischemia and reperfusion.

  5. Poly(acrylic acid) microspheres loaded with lidocaine: preparation and characterization for arterial embolization.

    Science.gov (United States)

    Cui, Dai-Chao; Lu, Wan-Liang; Sa, Er-A; Gu, Meng-Jie; Lu, Xiao-Jing; Fan, Tian-Yuan

    2012-10-15

    A new embolic agent, poly(acrylic acid) microspheres (PMs), was synthesized and the cytocompatibility was proved by mouse L929 fibroblast cells. An analgesic drug, lidocaine, was loaded on the PMs to relief pain caused by embolization. PMs and lidocaine loaded microspheres (LMs) were characterized by investigating infrared spectrum, morphology, particle size, and equilibrium water contents (EWC). A series of tests were employed to evaluate the elasticity of PMs, LMs and Embosphere™, including once compression, twice compression, and stress relaxation test. The pressures of PMs and LMs passing through a catheter were measured on line by our new designed device. Drug release was studied with T-cell apparatus. The properties of PMs and LMs were proved to be suitable for embolization. Both PMs and LMs in this study might be potential embolic agents in the future.

  6. Computed tomography angiography with pulmonary artery thrombus burden and right-to-left ventricular diameter ratio after pulmonary embolism.

    Science.gov (United States)

    Ouriel, Kenneth; Ouriel, Richard L; Lim, Yeun J; Piazza, Gregory; Goldhaber, Samuel Z

    2017-02-01

    Purpose Computed tomography angiography is used for quantifying the significance of pulmonary embolism, but its reliability has not been well defined. Methods The study cohort comprised 10 patients randomly selected from a 150-patient prospective trial of ultrasound-facilitated fibrinolysis for acute pulmonary embolism. Four reviewers independently evaluated the right-to-left ventricular diameter ratios using the standard multiplanar reformatted technique and a simplified (axial) method, and thrombus burden with the standard modified Miller score and a new, refined Miller scoring system. Results The intraclass correlation coefficient for intra-observer variability was .949 and .970 for the multiplanar reformatted and axial methods for estimating right-to-left ventricular ratios, respectively. Inter-observer agreement was high and similar for the two methods, with intraclass correlation coefficient of .969 and .976. The modified Miller score had good intra-observer agreement (intraclass correlation coefficient .820) and was similar to the refined Miller method (intraclass correlation coefficient .883) for estimating thrombus burden. Inter-observer agreement was also comparable between the techniques, with intraclass correlation coefficient of .829 and .914 for the modified Miller and refined Miller methods. Conclusions The reliability of computed tomography angiography for pulmonary embolism was excellent for the axial and multiplanar reformatted methods for quantifying the right-to-left ventricular ratio and for the modified Miller and refined Miller scores for quantifying of pulmonary artery thrombus burden.

  7. Embolization of renal arteries before transplantation in patients with polycystic kidney disease: a single institution long-term experience

    Energy Technology Data Exchange (ETDEWEB)

    Petitpierre, F.; Cornelis, F.; Lasserre, A.S.; Tricaud, E.; Le Bras, Y.; Grenier, N. [Pellegrin Hospital, Department of Radiology, Bordeaux (France); Couzi, L.; Merville, P. [Pellegrin Hospital, Department of Nephrology, Bordeaux (France); Combe, C.; Ferriere, J.M. [Pellegrin Hospital, Department of Urology, Bordeaux (France)

    2015-11-15

    We aimed to retrospectively assess the long-term safety and efficacy of embolization of renal arteries (ERA) in patients with polycystic kidney disease (PKD) before renal transplantation. Between January 2008 and November 2013, 82 ERA procedures were performed on 76 kidneys in 73 patients (mean age 53 years, range: 34-72). All patients had terminal-stage PKD and were under dialysis and on the renal transplant waiting list with a temporary contraindication due to excessive renal volume. ERA was considered successful in 89.5 % (68/76) of embolized kidneys, meaning that the temporary contraindication for transplantation could be withdrawn for 65 patients (on average 5.6 months, range: 2.8-24.3, after ERA). Mean volume reduction was 40 (range: 2-69) at 3 months and 59 % (35-86) thereafter (both p < 0.001). Post-embolization syndrome occurred after 15 of 82 procedures (18.3 %). The severe complication rate was 4.9 %. Forty-three (67.7 %) transplantations were successfully conducted after ERA, with a mean follow-up of 26.2 months (range: 1.8-59.5), and the estimated 5-year graft survival rate was 95.3 % [95 % CI: 82.7-98.8]. ERA is a safe and effective alternative to nephrectomy before renal transplantation in patients with PKD. (orig.)

  8. Clinical and multidetector CT follow-up results of renal artery aneurysms treated by detachable coil embolization using 3D rotational angiography

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Jung Min; Park, Kwang Bo; Kim, Keon Ha; Jeon, Pyoung; Shin, Sung Wook; Park, Hong Suk; Do, Young Soo (Dept. of Radiology and the Center for Imaging Science, Samsung Medical Center, Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)), email: kbparksmc@skku.edu; Kim, Dong-Ik; Kim, Young-Wook (Div. of Vascular Surgery, Dept. of Surgery, Samsung Medical Center, Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of))

    2011-10-15

    Background: There are very few reports regarding the use of 3D rotational angiography (3D RA) in embolization of renal artery aneurysms (RAAs). No valuable data have been reported on the follow-up result of coil embolization for RAAs on computed tomography (CT). Purpose: To evaluate the clinical and multidetector computed tomography (MDCT) follow-up results of renal artery aneurysms treated by detachable coil embolization using 3D RA. Material and Methods: Six patients diagnosed with RAAs were included. Five patients underwent detachable coil embolization. Five patients underwent 3D RA and the parameters used for planning endovascular treatment obtained by 2D CT, reformatted 3D CT angiography (3D CTA), 2D digital subtraction angiography (2D DSA) and 3D RA were compared. The post embolization MDCT follow-up findings were analyzed retrospectively. Results: The technical success rate for detachable coil embolization was 40%. The 3D CTA showed the dome-to-neck ratio (DNR) and tangential view of the renal artery aneurysm in five patients (83.3%) and the 2D CT showed it in four (66.7%). An optimal working angle assessment could not be obtained on the 2D CT and 3D CTA. The 3D RA showed the DNR, tangential view, and optimal working angle in all patients. Renal infarction occurred in three patients and Postprocedural hypertension developed in two patients during the follow-up period. Conclusion: The 3D RA was useful in preoperative determination of adequate working angle for detachable coil embolization of RAAs. Late complications of detachable coil embolization for RAAs were renal infarction and hypertension

  9. Gravidez e parto após embolização arterial para tratamento de leiomioma uterino Pregnancy and delivery after arterial embolization for fibroid treatment

    Directory of Open Access Journals (Sweden)

    Cláudio Emilio Bonduki

    2006-10-01

    Full Text Available OBJETIVO: Analisar a evolução da gestação e partos após tratamento de leiomioma uterino por embolização das artérias uterinas. MÉTODOS: Foram incluídas na avaliação inicial 112 pacientes submetidas a embolização de artérias uterinas para tratamento de mioma uterino. Destas, somente nove desejavam o tratamento conservador para manter a capacidade reprodutiva. Este procedimento foi indicado para estas nove pacientes, pois elas não eram susceptíveis ao tratamento conservador cirúrgico. Submeteram-se a embolização das artérias uterinas com partículas de álcool polivinílico ou embosferas com diâmetro de 500 a 700 µm e evoluíram sem intercorrências. RESULTADOS: Durante o acompanhamento dessas nove pacientes houve boa resposta clínica, com redução significativa no volume do útero e dos miomas. Dessas nove, quatro engravidaram, sendo que duas tiveram abortamento precoce e duas evoluíram normalmente até o final da gestação com parto a termo, sendo um deles gemelar. CONCLUSÃO: A embolização de artérias uterinas é uma opção para o tratamento de miomas uterinos e apresenta bons resultados clínicos e anatômicos, permitindo manter a capacidade reprodutiva.PURPOSE: To analyze gestation evolution and deliveries after myoma treatment by embolization of the uterine arteries. METHODS: In the initial evaluation, 112 patients submitted to embolization of uterine arteries were included for treatment of myoma. From those, only nine wanted to be submitted to conservative treatment in order to keep their reproductive capacity. This procedure was indicated to the nine patients, since they were not susceptible to a conservative surgical treatment. They were submitted to embolization of the uterine arteries with particles of polyvinyl alcohol or embospheres with diameters ranging from 500 to 700 µm, and they have evolved without intercurrence. RESULTS: During the follow-up of these patients, there was a good clinical response

  10. A dynamic concept of middle cerebral artery occlusion and cerebral infarction in the acute state based on interpreting severe hyperemia as a sign of embolic migration

    DEFF Research Database (Denmark)

    Olsen, T S; Lassen, N A

    1984-01-01

    The present study investigates the pathogenesis of focal cerebral hyperemia, its effect on brain tissue and discusses its pathophysiological and therapeutic importance in the light of interpreting severe hyperemia as a sign of arterial reopening probably due to embolic migration. Cerebral...... as well as in non-infarcted tissue. Apparently, it is the severity of the initial ischemic episode and not the hyperemia that determines whether or not tissue necrosis develops. Interpreting severe hyperemia as a sign of arterial reopening and embolic migration (evidenced by partial reopening affecting...

  11. Emergency gastroduodenal artery embolization by sandwich technique for angiographically obvious and oblivious, endotherapy failed bleeding duodenal ulcers

    Energy Technology Data Exchange (ETDEWEB)

    Anil, G., E-mail: ivyanil10@gmail.com [Department of Diagnostic Imaging, National University Hospital (Singapore); Department of Radiology, Changi General Hospital (Singapore); Tan, A.G.S.; Cheong, H.-W.; Ng, K.-S.; Teoh, W.-C. [Department of Radiology, Changi General Hospital (Singapore)

    2012-05-15

    Aim: To determine the feasibility, safety, and efficacy of adopting a standardized protocol for emergency transarterial embolization (TAE) of the gastroduodenal artery (GDA) with a uniform sandwich technique in endotherapy-failed bleeding duodenal ulcers (DU). Materials and methods: Between December 2009 and December 2010, 15 patients with endotherapy-failed bleeding DU were underwent embolization. Irrespective of active extravasation, the segment of the GDA supplying the bleeding DU as indicated by endoscopically placed clips was embolized by a uniform sandwich technique with gelfoam between metallic coils. The clinical profile of the patients, re-bleeding, mortality rates, and response time of the intervention radiology team were recorded. The angioembolizations were reviewed for their technical success, clinical success, and complications. Mean duration of follow-up was 266.5 days. Results: Active contrast-medium extravasation was seen in three patients (20%). Early re-bleeding was noted in two patients (13.33%). No patient required surgery. There was 100% technical success, while primary and secondary clinical success rates for TAE were 86.6 and 93.3%, respectively. Focal pancreatitis was the single major procedure-related complication. There was no direct bleeding-DU-related death. The response time of the IR service averaged 150 min (range 60-360 min) with mean value of 170 min. Conclusion: Emergency embolization of the GDA using the sandwich technique is a safe and highly effective therapeutic option for bleeding DUs refractory to endotherapy. A prompt response from the IR service can be ensured with an institutional protocol in place for such common medical emergencies.

  12. The role of CT in pelvic fracture. CT finding of retro-peritoneal hematoma and indication of transcatheter arterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Igarashi, Tsuneo; Hoshikawa, Yoshikazu; Saeki, Mitsuaki; Nakajima, Yasuo [St. Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine

    1998-10-01

    Although retro-peritoneal hematoma accompanying a pelvic fracture has been treated by arterial ligation formerly, it is associated with a high mortality rate and a transcatheter arterial embolization has now become the first choice of treatment. Meanwhile, the usefulness of computed tomography (CT) in traumatized patient has been reported frequently. Our hospital also employs CT positively as an examination following plain radiography in the cases with pelvic fracture. However, while indication of angiography is seen in several reports, the amount of retro-peritoneal hematoma as an index has not been reported. In the present study, we examined 112 patients given CT at the time of examination at the emergency center of our hospital between April 1, 1988, and June 30, 1997, and classified the amount of retro-peritoneal hematoma on CT into 5 groups to discuss indication of angiography. In the cases with moderate or massive amount of retro-peritoneal hematomas, cases with shock state exceeded 60% and the amount of hematoma was considered to reflect the circulation profile to a certain extent. As the amount of retro-peritoneal hematoma increased, the number of cases given embolization also increased; embolization was performed in 29 cases (61.7%) among those which had moderate or massive amount of hematoma. From the above findings, it was predicted that the amount of retro-peritoneal hematoma could be one of the deciding factors for indication of angiography. However, as there are cases falling into a shock state due to gradual increase of hematoma or associated with injuries in other organs, careful observation is needed for the cases judged out of indication. (author)

  13. Arterial embolization of an extrapleural hematoma from a dislocated fracture of the lumbar spine: a case report

    Directory of Open Access Journals (Sweden)

    Morita Seiji

    2009-06-01

    Full Text Available Abstract Background We present a report of a blunt-trauma patient who developed an atypical extrapleural hematoma with hemodynamic instability following a dislocation fracture of the first lumbar vertebra. We successfully treated her with arterial embolization (AE of the lumbar and intercostal arteries. Case report The patient, a 74-year-old woman, was injured in a traffic accident. At the scene of the accident, she was found to be alert, and her hemodynamic condition was stable. She arrived at our hospital complaining of lumbago. A thoracoabdominal computed tomography (CT scan with contrast enhancement showed a dislocation fracture of the first lumbar vertebra along with paravertebral and retroperitoneal hematomas. Therefore, we managed the patient conservatively with bed rest. However, 3 h after admission, her blood pressure suddenly decreased. A repeated thoracoabdominal CT scan showed enlargement of the right retroperitoneal hematoma with extravasation of the contrast medium into the right extrapleural space. Angiography was immediately performed, showing extravasation of the contrast media from the right intercostal (Th12 and lumbar arteries (L1. After arterial embolization (AE with gelatin-sponge particles, extravasation of the contrast medium ceased, and the patient's hemodynamic condition stabilized without massive fluid resuscitation. Conclusion The extrapleural hematoma reduced in size after AE, and almost disappeared on the 14th day of hospitalization. The lumbar spinal fracture was successfully repaired on day 16, and the patient was kept in the hospital to recuperate. We believe that AE is effective for the management of intractable bleeding following fractures of the spine.

  14. Selective embolization of the internal iliac arteries for the treatment of intractable hemorrhage in children with malignancies

    Directory of Open Access Journals (Sweden)

    Sul Hee Bae

    2011-04-01

    Full Text Available Purpose : Acute internal hemorrhage is an occasionally life-threatening complication in pediatric cancer patients. Many therapeutic approaches have been used to control bleeding with various degrees of success. In this study, we evaluated the efficacy of selective internal iliac artery embolization for controlling acute intractable bleeding in children with malignancies. Methods : We retrospectively evaluated the cases of 6 children with various malignancies (acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, T-cell prolymphocytic leukemia, Langerhans cell histiocytosis, and rhabdomyosarcoma, who had undergone selective arterial embolization (SAE of the internal iliac artery at the Chonnam National University Hwasun Hospital between January 2004 and December 2009. SAE was performed by an interventional radiologist using Gelfoam&#9415; and/or Tornado&#9415; coils. Results : The patients were 5 boys and 1 girl with median age of 6.9 years (range, 0.7&#8211;14.8 years at the time of SAE. SAE was performed once in 4 patients and twice in 2, and the procedure was unilateral in 2 and bilateral in 4. The causes of hemorrhage were as follows: hemorrhagic cystitis (HC in 3 patients, procedure-related internal iliac artery injuries in 2 patients, and tumor rupture in 1 patient. Initial attempt at conservative management was unsuccessful. Of the 6 patients, 5 (83.3% showed improvement after SAE without complications. Conclusion : SAE may be a safe and effective procedure for controlling acute intractable hemorrhage in pediatric malignancy patients. This procedure may obviate the need for surgery, which carries an attendant risk of morbidity and mortality in cancer patients with critical conditions.

  15. Uterine artery embolization for hemorrhage resulting from second-trimester abortion in women with scarred uterus: report of two cases.

    Science.gov (United States)

    Shen, Yunfeng; Liao, Yumei; Feng, Guangsen; Gu, Xiaoli; Wan, Shi

    2015-01-01

    This study was conducted to investigate the effect of uterine artery embolization for the treatment of hemorrhage following second-trimester labor induction for women with scarred uterus. Two cases of second-trimester abortion were retrospectively reviewed, both of which had a history of caesarean delivery and were complicated by gestational anemia. One was at 18 weeks' gestation and presented with persistent vaginal bleeding for two months resulting in relatively large area of blood clot in uterine cavity. The other was at 25 weeks' gestation with partial hydatidiform mole and presented with intermittent vaginal bleeding. Both patients presented with continuous and heavy vaginal bleeding after oral administration of mifepristone for labor induction, with one cervix left unopened, while the other cervix 3 cm left dilatation, yet felt obstructed by pregnant tissue. Both patients were immediately treated with uterine artery embolization (UAE). Both patients presented with alleviated hemorrhage and regular uterine contraction after UAE, followed by smooth induction of labor. No hemorrhage occurred since then during the follow-up. The results suggest that UAE is safe and effective for the treatment of massive hemorrhage of second-trimester abortion in women with scarred uterus. It can reduce time period of labor induction and alleviate hemorrhage, which not only rescues patients but also avoids cesarean sections and retains fertility for the pregnant.

  16. An unusual case of hematuria in a young female: renal artery embolism, mitral stenosis, and sinus rhythm

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2016-01-01

    Full Text Available Renal artery embolism (RAE is an uncommon entity that is most often secondary to a cardiac source. Most reported cases have been in patients with underlying atrial fibrillation (AF, and occurrence of RAE, especially in patients with valvular heart disease, and sinus rhythm is very rare. We describe an unusual case of a young female who presented with sudden onset right flank pain, vomiting, anorexia, and hematuria, and was found to have thrombotic occlusion of the distal right renal artery. Although she denied any previous cardiac history, detailed cardiovascular examination revealed the presence of severe rheumatic mitral stenosis without any evidence of AF or left atrial clot. She was initially managed conservatively using low molecular weight heparin followed by oral anticoagulation with resolution of symptoms. A successful balloon mitral valvotomy was performed six weeks later. The patient is asymptomatic at her last follow-up of six months with preserved renal function. In symptomatic patients, clinicians need to consider the possibility of RAE even in patients of valvular heart disease with underlying sinus rhythm. Appropriate management of the underlying cardiac condition is imperative since embolism may be recurrent leading to compromise of renal function, if left untreated.

  17. Massive variceal bleeding secondary to splenic vein thrombosis successfully treated with splenic artery embolization: a case report

    Directory of Open Access Journals (Sweden)

    Michalopoulos Antonis

    2010-05-01

    Full Text Available Abstract Introduction Splenic vein thrombosis results in localized portal hypertension called sinistral portal hypertension, which may also lead to massive upper gastrointestinal bleeding. Symptomatic sinistral portal hypertension is usually best treated by splenectomy, but interventional radiological techniques are safe and effective alternatives in the management of a massive hemorrhage, particularly in cases that have a high surgical risk. Case presentation We describe a 23-year-old Greek man with acute massive gastric variceal bleeding caused by splenic vein thrombosis due to a missing von Leiden factor, which was successfully managed with splenic arterial embolization. Conclusions Interventional radiological techniques are attractive alternatives for patients with a high surgical risk or in cases when the immediate surgical excision of the spleen is technically difficult. Additionally, surgery is not always successful because of the presence of numerous portal collaterals and adhesion. Splenic artery embolization is now emerging as a safe and effective alternative to surgery in the management of massive hemorrhage from gastric varices due to splenic vein thrombosis, which often occurs in patients with hypercoagulability.

  18. Cholesterol crystal embolism (atheroembolism)

    Science.gov (United States)

    VENTURELLI, CHIARA; JEANNIN, GUIDO; SOTTINI, LAURA; DALLERA, NADIA; SCOLARI, FRANCESCO

    2006-01-01

    Cholesterol crystal embolism, known as atheroembolic disease, is caused by showers of cholesterol crystals from an atherosclerotic plaque that occludes small arteries. Embolization can occur spontaneously or as an iatrogenic complication from an invasive vascular procedure (angiography or vascular surgery) and after anticoagulant therapy. The atheroembolism can give rise to different degrees of renal impairment. Some patients show a moderate loss of renal function, others severe renal failure requiring dialysis. Renal outcome can be variable: some patients deteriorate or remain on dialysis, some improve and some remain with chronic renal impairment. Clinically, three types of atheroembolic renal disease have been described: acute, subacute or chronic. More frequently a progressive loss of renal function occurs over weeks. Atheroembolization can involve the skin, gastrointestinal system and central nervous system. The diagnosis is difficult and controversial for the protean extrarenal manifestations. In the past, the diagnosis was often made post-mortem. In the last 10 yrs, awareness of atheroembolic renal disease has improved. The correct diagnosis requires the clinician to be alert. The typical patient is a white male aged >60 yrs with a history of hypertension, smoking and arterial disease. The presence of a classic triad (precipitating event, renal failure and peripheral cholesterol crystal embolization) suggests the diagnosis. This can be confirmed by a biopsy of the target organs. A specific treatment is lacking; however, it is an important diagnosis to make because an aggressive therapeutic approach can be associated with a more favorable clinical outcome. PMID:21977265

  19. Resection of a giant renal angiomyolipoma in a solitary kidney with preoperative arterial embolization

    Institute of Scientific and Technical Information of China (English)

    SHEN Wen-hao; PAN Jin-hong; YAN Ju-nan; CHEN Zhi-wen; ZHOU Zhan-song; LU Gen-sheng; LI Wei-bing

    2011-01-01

    Renal angiomyolipoma is a type of benign tumor that occurs sporadically in addition to being associated with tuberous sclerosis. Preoperative embolization of large tumors is important to avoid excessive blood loss during surgery. We reported a patient with a 5505-g giant renal angiomyolipoma in a solitary kidney. The patient was treated with preoperative embolization and radical nephrectomy without complications. This type of treatment for an enormous angiomyolipoma can reduce the risk of uncontrolled hemorrhage caused by rupture of the tumor during the operation and should be considered for the treatment of similar tumors.

  20. Improving cytopenia with splenic artery embolization in a patient with paroxysmal nocturnal hemoglobinuria on eculizumab.

    Science.gov (United States)

    Krishnan, Suresh K; Hill, Anita; Hillmen, Peter; Arnold, Louise M; Brooksbank, Gemma L; Wood, Alex; Scarsbrook, Andrew; Davies, Mervyn H; Kelly, Richard J

    2013-12-01

    Paroxysmal nocturnal hemoglobinuria is a rare acquired stem cell disorder characterized by intravascular hemolysis, aplasia and an increased risk of thrombosis. We describe a patient under treatment with the anti-complement antibody eculizumab who developed pancytopenia, requiring blood transfusions, due to massive splenomegaly. The patient underwent two separate splenic embolizations, which reduced the size of the spleen and improved his blood count to the point that blood transfusions were no longer necessary. Splenic embolization was chosen over splenectomy due to the potential postoperative complications of splenectomy, especially that of thrombosis.

  1. Acute pancreatitis associated left-sided portal hypertension with severe gastrointestinal bleeding treated by transcatheter splenic artery embolization: a case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Zhi-yu LI; Bin LI; Yu-lian WU; Qiu-ping XIE

    2013-01-01

    Left-sided portal hypertension (LSPH) followed by acute pancreatitis is a rare condition with most patients being asymptomatic.In cases where gastrointestinal (GI) bleeding is present,however,the condition is more complicated and the mortality is very high because of the difficulty in diagnosing and selecting optimal treatment.A successfully treated case with severe GI bleeding by transcatheter splenic artery embolization is reported in this article.The patient exhibited severe uncontrollable GI bleeding and was confirmed as gastric varices secondary to LSPH by enhanced computed tomography (CT) scan and CT-angiography.After embolization,the bleeding stopped and stabilized for the entire follow-up period without any severe complications.In conclusion,embolization of the splenic artery is a simple,safe,and effective method of controlling gastric variceal bleeding caused by LSPH in acute pancreatitis.

  2. Acute pancreatitis associated left-sided portal hypertension with severe gastrointestinal bleeding treated by transcatheter splenic artery embolization: a case report and literature review.

    Science.gov (United States)

    Li, Zhi-yu; Li, Bin; Wu, Yu-lian; Xie, Qiu-ping

    2013-06-01

    Left-sided portal hypertension (LSPH) followed by acute pancreatitis is a rare condition with most patients being asymptomatic. In cases where gastrointestinal (GI) bleeding is present, however, the condition is more complicated and the mortality is very high because of the difficulty in diagnosing and selecting optimal treatment. A successfully treated case with severe GI bleeding by transcatheter splenic artery embolization is reported in this article. The patient exhibited severe uncontrollable GI bleeding and was confirmed as gastric varices secondary to LSPH by enhanced computed tomography (CT) scan and CT-angiography. After embolization, the bleeding stopped and stabilized for the entire follow-up period without any severe complications. In conclusion, embolization of the splenic artery is a simple, safe, and effective method of controlling gastric variceal bleeding caused by LSPH in acute pancreatitis.

  3. Successful coil embolization of a ruptured basilar artery aneurysm in a child with leukemia: a case report.

    Science.gov (United States)

    Hayashi, Shihori; Maehara, Taketoshi; Mukawa, Maki; Aoyagi, Masaru; Yoshino, Yoshikazu; Nemoto, Shigeru; Ono, Toshiaki; Ohno, Kikuo

    2014-01-01

    Ruptured intracranial aneurysms are rare in the pediatric population compared to adults. This has incited considerable discussion on how to treat children with this condition. Here, we report a child with a ruptured saccular basilar artery aneurysm that was successfully treated with coil embolization. A 12-year-old boy with acute lymphoblastic leukemia and accompanying abdominal candidiasis after chemotherapy suddenly complained of a severe headache and suffered consciousness disturbance moments later. Computed tomography scans and cerebral angiography demonstrated acute hydrocephalus and subarachnoid hemorrhage caused by saccular basilar artery aneurysm rupture. External ventricular drainage was performed immediately. Because the patient was in severe condition and did not show remarkable signs of central nervous system infection in cerebrospinal fluid studies, we applied endovascular treatment for the ruptured saccular basilar artery aneurysm, which was successfully occluded with coils. The patient recovered without new neurological deficits after ventriculoperitoneal shunting. Recent reports indicate that both endovascular and microsurgical techniques can be used to effectively treat ruptured cerebral aneurysms in pediatric patients. A minimally invasive endovascular treatment was effective in the present case, but long-term follow-up will be necessary to confirm the efficiency of endovascular treatment for children with ruptured saccular basilar artery aneurysms.

  4. [Study on targeting drug delivery system--the characteristics of methotrexate microsphere and experimental treatment of hepatic tumor in rats by arterial embolization].

    Science.gov (United States)

    Chen, Q H; Lu, W G; Ge, Q H; Sheng, Q; Zhang, Y; Xie, X H; Wang, Y; Wu, M C; Zhang, X H

    1991-01-01

    Preparation of methotrexate microsphere (MTX-ms) by emulsion-freezing technique was introduced and the experimental results proved that MTX entrapped in the microspheres exhibited good stabilities towards temperature, cobalt-60 radiation and light. The dissolution and inflation rate of the microspheres in pH 7.4 buffer solution at different times measured by Coulter counter was presented. Antitumor activity of MTX-ms after hepatic arterial embolization was examined in a model of liver tumor in Wistar rats. The group of rats treated with MTX-ms showed a rather significant reduction in tumor growth and more extended tumor necrosis as compared with the other groups, e.g. normal saline solution, MTX solution, placebo gelatin-ms and the results demonstrate that the effect of arterial chemoembolization used by MTX-ms is superior to that of the groups either using arterial chemotherapy or arterial embolization alone in treating rat liver cancer.

  5. Effect of systemic vein chemotherapy and internal iliac arterial embolization infusion chemotherapy on angiogenesis and malignant degree of cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Gang Chen

    2016-01-01

    Objective:To analyze the effect of systemic vein chemotherapy and internal iliac arterial chemoembolization on angiogenesis and malignant degree of cervical cancer.Methods: A total of 108 cases of patients with middle and advanced cervical cancer were included in the research, and the time range of the research was from February 2014 to December 2015. According to different means of chemotherapy, included patients were divided into observation group 54 cases and control group 54 cases, control group received systemic vein chemotherapy, observation group received internal iliac arterial infusion chemotherapy and embolization treatment, and then differences in the levels of angiogenesis-related indicators, blood flow parameters within tumor, serum illness-related indicators, cervical tumor tissue proliferation-related indicators,etc. were compared between two groups after treatment.Results:Serum VEGFR-2, HIF-1α, vWF and Lam values of observation group after chemotherapy were lower than those of control group; PI, VI, FI, VFI and Vmax values of observation group after treatment were lower than those of control group while RI value was higher than that of control group; serum SCC-Ag, TK1, HE4, CYFRA21-1, IGF-Ⅱ and Gal-9 values of observation group after chemotherapy were lower than those of control group; miR-26b, SCD-1, Cyclin D1 and TLR4 protein expression levels in tumor tissue of observation group after treatment were lower than those of control group while miR-99b protein expression level was higher than that of control group.Conclusions: Internal iliac arterial infusion chemotherapy and embolization can significantly decrease tumor angiogenesis and inhibit tumor cell proliferation, and it is a perfect means of interventional chemotherapy.

  6. Carotid artery stenosis. Current state of therapy; Karotisstenose. Aktueller Stand der Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, K.I.; Papanagiotou, P.; Zimmer, A.; Reith, W. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany); Schaefers, H.J. [Universitaetsklinikum des Saarlandes, Klinik fuer Thorax- und Herz-Gefaess-Chirurgie, Homburg/Saar (Germany)

    2010-07-15

    Ipsilateral occlusive or embolizing carotid artery stenoses are found in 20-30% of all cases of ischemic stroke. Several randomized studies revealed endarterectomy to be the gold standard in the therapy of severe symptomatic (NASCET, ESCT) and to some extent of asymptomatic carotid stenoses (ACAS, ACST). Stent angioplasty has been established as an alternative therapeutic option although non-inferiority of this procedure has not yet been proven. We provide an overview of both procedures as well of the state of current trials. (orig.) [German] Okkludierende oder embolisierende Stenosen der A. carotis interna sind in 20-30% der Faelle fuer einen ipsilateralen ischaemischen Schlaganfall verantwortlich. Nach Abschluss mehrerer randomisierter Studien erscheint die Karotisendarteriektomie als Therapie der Wahl bei hochgradigen symptomatischen (NASCET, ESCT) und z. T. auch asymptomatischen Stenosen (ACAS, ACST). Seit einigen Jahren hat sich die (Stent-)Angioplastie zunehmend als Therapiealternative etabliert, auch wenn die bislang veroeffentlichten Studien die Gleichwertigkeit beider Verfahren noch nicht zeigen konnten. Wir geben einen Ueberblick ueber beide Verfahren sowie ueber die derzeitige Studienlage. (orig.)

  7. Endovascular therapy for renal artery stenoses; Endovaskulaere Therapie der Nierenarterienstenose

    Energy Technology Data Exchange (ETDEWEB)

    Uder, M. [Universitaetsklinik Homburg (Germany). Radiodiagnostik; Humke, U. [Urologische Universitaetsklinik Wuerzburg (Germany)

    2003-12-01

    Percutaneous transluminal balloon angioplasty and stenting for renal artery stenoses have become routine in the day-to-day life of interventional radiologists. New studies, however, have questioned the role of this methodology. This review discusses the technique of endovascular therapy for renal artery stenoses and the impact of the pathoanatomic differences on the outcome of angioplasty or stenting. Furthermore, the current role of revascularisation in the treatment of renal hypertension and renal insufficiency is analyzed and its contribution in competition with other methods is demonstrated. It is the goal of this review to give practical advice how to treat stenoses found in various clinical settings. (orig.) [German] Angioplastie und Stent-Therapie von Verengungen der Nierenarterie gehoeren laengst zum Alltagsgeschaeft interventioneller Radiologen. Neuere Untersuchungen stellen jedoch die klinische Bedeutung der Methode infrage. Der Beitrag beschaeftigt sich zunaechst mit der Technik der endovaskulaeren Therapie von Stenosen der Nierenarterie und damit, wie die Aethiologie der Erkrankung das Ansprechen auf PTA bzw. Stent beeinflusst. Anschliessend wird die aktuelle Bedeutung der Revaskularisation fuer die Behandlung einer renalen Hypertonie und einer Niereninsuffizienz analysiert und gezeigt, wo heute eine Therapie auch in Konkurrenz zu anderen Verfahren sinnvoll ist. Im Ergebnis soll der Artikel praktische Anleitung geben, welche Stenose in verschiedenen klinischen Konstellationen behandelt werden soll. (orig.)

  8. Clinical Observation on Treatment of Uterine Fibroid Artery Embolization Induced Postoperative Syndrome by Therapy of Promoting Blood Circulation and Removing Stasis in Patients with Uterus Myoma%化瘀散结法治疗子宫肌瘤动脉栓塞术后综合征的临床观察

    Institute of Scientific and Technical Information of China (English)

    冷观群; 亢雪峰; 魏毅利; 邱永秀

    2010-01-01

    目的 观察化瘀散结法治疗子宫肌瘤患者行子宫动脉栓塞术(uterine fibroid artery embolization,UFAE)后并发症的近期临床疗效.方法 将60例瘀阻胞宫证子宫肌瘤患者随机分为治疗组和对照组各30例,两组均采用Sldinger技术完成UFAE治疗.治疗组在术后3个月服用活血化瘀、散结消癥类中药,对照组酌情予对症治疗.两组患者均术后随访6个月,详细观察并记录患者治疗前后月经变化,栓塞综合征出现的时间、程度、缓解方法及消失时间.结果 两组术后均未发现闭经;对照组出现1例轻度泌尿生殖系统感染,治疗组无泌尿生殖系统感染;治疗组发生盆腔疼痛的病例数显著低于对照组;治疗组盆腔疼痛评分、持续时间和阴道不规则流血持续时间显著低于对照组(P<0.05).结论 化瘀散结法治疗UFAE并发症具有明显优势,不良反应少,临床具有较好的应用前景.

  9. Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 1, Pathological Background and Clinical Implications.

    Science.gov (United States)

    Sun, Fei; Crisóstomo, Verónica; Báez-Díaz, Claudia; Sánchez, Francisco M

    2016-01-01

    Pathological features of benign prostatic hyperplasia (BPH) dictate various responses to prostatic artery embolization (PAE). Typically, BPH originates in the transition zone and periurethral region, where should be considered the primary target area in PAE procedures. Given that histological heterogeneity of components in hyperplasia nodules, epithelial or stromal, identifying the more responsive nodules to PAE will have clinical implications. Since some lower urinary tract symptoms (LUTS) in patients with BPH are usually related to bladder outlet obstruction-induced changes in bladder function rather than to outflow obstruction directly, proper selection of candidate patients prior to PAE is of great clinical importance. BPH is a typical chronic progressive condition, suggesting PAE could aim not only to relieve LUTS but also to delay or prevent the clinical progression. Awareness of the pathological background of BPH is essential for interventional radiologists to improve clinical outcomes and develop new treatment strategies in clinical practice of PAE.

  10. [Arterial injury associated with tension-free vaginal tape procedure successfully treated by radiological embolization: a case report].

    Science.gov (United States)

    Takatera, Hiroshi; Mukai, Masatoshi; Fujii, Takahiro; Nishi, Masayo; Okada, Hiroshi; Nishimine, Kiyoshi; Tsushima, Juichi

    2006-09-01

    A 75-year-old woman underwent a tension-free vaginal tape (TVT) procedure for urinary stress incontinence. The patient complained of lower abdominal pain, a feeling of lower abdominal distension and nausea three hours after the operation. In addition, systolic blood pressure decreased gradually to 80 mmHg. Enhanced computed tomography revealed a retropubic hematoma sized up to 16 cm X 12 cm X 11 cm and bleeding from a vessel running through the posterosuperior aspect of the pubic bone. Successively, arteriography was performed. The arteriogram also confirmed arterial injury, which was successfully treated by selective embolization using a gelatin sponge and pushable coils. Postoperative course was uneventful requiring neither blood transfusion nor surgical removal of the hematoma.

  11. Prostatic Artery Embolization (PAE) for Symptomatic Benign Prostatic Hyperplasia (BPH): Part 1, Pathological Background and Clinical Implications

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Fei, E-mail: feisun@ccmijesususon.com; Crisóstomo, Verónica, E-mail: crisosto@ccmijesususon.com; Báez-Díaz, Claudia, E-mail: cbaez@ccmijesususon.com; Sánchez, Francisco M., E-mail: msanchez@ccmijesususon.com [Jesús Usón Minimally Invasive Surgery Centre (Spain)

    2016-01-15

    Pathological features of benign prostatic hyperplasia (BPH) dictate various responses to prostatic artery embolization (PAE). Typically, BPH originates in the transition zone and periurethral region, where should be considered the primary target area in PAE procedures. Given that histological heterogeneity of components in hyperplasia nodules, epithelial or stromal, identifying the more responsive nodules to PAE will have clinical implications. Since some lower urinary tract symptoms (LUTS) in patients with BPH are usually related to bladder outlet obstruction-induced changes in bladder function rather than to outflow obstruction directly, proper selection of candidate patients prior to PAE is of great clinical importance. BPH is a typical chronic progressive condition, suggesting PAE could aim not only to relieve LUTS but also to delay or prevent the clinical progression. Awareness of the pathological background of BPH is essential for interventional radiologists to improve clinical outcomes and develop new treatment strategies in clinical practice of PAE.

  12. Superior Hypogastric Nerve Block to Reduce Pain After Uterine Artery Embolization: Advanced Technique and Comparison to Epidural Anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Binkert, Christoph A., E-mail: christoph.binkert@ksw.ch [Kantonsspital Winterthur, Institute of Radiology and Nuclear Medicine (Switzerland); Hirzel, Florian C. [Kantonsspital Winterthur, Department of Gynecology (Switzerland); Gutzeit, Andreas; Zollikofer, Christoph L. [Kantonsspital Winterthur, Institute of Radiology and Nuclear Medicine (Switzerland); Hess, Thomas [Kantonsspital Winterthur, Department of Gynecology (Switzerland)

    2015-10-15

    PurposeTo evaluate a modified superior hypogastric nerve block (SHNB) to reduce pain after uterine artery embolization (UAE) compared to epidural anesthesia.Materials and methodsIn this retrospective study, the amount of opiate drugs needed after UAE was compared between SHNB and epidural anesthesia. Eighty one consecutive women (mean age: 43.67 years) were in the SHNB group and 27 consecutive women (mean age: 43.48 years) treated earlier at the same institution in the epidural anesthesia group. UAE was performed from a unilateral femoral artery approach using a 4F catheter. 500–700 or 700–900 μm trisacryl gelatine microspheres were used as embolic agents. The SHNB was performed by advancing a 21G from the abdominal wall below the umbilicus to the anterior portion of the 5th vertebral body. For optimal guidance a cranio-caudal tilt of 5°–15° was used. On a lateral view the correct contrast distribution in front of the vertebral body is confirmed. Then 20 ml local anesthesia (ropivacain 0.75 %) is injected. In case of an asymmetric right–left distribution the needle was repositioned.ResultsAll SHNB were successful without severe complications. The mean time for the SHNB was 4 min 38 s (2 min 38 s–9 min 27 s). The needle was repositioned in average 0.87 times. The opiate dose for the SHNB group was 19.33 ± 22.17 mg which was significantly lower. The average time to receive an opiate drug after SHNB was 4 h 41 min.ConclusionThe SHNB is a safe and minimally time-consuming way to reduce pain after UAE especially within the first 4 h.

  13. Prostatic Urethral Lift Vs Prostate Arterial Embolization: Novel Nonablative Strategies in the Management of Lower Urinary Tract Symptoms Secondary to Benign Prostate Hyperplasia.

    Science.gov (United States)

    Jones, Patrick; Rai, Bhavan Prasad; Aboumarzouk, Omar M; Somani, Bhaskar K

    2016-01-01

    Prostate urethral lift and prostate arterial embolization represent two evolving techniques with contrasting mechanisms of action (mechanical decompression vs angiographic embolization). Both yield relief of lower urinary tract symptoms over a period of several weeks. They display similar safety profiles with self-limiting pelvic discomfort characterizing the commonest minor adverse event. Both procedures have the potential to be carried out under local anesthesia and in the outpatient setting with suitability for patients with cardiovascular comorbidities. Neither has been found to cause degradation of sexual function. Further randomized studies are needed to delineate the formal position of these techniques in the surgical management of benign prostate hyperplasia.

  14. Selective Embolization of Systemic Collaterals for the Treatment of Recurrent Hemoptysis Secondary to the Unilateral Absence of a Pulmonary Artery in a Child

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Yin, E-mail: zhouyin502@163.com [West China Hospital, Sichuan University, Department of Pediatric Surgery (China); Tsauo, Jiaywei, E-mail: 80732059@qq.com [West China Hospital, Sichuan University, Institute of Interventional Radiology (China); Li, Yuan, E-mail: liyuanletters@163.com [West China Hospital, Sichuan University, Department of Pediatric Surgery (China); Li, Xiao, E-mail: simonlixiao@gmail.com [West China Hospital, Sichuan University, Institute of Interventional Radiology (China)

    2015-10-15

    The unilateral absence of the pulmonary artery (UAPA) is a rare anomaly. Hemoptysis due to systemic collaterals is one of the most common complications of UAPA. To the best of the authors’ knowledge, the utility of selective embolization for the treatment of this condition in children has not been reported previously. This report describes a 6-year-old girl with isolated UAPA (IUAPA) admitted for a 10-month history of recurrent hemoptysis that had worsened during the previous 2 months. Selective embolization of the bronchial systemic collaterals was performed. The patient remained asymptomatic with no recurrence of hemoptysis 8 months after the procedure.

  15. Efficacy and Safety of Transdermal Fentanyl(TDF)in Treatment of Pain Caused by Interventional Embolization Therapy

    Institute of Scientific and Technical Information of China (English)

    ZHU Xu; YANG Ren-jie; CHEN Hui

    2008-01-01

    Objective:Interventional embolization therapy is well accepted in cancer treatment,but patient may suffer from a moderate-to-severe pain after therapy and its quality of life(QoL)is influenced,this study is to observe the efficacy and safety of transdermal fentanyl(TDF)in the management of pain caused by interventional embolization therapy. Methods:Morphine 10mg and TDF 25μg/h were immediately used in 52 patients who had moderate-to-severe pain complicated by interventional embolization therapy,the pain intensity was evaluated by visual analogue scale(VAS).If VAS≥4 at 12h after treatment,the dosage of TDF added into 50 μg/h.At Oh,12h,24h,72h,1 week,2 weeks after TD,the vas and adverse events were observed respectively. Result:There was an obvious decrease in VAS at 12h after TDF treatment in the patients of which only 9 patients used 50ug/h dosage after partial splenic embolization(PSE)therapy.Most patients got satisfactory pain relief both the TDF 25μg/h and TDF 50μg/h group(VAS 0-1).The adverse events were nausea,vomiting and dizzy,especially in the TDF 50 μg/h group.No respiratory depression was observed and only one patient got retention of urine. Conclusion:TDF was effective and safe in the treatment of moderate-to-severe pain after interventional embolization therapy.

  16. Pulmonary embolism as a cause of cardiac arrest: Hypothermia in post-resuscitation period (cooling therapy

    Directory of Open Access Journals (Sweden)

    Niković Vuk

    2013-01-01

    Full Text Available Introduction. Pulmonary embolism as a possible cause of acute heart failure is a potentially fatal condition that can cause death in all age groups. Patients successfully resuscitated after cardiac arrest have a high risk of increased mortality and their poor long­term outcome is often associated with severe neurological complications. Case Outline. This is a case report of a 67­year­old man after a successful cardiopulmonary resuscitation (CPR which was followed by therapeutic hypothermia (TH. The patient visited the dermatological outpatients’ department with clinical presentation of pain and swelling of the right leg, shortness of breath and chest pain. During examination the patient lost consciousness, stopped breathing and had cardiac arrest. ECG was done which registered asystole. We began CPR. After 59 minutes of resuscitation return of heartbeat was achieved. The patient was transported to the Emergency Department. On admission, after computerized tomography (CT of the chest confirmed massive pulmonary embolism (PE, the patient was administered thrombolytic therapy with Metalyse (tenecteplase and anti­coagulation therapy (heparin. After stabilization, therapeutic hypothermia was applied. Combination of EMCOOLSpad on the chest and abdomen and cold Ringer lactate 500 ml at 4°C was flushed. Temperature was decreased to 33°C and kept stabile for 24 hours. After eight days the patient was conscious with a minimal neurological deficit. Conclusion. As shown in this case report, and according to the rich experience elsewhere, cooling therapy after out­of­hospital cardiac arrest and successful CRP may be useful in preventing neurological complications.

  17. Paradoxical embolism, deep vein thrombosis, pulmonary embolism in a patient with patent foramen ovale: a case report

    Directory of Open Access Journals (Sweden)

    Guo Shan

    2007-09-01

    Full Text Available Abstract Introduction Coexistence of pulmonary embolism and systemic arterial embolism suggest the diagnosis of paradoxical embolism which suggests the presence of intracardiac defects such as patent foramen ovale (PFO. Case presentation A 42 year old man was found to have a paradoxical embolism in the systemic arterial circulation, in the setting of pulmonary embolism and deep vein thrombosis (DVT in the lower extremities. Conclusion Paradoxical embolism and intracardiac shunt should be immediately considered in a patient with pulmonary embolism and systemic arterial embolism. Diagnostic modalities included arteriogram and saline contrast echocardiography. Closure of intracardiac shunt is needed for patients who are at risk for recurrent embolic events.

  18. Internal carotid artery pseudo occlusion with embolic cerebral ischemia and low flow in the central retinal artery: a diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Christoph Roehrer

    2011-08-01

    Full Text Available We present a rare case of internal carotid artery pseudoocclusion (ICAPO in a 60-yearold male Caucasian patient who experienced a reversible sudden loss of vision of the right eye for 10 min followed by recurrent blurring of vision as well as dysarthria and numbness in the left face. The referring ophthalmologist admitted the patient for suspicious occlusion of the internal carotid artery causing anterior ischemic optic neuropathy (AION.

  19. Bilateral Superior Cerebellar Artery Embolic Occlusion with a Fetal-Type Posterior Cerebral Artery Providing Collateral Circulation

    Directory of Open Access Journals (Sweden)

    Taylor J. Bergman

    2016-12-01

    Full Text Available Bilateral infarction of the superior cerebellar arteries with sparing of the rest of the posterior circulation, particularly the posterior cerebral arteries, is an uncommon finding in neurological practice. Most commonly, the deficits of the superior cerebellar arteries and posterior cerebral arteries occur together due to the close proximity of their origins at the top of the basilar artery. A patient was transferred to the neurological intensive care unit with a history of recent-onset falls from standing, profound hypertension, dizziness, and headaches. The neurological exam revealed cerebellar signs, including dysmetria of the right upper extremity and a decreased level of consciousness. Computed tomography of the head and neck revealed decreased attenuation throughout most of the cerebellar hemispheres suggestive of ischemic injury with sparing of the rest of the brain. Further investigation with a computed tomography angiogram revealed a fetal-type posterior cerebral artery on the right side that was providing collateral circulation to the posterior brain. Due to this embryological anomaly, the patient was spared significant morbidity and mortality that would have likely occurred had the circulation been more typical of an adult male.

  20. Transcatheter Embolization for Giant Splenic Artery Aneurisms: Still an Open Question

    Directory of Open Access Journals (Sweden)

    Marianna Mastroroberto

    2012-01-01

    patients with portal hypertension. It is indicated when the SAA diameter reaches 20 mm. Although endovascular techniques are effective and safe for the treatment of medium-sized SAAs, little is known about their applicability to large-sized SAAs. Herein, we report a case of giant SAA, which was treated with transcatheter coil embolization. The case was not considered suitable for surgery because of the presence of severe portal hypertension. The procedure was complicated by bacterial infection of the coils within the aneurismatic sac, leading to the development of hepatic failure. A liver transplant was then successfully performed despite the presence of a nonresponsive infection.

  1. Palliative embolization of renal tumors

    Directory of Open Access Journals (Sweden)

    Jaganjac Suad

    2015-01-01

    Full Text Available Background/Aim. Palliative embolization of renal tumors is the method of choice in the treatment of advanced inoperable renal cell carcinoma in patients with hematuria and pain. Patients with small tumors in the remaining solitary kidney who refuse surgery are suitable for this type of therapy as well as patients with centrally located inoperable tumors. The prerequisite for successful capillary embolization is the closure of the main arte-rial trunk with metal spirals. Methods. In the period from 2000 to 2010 we conducted 42 palliative embolizations. The average age of the patients was 75 years, including 26 men and 16 women. In 8 of the patients the intervention was repeated and in one with severe AV shunts embolization was performed 4 times. Embolization was performed with alcohol, Ivalon 150-250 μm and with metal coils. Results. No serious complications were observed during and after the intervention. Fourteen patient were still alive then and among the deceased patients the average survival time was 13.5 ± 10.8 months with the range of 1 to 56 months. The minimal survival time was 1 month with a maxi-mum survival time of 56 months. Conclusion. Our results are consistent with data in the literature. Survival in patients without metastases was longer than in those with metastases, as con-firmed by the 14 of the patients from the study. An additional therapeutic safety in the treatment of small cancers is provided with a combination therapy of embolization and radiofrequency thermoablation.

  2. Selective arterial embolization for control of haematuria secondary to advanced or recurrent transitional cell carcinoma of the bladder.

    LENUS (Irish Health Repository)

    Halpenny, D

    2014-05-02

    Haematuria is a common symptom in patients with advanced transitional cell carcinoma of the bladder. We report our experience of selective pelvic embolization using gelfoam as an embolic agent to treat intractable haematuria in these patients.

  3. Embolic intracranial arterial occlusion visualized by non-enhanced computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Tomita, Masaaki; Minematsu, Kazuo; Choki, Junichiro; Yamaguchi, Takenori (National Cardiovascular Center, Suita, Osaka (Japan))

    1984-12-01

    A 77-year-old woman with a history of valvular heart disease, atrial fibrillation and a massive infarction in the right cerebral hemisphere developed contralateral infarction due to occlusion of the internal carotid artery. A string-like structure with higher density than normal brain was demonstrated on non-enhanced computed tomography that was performed in the acute stage. This abnormal structure seen in the left hemisphere was thought to be consistent with the middle cerebral artery trunk of the affected side. Seventeen days after the onset, the abnormal structure was no more visualized on non-enhanced CT. These findings suggested that the abnormal structure with increased density was compatible with thromboembolus or intraluminal clot formed in the distal part of the occluded internal carotid artery. The importance of this finding as a diagnostic sign of the cerebral arterial occlusion was discussed.

  4. Clinical Results After Prostatic Artery Embolization Using the PErFecTED Technique: A Single-Center Study

    Energy Technology Data Exchange (ETDEWEB)

    Amouyal, Gregory, E-mail: gregamouyal@hotmail.com; Thiounn, Nicolas, E-mail: nicolas.thiounn@aphp.fr; Pellerin, Olivier, E-mail: olivier.pellerin@aphp.fr [Université Paris Descartes - Sorbonne - Paris - Cité, Faculté de Médecine (France); Yen-Ting, Lin, E-mail: ymerically@gmail.com [Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Interventional Radiology Department (France); Giudice, Costantino Del, E-mail: costantino.delgiudice@aphp.fr [Université Paris Descartes - Sorbonne - Paris - Cité, Faculté de Médecine (France); Dean, Carole, E-mail: carole.dean@aphp.fr [Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Interventional Radiology Department (France); Pereira, Helena, E-mail: helena.pereira@aphp.fr [Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit (France); Chatellier, Gilles, E-mail: gilles.chatellier@aphp.fr; Sapoval, Marc, E-mail: marc.sapoval2@aphp.fr [Université Paris Descartes - Sorbonne - Paris - Cité, Faculté de Médecine (France)

    2016-03-15

    BackgroundProstatic artery embolization (PAE) has been performed for a few years, but there is no report on PAE using the PErFecTED technique outside from the team that initiated this approach.ObjectiveThis single-center retrospective open label study reports our experience and clinical results on patients suffering from symptomatic BPH, who underwent PAE aiming at using the PErFecTED technique.Materials and MethodsWe treated 32 consecutive patients, mean age 65 (52–84 years old) between December 2013 and January 2015. Patients were referred for PAE after failure of medical treatment and refusal or contra-indication to surgery. They were treated using the PErFecTED technique, when feasible, with 300–500 µm calibrated microspheres (two-night hospital stay or outpatient procedure). Follow-up was performed at 3, 6, and 12 months.ResultsWe had a 100 % immediate technical success of embolization (68 % of feasibility of the PErFecTED technique) with no immediate complications. After a mean follow-up of 7.7 months, we observed a 78 % rate of clinical success. Mean IPSS decreased from 15.3 to 4.2 (p = .03), mean QoL from 5.4 to 2 (p = .03), mean Qmax increased from 9.2 to 19.2 (p = .25), mean prostatic volume decreased from 91 to 62 (p = .009) mL. There was no retrograde ejaculation and no major complication.ConclusionPAE using the PErFecTED technique is a safe and efficient technique to treat bothersome LUTS related to BPH. It is of interest to note that the PErFecTED technique cannot be performed in some cases for anatomical reasons.

  5. Selective arterial embolization of symptomatic and asymptomatic renal angiomyolipomas: a retrospective study of safety, outcomes and tumor size reduction

    Science.gov (United States)

    Bardin, Florian; Chevallier, Olivier; Bertaut, Aurélie; Delorme, Emmanuel; Moulin, Morgan; Pottecher, Pierre; Di Marco, Lucy; Gehin, Sophie; Mourey, Eric; Cormier, Luc; Mousson, Christiane; Midulla, Marco

    2017-01-01

    Background Angiomyolipoma (AML) is the most common renal benign tumor. Treatment should be considered for symptomatic patients or for those at risk for complications, especially retroperitoneal bleeding which is correlated to tumor size, grade of the angiogenic component and to the presence of tuberous sclerosis complex (TSC). This study reports our single-center experience with the use of selective arterial embolization (SAE) in the management of symptomatic and asymptomatic renal AMLs. Methods In this retrospective mono-centric study, all demographic and imaging data, medical records, angiographic features, outpatient charts and follow-up visits of patients who underwent prophylactic or emergency SAE for AMLs between January 2005 and July 2016 were reviewed. Tumor size and treatment outcomes were assessed at baseline and after the procedure during follow-up. Computed tomography (CT), magnetic resonance imaging (MRI) or ultrasonography was used to evaluate AML shrinkage. Renal function was measured pre- and post-procedure. Results Twenty-three patients (18 females, 5 males; median age, 45 years; range, 19–85 years) who underwent SAE either to treat bleeding AML (n=6) or as a prophylactic treatment (n=17) were included. Overall, 34 AMLs were embolized. TSC status was confirmed for 6 patients. Immediate technical success rate was 96% and 4 patients benefitted from an additional procedure. Major complications occurred in 3 patients and minor post-embolization syndrome (PES) in 14 patients. The mean AML size reduction rate was 26.2% after a mean follow-up was 20.5 months (range, 0.5–56 months), and only non-TSC status was significantly associated with better shrinkage of tumor (P=0.022). Intralesional aneurysms were significantly more frequent in patients with hemorrhagic presentation (P=0.008). There was no change in mean creatinine level after SAE. Conclusions SAE is a safe and effective technique to manage renal AMLs as a preventive treatment as well as in

  6. Clinical effects of transcatheter hepatic arterial embolization with holmium-166 poly(l-lactic acid) microspheres in healthy pigs

    Energy Technology Data Exchange (ETDEWEB)

    Vente, M.A.D.; Nijsen, J.F.W.; Wit, T.C. de; Schip, A.D. van het [University Medical Center Utrecht, Department of Nuclear Medicine, P.O. Box 85500, Utrecht (Netherlands); Seppenwoolde, J.H.; Seevinck, P.R. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Krijger, G.C. [Delft University of Technology, Department of Radiation, Radionuclides and Reactors, Faculty of Applied Sciences, Delft (Netherlands); Huisman, A. [University Medical Center Utrecht, Department of Clinical Chemistry and Haematology, Utrecht (Netherlands); Zonnenberg, B.A. [University Medical Center Utrecht, Department of Internal Medicine, Utrecht (Netherlands); Ingh, T.S.G.A.M. van den [TCCI Consultancy B.V., P.O. Box 85032, Utrecht (Netherlands)

    2008-07-15

    The aim of this study is to evaluate the toxicity of holmium-166 poly(l-lactic acid) microspheres administered into the hepatic artery in pigs. Healthy pigs (20-30 kg) were injected into the hepatic artery with holmium-165-loaded microspheres ({sup 165}HoMS; n = 5) or with holmium-166-loaded microspheres ({sup 166}HoMS; n = 13). The microspheres' biodistribution was assessed by single-photon emission computed tomography and/or MRI. The animals were monitored clinically, biochemically, and ({sup 166}HoMS group only) hematologically over a period of 1 month ({sup 165}HoMS group) or over 1 or 2 months ({sup 166}HoMS group). Finally, a pathological examination was undertaken. After microsphere administration, some animals exhibited a slightly diminished level of consciousness and a dip in appetite, both of which were transient. Four lethal adverse events occurred in the {sup 166}HoMS group due either to incorrect administration or comorbidity: inadvertent delivery of microspheres into the gastric wall (n = 2), preexisting gastric ulceration (n = 1), and endocarditis (n = 1). AST levels were transitorily elevated post-{sup 166}HoMS administration. In the other blood parameters, no abnormalities were observed. Nuclear scans were acquired from all animals from the {sup 166}HoMS group, and MRI scans were performed if available. In pigs from the {sup 166}HoMS group, atrophy of one or more liver lobes was frequently observed. The actual radioactivity distribution was assessed through ex vivo {sup 166m}Ho measurements. It can be concluded that the toxicity profile of HoMS is low. In pigs, hepatic arterial embolization with {sup 166}HoMS in amounts corresponding with liver-absorbed doses of over 100 Gy, if correctly administered, is not associated with clinically relevant side effects. This result offers a good perspective for upcoming patient trials. (orig.)

  7. Arterial embolization of massive hepatocellular carcinoma with lipiodol and gelatin sponge

    Directory of Open Access Journals (Sweden)

    L L Xie

    2014-01-01

    Full Text Available Background: Transarterial chemoembolization (TACE has been used to treat unresectable massive hepatocellular carcinoma (HCC. Lots of embolic agents have been applied in embolization because of it can decrease patient discomfort and side-effects. Aim: The aim was to evaluate the clinical efficacy and safety of TACE with lipiodol and gelatin sponge. Materials and Methods: A total of 109 patients with massive HCC (the size of tumor >10 cm and unresectable from January 2011 to August 2014 in our institution was divided into group A and group B based on the different embolitic agents. Before and about 1-month after each case of TACE, clinical and biological data such as tumor size, child-pugh stage, serum Alpha-fetoprotein (AFP, complications, were recorded at the same time. Results: In group A, the diameter of the tumor reduced from 12.57 ± 1.26 cm to 9.04 ± 0.89 cm. No patient was complete response (CR, partial response (PR 36, stable disease (SD 7 and PD 6; in group B, the diameter of tumor decreased from 12.08 ± 1.42 cm to 8.43 ± 1.05 cm, CR 0, but PR 27, SD 18 and PD 15. RR in group A was significantly higher than in group B (P < 0.05.The change of child-pugh stage and AFP pre- and post-operative in group A can be found significantly better than in group B. Conclusions: TACE with lipiodol and gelatin sponge is a highly effective for massive HCC.

  8. Gastric ulcer bleeding from a variant left gastric artery accompanied by congenital absence of the splenic artery successfully treated with coil embolization: a case report and review of the literature.

    Science.gov (United States)

    Namikawa, Masashi; Kakizaki, Satoru; Takakusaki, Satoshi; Saito, Shuichi; Yata, Yutaka; Mori, Masatomo

    2011-12-01

    Endoscopic hemostasis is a useful treatment modality for gastric ulcer bleeding. However, it is sometimes difficult to achieve hemostasis in cases with arterial bleeding, especially those complicated with vascular abnormalities. We describe a case with gastric ulcer bleeding from a variant left gastric artery accompanied by congenital absence of the splenic artery. A 50-year-old female was admitted to our hospital with dizziness and tarry stools. Upper gastrointestinal endoscopy revealed bleeding from a gastric ulcer, and endoscopic hemostasis by endoscopic clipping was carried out. Computed tomography and abdominal angiography revealed the variant left gastric artery running below the gastric ulcer. In spite of endoscopic hemostasis and medication, re-bleeding from the gastric ulcer occurred. A transcatheter coil embolization for the variant left gastric artery was performed and successfully achieved hemostasis. This case was accompanied by congenital absence of the splenic artery, which is an extremely rare condition. We herein describe this rare case and review previously reported cases.

  9. Arterial steal syndrom in patients after liver transplantation: transarterial embolization of the splenic and gastroduodenal arteries; Arterielles Steal-Syndrom bei Patienten nach Lebertransplantation: transarterielle Embolisation von A. lienalis oder A. gastroduodenalis

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, Th.J.; Pegios, W.; Balzer, J.O.; Lobo, M. [Frankfurt Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Neuhaus, P. [Klinik fuer Allgemeinchirurgie und Transplantationschirurgie Campus Charite, Virchow-Klinikum (Germany)

    2001-10-01

    Purpose: To evaluate transaterial embolization of splenohepatic and gastroduodenal steal syndrome in patients with impaired liver function tests after liver transplantation. Methods and Material: In a prospective study 22 patients (10 male, 12 female; mean age 49.5 years) with unexplained elevation of hepatic enzymes after liver transplantation underwent transcatheter arterial embolization of splenohepatic (n = 18) and gastroduodenal (n = 4) steal syndrome with use of Gianturco coils or microcoils. Liver and spleen parenchyma were surveyed and evaluated before and after embolization with plain helical CT, including volumetry of liver and spleen. Results: DSA examinations revealed a dilated splenic artery (n = 18) or gastroduodenal artery (n = 4) combined with a slightly decreased perfusion of the hepatic arteries, while immediately after successful embolization a normal perfusion of the hepatic arteries could be noted. Volumetric measurements before and after embolization showed no significant changes in liver parenchyma (x = + 7% {+-} 2), and variable changes in splenic volume of - 5% to + 28% (mean, + 11%), with initial measurements. Clinical follow-up examinations revealed a normalization of the previously elevated hepatic enzymes and a normalization of liver function tests after successful embolization. Complications were observed in 4 patients (infarction of the spleen). Conclusions: The preliminary results reveal that in liver transplant candidates with splenohepatic and gastroduodenal steal syndrome successful embolization results in an improvement of organ perfusion with normalization of function tests. (orig.) [German] Einleitung: Evaluierung der transarteriellen Embolisation von A. lienalis/A. gastroduodenalis-Steal-Syndromen bei Patienten mit erhoehten Laborparametern nach Lebertransplantation. Material und Methode: Im Rahmen einer prospektiven Studie wurden 22 Patienten (maennlich/weiblich: 12/10) mit aetiologisch unklarer Erhoehung der Leberenzyme nach

  10. Antiplatelet therapy at the time of coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Kremke, Michael; Tang, Mariann; Bak, Mikkel;

    2013-01-01

    OBJECTIVES: The purpose of this multicentre cohort study was to examine the relationship between antiplatelet therapy (APT) at the time of coronary artery bypass grafting (CABG) and postoperative bleeding complications, transfusion requirements and adverse cardiovascular events. METHODS: A matched...

  11. Fluoroscopic guided fogarty embolectomy for an angio-seal embolism in the popliteal artery

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Dong; Lee, Seung Hwa; Chung, Hwan Hoon; Seo, Bo Kyoung; Cha, Sang Hoon; Lee, Kee Yeol; Ahn, Jeong Cheon [Korea University Ansan Hospital, College of Medicine, Korea University, Ansan (Korea, Republic of)

    2013-08-15

    The Angio-Seal is a widely used arterial closure device that helps achieve faster hemostasis and provide early ambulation to patients. However, it can cause various complications in clinical practice. We present the uncommon complication of popliteal artery occlusion following Angio-Seal deployment, and describe an effective interventional approach to its treatment. Because fluoroscopy-guided Fogarty embolectomy has the advantages of complete removal of the embolus without fragmentation, and clear visualization of the exact location of the embolus during the procedure, it is a suitable method for treating this complication.

  12. Successful management with glue injection of arterial rupture seen during embolization of an arteriovenous malformation using a flow-directed catheter: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jong Won; Baik, Seung Kug; Shin, Mi Jung; Choi, Han Yong; Kim, Bong Gi [Wallace Memorial Baptist Hospital, Pusan (Korea, Republic of)

    2000-12-01

    We present a case in which an arterial rupture occurring during embolization of an arteriovenous malformation of the left occipital lobe with a flow-directed micro-catheter, was successfully sealed with a small amount of glue. We navigated a 1.8-Fr Magic catheter through the posterior cerebral artery, and during superselective test injection, extravasation was observed at the parieto-occipital branch. The catheter was not removed and the perforation site was successfully sealed with a small amount of glue injected through the same catheter. Prompt recognition and closure of the perforation site is essential for good prognosis. (author)

  13. Comparison of Flow Impairment during Carotid Artery Stenting Using Two Types of Eccentric Filter Embolic Protection Devices

    Science.gov (United States)

    NII, Kouhei; TSUTSUMI, Masanori; MAEDA, Hitoshi; AIKAWA, Hiroshi; INOUE, Ritsuro; ETO, Ayumu; SAKAMOTO, Kimiya; MITSUTAKE, Takafumi; HANADA, Hayatsura; KAZEKAWA, Kiyoshi

    2016-01-01

    We investigated the angiographic findings and the clinical outcomes after carotid artery stenting (CAS) using two different, eccentric filter embolic protection devices (EPDs). Between July 2010 and August 2015, 175 CAS procedures were performed using a self-expandable closed-cell stent and a simple eccentric filter EPD (FilterWire EZ in 86 and Spider FX in 89 procedures). The angiographic findings (i.e., flow impairment and vasospasm) at the level of EPDs, neurologic events, and post-operative imaging results were compared between the FilterWire EZ and the Spider FX groups. The CAS was angiographically successful in all 175 procedures. However, the angiographs were obtained immediately after CAS-detected flow impairment in the distal internal carotid artery (ICA) in 11 (6.3%) and ICA spasms at the level of the EPD in 40 cases (22.9%). The incidence of these complications was higher with FilterWire EZ than Spider FX (ICA flow impairment of 10.5% vs. 2.2%, P = 0.03; vasospasm 30.2% vs. 15.7%, P = 0.03). There were nine neurologic events (5.1%); five patients were presented with transient ischemic attacks, three had minor strokes, and one had a major stroke. New MRI lesions were seen in 25 (29.1%) FilterWire-group and in 36 (40.4%) Spider-group patients. The neurologic events and new MRI lesions were not associated with the type of EPD used. Although the ICA flow impairment may result in neurologic events, there was no significant association between the FilterWire EZ and the Spider FX CAS with respect to the incidence of neurologic events by the prompt treatment such as catheter aspiration. PMID:27319302

  14. Usefulness of Clinical Prediction Rules, D-dimer, and Arterial Blood Gas Analysis to Predict Pulmonary Embolism in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Shazia Awan

    2017-03-01

    Full Text Available Objectives: Pulmonary embolism (PE is seven times more common in cancer patients than non-cancer patients. Since the existing clinical prediction rules (CPRs were validated predominantly in a non-cancer population, we decided to look at the utility of arterial blood gas (ABG analysis and D-dimer in predicting PE in cancer patients. Methods: Electronic medical records were reviewed between December 2005 and November 2010. A total of 177 computed tomography pulmonary angiograms (CTPAs were performed. We selected 104 individuals based on completeness of laboratory and clinical data. Patients were divided into two groups, CTPA positive (patients with PE and CTPA negative (PE excluded. Wells score, Geneva score, and modified Geneva score were calculated for each patient. Primary outcomes of interest were the sensitivities, specificities, positive, and negative predictive values for all three CPRs. Results: Of the total of 104 individuals who had CTPAs, 33 (31.7% were positive for PE and 71 (68.3% were negative. There was no difference in basic demographics between the two groups. Laboratory parameters were compared and partial pressure of oxygen was significantly lower in patients with PE (68.1 mmHg vs. 71 mmHg, p = 0.030. Clinical prediction rules showed good sensitivities (88−100% and negative predictive values (93−100%. An alveolar-arterial (A-a gradient > 20 had 100% sensitivity and negative predictive values. Conclusions: CPRs and a low A-a gradient were useful in excluding PE in cancer patients. There is a need for prospective trials to validate these results.

  15. Severe primary postpartum hemorrhage due to genital tract laceration after operative vaginal delivery: successful treatment with transcatheter arterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Fargeaudou, Yann; Soyer, Philippe; Sirol, Marc; Dref, Olivier le; Boudiaf, Mourad; Dahan, Henri; Rymer, Roland [Hopital Lariboisiere-APHP-GHU Nord et Universite Diderot-Paris 7, Department of Abdominal and Interventional Imaging, Paris (France); Morel, Olivier [Hopital Lariboisiere-APHP-GHU Nord et Universite Diderot-Paris 7, Department of Obstetrics, Paris (France)

    2009-09-15

    The purpose of this study was to report our experience in the management of severe primary postpartum hemorrhage due to genital tract laceration following operative vaginal delivery with forceps using pelvic transcatheter arterial embolization (TAE). Ten women (mean age, 31.9 years) with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps were treated with TAE. TAE was indicated because of intractable bleeding that could not be controlled with uterotonic drugs, blood transfusion, attempted suturing and packing in all patients. Postdelivery perineal examination showed cervical or vaginal tears in all women and associated paravaginal hematoma in four. Angiography revealed extravasation of contrast material in six patients. TAE performed with gelatin sponge allowed to control the bleeding in all patients. Cervical and vaginal suturing was made possible and successfully achieved in the six women who had failed suturing attempts before TAE. Paravaginal hematoma was successfully evacuated in four patients in whom it was present after TAE. No complications related to TAE were noted. We conclude that in women with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps, TAE is effective and safe for stopping the bleeding and helps genital tract suturing and evacuation of hematoma. (orig.)

  16. Preparation and Characterization of Fe3O4/Ethiodized-oil Magnetic Fluids Used in Arterial Embolization Hyperthermia

    Institute of Scientific and Technical Information of China (English)

    罗志; 王益明; 洪若瑜; 李洪钟

    2012-01-01

    Fe3O4 nanoparticles (NPs) were prepared by the co-precipitation of Fe3+ and Fe2+ with ammonium hydroxide, and were modified by four different surfactants. The modified Fe3O4 NPs were characterized by Fourier transform infrared spectroscopy, X-ray powder diffraction, transmission electron microscopy and vibrating sample magne- tometer. Then, the modified Fe3O4 NPs were dispersed in ethiodized-oil by mechanical agitation and ultrasonic vi- bration to obtain stable Fe3O4 /ethiodized-oil magnetic fluids (MFs). The magnetic properties and rheological prop- erties of the MFs were measured using a Gouy magnetic balance and a rotational rheometer, respectively. The satu- ration magnetization of the Fe3O4 modified by oleic acid was 52.1 Emu/g. Furthermore, the result showed that the inductive heating effect of oleic acid stabilized Fe3O4/ethiodized-oil MF was remarkable and it only took 650 s for the temperature rising from 25 ℃ to 65 ℃. The specific absorption rate of the MF was 50.16 W/(g of Fe). It had a potential application in arterial embolization hyperthermia.

  17. Can measurement of apparent diffusion coefficient before treatment predict the response to uterine artery embolization for adenomyosis?

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yaewon; Kim, Man Deuk; Jung, Dae Chul; Lee, Shin Jae; Kim, Gyoungmin; Park, Sung Il; Won, Jong Yun; Lee, Do Yun [Yonsei University College of Medicine, Department of Radiology, Severance Hospital, Seoul (Korea, Republic of)

    2015-05-01

    To determine the usefulness of the apparent diffusion coefficient (ADC) in predicting response to uterine artery embolization (UAE) for symptomatic adenomyosis. A prospective study was performed on 25 patients who underwent diffusion-weighted (DW) magnetic resonance imaging (MRI) before UAE between June 2011 and December 2012. All patients underwent 3-month follow-up MRI after UAE using non-spherical polyvinyl alcohol (PVA) particles ranging from 150 to 500 μm. Quantitative measurement of the ADC was performed for each adenomyosis. Complete response and incomplete response were defined as ≥90 % or <90 %, respectively, of the non-perfusion area with adenomyosis at the follow-up MRI. The ADC values were compared between patients who achieved complete or incomplete response which was assessed according to the MRI findings after UAE. Nineteen patients showed complete response, and six showed incomplete response. The ADC value ranged from 0.842 to 1.346 x 10{sup -3} mm{sup 2}/s (mean 1.075 ± 0.117). The mean ADC was 1.043 ± 0.237 in the complete response group and 1.176 ± 0.429 in the incomplete response group (0.012). Using a threshold of <1.147 x 10{sup -3} mm{sup 2}/s, the sensitivity and specificity of the ADC to predict success after UAE were 83.3 % and 84.2 %. The ADC of adenomyosis may potentially predict a successful response to UAE for adenomyosis. (orig.)

  18. Hepatic artery aneurysm: incidental diagnosis with abdominal ultrasonography and treatment by coil embolization

    OpenAIRE

    Andrade, Luis Jesuino de Oliveira; Silva,Antonio Carlos Botelho da; França,Larissa Santos; França,Luciana Santos; Souza,José Rebouças de

    2012-01-01

    Hepatic artery aneurysm (HAA) was first reported at autopsy in 1809, represents one fifth of visceral aneurysms and the mortality from spontaneous rupture is high in most of cases. We are reporting a case of an asymptomatic 48-year-old woman with an extrahepatic HAA, diagnosed initially and incidentally with abdominal ultrasonography, confirmed by a three-dimensional contrast-enhanced magnetic resonance imaging and angiography. Endovascular treatment was considered feasible and was successful...

  19. Chronic post-embolic pulmonary hypertension: a new target for medical therapies?

    Directory of Open Access Journals (Sweden)

    Marion Delcroix

    2013-09-01

    Full Text Available The rationale for the use of pulmonary arterial hypertension-targeted drugs in chronic thromboembolic pulmonary hypertension is based on four bundles of evidence, as follows: 1 the pathobiology of the disease, with a distal component of pre-capillary arteriopathy that is very similar to pulmonary arterial hypertension; 2 the inoperability of some patients, and the persistence or recurrence of pulmonary hypertension after pulmonary endarterectomy in others; 3 the short-term efficacy and safety of pulmonary arterial hypertension-targeted drugs in these patients; and 4 their potential effect on survival. Chronic thromboembolic pulmonary hypertension is essentially a surgical disease, curable by pulmonary endarterectomy, with acceptable procedural mortality in experienced centres. Patient selection for surgery is extremely complex and results in 30–50% of patients considered inoperable. A large clinical experience has been built up with endothelin receptor antagonists and phosphodiesterase-5 inhibitors, while evidence from controlled trials is running far behind schedule. More recently, a randomised controlled trial with the guanylate cyclase stimulator, riociguat, achieved its target and showed haemodynamic, as well as functional, improvements within 4 months of therapy. The place of this therapy in the therapeutic arsenal needs to be further defined, but should be strictly limited to inoperable patients.

  20. 不同栓塞剂栓塞子宫动脉治疗子宫腺肌症的中远期随访分析%Uterine artery embolization for the treatment of uterine adenomyosis:comparison study of different embolic agents

    Institute of Scientific and Technical Information of China (English)

    姚群立; 陆建东; 徐向荣; 柳玉华; 张建亚

    2015-01-01

    目的:探讨应用不同栓塞剂栓塞子宫动脉治疗子宫腺肌症的临床疗效和并发症的发生情况。方法回顾性分析2004—2011年分别以国产碘化油、海藻酸钠微球和Embosphere微球栓塞子宫动脉治疗的子宫腺肌症患者45例,其痛经等症状变化、子宫磁共振影像改变及临床严重并发症的发生情况进行了为期2年以上的随访。结果术后3组患者痛经程度、月经量等临床症状均有改善,6个月时碘化油组、海藻酸钠微球组和Embosphere微球组痛经明显缓解率分别为33.3%(5/15),30.8%(4/13),41.1%(7/17);12个月时MRI显示子宫体积分别缩小为49.19%、48.25%和50.05%;24个月时有8例患者痛经复发,分别为碘化油组2例,海藻酸钠微球组4例和Embosphere微球组2例。碘化油组发生闭经2例, Embosphere微球组发生闭经1例。结论以碘化油、海藻酸钠微球或Embosphere微球进行超选择性子宫动脉栓塞治疗子宫腺肌症对缓解患者痛经程度、缩小子宫体积具有良好的效果;栓塞治疗发生闭经的原因除卵巢功能减退外,也可能为子宫宫腔粘连;在取得临床疗效相似的情况下,使用颗粒型固体栓塞剂进行栓塞治疗其安全性可能较液体栓塞剂为高。%Objective To investigate the clinical effects and complications of uterine artery embolization (UAE) therapy using different embolic agents in treating uterine adenomyosis. Methods During 2004—2011, a total of 45 female patients with uterine adenomyosis were admmitted to authors’ hospital to receive uterine artery embolization therapy. The embolic agents used in the procedures included domestic iodized oil, sodium alginate microspheres and Embosphere microspheres. The patients were randomly divided into group A (n=15, using domestic iodized oil as embolic agent), Group B (n=13, using sodium alginate microspheres as embolic agent) and group C (n = 17, using Embosphere microspheres as embolic

  1. Outcome of uterine artery embolization versus MR-guided high-intensity focused ultrasound treatment for uterine fibroids: Long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Froeling, V., E-mail: Vera.Froeling@charite.de [Department of Radiology, Charité – Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin (Germany); Meckelburg, K., E-mail: Katrin.Meckelburg@charite.de [Department of Radiology, Charité – Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin (Germany); Schreiter, N.F., E-mail: Nils.Schreiter@charite.de [Department of Radiology, Charité – Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin (Germany); Scheurig-Muenkler, C., E-mail: Christian.Scheurig@charite.de [Department of Radiology, Charité – Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin (Germany); Kamp, J., E-mail: Julia.Kamp@charite.de [Department of Radiology, Charité – Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin (Germany); Maurer, M.H., E-mail: Martin.Maurer@charite.de [Department of Radiology, Charité – Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin (Germany); Beck, A., E-mail: Alexander.Beck@charite.de [Department of Radiology, Charité – Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin (Germany); Hamm, B., E-mail: Bernd.Hamm@charite.de [Department of Radiology, Charité – Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin (Germany); and others

    2013-12-01

    Objectives: To compare the long-term outcome after uterine artery embolization (UAE) versus magnetic resonance-guided high-intensity focused ultrasound (MR-g HIFU) for symptomatic uterine fibroids. Methods: Seventy-seven women (median age, 39.3 years; range, 29.2–52.2 years) with symptomatic uterine fibroids, equally eligible for UAE and MR-g HIFU based on our exclusion criteria underwent treatment (UAE, N = 41; MR-g HIFU, N = 36) from 2002 to 2009 at our institution. Symptom severity (SS) and total health-related quality of life (Total HRQoL) scores were assessed by the uterine fibroid symptom and quality of life (UFS-QoL) questionnaire before treatment and at long-term follow-up after UAE (median 61.9 months) and after MR-g HIFU (median: 60.7 months). Re-intervention rates were assessed for each therapy and compared. Results: Re-intervention was significantly lower after UAE (12.2%) than after MR-g HIFU (66.7%) at long-term follow-up (p < 0.001). After UAE changes in SS (50 pre-treatment vs. 6.3 post-treatment) and Total HRQoL (57.8 pre-treatment vs. 100 post-treatment) were significantly better than changes in SS (42.2 pre-treatment vs. 26.6 post-treatment) and Total HRQoL score (66.4 pre-treatment vs. 87.9 post-treatment) after MR-g HIFU (p = 0.019 and 0.049 respectively). Conclusions: Improvement of SS and Total HRQoL scores was significantly better after UAE resulting in a significant lower re-intervention rate compared to MR-g HIFU.

  2. The association atorvastatin-meloxicam reduces brain damage, attenuating reactive gliosis subsequent to arterial embolism = La asociación atorvastatina-meloxicam reduce el daño cerebral, atenuando la gliosis reactiva consecuente a embolismo arterial

    Directory of Open Access Journals (Sweden)

    Marcela Hernández Torres

    2013-10-01

    Full Text Available The association atorvastatin-meloxicam reduces brain damage, attenuating reactive gliosis subsequent to arterial embolism Introduction: Stroke is the leading cause of disability and the third of death in Colombia and in the world and it is associated with neurodegenerative and mental diseases. Objective: To determine the effects of the atorvastatin- meloxicam association on reactive gliosis in a model of cerebral ischemia produced by arterial embolization. Materials and methods: 56 adult male Wistar rats were used, divided into four ischemic and four control groups, plus 10 additional animals to determine the distribution and extent of infarction by injury in six of them and simulation (sham in the remaining four. The treatments were: placebo, atorvastatin (ATV, meloxicam (MELOX and ATV + MELOX in ischemic and simulated animals. 24 hours post-ischemia mitochondrial enzymatic activity was evaluated with triphenyl- tetrazolium (TTC, and at 120 hours astrocytic reactivity (anti-GFAP was analyzed by conventional immunohistochemistry. Results: The association ATV + MELOX favored the modulation of the response of protoplasmatic and fibrous astrocytes in both the hippocampus and the paraventricular zone by reducing their hypereactivity. Conclusion: Atorvastatin and meloxicam, either individually or associated, reduce cerebral damage by lessening the reactive gliosis produced by arterial embolization; this suggests new mechanisms of neuroprotection against thromboembolic cerebral ischemia, and opens new perspectives in its early treatment.

  3. 选择性动脉栓塞治疗在产科的临床应用价值%Clinical application value of selective arterial embolism in obstetric department

    Institute of Scientific and Technical Information of China (English)

    刁震; 陈香娟; 陈云琴; 张文淼; 黄引平

    2012-01-01

    Objective: To observe the clinical application value of selective arterial embolism in obstetric department. Methods: Nineteen patients who underwent selective arterial embolism in obstetric department of the hospital were analyzed retrospectively, all the patients underwent right femoral artery puncture and intubation, bilateral internal iliac artery angiography via Seldinger technique, after defining the positions, stopping blood supply by super - selective bilateral uterine artery intubation and infusion of gel foam uterine artery embolism or internal iliac artery embolism were performed. Results: After embolism, bleeding was stopped among the patients with hemorrhage, induced abortion succeeded among the patients with placenta previa, no recurrent bleeding and severe complications occurred. Conclusion: Selective artery embolism is a minimally invasive and effective method for obstetric patients.%目的:观察选择性动脉栓塞治疗在产科的临床应用价值.方法:回顾性分析19例接受选择性动脉栓塞的产科患者,所有病例均采用Seldinger技术行右股动脉穿刺插管双侧髂内动脉造影,明确部位后,超选择双侧子宫动脉插管注入明胶海绵颗粒,阻断供血,行子宫动脉或髂内动脉栓塞.结果:栓塞术后,产后出血患者出血停止,前置胎盘患者成功引产,所有患者均无复发出血及严重并发症发生.结论:选择性动脉栓塞是治疗产科患者微创、有效的方法.

  4. A Controlled Clinical Study between Hepatic Arterial Infusion with Embolized Curcuma Aromatic Oil and Chemical Drugs in Treating Primary Liver Cancer

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To evaluate the effectiveness, toxicity and prospective application of hepatic arterial infusion (HAI) with embolized Curcuma Aromatic oil (CAO) in treating primary liver cancer (PLC). Methods: In the treated group, 32 patients with PLC were treated by HAI with 1-3 ml embolized CAO and oral administration of Chinese herbal medicine. In the control group, 32 patients with PLC were treated with transcatheter artery chemoembolization (TACE). Results: In the treated group, one patient attained complete remission (CR) and 13 partial remission (PR), the total effective rate being 43.75%. The level of alpha fetal protein (AFP) turned to normal range in 7 cases and decreased in other 7. In the control group, 10 obtained PR and the total effective rate being 31.25%, AFP level turned to normal in 5 and decreased in 2. There was no statistical significance between the two groups. The incidences of post-embolism Sydrome, such as fever, abdominal pain and vomiting were similar between the two groups but no myelosuppression occurred in the treated group with significant difference as comparing with that in the control group (P<0.01). The mean survival time, median survival time, 1-, 2- and 3-year survival rate in the treated group were 11.5 months, 10 months, 37.5%, 13.3% and 6.9% respectively, while in the control group they were 7.25 months, 6 months, 15.6%, 3.2% and 0% respectively. Better result in mean survival time, median survival time and 1-year survival rate was found in the treated group than that of the control group (P<0.05). Conclusion:HAI with embolized CAO showed a similar good effect in treating PLC as that of TACE, but superior to TACE with longer survival time and milder myelosuppression.

  5. 肾动脉栓塞的超声造影分析%Diagnosis of renal artery embolism with contrast-enhanced ultrasound

    Institute of Scientific and Technical Information of China (English)

    姚春晓; 杨斌; 傅宁华; 魏淑萍; 刘萍

    2010-01-01

    Objective To evaluate contrast-enhanced ultrasound(CEUS)appearances of renal artery embolism and its clinical value.Methods Ten patients with renal artery embolism were involved.The renal size was measured.and the renal echogenicity and distribution of renal arterial and venous blood signals were observed by routine ultrasound.Then CEUS were taken,the perfusion pattern and changes of echogenicity were monitored.Results Seven patients with acute renal artery embolism were correctly indicated by CEUS,among which 2 indicated extensive non-enhancing regions in the whole renal,and 5 displayed wedge un-enhanced in one or more poles.The CEUS findings of the three patients with obsolete infarction were fragmentized non-enhanced regions under the renal envelope.Conclusions CEUS is a relatively sensitive and highly specific method to diagnose renal artery embolism,and can be used as the first screening modality for this disease.%目的 探讨肾动脉柃塞的超声造影表现及其诊断价值.方法 回顾性分析10例肾动脉栓塞患者的临床和超声造影资料.超声测量肾大小,观察肾内回声以及动静脉血流信号分布情况;随后进行超声造影检查,观察造影剂在肾内的灌注过程和回声强度变化,出现肾内造影剂异常充填缺损区确诊为肾动脉栓塞.结果 7例为急性肾动脉栓塞,其中2例超声造影表现为广泛肾实质无强化,余5例表现为.肾一极或多处楔形无强化区;3例为局灶性陈旧性肾梗塞,超声造影表现为肾包膜下的小片无强化区.结论 超声造影对肾动脉栓塞具有较高的诊断价值,可作为首选的影像学诊断方法.

  6. Epidural Analgesia Versus Patient-Controlled Analgesia for Pain Relief in Uterine Artery Embolization for Uterine Fibroids: A Decision Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kooij, Sanne M. van der, E-mail: s.m.vanderkooij@amc.uva.nl; Moolenaar, Lobke M.; Ankum, Willem M. [Academic Medical Centre, Department of Gynaecology (Netherlands); Reekers, Jim A. [Academic Medical Centre, Department of Radiology (Netherlands); Mol, Ben Willem J. [Academic Medical Centre, Department of Gynaecology (Netherlands); Hehenkamp, Wouter J. K. [VU University Medical Centre, Department of Gynaecology (Netherlands)

    2013-12-15

    Purpose: This study was designed to compare the costs and effects of epidural analgesia (EDA) to those of patient-controlled intravenous analgesia (PCA) for postintervention pain relief in women having uterine artery embolization (UAE) for systematic uterine fibroids. Methods: Cost-effectiveness analysis (CEA) based on data from the literature by constructing a decision tree to model the clinical pathways for estimating the effects and costs of treatment with EDA and PCA. Literature on EDA for pain-relief after UAE was missing, and therefore, data on EDA for abdominal surgery were used. Outcome measures were compared costs to reduce one point in visual analogue score (VAS) or numeric rating scale (NRS) for pain 6 and 24 h after UAE and risk for complications. Results: Six hours after the intervention, the VAS was 3.56 when using PCA and 2.0 when using EDA. The costs for pain relief in women undergoing UAE with PCA and EDA were Euro-Sign 191 and Euro-Sign 355, respectively. The costs for EDA to reduce the VAS score 6 h after the intervention with one point compared with PCA were Euro-Sign 105 and Euro-Sign 179 after 24 h. The risk of having a complication was 2.45 times higher when using EDA. Conclusions: The results of this indirect comparison of EDA for abdominal surgery with PCA for UAE show that EDA would provide superior analgesia for post UAE pain at 6 and 24 h but with higher costs and an increased risk of complications.

  7. Complications and Reinterventions in Uterine Artery Embolization for Symptomatic Uterine Fibroids: A Literature Review and Meta Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Martin, Jason, E-mail: Jason.martin@medportal.ca; Bhanot, Kunal, E-mail: Kunal.Bhanot@medportal.ca [Michael G. DeGroote School of Medicine, McMaster University (Canada); Athreya, Sriharsha, E-mail: harshavbs@yahoo.com [St. Joseph' s Health Care Hamilton, McMaster University, Faculty of Health Sciences (Canada)

    2013-04-15

    To perform a literature review of the spectrum of complications associated with UAE relative to surgery and compare the risk of reintervention as well as minor, major, and overall complications. Literature review was conducted in PubMed, MEDLINE, Cochrane, and CINAHL databases, and meta-analysis was performed. In randomized clinical trials, common complications were discharge and fever (4.00 %), bilateral uterine artery embolization (UAE) failure (4.00 %), and postembolization syndrome (2.86 %). Two trials showed a significantly decreased risk in major complications with UAE, with odds ratios (ORs) of 0.07143 (0.009426-0.5413) and 0.5196 (0.279-0.9678). None of the trials showed a significant difference in OR for minor complications of UAE. None of the trials showed a significant difference in risk for overall complications of UAE. Three trials showed a significantly increased risk for reintervention with UAE with ORs of 10.45 (2.654-41.14), 2.679 (1.289-5.564), and 9.096 (1.269-65.18). In 76 nonrandomized studies, common complications were amenorrhea (4.26 %), pain (3.59 %), and discharge and fever (3.37 %). In 41 case studies, common complications were discharge and fever (n = 22 cases), repeat UAE (n = 6 cases), and fibroid expulsion (n = 5 cases). Overall, UAE has a significantly lower rate of major complications relative to surgery, but it comes at the cost of increased risk of reintervention in the future. Educating patients about the rate and types of complications of UAE versus surgery, as well as the potential for reintervention, should help the patient and clinician come to a reasoned decision.

  8. Spontaneous Coronary Artery Dissection following Topical Hormone Replacement Therapy

    Directory of Open Access Journals (Sweden)

    Alexander L. Pan

    2012-01-01

    Full Text Available Spontaneous coronary artery dissection is a rare condition, usually presenting as an acute coronary syndrome, and is often seen in states associated with high systemic estrogen levels such as pregnancy or oral contraceptive use. While topical hormonal replacement therapy may result in increased estrogen levels similar to those documented with oral contraceptive use, there are no reported cases of spontaneous coronary dissection with topical hormonal replacement therapy. We describe a 53-year-old female who developed two spontaneous coronary dissections while on topical hormonal replacement therapy. The patient had no other risk factors for coronary dissection. After withdrawal from topical hormonal therapy, our patient has done well and has not had recurrent coronary artery dissections over a one-year follow-up period. The potential contributory role of topical hormonal therapy as a cause of spontaneous coronary dissection should be recognized.

  9. Stent-assisted coil embolization of a symptomatic middle cerebral artery aneurysm in an infant.

    Science.gov (United States)

    Savastano, Luis E; Chaudhary, Neeraj; Gemmete, Joseph J; Garton, Hugh J L; Maher, Cormac O; Pandey, Aditya S

    2014-11-01

    Pediatric intracranial aneurysms are rare and challenging to treat. Achieving efficacy and durability of aneurysmal occlusion while maintaining parent vessel patency requires innovative treatment strategies, especially in cases in which aneurysmal location or morphology pose substantial morbidity associated with microsurgical treatment. In the last 3 decades, endovascular treatments have had a remarkable evolution and are currently considered safe and effective therapeutic options for cerebral aneurysms. While endovascular techniques are well described in the English literature, the endovascular management of pediatric aneurysms continues to pose a challenge. In this report, the authors describe the case of a 9-month-old infant who presented with a 1-day history of acute-onset left-sided hemiparesis and left facial droop. Imaging revealed a large symptomatic saccular middle cerebral artery aneurysm. Treatment included successful stent-assisted aneurysm coiling. At follow-up, the patient continued to fare well and MR angiography confirmed complete occlusion of the aneurysm dome. This case features the youngest patient in the English literature to harbor an intracranial aneurysm successfully treated with stent-assisted coiling. Based on this experience, endovascular intervention with vascular reconstruction can be safe and effective for the treatment of infants and could further improve prognosis; however, further studies are necessary to confirm these findings.

  10. Clinical analysis of 3 cases of renal artery embolism and literature review%肾动脉栓塞3例临床分析并文献复习

    Institute of Scientific and Technical Information of China (English)

    苏宇; 王晓民; 徐万海; 王科亮

    2012-01-01

    Objective To explore the clinical character, diagnosis and treatment of the acute abdomen caused by renal artery embolism ( RAE). Methods The clinical data of three cases of RAE in our hospital were summarised. All of them were represented "acute abdomen pain" as the main symptom and were combined with atrial fibrillation or a history of other parts of arterial thrombosis. The correct diagnosis of the patients were not made in the first time. Two patients were diagnosed as "renal colic" , and 1 case was considerd as "aortic dissection". Results Three patients were diagnosed by abdominal CT angiography, 2 patients for the limitations of renal infarction, symptoms improved after anticoagulant therapy; one case was embolism at the main trunk more than 24 h and not suitable for treatment with intervention, finally treated with line of nephrectomy. Conclusion CT angiography is considered as preferred method of diagnosis of renal artery embolization. Early diagnosis and early treatment is the key to save renal function in patients with RAE.%目的 探讨肾动脉栓塞引发急腹症的临床特点及诊断、治疗方法.方法 总结我院收治的3例肾动脉栓塞患者临床资料.3例患者均以“突发性腹痛”为主要症状,均合并房颤或其余部位动脉血栓病史.患者均未能在第一时间做出正确诊断,2例诊为“肾绞痛”,1例考虑为“主动脉夹层”.结果 3例患者均通过腹部CT血管造影做出确定诊断,2例患者为局限性肾段梗死,行抗凝治疗后症状好转;1例患者为肾动脉主干梗塞,且时间超过24 h,不适宜行介入治疗,最终行肾脏切除术.结论 CT血管造影可作为肾动脉栓塞确诊的首选方法,早期诊断、早期治疗是挽救肾动脉栓塞患者肾脏功能的关键.

  11. Trans-arterial gene therapy for hepatocellular carcinoma in a rabbit model

    Institute of Scientific and Technical Information of China (English)

    Tao Gu; Cai-Xia Li; Yan Feng; Qian Wang; Chun-Hai Li; Chuan-Fu Li

    2007-01-01

    AIM: To study the effect of adenovirus (Ad)-p53 gene therapy on hepatocellular carcinoma (HCC) in a rabbit model.METHODS: VX2 tumor was grown in the liver of 24rabbits. Animals were divided into four groups: group A receiving trans-arterial gene therapy (Ad-p53) only,group B receiving combined Ad-p53 therapy and transarterial embolization (lipiodol), group C receiving transarterial chemoembolization (lipiodol + mitomycin C),control group (D) receiving sodium chloride. Tumor volume (V1) was measured by using MRI (d 13).Interventional procedure was applied (d 14).Tumor volume (V2) was assessed by MRT (d 21) and the mean ratio (V2/V1) was calculated. After the second MRI,specimens of the liver were abstained and examined immunohistochemically using mutant-type p53 antibody.The positive expression was scored.RESULTS: Compared with control group ((-x) = 3.14± 0.64), therapeutic groups all showed a significant decrease in the tumor growth ratio (P < 0.05). A slight difference was found between group A ((-x) =2.35 ±0.59) and group B ((-x) = 1.75 ± 0.28) (P = 0.048). Nostatistically significant difference was observed between group B and group C ((-x) = 2.00 ± 0.44). The positive expression rate of mutant-type p53 was the lowest in group B and significantly different between group A and group C (P < 0.05).Compared to the control subjects, groups A and C both showed a decrease in the expression of mutant-type p53, but there was no significant difference between them.CONCLUSION: Trans-arterial Ad-p53 gene therapy can reduce tumor growth of HCC in rabbit model.

  12. Air Embolism: Diagnosis, Clinical Management and Outcomes

    Directory of Open Access Journals (Sweden)

    Colin J. McCarthy

    2017-01-01

    Full Text Available Air embolism is a rare but potentially fatal complication of surgical procedures. Rapid recognition and intervention is critical for reducing morbidity and mortality. We retrospectively characterized our experience with air embolism during medical procedures at a tertiary medical center. Electronic medical records were searched for all cases of air embolism over a 25-year period; relevant medical and imaging records were reviewed. Sixty-seven air embolism cases were identified; the mean age was 59 years (range, 3–89 years. Ninety-four percent occurred in-hospital, of which 77.8% were during an operation/invasive procedure. Vascular access-related procedures (33% were the most commonly associated with air embolism. Clinical signs and symptoms were related to the location the air embolus; 36 cases to the right heart/pulmonary artery, 21 to the cerebrum, and 10 were attributed to patent foramen ovale (PFO. Twenty-one percent of patients underwent hyperbaric oxygen therapy (HBOT, 7.5% aspiration of the air, and 63% had no sequelae. Mortality rate was 21%; 69% died within 48 hours. Thirteen patients had immediate cardiac arrest where mortality rate was 53.8%, compared to 13.5% (p = 0.0035 in those without. Air emboli were mainly iatrogenic, primarily associated with endovascular procedures. High clinical suspicion and early treatment are critical for survival.

  13. Deep lingual arterial chemoembolization of tongue carcinoma with microcapsuled anticancer drug

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: Microcapsule chemoembolism is a promising treatment of tumors. We describe a deep lingual arterial embolization of tongue carcinoma with microcapsuled carboplatinum. Methods: Lingual artery cast specimens from cadavers were microscopically examined, and 78 patients with tongue cancer were recruited and treated with the deep lingual arterial embolization therapy. Results: Microcapsule embolism occurred approximately at the fifth or sixth level of the deep lingual artery branches. The five-year survival rate was 88.5% (69 out of 78), and the ten-year survival rate 52.6% (41 out of 78). Conclusion:The deep lingual arterial embolization of tongue carcinoma with microcapsuled carboplatinum is an effective therapy to treat carcinoma in mid-margin or mid-body of the tongue.

  14. Spontaneous Coronary Artery Dissection following Topical Hormone Replacement Therapy

    OpenAIRE

    2012-01-01

    Spontaneous coronary artery dissection is a rare condition, usually presenting as an acute coronary syndrome, and is often seen in states associated with high systemic estrogen levels such as pregnancy or oral contraceptive use. While topical hormonal replacement therapy may result in increased estrogen levels similar to those documented with oral contraceptive use, there are no reported cases of spontaneous coronary dissection with topical hormonal replacement therapy. We describe a 53-year...

  15. Endovascular therapy using flow diversion for giant internal carotid artery pseudoaneurysm arising in the setting of an invasive pituitary macroadenoma

    Science.gov (United States)

    Syed, Almas; Marashi, Keyan B.; O'Rourke, Brian D.; Hise, Joseph H.; Opatowsky, Michael J.; Layton, Kennith F.

    2017-01-01

    This report illustrates the unusual occurrence of a pseudoaneurysm arising in the setting of a skull base mass and describes the first reported use of endovascular flow diversion therapy in such a setting. A 63-year-old man with occasional headaches during the preceding month presented with the acute onset of severe left retroorbital headache and oculomotor nerve palsy. Computed tomography (CT) and CT angiogram revealed a destructive skull base mass with an associated giant probable pseudoaneurysm of the cavernous segment of the left internal carotid artery. The patient underwent endoscopic transsphenoidal biopsy with a subsequent diagnosis of prolactinoma. Endovascular therapy utilizing two Pipeline™ flow diversion embolization devices was performed with subsequent resolution of the patient's headache and improvement in his cranial nerve deficits/cavernous sinus syndrome. PMID:28127130

  16. 前交通动脉瘤的介入栓塞治疗%Endovascular Embolization for Anterior Communicating Artery Aneurysms

    Institute of Scientific and Technical Information of China (English)

    蒋世杰; 喻明; 赵磊; 顾成武; 李琳琳; 聂本刚

    2012-01-01

    Objective To summarize the treatment experiences of endovascular embolization for anterior communicating artery aneurysms. Methods Twenty-three patients with anterior communicating artery aneurysms were treated with endovascular embolization under general anesthesia between January 2008 and August 2011. Microcatheter-assisted or microwire-assisted technique was undertaken to keep patency of parent arteries in 4 patients. One patient suffered from aneurysm rupture during the procedure because of jumping of the microwire. One stent was post-planted in one case because of occlusion of the ipsilateral A2 segment. Results Interventional endovascular embolizations were performed successfully in 23 patients. Complete embolization was achieved in 11 cases, while subtotal in 8 ( > 90%) and partial in 4 ( < 90%) cases. The patient with stent planting suffered from cerebral infarction and recovered in one month. There was no re-hemorrhage during clinical follow-up of 6-24 months, and no recurrence in follow-up angiograms in 16 patients. Five aneurysms including 3 cases of primary subtotal and 2 cases of partial embolization occluded completely in the follow-up angiograms. Conclusion Endovascular embolization is a relatively safe and effective method for the management of anterior communicating artery aneurysm.%目的 总结前交通动脉瘤栓塞治疗的经验.方法 2008年1月-2011年8月,23例前交通动脉瘤患者均在全身麻醉下行动脉瘤内栓塞治疗.其中4例在导丝或导管保护动脉瘤颈情况下行栓塞治疗;1例术中导丝刺破动脉瘤,继续快速填塞至动脉瘤完全栓塞;1例栓塞后弹簧圈突入载瘤动脉,行A1-A2段支架后置入.结果 23例患者手术技术成功率100%.术后即刻造影,动脉瘤完全栓塞11例,>90%栓塞8例,<90%栓塞4例.支架后置入患者术后出现脑梗死,经治疗1个月后康复出院.所有患者临床随访6~24个月,未见再出血.16例患者行全脑血管数字减影

  17. Onyx embolization of an intraosseous pseudoaneurysm of the middle meningeal artery in a patient with meningiomatosis, McCune-Albright syndrome, and gray platelet syndrome.

    Science.gov (United States)

    Settecase, Fabio; Nicholson, Andrew D; Amans, Matthew R; Higashida, Randall T; Halbach, Van V; Cooke, Daniel L; Dowd, Christopher F; Hetts, Steven W

    2016-03-01

    A 13-year-old boy with meningiomatosis, McCune-Albright syndrome, and gray platelet syndrome presented with an enlarging "lump" on his right forehead. A head CT scan revealed a polyostotic fibrous dysplasia involving the entire skull. A 3.4-cm right frontal osseous cavity and an overlying right forehead subcutaneous soft-tissue mass were seen, measuring 5.2 cm in diameter and 1.6 cm thick. Ultrasound of the cavity and overlying mass showed swirling of blood and an arterialized waveform. MRI revealed an en plaque meningioma underlying the cavity. An intraosseous pseudoaneurysm fed by 3 distal anterior division branches of the right middle meningeal artery (MMA) with contrast extravasation was found on angiography. Two MMA feeders were embolized with Onyx, with anterograde filling of the intraosseous cavity with Onyx. A small pocket of residual intracavity contrast filling postembolization from a smaller third MMA feeder eventually thrombosed and the forehead lump regressed.

  18. Ovarian protection by selective coil embolization of a uteroovarian anastomosis before uterine fibroid embolization: a report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Seung Boo; Im, Han Hyeok [Soonchunhyang University, Gumi (Korea, Republic of); Chang, Yun Woo; Goo, Dong Erk [Soonchunhyang University Hospital, Gumi (Korea, Republic of)

    2006-09-15

    Premature menopause can be developed as a result of undesired nontarget ovary embolization during the performance of uterine fibroid embolization. The etiology of varian failure after uterine fibroid embolization is not yet clearly defined, but one of the leading possibilities is nontarget embolization of the varies. We report here on two cases in which superselective coil embolization of distal uterine artery collateral pathways to the ovary was performed during uterine fibroid embolization.

  19. Anesthetic management of a parturient with placenta previa totalis undergoing preventive uterine artery embolization before placental expulsion during cesarean delivery: a case report.

    Science.gov (United States)

    Lee, Jae Woo; Song, In Ae; Ryu, Junghee; Park, Hee-Pyoung; Jeon, Young-Tae; Hwang, Jung-Won

    2014-10-01

    Placenta previa totalis can cause life-threatening massive postpartum hemorrhage, and careful anesthetic management is essential. Preventive uterine artery embolization (UAE) before placental expulsion was introduced to reduce postpartum bleeding in cases of placenta previa totalis. We describe the case of a 40-year-old woman (gravida 0, para 0) with placenta previa totalis and uterine myomas who underwent intraoperative UAE, which was preoperatively planned at the strong recommendation of the anesthesiologist, immediately after delivery of a fetus and before removal of the placenta during cesarean delivery under spinal-epidural anesthesia. After confirming embolization of both uterine arteries, removal of the placenta resulted in moderate bleeding. The estimated blood loss was 2.5 L, and 5 units of red blood cells were transfused. The parturient was discharged uneventfully on postoperative day 4. This case shows that the bleeding risk is reduced by intraoperative UAE in a patient with placenta previa totalis, and anesthesiologists have an important role in a multidisciplinary team approach.

  20. Impact of 3D Rotational Angiography on Liver Embolization Procedures: Review of Technique and Applications

    Energy Technology Data Exchange (ETDEWEB)

    Lucatelli, Pierleone, E-mail: pierleone.lucatelli@gmail.com; Corona, Mario, E-mail: mario.corona68@gmail.com; Argirò, Renato, E-mail: renato.argiro@gmail.com; Anzidei, Michele, E-mail: michele.anzidei@gmail.com [Sapienza University of Rome, Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences (Italy); Vallati, Giulio, E-mail: vallati@ifo.it [Istituto Nazionale Tumori, Regina Elena, Department of Angiography and Interventional Radiology (Italy); Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it; Bezzi, Mario, E-mail: mario.bezzi@uniroma1.it; Catalano, Carlo, E-mail: carlo.catalano@uniroma1.it [Sapienza University of Rome, Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences (Italy)

    2015-06-15

    In the last years, the interest into interventional applications of C-arm cone-beam CT (CBCT) progressively raised, widening its clinical application from the original field of interventional neuroradiology to the field of peripheral procedures. Liver embolization procedures, due to their complexity and potential treatment-related life-threatening complications, represent one of the main clinical applications of this novel angiographic technique. CBCT has been demonstrated to render procedures safer and technically easier, and to predict outcome as well as to avoid major complications in different treatment scenarios (trans-arterial embolization, trans-arterial chemoembolization, selective internal radiation therapy, percutaneous portal vein embolization). This review summarizes all technical, dosimetric and procedural aspects of CBCT techniques, underlying all its potential clinical advantages in the field of liver embolization procedures. Moreover, the paper provides all the instructions to obtain the best diagnostic performance out of this novel angiographic technique.

  1. Transcatheter Coil Embolization of an Arc of Buhler Aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Su Jin; Lim, Nam Yeul; Choi, Soo Jin Nah; Kim, Jae Kyu; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Hospital, Gwangju (Korea, Republic of); Jang, Nam Kyu [Hwasun Chonnam National University Hospital, Hwasun (Korea, Republic of)

    2008-07-15

    We report the findings of a patient with an asymptomatic Arc of Buhler (AOB) aneurysm, which was successfully treated by transcatheter coil embolization. An abdominal CT and angiography revealed an intact pancreaticoduodenal artery arcade (PDAA) and an anomalous communication between the SMA and celiac axis, termed an AOB. An aneurysm was observed at the origin of the AOB and treated with a transcatheter embolization using coils. A follow-up CT imaging confirmed the total occlusion of the aneurysm with a patent PDAA. The successful results of this treatment suggest that the endovascular therapy of an AOB aneurysm with a celiac axis occlusion and an intact PDAA is feasible and safe.

  2. Embolization in combination with radioiodine therapy for bone metastases from differentiated thyroid carcinoma

    NARCIS (Netherlands)

    van Tol, KM; Hew, JM; Jager, PL; Vermey, A; Dullaart, RPF; Links, TP

    2000-01-01

    BACKGROUND The outcome for patients with bone metastases from differentiated thyroid carcinoma is worse compared to the overall prognosis of patients with differentiated thyroid carcinoma. The aim of this study is to evaluate the effect of embolization with concomitant radioiodine treatment on the s

  3. Management of post-biopsy renal allograft arteriovenous fistulas with selective arterial embolization: immediate and long-term outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Loffroy, R. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France)], E-mail: loffroy.romaric@neuf.fr; Guiu, B.; Lambert, A. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France); Mousson, C.; Tanter, Y. [Department of Nephrology and Renal Transplantation (France); Martin, L. [Department of Pathology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France); Cercueil, J.-P.; Krause, D. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France)

    2008-06-15

    Aim: To evaluate the outcomes after transcatheter embolization of percutaneous biopsy-related arteriovenous fistulas in renal allografts. Materials and methods: All post-biopsy renal-transplant vascular injuries referred for embolization between June 1999 and October 2006 were reviewed retrospectively. There were six male and six female patients with a mean age of 49.8 years (range 25-67 years); nine patients were symptomatic, three asymptomatic. Colour Doppler ultrasound (CDUS) and angiography showed one intra-renal arteriovenous fistula in 10 patients and two in two patients, combined with a pseudoaneurysm in six patients. Superselective embolization using a single catheter or coaxial microcatheter was performed with 0.035'' coils or 0.018''microcoils, respectively, in all 12 cases. 24-h creatinine clearance values before (the day of biopsy) and after (7-14 days; 3 months) the procedure were compared using the Wilcoxon signed-rank test. Physical examination and CDUS were performed after 1, 6, and 12 months, and yearly thereafter. Mean follow-up was 33.6 months. Results: Complete definitive occlusion of the fistula was achieved consistently with a single procedure. No procedure-related complications occurred. Renal infarction was minor in all patients (0-10% in nine and 10-20% in three). Symptoms resolved completely. Creatinine clearance values obtained before and after embolization were not statistically different (p = 0.168;.889 respectively). No late recurrences were reported. Conclusion: Transcatheter embolization with coaxial or single-catheter techniques was effective and safe for treating post-biopsy arteriovenous fistulas in renal transplants. The loss of renal parenchyma was minimal and no mid-term deterioration of allograft function was noted. The long-term survival of the renal allograft seemed to be not affected by embolization.

  4. Clinical study of bronchial artery embolization in the treatment of 38 patients with mass hemoptysis%支气管动脉栓塞治大咯血38例临床研究

    Institute of Scientific and Technical Information of China (English)

    李洪福; 常刚; 欧阳修和

    2011-01-01

    Objectives To investigate the effectiveness of bronchial arteriography and bronchial artery embolization (BAE) in the treatment of 38 patients with mass hemoptysis. Methods A review of clinical experience to evaluate the demographics, clinical presentation , radiographic studies, bronchoscopy, and complications of bronchial arteriography and BAE, and 38 patients in hospital from 2000 to 2008. Results 38 patients underwent bronchial arteriography. There were 26 men and 12 women with a mean age of 56 ±9 years. Hemoptysis was the most common indication in 31 patients (81.6%). Hemoptysis?vas caused by bronchiectasis (27 patients) , bronchopul-monary cyst (4 patients), pulmonary tuberculosis (3 patients). The cause could not be identified in 4 patients. Bronchial arteriography revealed hypervascularity (all patients). BAE was attempted in 38 patients, completed, and unsuccessful. Overall, embolization sessions were performed with a total of 38 arteries embolized. Control of hemoptysis was observed in 35 patients (92% ) for 1 week. Rebleeding oc-curred within 1 year in 2 patients. The complications of embolization included thoracalgia in 3 cases, omalgia in 2 patients, dyspnea in 3 patients, and 3 subjects with sug( g) illation at groin, but taking a favorable turn after treatment. Conclusions BAE is a useful therapy to control both acute and chronic hemoptysis. BAE may help to avoid surgical risk in patients who are not good surgical candidates. Should hemoptysis recur in these patients, repeat embolization can be performed safely.%目的 观察支气管动脉栓塞术对大咯血患者的临床疗效.方法 2000年至2008年因大咯血住院患者,经胸部影像学检查或纤维支气管镜、支气管动脉造影明确诊断的患者行支气管动脉栓塞术.结果 共38例患者,男26,女12例,年龄56±9岁,反复咯血31例,支气管扩张27例,支气管肺囊肿4例,不明原因4例,肺结核3例.支气管动脉造影均表现为血管畸形,给

  5. Uterine artery embolization - discharge

    Science.gov (United States)

    ... 76. Yang-Kauh C. Complications of gynecological procedures, abortion, and assisted reproductive technology. In: Adams ... of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma ...

  6. Mycotic aneurysm of the superior mesenteric artery after septic embolism; Entwicklung eines mykotischen Aneurysmas der A. mesenterica superior nach septischer Embolie

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, F.; Dinkel, H.P. [Institut fuer Diagnostische Radiologie, Inselspital, Universitaetsklinik Bern (Switzerland)

    2002-07-01

    Mycotic aneurysms of the aorta and the visceral arteries are life-threatening diseases, due to potential rupture and organ or limb ischemia. They occur in endocarditis, immunodeficiency, bacteremia and fungemia, and have a poor prognosis.We report on a case of a 54-year-old male patient suffering from abdominal angina after mitral valve replacement for septic mycotic endocarditis. In presence of a mycotic-embolic occlusion of the left popliteal artery and multiple septic organ infarctions a mycotic aneurysm of the superior mesenteric artery was found in abdominal spiral-CT.Based on sequential spiral-CT examinations, this case demonstrates the development of a septic aneurysm of the superior mesenteric artery. (orig.) [German] Mykotische Aneurysmen der Aorta und ihrer Aeste stellen wegen Rupturgefahr und moeglicher Minderperfusion von Organen und Extremitaeten eine lebensgefaehrliche Erkrankung mit unguenstiger Prognose dar. Beguenstigende Faktoren sind geschwaechte Immunabwehr, Endokarditis, Bakteriaemie und Fungaemie.Wir berichten ueber einen 54-jaehrigen Patienten, der nach einem Mitralklappenersatz bei mykotischer Endokarditis zunehmende abdominelle Beschwerden im Sinne einer Angina abdominalis entwickelte. Die abdominelle Spiralcomputertomographie zeigte ein mykotisches Aneurysma der A. mesenterica superior. Daneben bestanden ein mykotischer Verschluss der linken A. poplitea und multiple septische Organinfarkte.Der Fall demonstriert anhand sequentieller Computertomographien eindrucksvoll die Entwicklung eines septischen Viszeralarterienaneurysmas. (orig.)

  7. Gene therapy and angiogenesis in patients with coronary artery disease

    DEFF Research Database (Denmark)

    Kastrup, Jens

    2010-01-01

    Not all patients with severe coronary artery disease can be treated satisfactorily with current recommended medications and revascularization techniques. Various vascular growth factors have the potential to induce angiogenesis in ischemic tissue. Clinical trials have only evaluated the effect...... of VEGF and FGF in patients with coronary artery disease. The initial small and unblinded studies with either recombinant growth factor proteins or genes encoding growth factors were encouraging, demonstrating both clinical improvement and evidence of angiogenesis. However, subsequent larger double...... an improvement in clinical results can be obtained with a cocktail of growth factors or by a combination of gene and stem cell therapy in patients with severe coronary artery disease, which cannot be treated effectively with current treatment strategies....

  8. Venous and arterial thrombo-embolic complications of hormonal treatment in a male-to-female transgender patient.

    LENUS (Irish Health Repository)

    Mullins, G M

    2012-02-03

    We present a male-to-female (MTF) transgender patient admitted with a pulmonary embolism. The patient had been treated with high-dose oestrogens since the age of 16. Following a prolonged period of hypotension, our patient sustained cerebral border zone infarcts. There was evidence of bilateral carotid stenosis on Doppler ultrasound. We discuss the treatment and vascular complications of gender dysphoria.

  9. CryoPlasty therapy of the superficial femoral and popliteal arteries: a single center experience.

    Science.gov (United States)

    Samson, Russell H; Showalter, David P; Lepore, Michael R; Ames, Scott

    Long-term patency remains a significant hurdle in the minimally invasive treatment of arteriosclerosis in the superficial femoral and popliteal arteries. New technologies designed to address the sources of restenosis have recently been introduced. CryoPlasty therapy (Boston Scientific, Natick, Mass) is a new approach designed to significantly reduce injury, elastic recoil, stent implantation, neointimal hyperplasia, and constrictive remodeling. The technique combines the dilatation forces of percutaneous transluminal angioplasty with cold thermal energy applied to the plaque and vessel wall. The cumulative effect of limiting the sources of restenosis with CryoPlasty therapy was shown to demonstrate longer term patency in a prospective, multicenter, Investigational Device Exemption study of the PolarCath Peripheral Dilatation System. The CryoPlasty therapy experience of 1 center is reported, in which 47 lesions in 32 consecutive patients (34 procedures, 33 limbs) were treated. The technical success rate was 96%. There were no type 3 flow-limiting dissections, and only 4 (8.5%) lesions were stented. There were no unanticipated adverse events, specifically no thrombus, acute occlusions, distal embolizations, aneurysms, or groin complications. With an average follow-up of 12 months, only 5 lesions have recurred, 4 requiring re-intervention. The 12-month freedom from restenosis for lesions and limbs treated was 82.2% and 84.4%, respectively. These results are similar to the findings of the Investigational Device Exemption study and are encouraging. CryoPlasty therapy appears to be a viable endovascular therapeutic option to achieve longer term patency without compromising options for future interventions. The lack of early occlusions may be due to a low rate of spiral dissection that may be a particular benefit of this form of angioplasty.

  10. Gene therapy and angiogenesis in patients with coronary artery disease

    DEFF Research Database (Denmark)

    Kastrup, Jens

    2010-01-01

    -blind placebo-controlled trials could not confirm the initial high efficacy of either the growth factor protein or the gene therapy approaches observed in earlier small trials. The clinical studies so far have all been without any gene-related serious adverse events. Future trials will focus on whether...... an improvement in clinical results can be obtained with a cocktail of growth factors or by a combination of gene and stem cell therapy in patients with severe coronary artery disease, which cannot be treated effectively with current treatment strategies....... of VEGF and FGF in patients with coronary artery disease. The initial small and unblinded studies with either recombinant growth factor proteins or genes encoding growth factors were encouraging, demonstrating both clinical improvement and evidence of angiogenesis. However, subsequent larger double...

  11. Comparing the Use of Uterine Artery Embolization to Gonadotropin-Releasing Hormone Agonists in Shrinking Fibroid Size: A Pilot Study in Kazakhstan

    Directory of Open Access Journals (Sweden)

    Balkenzhe Imankulova

    2015-09-01

    Full Text Available Introduction: Uterine fibroids are the most common benign tumor in women in Kazakhstan. In the past two decades, endoscopic surgery has played an important role in the development of gynecologic surgery, particularly in the treatment of uterine fibroids. The goal of this paper is to evaluate whether uterine artery embolization (UAE or gonadotropin-releasing hormone agonists (GnRHa prior to myomectomy was more effective in decreasing fibroid size and improving surgical outcomes in a pilot study of women in Kazakhstan.Methods: This pilot investigation included 24 patients separated into 2 groups: medication group (pre-treatment with GnRHa – 13 patients and embolization group (pre-treatment with UAE – 11 patients. All patients had uterine fibroids, 3-10 cm in diameter, and were treated with myomectomy at the National Research Center for Maternal and Child Health, Astana, Kazakhstan. All patient data were obtained by a retrospective medical records review. Descriptive statistics were utilized to characterize participant demographics data. Independent t-tests were used to analyze continuous variables, and Chi-square and Fisher’s exact tests were used where appropriate for count data.Results: The group treated with GnRHa had an operating time of 40±10 minutes longer than the group treated with UAE, due to the peri-operative difficulties encountered by surgeons in detecting the layer between the myometrium and fibroid capsule. The group treated with UAE experienced better patient outcomes (less blood loss, less surgical time, and reduced use of anesthesia and was a technically easier surgery due to visible differences in uterine layers.Conclusions: Despite the fact that both treatments (GnRHa and UAE were effective for fibroid shrinking, embolization resulted in more optimal surgical time and improved patient outcomes. Results of this pilot study need to be confirmed in a randomized clinical trial, specifically focused on Kazakhstan and the

  12. Interventional Therapy of Splenic Artery Aneurysms and Pseudoaneurysms%脾动脉瘤的介入治疗

    Institute of Scientific and Technical Information of China (English)

    宋进华; 顾建平; 楼文胜; 何旭; 陈亮; 陈国平; 苏浩波; 汪涛

    2012-01-01

    Objective To evaluate the value of the endovascular interventional therapy in treatment of splenic artery an-eurysms and pseudoaneurysms. Methods Sixteen patients with splenic artery aneurysms (n - 10) and false aneurysms (n=6) proveded by color doppler ultrasound, CT and DSA angiography were collected in the study. Embolization with coils were carried out to the artery aneurysms or parent artery in 14 cases. Coils were deployed into the aneurysms assisted by stents in 2 case. Routine blood tests and serum amylase were checked at 3 and 7 days after the procedure. Enhanced CT was performed at 7 days, 3 and 6 months after the procedure. Results The splenic artery has been embolized successfully in 14 cases. The aneurysms and pseudoaneurysms in all patients were not enhanced on CT angiography at 3 or 6 months after embolization. Complete aneurysms thrombosis and normal splenic artery branching has been showed on CT images 3 or 6 months after the stents and coils implanted in 2 cases. Low grade fever and bellyache were occurred after embolization in 7 and 8 cases respectively, which were relieved after 3 to 5 days. Transient elevation of serum aniylase was recovered in 1 week in 5 patients. Conclusion Endovascular treatment is a simple ,minimally invasive, safe and effective treatment for splenic artery aneurysms and pseudoaneurysms.%目的 探讨介入血管腔内治疗脾动脉瘤的临床价值.方法 16例脾动脉瘤患者,其中真性脾动脉瘤10例,假性脾动脉瘤6例,介入治疗术前均经血管超声、CT及DSA明确诊断.14例行弹簧圈动脉瘤或载瘤动脉栓塞术,2例采用支架辅助弹簧圈瘤体内填塞.患者术后3天和1周复查血常规和血淀粉酶;术后1周、3个月、6个月CT增强扫描复查.结果 14例弹簧圈栓塞患者术后CT增强扫描均未见栓塞以远脾动脉主干显影,动脉瘤体无对比剂填充,2例支架辅助弹簧圈瘤体内填塞患者术后3个月、6个月CT增强扫描示脾动脉主干及

  13. Transcatheter artery embolization guided by MSCTA in emergency treatment of massive gastrointestinal bleeding%MSCTA指导下急诊动脉栓塞治疗消化道大出血

    Institute of Scientific and Technical Information of China (English)

    陈光斌; 李江山; 唐先志; 张自力; 敖锋

    2012-01-01

    Objective To investigate the clinical value of transcatheter arterial embolization guided by MSCTA in emergency of massive gastrointestinal bleeding. Methods Fourteen patients with massive gastrointestinal bleeding were examined with MSCTA at the same time of anti-shock treatment. Emergency arterial embolization was performed after locating of the bleeding site and bleeding artery by MSCTA. In the course of artery embolization, gelfoam particles were used with super-selective catheterization technique. Results After embolization, bleeding stopped immediately in 12 patients. For 2 patients with continuous bleeding, emergent surgical operation was performed in one patient, and the other with venous hemorrhage was cured with endoscopy. Conclusion Transcatheter arterial embolization guided by MSCTA is simple, rapid, accurate and safe for the treatment of massive gastrointestinal bleeding.%目的 探讨MSCTA指导下行急诊动脉栓塞治疗消化道大出血的临床价值.方法 对14例消化道大出血病例,术前在抗休克治疗同时急诊行MSCTA检查,明确出血部位或出血动脉后行急诊动脉栓塞术,超选择插管至出血动脉支,并以明胶海绵颗粒进行栓塞.结果 动脉栓塞后,12例患者有效控制了出血,休克得到纠正.1例明确出血部位及性质后行急诊手术治疗,1例疑静脉出血,后行急诊内镜治疗.结论 MSCTA指导下行急诊动脉栓塞术治疗消化道大出血简便迅速、准确性高、安全性好、并发症少.

  14. 腔内导管抽栓或联合溶栓在肠系膜上动脉栓塞中的应用%Catheter aspiration alone or combined with thrombolysis in the treatment of superior mesenteric artery embolism

    Institute of Scientific and Technical Information of China (English)

    黄渊全; 贾中芝; 王祁; 陈文华; 何忠明; 张俊; 王凯; 田丰

    2014-01-01

    patients with branch artery embolism received catheter aspiration combined with thrombolytic therapy. Among these 11 patients , complete open, partial open and non-open of branch arteries were found in 5, 3, 3 cases respectively, while collateral circulation increased significantly in non-open patients. During the follow-up period of (4.1±2.2) months, clinical symptom relief and digestive function recovery were observed in 24 cases. Only one case underwent bowel resection because of intestinal necrosis 24 hours after treatment and developed short bowel syndrome. Conclusion Catheter aspiration or combined with thrombolysis is a safe and effective method in treating SMAE.

  15. Comparison of an Additional Transdermal Fentanyl Patch Compared to Intravenous NSAID and Opioid Analgesics within 24 Hours of an Uterine Artery Embolization for Myoma and Adenomyosis

    Energy Technology Data Exchange (ETDEWEB)

    Song, Suk Yun; Kang, Byung Chul; Rho, Kyung Min [Dept. of Radiology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

    2011-05-15

    To evaluate the effectiveness of an additional transdermal fentanyl patch compared to intravenous analgesics in pain control during the 24-hour period following uterine artery embolization (UAE) for myoma and adenomyosis. Between September 2009 and August 2010, 42 patients underwent UAE for myoma or adenomyosis. Of these, 21 received an intravenous opioid (pethidine) and a nonsteroidal anti-inflammatory drug (group A), and 21 received an additional transdermal fentanyl patch (group B). Pain perception levels were established verbally on a 0-10 scale during the 24-hour period following UAE. Differences in pain trends, mean dose of intravenous pethidine, and adverse effects were compared between the two groups. Pain perception was most severe at 6 hours after UAE and the mean pain level of group B at that time was 6.3 {+-} 0.7, which was significantly lower than that of group A, 8.2 {+-} 0.7 (p<0.05). The mean dose of intravenous pethidine was 114.3 {+-} 59.5 mg in group A and 90.5 {+-} 49.0 mg in group B, while the incidence of nausea was 67% in group A and 77% in group B. In both cases, the differences were not significantly different (p>0.05), and no evidence of respiratory distress was demonstrated. The addition of a transdermal fentanyl patch to intravenous analgesics is effective in reducing post-embolization pain during the 24-hour period after UAE.

  16. Clinical Application of Vascular Regenerative Therapy for Peripheral Artery Disease

    Directory of Open Access Journals (Sweden)

    Hiroshi Suzuki

    2013-01-01

    Full Text Available Prognosis of peripheral artery disease (PAD, especially critical limb ischemia, is very poor despite the development of endovascular therapy and bypass surgery. Many patients result in leg amputation and, therefore, vascular regenerative therapy is expected in this field. Gene therapy using vascular endothelial growth factor is the first step of vascular regenerative therapy, but did not confirm effectiveness in a large-scale randomized comparative study. Based on animal experiments, bone marrow mononuclear cells (MNCs, peripheral blood MNCs were used as the cell source for regenerative therapy. Those cells were confirmed to be effective to decrease rest pain and ulcer size, but its effect was not fully satisfied. Mesenchymal stem cells (MSCs are expected as an effective cell source for vascular regeneration and clinical studies are ongoing, because the cells are able to differentiate into various cell types and produce a significant amount of vascular growth factors. Of vascular regeneration therapy, peripheral MNCs and bone marrow MNCs were recognized as advanced medical technology but do not attain to the standard therapy. However, clinical use of MSCs have already started, and induced pluripotent stem cells are surely promising tool for vascular regeneration therapy although further basic studies are required for clinical application.

  17. Cerebral Air Embolism from Angioinvasive Cavitary Aspergillosis

    Directory of Open Access Journals (Sweden)

    Chen Lin

    2014-01-01

    Full Text Available Background. Nontraumatic cerebral air embolism cases are rare. We report a case of an air embolism resulting in cerebral infarction related to angioinvasive cavitary aspergillosis. To our knowledge, there have been no previous reports associating these two conditions together. Case Presentation. A 32-year-old female was admitted for treatment of acute lymphoblastic leukemia (ALL. Her hospital course was complicated by pulmonary aspergillosis. On hospital day 55, she acutely developed severe global aphasia with right hemiplegia. A CT and CT-angiogram of her head and neck were obtained demonstrating intravascular air emboli within the left middle cerebral artery (MCA branches. She was emergently taken for hyperbaric oxygen therapy (HBOT. Evaluation for origin of the air embolus revealed an air focus along the left lower pulmonary vein. Over the course of 48 hours, her symptoms significantly improved. Conclusion. This unique case details an immunocompromised patient with pulmonary aspergillosis cavitary lesions that invaded into a pulmonary vein and caused a cerebral air embolism. With cerebral air embolisms, the acute treatment option differs from the typical ischemic stroke pathway and the provider should consider emergent HBOT. This case highlights the importance of considering atypical causes of acute ischemic stroke.

  18. Embolization for gastrointestinal hemorrhages

    Energy Technology Data Exchange (ETDEWEB)

    Kraemer, S.C.; Goerich, J.; Rilinger, N.; Aschoff, A.J.; Vogel, J.; Brambs, H.J. [Dept. of Diagnostic Radiology, University of Ulm (Germany); Siech, M. [Dept. of Abdominal Surgery, University of Ulm (Germany)

    2000-05-01

    Retrospective evaluation of interventional embolization therapy in the treatment of gastrointestinal hemorrhage over a long-term observation period from 1989 to 1997. Included in the study were 35 patients (age range 18-89 years) with gastrointestinal bleeding (GI) referred for radiological intervention either primarily or following unsuccessful endoscopy or surgery. Sources of GI bleeding included gastric and duodenal ulcers (n = 7), diverticula (n = 3), erosion of the intestinal wall secondary to malignancy (n = 6), vascular malformations (n = 4), and hemorrhoids (n = 2), as well as from postoperative (n = 6), posttraumatic (n = 2), postinflammatory (n = 4) or unknown (n = 1) causes. Ethibloc (12 cases) or metal coils (14 cases) were predominantly used as embolisates. In addition, combinations of tissue adhesive and gelfoam particles and of coils and Ethibloc were used (six cases). Finally, polyvinyl alcohol particles, a coated stent, and an arterial wire dissection were utilized in one case each. Bleeding was stopped completely in 29 of 35 cases (83 %). In one case (3 %) the source of bleeding was recognized but the corresponding vessel could not be catheterized. In five other cases (14 %) there was partial success with reduced, though still persistent, bleeding. The rate of complications was 14 %, including four instances of intestinal ischemia with fatal outcome in the first years, and, later, one partial infarction of the spleen without serious consequences. Gastrointestinal hemorrhage can be controlled in a high percentage of patients, including the seriously ill and those who had previously undergone surgery, with the use of minimally invasive interventional techniques. The availability of minicoils instead of fluid embolization agents has reduced the risk of serious complications. (orig.)

  19. A Case of Ruptured Blood Blister-like Aneurysm Treated with Pipeline Embolization Device: Clinical Significance of Fetal-type Posterior Communicating Artery

    Science.gov (United States)

    Park, Ki-Su; Son, Won-Soo; Park, Jaechan; Kim, Young-Sun; Kim, Byung Moon

    2017-01-01

    Blood-blister like aneurysms (BBAs) are challenging lesions because of their wide fragile neck. Flow-diverting stents (FDSs), such as the Pipeline Embolization Device (PED), have been applied to treat BBAs less amenable to more established techniques of treatment. However, the use of FDSs, including the PED, in acute subarachnoid hemorrhage (SAH) still remains controversial. We report a case of aneurysm regrowth following PED application for a ruptured BBA that overlapped the origin of the dominant posterior communicating artery (PCoA), which was successfully treated after coil trapping of the origin of the fetal-type PCoA. And, we discuss the clinical significance of the fetal-type PCoA communicating with a BBA in terms of PED failure. PMID:28316868

  20. Pseudoaneurysm of the Profunda Femoris Artery following Blunt Trauma Treated by Endovascular Coil Embolization: Review of Two Cases and Relevant Literature

    Science.gov (United States)

    McNerney, Patrick; Kiproff, Paul

    2017-01-01

    Profunda femoris artery (PFA) pseudoaneurysm after blunt trauma without associated femur fracture is a rare occurrence. Most of the reported cases of PFA pseudoaneurysm in the English literature developed after penetrating trauma, surgical procedures, and femur fractures. We present two such cases following blunt trauma and without any associated long bone injury. After initial imaging failed to show any long bone fracture, CT angiography confirmed pseudoaneurysm of the branch of the PFA. Both patients were then treated with emergent coil embolization of the bleeding vessel. Pseudoaneurysms typically present late and signs of persistent hip pain, thigh swelling, presence of a pulsatile mass, and even unexplained anemia all may suggest the diagnosis. Recognition of PFA pseudoaneurysm requires high index of suspicion and is often difficult to diagnose clinically because of its location. PMID:28246563

  1. Effects of HGF gene polymorphisms and protein expression on transhepatic arterial chemotherapeutic embolism efficacy and prognosis in patients with primary liver cancer

    Science.gov (United States)

    Chen, Hai-Yong; Chen, Yao-Min; Wu, Jian; Yang, Fu-Chun; Lv, Zhen; Qian, Yi-Gang; Zheng, Shu-Sen

    2017-01-01

    Objective To investigate the correlations of two hepatocyte growth factor (HGF) gene polymorphisms (rs5745652 and rs2074725) and their protein expression levels with the efficacy of transhepatic arterial chemotherapeutic embolism (TACE) and prognosis in patients with primary liver cancer (PLC). Methods From March 2011 to June 2012, 109 PLC patients (the case group) who chose TACE as primary treatment and 80 healthy people (the control group) who had undergone physical examination in The First Affiliated Hospital, Zhejiang University were selected during the same period. Gene polymorphisms of HGF rs5745652 and HGF rs2074725 were detected. Serum HGF level, treating efficacy, survival quality, and 3-year survival rate for PLC patients who received TACE were observed. Results There were significant differences in genotype and allele frequencies of HGF rs5745652 and HGF rs2074725, between the case and control groups (all PCancer stage were independent prognostic factors for PLC (Pprognosis after TACE treatment.

  2. New trial designs and potential therapies for pulmonary artery hypertension.

    Science.gov (United States)

    Gomberg-Maitland, Mardi; Bull, Todd M; Saggar, Rajeev; Barst, Robyn J; Elgazayerly, Amany; Fleming, Thomas R; Grimminger, Friedrich; Rainisio, Maurizio; Stewart, Duncan J; Stockbridge, Norman; Ventura, Carlo; Ghofrani, Ardeschir H; Rubin, Lewis J

    2013-12-24

    A greater understanding of the epidemiology, pathogenesis, and pathophysiology of pulmonary artery hypertension (PAH) has led to significant advances, but the disease remains fatal. Treatment options are neither universally available nor always effective, underscoring the need for development of novel therapies and therapeutic strategies. Clinical trials to date have provided evidence of efficacy, but were limited in evaluating the scope and duration of treatment effects. Numerous potential targets in varied stages of drug development exist, in addition to novel uses of familiar therapies. The pursuit of gene and cell-based therapy continues, and device use to help acute deterioration and chronic management is emerging. This rapid surge of drug development has led to multicenter pivotal clinical trials and has resulted in novel ethical and global clinical trial concerns. This paper will provide an overview of the opportunities and challenges that await the development of novel treatments for PAH.

  3. Clinical application of partial splenic artery embolization in the treatment of cirrhosis of the liver and spleen hyperfunction%部分脾动脉栓塞在肝硬化脾功能亢进治疗中的临床运用

    Institute of Scientific and Technical Information of China (English)

    毛亚莉; 沈丽荣; 张盾; 张晓忠

    2014-01-01

    Objective To discuss partial splenic artery embolization in cirrhosis of the liver and spleen hyper-function therapy and clinical significance. Methods Forty-seven patients with cirrhosis of the liver and spleen hy-perfunction underwent splenic artery embolization using Seldinger technique with PVA particles line, and the preoper-ative and postoperative hemogram were observed respectively. Results Review of 47 patients after 1 month, 3 months and 3 years′follow-up:the number of peripheral white blood cells and platelets was improved significantly; red blood cells were roughly similar to that before. Conclusion Partial splenic artery embolization in the management of splenic hyperfunction has good curative effect, less complications,and it is worth clinical application.%目的:探讨部分脾动脉栓塞在肝硬化脾功能亢进治疗中的疗效及临床意义。方法选择47例肝硬化脾功能亢进患者,采用Seldinger技术用PVA微粒行脾动脉部分栓塞术,并观察术前、术后血象变化。结果47例患者术后1个月、3个月复查,随访3年:外周血白细胞、血小板较术前明显升高;红细胞较前大致相仿。结论部分脾动脉栓塞术治疗脾功能亢进疗效好,并发症少,值得临床运用。

  4. 医源性全血尿:动脉造影与栓塞治疗%Iatrogenic Hematuria:Arterial Angiography and Transcatheter Embolization

    Institute of Scientific and Technical Information of China (English)

    曾晓华; 邱怀明; 刘忠; 易翠荣; 罗力

    2011-01-01

    目的 探讨医源性血尿的动脉造影诊断及其血管内介入治疗的价值.资料与方法 24例医源性血尿患者,依据其临床治疗经过,采用Seldering技术行一侧股动脉穿刺插管,选择性行患侧肾动脉或双侧髂内动脉造影,以微导管行超选择性造影,明确出血原因、具体部位,以明胶海绵碎屑或/并微弹簧罔栓塞.最后行栓塞后造影.观察栓塞情况.结果 24例动脉造影均获得明确诊断,其中经皮肾盂穿刺造瘘术后局部肾动脉小分支损伤、局部假性动脉瘤形成、全血尿8例,经皮肾穿刺取石术后肾动脉小分支损伤全血尿6例,超声碎石术后肾实质损伤全血尿2例,前列腺癌、前列腺增生症摘除术后手术区渗血、全血尿7例,男性尿道医源性损伤出血1例.所有病例栓塞治疗后止血效果明显,无并发症发生.结论 对于医源性全血尿患者,依据其临床治疗经过,行患侧肾动脉或双侧髂内动脉造影具有定性定位诊断价值,经微导管对所涉动脉分支超选择性栓塞能成功控制出血.%Objective To evaluate the clinical value of arterial angiography and transcatheter embolization in treatment of iatrogenic hematuria. Materials and Methods Arterial angiography by Seldinger technique in abdomal aorta, selective angiography in renal artery or in the internal iliac artery, superselective angiography in the arterial branch were performed for 24 patients with hematuria secondary to urology surgical procedures. The embolization with gelfoam particle and steel spring coil was performed to stop bleeding. Results The hematuria was secondary to percutaneous nephrostomy in 8 cases, minimally invasive percutaneous nephrolithotomy in 6 cases, ultrasonic lithotripsy in 2 cases, prostatectomy in 7 cases, and male urethra injury in 1 case. The cause of iatrogenic hematuria was identified and the hematuria was halted successfully. Conclusion Aterial angiography is effective in diagnosis of

  5. Comparison of clinical characteristics and survival on patients with idiopathic pulmonary arterial hypertension and familial pulmonary arterial hypertension during conventional therapy era and targeted therapy era

    Institute of Scientific and Technical Information of China (English)

    徐希奇

    2014-01-01

    Objective To compare the clinical characteristics and survival on Chinese patients with idiopathic pulmonary arterial hypertension(IPAH)and familiar pulmonary arterial hypertension(FPAH)during conventional therapy era and targeted therapy era.Methods IPAH and FPAH patients who were referred between Jan 1999and Oct 2004 in Fuwai Hospital were defined as conventional therapy era group(before 2005 no PAH-specific drug was available in China).All patients in this group

  6. Clinical effects of transcatheter hepatic arterial embolization with holmium-166 poly(l-lactic acid) microspheres in healthy pigs

    NARCIS (Netherlands)

    Vente, M.A.D.; Nijsen, J.F.W.; De Wit, T.C.; Seppenwoolde, J.H.; Krijger, G.C.; Seevinck, P.R.; Huisman, A.; Zonneneberg, B.A.; Van den Ingh, T.S.G.A.M.; Van het Schip, A.D.

    2008-01-01

    Purpose The aim of this study is to evaluate the toxicity of holmium-166 poly(l-lactic acid) microspheres administered into the hepatic artery in pigs. Methods Healthy pigs (20–30 kg) were injected into the hepatic artery with holmium-165-loaded microspheres (165HoMS; n = 5) or with holmium-166-l

  7. Effects of different therapies on coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    吕树铮; 刘文娴; 宋现涛; 陈韵岱; 柳弘; 陈立颖; 卢艳玲; 陈欣; 田锐; 张金荣

    2003-01-01

    Objective To analyse the effects of different therapies on coronary artery disease (CAD).Methods A total of 1055 patients who suffered from CAD diagnoised by coronary angiograpy were divided into three groups, namely pure drug therapy, percutanious coronary intervention (PCI) and coronary artery bypass graft (CABG) groups. Follow up was carried out from March to May in 2001, and the major adverse cardiac events (MACEs) including death, no-lethal myocardial infarction (MI) and revascularization were observed. In long-term observation, angina reoccured, and their improvement was evaluated. The short-term period was defined as the duration of 30 days after discharge, and the long term period was defined as the duration from 30 days after discharge.Results In the long-term period, the recurrences of angina both in PCI group and CABG group were lower than pure drug group (P 0.018, 0.002 respectively). No differences about long-term endpoint events were observed among these three groups (P>0.05). Forty-two patients suffering from left main coronary disease were intervened by the three therapies, and there was no death or MI both in PCI and CABG groups, three patients died and suffered from AMI in pure drug therapy group (P=0.015). In the short-term period, mortality in CABG group (5.77%) was higher than those in the other two groups (1.91% for PCI, and 1.40% for medical therapy, P=0.002), and no obvious difference observed in the latter two groups. No significance was concluded about the recent MI among this three groups (P=0.357). There were no differences on revascularization in these three groups.Conclusions Percutanious coronary interventions can not only reduce the attack of angina but also improve the life quality of patients, however it can not improve the long-term existance but left main CAD.

  8. Value of uterine arterial embolization in the control and prevent of severe postpartum hemorrhage in department of obstetrics%子宫动脉栓塞术在控制和预防产科大出血的价值

    Institute of Scientific and Technical Information of China (English)

    张红军; 常树勋; 张向锋; 董伟风

    2012-01-01

    Objective To investigate the efficacy and safety of uterine arterial embolization in the control and prevent of severe postpartum hemorrhage in department of obstetrics.Methods The efficacy of 32 cases of severe postpartum hemorrhage and 26 patients with bleeding tendency treated with uterine artery or internal iliac artery embolization to prevent hemorrhage were observed.Results Among the 58 patients after artery embolization treatment,control and prevention of massive hemorrhage in 54 cases,the patients' blood pressure and hemoglobin rised steadily,induction of labor,fetal and affiliated organizations smooth delivered.Conclusions Uterine artery embolization for postpartum hemorrhage and the prevention of postpartum hemorrhage is effective.%目的 探讨子宫动脉栓塞术在控制和预防产科大出血的疗效和安全性.方法 观察32例产后大出血和26例有大出血倾向患者行子宫动脉或髂内动脉栓塞预防出血的临床疗效.结果 58例患者经动脉栓塞术治疗后控制和预防大出血54例,患者血压和血红蛋白含量稳定回升,引产时,胎儿及附属组织顺利娩出.结论 子宫动脉栓塞术对产后大出血和预防产后大出血是行之有效的.

  9. Aneurysmal bone cyst of the mandible managed by conservative surgical therapy with preoperative embolization

    Energy Technology Data Exchange (ETDEWEB)

    An, Seo Young [School of Dentistry, Kyungpook National University, Daegu (Korea, Republic of)

    2012-03-15

    A 9-year-old girl visited our hospital, complaining of a rapid-growing and rigid swelling on the left posterior mandibular area. Panoramic radiograph showed a moderately defined multilocular honeycomb appearance involving the left mandibular body. CT scan revealed an expansile, multilocular osteolytic lesion and multiple fluid levels within cystic spaces. Bone scan demonstrated increased radiotracer uptake and angiography showed a highly vascularized lesion. The lesion was suspected as aneurysmal bone cyst (ABC) and preoperative embolization was performed, which minimize the extent of operation and the surgical complication. The lesion was treated by surgical curettage and lateral decortication with repositioning. No additional treatment such as a surgical reconstruction or bone graft was needed. Early diagnosis of ABC is very important and appropriate treatment should be performed considering several factors such as age, surgical complication, and possibility of recurrence.

  10. Cerebral embolic stroke after disappearing takotsubo cardiomyopathy.

    Science.gov (United States)

    Matsuzono, Kosuke; Ikeda, Yoshio; Deguchi, Shoko; Yamashita, Toru; Kurata, Tomoko; Deguchi, Kentaro; Abe, Koji

    2013-11-01

    Takotsubo cardiomyopathy can induce cerebral embolic stroke because of intracardiac thrombosis, but the timing of cardiogenic embolism relating to takotsubo cardiomyopathy has not been well described. We evaluated a 71-year-old woman with takotsubo cardiomyopathy, who developed cardiogenic cerebral embolism after recovery of cardiac wall motion. Nevertheless, we treated her with anticoagulation therapy. The present clinical observation suggests that attention should be paid to the timing when takotsubo cardiomyopathy resolves against risk of cardiogenic cerebral embolism.

  11. Splenic arteriovenous fistula and sudden onset of portal hypertension as complications of a ruptured splenic artery aneurysm: Successful treatment with transcatheter arterial embolization. A case study and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Dimitrios Siablis; Zafiria G Papathanassiou; Dimitrios Karnabatidis; Nikolaos Christeas; Konstantinos Katsanos; Constantine Vagianos

    2006-01-01

    Splenic arteriovenous fistula (SAVF) accounts for an unusual but well-documented treatable cause of portal hypertension[1-4]. A case of a 50-year-old multiparous female who developed suddenly portal hypertension due to SAVF formation is presented. The patient suffered from repeated episodes of haematemesis and melaena during the past twelve days and thus was emergently admitted to hospital for management. Clinical and laboratory investigations established the diagnosis of portal hypertension in the absence of liver parenchymal disease. Endoscopy revealed multiple esophageal bleeding varices. Abdominal computed tomography (CT)and transfemoral celiac arteriography documented the presence of a tortuous and aneurysmatic splenic artery and premature filling of an enlarged splenic vein, findings highly suggestive of an SAVF. The aforementioned vascular abnormality was successfully treated with percutaneous transcatheter embolization. Neither recurrence nor other complications were observed.

  12. Effect of hepatic artery embolization on liver hypertrophy response in a rabbit liver VX2 tumor model

    Institute of Scientific and Technical Information of China (English)

    Krijn P van Lienden; Lisette T Hoekstra; Jessica D van Trigt; Joris J Roelofs

    2013-01-01

    BACKGROUND: Portal  vein  embolization  not  only  induces hypertrophy  of  the  non-embolized  liver,  but  also  enhances tumor growth. The latter could be prevented by embolizing the hepatic  arteries  supplying  the  tumor-bearing  liver  segments. This  study  aimed  to  determine  the  effects  of  transcatheter arterial  embolization  (TAE)  on  tumor  volume  and  liver regeneration in a rabbit VX2 tumor model. METHODS: Twenty-three  rabbits  underwent  subcapsular tumor  implantation  with  a  VX2  tumor.  Two  weeks  after implantation,  18  rabbits  were  used  for  TAE  experiments,  5 were for sham controls. Tumor response and liver regeneration response of the  embolized  cranial  and  non-embolized caudal liver lobes were assessed by CT volumetry, liver to body weight index, and the amount of proliferating hepatocytes. RESULTS: All  super-selective  arterial  tumor  embolization procedures were performed successfully. Despite embolization, the  tumor  volume  increased  after  an  initial  steady  state.  The tumor volume after embolization was smaller than that of the sham  group,  but  this  difference  was  not  significant.  Massive necrosis  of  the  tumor,  however,  was  seen  after  embolization, without  damage  of  the  surrounding  liver  parenchyma.  There was a significant atrophy response of the tumor bearing cranial lobe  after  super-selective  arterial  embolization  of  the  tumor with a concomitant hypertrophy response of the non-embolized, caudal  lobe.  This  regeneration  response  was  confirmed histologically by a

  13. Primary choriocarcinoma of uterine cervix treated by uterine artery drug pouring and embolism:one case report%子宫动脉药物灌注及栓塞治疗原发性宫颈绒癌一例

    Institute of Scientific and Technical Information of China (English)

    Yan Wang; Haiyang Jiang; Shaoguang Wang; Xuan Wang; Zhiyun Song

    2009-01-01

    Primary choriocarcinoma of the uterine cervix (PCC) is an extremely rare disease. The conventional treatment of PCC is a combination of hysterectomy and chemotherapy. We present one rare case proved by cervical biopsy. The patient was an 36-year-old Chinese woman with irregular vaginal bleeding for 60 days. A cervical tumoral mass was seen in the pel-vic examination and biopsy revealed active hyperplasia of trophoblastic cell, Because of massive vaginal haemorThage, the patient accepted uterine artery drug pouring and embolism emergently. This management had gained a satisfactory effect. Thus, Uterine artery drug pouring and embolism is one new and effective weapon for PCC, which can preserve the patient's productive abUity.

  14. CDC Group EO-4 and Candida tropicalis Peritonitis in a Patient on Peritoneal Dialysis after Upper Endoscopy, Colonoscopy and Coil Embolization of the Gastroduodenal Artery

    Science.gov (United States)

    Gayen, Shameek; Ziemba, Yonah; Jaiswal, Shikha; Frank, Adam; Brahmbhatt, Yasmin

    2016-01-01

    Peritoneal dialysis (PD) is an excellent form of renal replacement therapy for many patients with end-stage renal disease (ESRD). Over 10,000 patients receive PD in the United States [United States Renal Data System: 2015 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States, 2015]. PD has superior outcomes compared to hemodialysis in the first 2 years of ESRD [Sinnakirouchenan and Holley: Adv Chronic Kidney Dis 2011;18: 428-432]. However, peritonitis is a known complication and may result in significant morbidity and necessitate transition to hemodialysis, which increases medical costs [Holley and Piraino: Semin Dial 1990;3: 245-248]. We report the first case of a PD patient who underwent endoscopy, colonoscopy and CT angiogram with coil embolization for gastrointestinal bleeding without antibiotic prophylaxis and subsequently developed CDC group EO-4 organism and fungal peritonitis.

  15. CDC Group EO-4 and Candida tropicalis Peritonitis in a Patient on Peritoneal Dialysis after Upper Endoscopy, Colonoscopy and Coil Embolization of the Gastroduodenal Artery

    Directory of Open Access Journals (Sweden)

    Shameek Gayen

    2016-11-01

    Full Text Available Peritoneal dialysis (PD is an excellent form of renal replacement therapy for many patients with end-stage renal disease (ESRD. Over 10,000 patients receive PD in the United States [United States Renal Data System: 2015 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States, 2015]. PD has superior outcomes compared to hemodialysis in the first 2 years of ESRD [Sinnakirouchenan and Holley: Adv Chronic Kidney Dis 2011;18: 428–432]. However, peritonitis is a known complication and may result in significant morbidity and necessitate transition to hemodialysis, which increases medical costs [Holley and Piraino: Semin Dial 1990;3: 245–248]. We report the first case of a PD patient who underwent endoscopy, colonoscopy and CT angiogram with coil embolization for gastrointestinal bleeding without antibiotic prophylaxis and subsequently developed CDC group EO-4 organism and fungal peritonitis.

  16. Paraplegia after aortic and superior mesenteric artery stenting for occlusive disease.

    Science.gov (United States)

    Hans, Sachinder S; Ngo, William; McAllister, Michael

    2014-02-01

    Paraplegia after endovascular therapy for aortic and visceral artery occlusive disease is an extremely uncommon occurrence. Two cases of paraplegia after placement of an aortic covered stent for infrarenal aortic stenosis and a superior mesenteric artery stent for chronic visceral ischemia are presented. In both patients, embolization of the arterial supply to the spinal cord was the presumed cause. One patient had a slight recovery after intense physical therapy and rehabilitation. The second patient did not have any recovery from her paraplegia.

  17. Embolization for vertebral metastases of follicular thyroid carcinoma.

    Science.gov (United States)

    Smit, J W; Vielvoye, G J; Goslings, B M

    2000-03-01

    The technique of selective embolization has been applied for years in the treatment of vascular anomalies, severe hemorrhage and benign or malignant tumors, notably vertebral metastases of renal cell carcinoma. Because this technique is relatively easy to perform and offers immediate relief of symptoms, it is an attractive option for patients with vertebral metastases of thyroid carcinoma with signs of spinal cord compression. In these patients, other treatment modalities like radioactive iodine, external irradiation, or surgery are more cumbersome or less effective in the short term. We describe four patients with metastasized follicular thyroid carcinoma, presenting with neurological symptoms due to vertebral metastases. All patients had undergone total thyroidectomy, ranging from 1 month to 4 yr before embolization. Embolization was combined with iodine-131 therapy when appropriate. Selective catheterization of the arteries feeding the metastases was performed, followed by infusion of polyvinyl alcohol particles (Ivalon). The procedure was technically successful in all patients without adverse effects. In the patients described, embolization resulted in rapid resolution of neurological symptoms, sometimes within hours. The therapeutic effect lasted from months to years. We conclude that embolization of vertebral metastases of follicular thyroid carcinoma is an attractive palliative therapeutic option that may offer rapid relief of symptoms.

  18. Absolute Ethanol Embolization of Arteriovenous Malformations in the Periorbital Region

    Energy Technology Data Exchange (ETDEWEB)

    Su, Li-xin, E-mail: sulixin1975@126.com [Shanghai Jiao Tong University School of Medicine, Department of Oral and Maxillofacial & Head and Neck Oncology, Ninth People’s Hospital (China); Jia, Ren-Bing, E-mail: jrb19760517@hotmail.com [Shanghai Jiao Tong University School of Medicine, Department of Ophthalmology, Ninth People’s Hospital (China); Wang, De-Ming, E-mail: wdmdeming@hotmail.com; Lv, Ming-Ming, E-mail: lvmingming001@163.com; Fan, Xin-dong, E-mail: fanxindong@aliyun.com [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Ninth People’s Hospital (China)

    2015-06-15

    ObjectiveArteriovenous malformations (AVMs) involving the periorbital region are technically challenging clinical entities to manage. The purpose of the present study was to present our initial experience of ethanol embolization in a series of 16 patients with auricular AVMs and assess the outcomes of this treatment.MethodsTranscatheter arterial embolization and/or direct percutaneous puncture embolization were performed in the 16 patients. Pure or diluted ethanol was manually injected. The follow-up evaluations included physical examination and angiography at 1- to 6-month intervals.ResultsDuring the 28 ethanol embolization sessions, the amount of ethanol used ranged from 2 to 65 mL. The obliteration of ulceration, hemorrhage, pain, infection, pulsation, and bruit in most of the patients was obtained. The reduction of redness, swelling, and warmth was achieved in all the 16 patients, with down-staging of the Schobinger status for each patient. AVMs were devascularized 100 % in 3 patients, 76–99 % in 7 patients, and 50–75 % in 6 patients, according to the angiographic findings. The most common complications were necrosis and reversible blister. No permanent visual abnormality was found in any of the cases.ConclusionEthanol embolization is efficacious and safe in the treatment of AVMs in the periorbital region and has the potential to be accepted as the primary mode of therapy in the management of these lesions.

  19. 小颗粒明胶海绵栓塞犬髂内动脉及骶正中动脉后并发症的研究%COMPLICATION AFTER SELECTIVE ARTERIAL EMBOLIZATION IN INTERNAL ILIAC ARTERY AND MEDIAN SACRAL ARTERY WITH GELFOAM PARTICLE IN DOGS

    Institute of Scientific and Technical Information of China (English)

    李叶天; 尹宗生; 王伟; 秦坤鹏; 王亚光

    2011-01-01

    Objective To observe the complication after embol izing the bilateral internal iliac arteries and the median sacral artery of dogs by different combinations and embolization levels with gelfoam particle, and to provide a reference for safety application of gelfoam in clinic.Methods Sixteen common grade adult healthy dogs (weighing 10-13 kg, 14 males and 2 females) were randomly divided into 5 groups.Under the monitoring of digital subtraction angiography (DSA), the embolization was performed with gelfoam particle (diameter, 50-150 μm) in bilateral internal iliac arteries and the main branch of the median sacral artery (group A, n=3), in bilateral internal iliac arteries and the first branch of the median sacral artery (group B, n=3), in the main branch of bilateral internal iliac arteries (group C, n=3), in the unilateral internal iliac artery and the main branch of the median sacral artery (group D, n=4), and in the main branch of unilateral internal iliac artery (group E, n=3).Under the DSA,the anatomic relationships of the abdominal aorta, bilateral external iliac arteries, bilateral internal iliac arteries, and median sacral artery were observed before embolization.The survival dogs were observed and the specimens of bladder, rectum, sciatic nerve, and gluteal muscles were harvested for the general and histological observations at 3 days after embolization.Results In dogs, there was no common iliac artery; bilateral external iliac arteries originated from the abdominal aorta and the starting of the median sacral artery had variation.Seven dogs (3 in group A, 3 in group C, and 1 in group D) died within 2 days after embolization, and the others survived to the end of the experiment.In the dead dogs of groups A, C, and D, the darkening and necrosis of the rectum were observed; the bladder presented lamellar obfuscation and focal hemorrhage and edema; and the median urinary volume in bladder was 270.6 mL.In survival dogs, no obvious change was observed in the

  20. Effects of HGF gene polymorphisms and protein expression on transhepatic arterial chemotherapeutic embolism efficacy and prognosis in patients with primary liver cancer

    Directory of Open Access Journals (Sweden)

    Chen HY

    2017-02-01

    Full Text Available Hai-Yong Chen,1,2 Yao-Min Chen,3 Jian Wu,1,2 Fu-Chun Yang,1,2 Zhen Lv,1,2 Yi-Gang Qian,1,2 Shu-Sen Zheng1,2 1Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University, 2Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, 3Department of Breast Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China Objective: To investigate the correlations of two hepatocyte growth factor (HGF gene polymorphisms (rs5745652 and rs2074725 and their protein expression levels with the efficacy of transhepatic arterial chemotherapeutic embolism (TACE and prognosis in patients with primary liver cancer (PLC. Methods: From March 2011 to June 2012, 109 PLC patients (the case group who chose TACE as primary treatment and 80 healthy people (the control group who had undergone physical examination in The First Affiliated Hospital, Zhejiang University were selected during the same period. Gene polymorphisms of HGF rs5745652 and HGF rs2074725 were detected. Serum HGF level, treating efficacy, survival quality, and 3-year survival rate for PLC patients who received TACE were observed. Results: There were significant differences in genotype and allele frequencies of HGF rs5745652 and HGF rs2074725, between the case and control groups (all P<0.05. Compared with CT+TT genotype of HGF rs5745652, patients carrying CC genotype had lower serum HGF levels, higher efficacy, better survival quality, and prolonged 3-year survival rate (all P<0.05. In rs2074725, patients carrying CA+AA genotype had lower serum HGF levels, higher efficacy, better survival quality, and prolonged 3-year survival rate compared with patients carrying rs2074725 CC genotype (all P<0.05. Gene polymorphisms of HGF rs5745652 and HGF rs2074725, tumor size, and Barcelona Clinic Liver Cancer stage were independent prognostic factors for PLC (P<0.05. Conclusion: Our

  1. Is prophylactic embolization of the hepatic falciform artery needed before radioembolization in patients with {sup 99m}Tc-MAA accumulation in the anterior abdominal wall?

    Energy Technology Data Exchange (ETDEWEB)

    Ahmadzadehfar, Hojjat; Sabet, Amir; Muckle, Marianne; Haslerud, Torjan; Biersack, Hans Juergen; Ezziddin, Samer [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); Moehlenbruch, Markus; Meyer, Carsten; Wilhelm, Kai; Schild, Hans Heinz [University Hospital Bonn, Department of Radiology, Bonn (Germany)

    2011-08-15

    While influx of chemoembolic agents into the hepatic falciform artery (HFA) from the hepatic artery can cause supraumbilical skin rash, epigastric pain and even skin necrosis, the significance of a patent HFA in patients undergoing radioembolization is not completely clear. Furthermore, the presence of tracer in the anterior abdominal wall seen in {sup 99m}Tc-macroaggregated albumin ({sup 99m}Tc-MAA) images, which is generally performed prior to radioembolization, has been described as a sign of a patent HFA. The aim of this retrospective study was to evaluate the incidence and consequences of {sup 99m}Tc-MAA accumulation in the anterior abdominal wall, indicating a patent HFA, in patients undergoing radioembolization of liver tumours. A total of 224 diagnostic hepatic angiograms combined with {sup 99m}Tc-MAA SPECT/CT were acquired in 192 patients with different types of cancer, of whom 142 were treated with a total of 214 radioembolization procedures. All patients received a whole-body scan, and planar and SPECT/CT scans of the abdomen. Only patients with extrahepatic {sup 99m}Tc-MAA accumulation in the anterior abdominal wall were included in this study. Posttreatment bremsstrahlung SPECT/CT and follow-up results for at least 3 months served as reference standards. Tracer accumulation in the anterior abdominal wall was present in pretreatment {sup 99m}Tc-MAA SPECT/CT images of 18 patients (9.3%). The HFA was found and embolized by radiologists before treatment in one patient. In the remaining patients radioembolization was performed without any modification in the treatment plan despite the previously mentioned extrahepatic accumulation. Only one patient experienced abdominal muscle pain above the navel, which started 24 h after treatment and lasted for 48 h without any skin changes. The remaining patients did not experience any relevant side effects during the follow-up period. Side effects after radioembolization in patients with tracer accumulation in the

  2. Emergency embolization therapy for massive hemoptysis due to bronchiectasis%支气管扩张大咯血的急诊介入栓塞治疗

    Institute of Scientific and Technical Information of China (English)

    徐伟; 史中兴; 徐春阳; 王宏辉

    2014-01-01

    Objective To identify various arteriographic manifestations of massive hemoptysis due to bronchiectasis and the efficacy of emergency embolization .Methods Emergency arteriography was performed for 90 patients of bronchietasis with massive hemoptysis .Emergency embolization was conducted using embolic agents as soon as bleeding arteries were i‐dentified .The arteriographic manifestations and effect of the treatment for massive hemoptysis were retrospectively ana‐lyzed .Results 135 bleeding arteries were found and be embolized succefully in 90 patients .A 12‐month follow‐up re‐vealed that complete hemostasis was achieved in 84 patients within 24 hours ,6 hemoptysis stopped completely in 3 days of embolotherapy .8 patients had recurrent hemoptysis ,among whom 6 hemoptysis stopped completely after lobectomies ,2 patients died of the complications of TB/aspergillus coinfection .The overall effective rate of the emergency embolization was 91 .11% (82/90) .No serious complications occurred after embolotherapy .Conclusion Emergency arterial emboliza‐tion for hemoptysis of bronchiectasis is a safe and effective treatment for massive hemoptysis due to bronchiectasis .The key to successful treatment is reasonable choice and use of embolic agents and thorough and complete embolization of the bleeding arteries .%目的:探讨90例支气管扩张大咯血患者的动脉造影表现及急诊介入栓塞治疗的疗效。方法对90例支气管扩张大咯血的患者行急诊动脉造影检查,明确出血部位后,选用不同的栓塞剂栓塞出血动脉,对动脉造影的表现及治疗结果进行回顾性总结及评价。结果90例患者共找到135支出血动脉,全部成功栓塞治疗。栓塞术后随访12个月,8例患者复发咯血,6例采用肺叶切除手术后出血停止。2例患者死于结核菌合并曲霉菌感染所致的并发症。栓塞治疗的总有效率91.11%(82/90)。栓塞术后无严重并发症出现。结

  3. Embolization for the treatment of unilateral A1 segment anterior communicating artery aneurysm: a report of 48 cases

    OpenAIRE

    Qing-dong GUO; Liu, Wei; Fu, Luo-An; Zhang, Lei; Zhang, Xue-Xi; Jing HU; Fei, Zhou

    2011-01-01

    Objective To summarize the experience and method of endovascular treatment of unilateral A1 segment anterior communicating artery aneurysm with detachable coils.Methods Forty-eight patients with unilateral A1 anterior communicating artery aneurysm(23 males and 25 females,age ranged from 32 to 72 years with mean of 53.4,hospitalized in Xijing hospital from Jan.2009 to Apr.2010) were involved in present study.All of the aneurysms were measured with rotational digital subtraction angiography(RDS...

  4. Superselective transcatheter renal artery embolization in treatment of iatrogenic renal hemorrhage%超选择性肾动脉栓塞术治疗医源性肾损伤出血

    Institute of Scientific and Technical Information of China (English)

    丁以锟; 吕维富; 鲁东; 周春泽

    2013-01-01

    Objective To observe the therapeutic effect of transcatheter superselective renal artery embolization for iatrogenic renal hemorrhage,as well as the impact of embolization on renal function.Methods Eleven patients with iatrogenic renal hemorrhage were enrolled.Renal arteriography was performed to observe the bleeding site and severity firstly,and then transcatheter superselective renal artery embolization with coils and gelatin sponge were performed.All patients were followed up for 6-12 months.Results In all 11 patients,bleeding arteries were found after renal angiography.Bleeding stopped in 10 patients after once embolization,but continued in one patient after twice embolization,whose hematuresis disappeared after undergoing transurethral plot clot dissection.No recurrence of hematuria was observed during the following-up period.Conclusion Transcatheter superselective renal artery embolization is secure and effective,being able to protect renal function,and can be used as the preferred alternation for the treatment of iatrogenic renal hematuria.%目的 观察超选择性肾动脉栓塞术治疗医源性肾损伤出血的疗效及对肾功能的影响.方法 收集11例医源性肾损伤出血患者,先行超选择性肾动脉造影,明确出血部位和性质,再行超选择插管,采用弹簧圈、明胶海绵进行栓塞治疗;术后随访6~12个月.结果 对11例患者行肾动脉造影均可明确出血部位.10例一次栓塞止血成功;1例经2次栓塞后仍有持续血尿,行经尿道膀胱积血块清除术后血尿消失.随访期间无血尿发生.结论 超选择肾动脉栓塞术是治疗医源性肾损伤出血的安全、有效的方法,能最大程度保护肾功能,可作为首选治疗方法.

  5. [New trial designs and potential therapies for pulmonary artery hypertension].

    Science.gov (United States)

    Gomberg-Maitland, Mardi; Bull, Todd M; Saggar, Rajeev; Barst, Robyn J; Elgazayerly, Amany; Fleming, Thomas R; Grimminger, Friedrich; Rainisio, Maurizio; Stewart, Duncan J; Stockbridge, Norman; Ventura, Carlo; Ghofrani, Ardeschir H; Rubin, Lewis J

    2014-10-01

    A greater understanding of the epidemiology, pathogenesis, and pathophysiology of pulmonary artery hypertension (PAH) has led to significant advances, but the disease remains fatal. Treatment options are neither universally available nor always effective, underscoring the need for development of novel therapies and therapeutic strategies. Clinical trials to date have provided evidence of efficacy, but were limited in evaluating the scope and duration of treatment effects. Numerous potential targets in varied stages of drug development exist, in addition to novel uses of familiar therapies. The pursuit of gene and cell-based therapy continues, and device use to help acute deterioration and chronic management is emerging. This rapid surge of drug development has led to multicenter pivotal clinical trials and has resulted in novel ethical and global clinical trial I concerns. This paper will provide an overview of the opportunities and challenges that await the development of novel treatments for PAH. (J Am Coil Cardiol 2013;62:D82-91) ©2013 by the American College of Cardiology Foundation.

  6. Combined Therapies for the Treatment of Technically Unresectable Liver Malignancies: Bland Embolization and Radiofrequency Thermal Ablation within the Same Session

    Energy Technology Data Exchange (ETDEWEB)

    Bonomo, Guido, E-mail: guido.bonomo@ieo.it; Della Vigna, Paolo, E-mail: paolo.dellavigna@ieo.it; Monfardini, Lorenzo, E-mail: lorenzo.monfardini@ieo.it; Orgera, Gianluigi, E-mail: gianluigi.orgera@ieo.it [European Institute of Oncology, Unit of Interventional Radiology (Italy); Chiappa, Antonio, E-mail: antonio.chiappa@ieo.it [European Institute of Oncology, Unit of Biliopancreatic Surgery (Italy); Bianchi, Paolo Pietro, E-mail: paolo.bianchi@ieo.it [European Institute of Oncology, Unit of Minimally-Invasive Surgery (Italy); Zampino, Maria Giulia, E-mail: maria.zampino@ieo.it [European Institute of Oncology, Division of Medical Oncology (Italy); Orsi, Franco, E-mail: franco.orsi@ieo.it [European Institute of Oncology, Unit of Interventional Radiology (Italy)

    2012-12-15

    Purpose: This retrospective study evaluated the feasibility, efficacy, and safety of combining transcatheter arterial embolization (TAE) with radiofrequency thermal ablation (RFA) in a single session for the treatment of technically unresectable liver-only malignancies. Methods: From May 2006 to January 2011, a total of 30 patients affected by liver metastases with single or multiple unresectable liver-only lesions underwent a combined treatment with TAE followed by RFA in the same session, for a total of 36 treated lesions. Patients were extrapolated from a cohort of patients discussed within the weekly institutional tumor board. TAE was performed by using 100 {mu}m microspheres; RFA was performed immediately after TAE by positioning the electrode needle via ultrasound and/or computed tomographic guidance. Local tumor responses and procedure-related complications were evaluated. Results: Completion of both procedures was obtained in all patients for all 36 lesions. Liver lesions had a maximum axial diameter ranging 16-59 mm. Postintervention unenhanced ablated areas ranged 28-104 mm in maximum axial diameter. Safety margins ranged 1-30.5 mm. Complete response, defined as complete devascularization at computed tomography, was obtained in all treated lesions for a maximum period of 12 months. Tumor relapse was observed in one patient at 12 months. Sixteen patients developed new liver lesions or progressive systemic disease during follow-up. Nine patients were still disease-free. Seven patients died as a result of systemic progressive disease. One major treatment-related complication was observed. Conclusions: In patients with technically unresectable liver-only malignancies, single-session combined TAE-RFA is an effective and safe treatment.

  7. Changes in distribution of reticuloendothelial function in transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC), estimated by single photon emission computed tomography (SPECT)

    Energy Technology Data Exchange (ETDEWEB)

    Taniai, Nobuhiko; Onda, Masahiko; Tajiri, Takashi; Kim, Tokuei [Nippon Medical School, Tokyo (Japan)

    1995-06-01

    In order to study the changes in distribution of reticuloendothelial function in transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC), the radioactivity of {sup 99m}Tc-phytate was calculated by the accumulation rate in the organs by means of the single emission computed tomography (SPECT). It was regarded as the reticuloendothelial function in the liver and spleen, and was evaluated independently. Before TAE, the significant increases were noted in both splenic activity and splenic volume in the cirrhotic patients, as compared with non-cirrhotic patients. After TAE, the activity in the liver was reduced at the first day after TAE, which returned to the normal level by 5 days. While that in the spleen increased immediately after TAE. After one day of TAE, reticuloendothelial functions of the spleen was significantly higher in the cirrhotic cases then in the non-cirrhotic cases. Furthermore, in the cirrhotic patients, it was significantly higher in the cases embolizated in more than two segments than in those embolizated in one segment only. In conclusion, the reticuloendothelial function of the liver was significantly reduced by the TAE in the cirrhotic patients as compared with non-cirrhotic patients. However the reduced reticuloendothelial function of the liver in the cirrhotic patients was compensated by the increased reticuloendothelial function of the spleen. (author).

  8. Diagnosis and treatment of acute superior mesenteric artery embolism%急性肠系膜上动脉栓塞46例诊治体会

    Institute of Scientific and Technical Information of China (English)

    仝麟龙; 仝现州

    2016-01-01

    目的 探讨急性肠系膜上动脉栓塞(acute superior mesenteric artery embolism,ASMAE)早期诊断及早期治疗要点,避免误诊,降低致残及致死率.方法 对2004-01~2011-01该院收治的46例ASMAE患者的临床资料进行回顾性分析.结果 病程1 h~10d,46例均经上腹CT及腹部计算机断层X线血管造影(CTA)检查确诊为ASMAE.手术切除肠管28例,经皮介入肠系膜上动脉置管溶栓10例,肠系膜上动脉切开取栓血管再成型8例.围手术期死亡5例,短肠综合征8例,随访3年死亡,其余33例随访3年,恢复良好.结论 如出现突发剧烈腹痛和不典型的腹部体征,应警惕是ASMAE,尽早行腹部CTA检查,早期确诊、早期治疗是降低致残及致死率的关键.

  9. 536例肢体动脉栓塞的治疗经验%Experience in the treatment of arterial embolism of the extremities, report of 536 cases

    Institute of Scientific and Technical Information of China (English)

    吴章敏; 吴庆华; 陈忠; 邓鸿儒; 杨宝钟

    2008-01-01

    Objective To evaluate the treatment for acute embolism in the extremities and define the primary factors affecting the prognosis. Methods From December 1984 to December 2006,536 patients with acute embolism of extremities were treated. Embolectomy with Forgarty catheters were performed in 507 cases, including salvage surgery in 34 cases and conservative therapy in 29 cases. Results The cure rate, mortality and amputation rate were 76.68%,9.51% and 10.26% respectively. Embolism recurred in 11.7% cases. Cardiopulmonary (27.5% ) and renal failure ( 25.5% ) were main causes of death during perioperative period. No bleeding nor other major complications occurred in 221 patients with atrial fibrillation who routinely received wafarine under proper monitoring. About 25.6% patients underwent heart valves surgery during hospitalization or within one year after discharge. Conclusions Patients suffering from acute embolism of the extremities should receive combination treatment. The main factors affecting the prognosis include time and degree of ischemia, and ischemia-reperfusion injury. Anticoagulant and etiologic treatment should be adopted in those with cardiogenic embolus and atrial fibrillation.%目的 总结肢体动脉栓塞病例的治疗效果,探讨影响疗效的主要因素以提高疗效.方法 对1984年12月至2006年12月收治的536例次动脉栓塞病例的病因、治疗、预后及随访结果进行回顾性分析.急诊或限期的Fogarty取栓导管动脉取栓术507例次,二次手术34例次.保守治疗29例次.结果 痊愈率76.68%;死亡率9.51%;截肢率10.26%.复发率为11.7%.心肺功能衰竭(27.45%)、肾功能衰竭(25.49%)等是围手术期主要致死原因.出院后正规服用华法令并监测的221例房颤患者,均无明显出血倾向及严重并发症.25.6%的患者同次住院期间或出院后1年内接受了心脏换瓣等手术治疗.结论 动脉栓塞对肢体和生命均构成威胁,治疗应足综合性的;缺血时间、

  10. Embolización arterial de miomas uterinos: resultados morfológicos y funcionales a corto y mediano plazo Uterine fibroid embolization: morphologic and functional results at short-to-medium term

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    Sergio Lucino

    2010-06-01

    Full Text Available Introducción: Los miomas uterinos son los tumores sólidos más frecuentes del aparato genital femenino. En un alto porcentaje son asintomáticos, pero cuando se acompañan de sangrado uterino anormal, dolor o síntomas de compresión, se debe aplicar un tratamiento. La Embolización Arterial Uterina (EAU se presenta como una alternativa al tratamiento quirúrgico. Objetivo: El objetivo de este trabajo es medir la eficacia de la EAU como tratamiento de la miomatosis sintomática a corto y mediano plazo, evaluar la seguridad y comparar los resultados con otros tratamientos. Material y Método: Se realizó un estudio prospectivo de 28 pacientes seleccionadas entre diciembre de 2000 y abril de 2005, cuya edad promedio era 41 años y que presentaban miomatosis sintomática, con alteraciones en el sangrado menstrual y deseos de conservación del útero. Las EAU fueron realizadas con partículas de polivinil alcohol de 500 a 1000 μm. A todas se les hizo un seguimiento posterior mayor de 2 años. Resultados: En 27 pacientes, el alta médica se otorgó a las 24 horas post EAU. Una paciente permaneció internada por la persistencia de dolor pelviano y una se reinternó por la misma causa a las 48 horas post procedimiento. Todas las pacientes reanudaron sus actividades rutinarias a los 7 ± 4 días post embolización. No se presentaron complicaciones. Luego de un seguimiento de 6 meses, el 100 % de las pacientes se manifestaron satisfechas con el procedimiento. Conclusión: La EAU es una excelente alternativa a los tratamientos clásicos y una opción terapéutica para las pacientes portadoras de miomas uterinos sintomáticos.Introduction: Uterine myomas are the most frequent solid tumours of the female reproductive system. In a high percentage of cases patients are asymptomatic; however, when clinical manifestations occur such as abnormal uterine bleeding, pain or compressive symptoms, some kind of therapy must be initiated. Uterine artery embolization

  11. Study of responsible arteries of duodenal ulcer hemorrhage and the significance of transcatheter arterial embolization%十二指肠溃疡出血责任动脉的研究及在栓塞治疗中的意义

    Institute of Scientific and Technical Information of China (English)

    李强; 吴亮; 汤继军

    2014-01-01

    Objective To study the responsible arteries of duodenal ulcer hemorrhage and the significance of transcatheter arterial embolization.Methods There were 1 7 patients of massive bleeding of duodenal ulcer,in which 1 6 patients were diagnosed and 8 ca-ses were treated by endoscope initially.DSAs were performed at gastr-oduodenal arteries or their ramus in all patients.DSA signs were analysed by two salted docters together.At first the responsible ar-teries for duodenal ulcer hemorrhage were affirmed,and then endo-vascular embolization was performed.Results The responsible arteries for duodenal ampulla ulcer hemorrhage were the ascending duodenal artery(ADA)、the pancreaticoduodenal trunk(PDT)、the supraduodenal artery(SDA)and the retroduodenal artery (RDA).The responsible arteries for descendant duodenum ulcer hemorrhage were the anterior superior pancreaticoduodenal artery (ASPDA)and the posterior superior pancreaticoduodenal artery(PSPDA).The positive rate of bleeding that showed the signs of bleeding was 100%,the s-uccess rate of the operations was 100%,the complete efficiency ra-te of hemostasis was 88.2%,the par-tial efficiency rate of hemostas was 1 1.8%.Conclusion The responsible arteries of duodenal ulcer hemorrhage are multiples,which is important for guiding transcatheter arterial embolization of the responsible arteries of duodenal ulcer hemorrhage accurately.%目的:探讨十二指肠溃疡出血的责任动脉及在栓塞治疗中的意义。方法17例十二指肠溃疡大出血患者,分析其 DSA表现,判定出血的责任动脉,然后实施栓塞治疗。结果十二指肠球部溃疡出血的责任动脉为十二指肠升动脉(ADA)、十二指肠胰干(PDT)、十二指肠上动脉(SDA)、十二指肠后动脉(RDA),十二指肠降部溃疡出血的责任动脉为胰十二指肠上前动脉(ASPDA)和胰十二指肠上后动脉(PSPDA)。结论十二指肠溃疡出血的责任动脉众多,准确判定十二指肠溃疡出血的责任动

  12. Pulmonary Air Embolism: An Infrequent Complication in the Radiology Suite

    Science.gov (United States)

    Lanfranco, Julio; Romero-Legro, Ivan; Freire, Amado X.; Nearing, Katherine; Ratnakant, Sanjay

    2017-01-01

    Patient: Female, 64 Final Diagnosis: Pulmonary air embolism Symptoms: Shortness of breath Medication: — Clinical Procedure: — Specialty: Critical Care Medicine Objective: Unusual or unexpected effect of treatment Background: Air embolism can occur in a number of medical-surgical situations. Venous air embolism is frequently lethal when a substantial amount enters the venous circulation rapidly and can lead to significant morbidity if crossover to the systemic arterial circulation occurs. The diagnosis of massive air embolism is usually made on clinical grounds by the development of abrupt hemodynamic compromise. The true incidence, morbidity, and mortality of this event is unknown given the difficulties in diagnosis. Case Report: An inadvertent antecubital venous injection of 150 mL of air using a contrast power injector during a computed tomography (CT) is reported. Immediate imaging (CT) showed a significant amount of air in the right atrium and right ventricular cavity, and air mixed with contrast in the main pulmonary artery and proximal divisions of the pulmonary circulation. Patient condition deteriorated requiring mechanical ventilation for 48 hours. Condition improved over the next few days and patient was successfully extubated and discharged home. Conclusions: Air embolism is a rare complication, the potential for this to be life threatening makes prevention and early detection of this condition essential. This condition should be suspected when patients experience sudden onset respiratory distress and/or experience a neurological event in the setting of a known risk factor. Treatment options include Durant’s maneuver; left-lateral decubitus, head-down positioning; to decrease air entry into the right ventricle outflow tract, hyperbaric therapy, 100% O2 and supportive care. PMID:28115731

  13. An interesting septic embolism

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    Funda Uluorman

    2014-01-01

    Full Text Available Septic pulmonary embolism is a rare disease but mortality and morbidity of it is high. Septic pulmonary emboli comes from infected heart valves, thrombophlebitis, and pulmonary artery catheter or infected pacemaker wires as many sources [1,2]. In recent years, pacemaker is a common treatment of the bradiarrhythmia that is persisted in the etiology of septic embolism, its applications has started to pick up [3]. There is the growing number of patients with pacemaker, according to this the frequency of pacemaker lead infection and the number of patients at risk for right-sided endocarditis increase [4]. The patients don't have specific clinical and radiological features because of this it is very difficult to define, so the diagnosis is often delayed [5]. A detailed medical history, a detailed physical examination in diagnosis and evaluation of good additional imaging methods is very important. Early diagnosis and proper treatment, the implementation of the management, can provide good results.

  14. An interesting septic embolism.

    Science.gov (United States)

    Uluorman, Funda; Tanrıverdi, Zülkif; Sevinç, Can; Badak, Özer; Çatalyürek, Hüdai

    2014-01-01

    Septic pulmonary embolism is a rare disease but mortality and morbidity of it is high. Septic pulmonary emboli comes from infected heart valves, thrombophlebitis, and pulmonary artery catheter or infected pacemaker wires as many sources [1,2]. In recent years, pacemaker is a common treatment of the bradiarrhythmia that is persisted in the etiology of septic embolism, its applications has started to pick up [3]. There is the growing number of patients with pacemaker, according to this the frequency of pacemaker lead infection and the number of patients at risk for right-sided endocarditis increase [4]. The patients don't have specific clinical and radiological features because of this it is very difficult to define, so the diagnosis is often delayed [5]. A detailed medical history, a detailed physical examination in diagnosis and evaluation of good additional imaging methods is very important. Early diagnosis and proper treatment, the implementation of the management, can provide good results.

  15. Thermo-sensitive composite hydrogels based on poloxamer 407 and alginate and their therapeutic effect in embolization in rabbit VX2 liver tumors

    Science.gov (United States)

    Huang, Lili; Shen, Ming; Li, Rongxin; Zhang, Xiangyu; Sun, Ying; Gao, Pei; Fu, Hao; Liu, Hongqiang; He, Yang; Du, Yuqing; Cao, Jun; Duan, Yourong

    2016-01-01

    Interventional embolization therapy is an effective, most widely used method for inoperable liver tumors. Blood-vessel-embolic agents were essential in transarterial embolization (TAE). In this work, thermo-sensitive composite hydrogels based on poloxamer 407, sodium alginate, hydroxymethyl cellulose and iodixanol (PSHI), together with Ca2+ (PSHI-Ca2+) were prepared as liquid embolic agents for TAE therapy to liver cancer. With increasing temperature, PSHI exhibited two phase states: a flowing sol and a shrunken gel. Rheology tests showed good fluidity and excellent viscoelastic behavior with a gelation temperature (GT) of 26.5°C. The studies of erosion indicated that PSHI had calcium ion-related erosion characteristics and showed a slow erosion rate in an aqueous environment. When incubated with L929 cells, the thermo-sensitive composite hydrogels had low cytotoxicity in vitro. The results of analyzing the digital subtraction angiography and computed tomography images obtained from in vitro and in vivo assays indicated a good embolic effect in the renal arteries of normal rabbits. Angiography and histological studies on VX2 tumor-bearing rabbits indicated that PSHI-Ca2+ successfully occluded the tumors, including the peripheral vessels. In conclusion, PSHI-Ca2+ was a promising embolic agent for transarterial embolization therapy. PMID:27602579

  16. Thermo-sensitive composite hydrogels based on poloxamer 407 and alginate and their therapeutic effect in embolization in rabbit VX2 liver tumors.

    Science.gov (United States)

    Huang, Lili; Shen, Ming; Li, Rongxin; Zhang, Xiangyu; Sun, Ying; Gao, Pei; Fu, Hao; Liu, Hongqiang; He, Yang; Du, Yuqing; Cao, Jun; Duan, Yourong

    2016-11-08

    Interventional embolization therapy is an effective, most widely used method for inoperable liver tumors. Blood-vessel-embolic agents were essential in transarterial embolization (TAE). In this work, thermo-sensitive composite hydrogels based on poloxamer 407, sodium alginate, hydroxymethyl cellulose and iodixanol (PSHI), together with Ca2+ (PSHI-Ca2+) were prepared as liquid embolic agents for TAE therapy to liver cancer. With increasing temperature, PSHI exhibited two phase states: a flowing sol and a shrunken gel. Rheology tests showed good fluidity and excellent viscoelastic behavior with a gelation temperature (GT) of 26.5°C. The studies of erosion indicated that PSHI had calcium ion-related erosion characteristics and showed a slow erosion rate in an aqueous environment. When incubated with L929 cells, the thermo-sensitive composite hydrogels had low cytotoxicity in vitro. The results of analyzing the digital subtraction angiography and computed tomography images obtained from in vitro and in vivo assays indicated a good embolic effect in the renal arteries of normal rabbits. Angiography and histological studies on VX2 tumor-bearing rabbits indicated that PSHI-Ca2+ successfully occluded the tumors, including the peripheral vessels. In conclusion, PSHI-Ca2+ was a promising embolic agent for transarterial embolization therapy.

  17. Clinical, Laboratorial, and Urodynamic Findings of Prostatic Artery Embolization for the Treatment of Urinary Retention Related to Benign Prostatic Hyperplasia. A Prospective Single-Center Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Antunes, Alberto A. [University of Sao Paulo Medical School, Division of Urology (Brazil); Carnevale, Francisco C., E-mail: fcarnevale@uol.com.br; Motta Leal Filho, Joaquim M. da [University of Sao Paulo Medical School, Interventional Radiology Unit (Brazil); Yoshinaga, Eduardo M. [University of Sao Paulo Medical School, Division of Urology (Brazil); Cerri, Luciana M. O. [University of Sao Paulo Medical School, Ultrasound Unit (Brazil); Baroni, Ronaldo H. [University of Sao Paulo Medical School, Magnetic Resonance Unit (Brazil); Marcelino, Antonio S. Z. [University of Sao Paulo Medical School, Ultrasound Unit (Brazil); Cerri, Giovanni G. [University of Sao Paulo Medical School, Radiology Department (Brazil); Srougi, Miguel [University of Sao Paulo Medical School, Division of Urology (Brazil)

    2013-08-01

    PurposeThis study was designed to describe the clinical, laboratorial, and urodynamic findings of prostatic artery embolization (PAE) in patients with urinary retention due to benign prostatic hyperplasia (BPH).MethodsA prospective study of 11 patients with urinary retention due to BPH was conducted. Patients underwent physical examination, prostate specific antigen (PSA) measurement, transrectal ultrasound, and magnetic resonance imaging. International prostate symptom score (IPSS), quality of life (QoL), and urodynamic testing were used to assess the outcome before and after 1 year.ResultsClinical success was 91 % (10/11 patients) with a mean follow-up of 22.3 months (range, 12-41 months). At the first year follow-up, the mean IPSS score was 2.8 points (p = 0.04), mean QoL was 0.4 points (p = 0.001), mean PSA decreased from 10.1 to 4.3 ng/mL (p = 0.003), maximum urinary flow (Qmax) improved from 4.2 to 10.8 mL/sec (p = 0.009), and detrusor pressure (Pdet) decreased from 85.7 to 51.5 cm H{sub 2}O (p = 0.007). Before PAE, Bladder Outlet Obstruction Index (BOOI) showed values >40 in 100 % of patients. After PAE, 30 % of patients were >40 (obstructed), 40 % were between 20 and 40 (undetermined), and 30 % were <20 (unobstructed). Patients with a BOOI <20 had higher PSA values at 1-day after PAE.ConclusionsClinical and urodynamic parameters improved significantly after PAE in patients with acute urinary retention due to BPH. Total PSA at day 1 after PAE was higher in patients with unobstructed values in pressure flow studies.

  18. Treatment Challenges of a Primary Vertebral Artery Aneurysm Causing Recurrent Ischemic Strokes

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    Davide Strambo

    2017-01-01

    Full Text Available Background. Extracranial vertebral artery aneurysms are a rare cause of embolic stroke; surgical and endovascular therapy options are debated and long-term complication may occur. Case Report. A 53-year-old man affected by neurofibromatosis type 1 (NF1 came to our attention for recurrent vertebrobasilar embolic strokes, caused by a primary giant, partially thrombosed, fusiform aneurysm of the left extracranial vertebral artery. The aneurysm was treated by endovascular approach through deposition of Guglielmi Detachable Coils in the proximal segment of the left vertebral artery. Six years later the patient presented stroke recurrence. Cerebral angiography and Color Doppler Ultrasound well characterized the unique hemodynamic condition developed over the years responsible for the new embolic event: the aneurysm had been revascularized from its distal portion by reverse blood flow coming from the patent vertebrobasilar axis. A biphasic Doppler signal in the left vertebral artery revealed a peculiar behavior of the blood flow, alternately directed to the aneurysm and backwards to the basilar artery. Surgical ligation of the distal left vertebral artery and excision of the aneurysm were thus performed. Conclusion. This is the first described case of NF1-associated extracranial vertebral artery aneurysm presenting with recurrent embolic stroke. Complete exclusion of the aneurysm from the blood circulation is advisable to achieve full resolution of the embolic source.

  19. Coronary arterial disease after electroconvulsive therapy: a case report

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    Nataly Pimentel Rodrigues

    2015-06-01

    Full Text Available Objectives Unipolar depression (UPD is a leading cause of global burden of diseases, particularly among the elderly, whose treatment may be challenging. In such cases, ECT is often recommended due to its safety and efficacy. This report presents a case of a 67-year-old male inpatient that developed a rare cardiac complication during ECT. Methods Clinical case report with patient’s consent and bibliographic review. Results A 67-year-old male inpatient with recurrent severe psychotic depression was hospitalized and ECT was indicated after failure of the pharmacological treatment. A comprehensive clinical pre-evaluation revealed only nonspecific ST-segment changes in electrocardiogram. During the 7th ECT session, it was observed transitory ST-segment depression followed by a discrete increase of plasma troponin I. Severe tri-vessel coronary artery stenosis was found and a percutaneous coronary angioplasty was performed, with satisfactory psychiatric and cardiac outcomes. Conclusions Unipolar depression (UPD and cardiovascular disease are often coexistent conditions, especially among the elderly. In the current case, myocardial ischemia was detected lately during ECT therapy and its treatment allowed the UPD treatment to be completed adequately.

  20. Apoptosis-based therapy to treat pulmonary arterial hypertension

    Science.gov (United States)

    Suzuki, Yuichiro J.; Ibrahim, Yasmine F.; Shults, Nataliia V.

    2016-01-01

    Pulmonary arterial hypertension (PAH) is rare, but patients who are diagnosed with this disease still suffer from a lack of satisfactory treatment strategies to prolong survival. While currently approved drugs for PAH have some benefits, these vasodilators only have limited efficacy for eliminating pulmonary vascular remodeling and reducing mortality. Thus, our laboratory has been exploring the use of aggressive drugs, which are capable of causing apoptotic cell death, to treat PAH. We have so far found that three classes of anti-tumor agents, including anthracyclines, taxanes, and proteasome inhibitors, are capable of reducing pulmonary vascular thickness in rats with PAH. These drugs kill cells in remodeled pulmonary vessels without affecting the normal, healthy pulmonary vasculature, revealing that proliferating vascular cells in PAH patients are more sensitive to drug-induced apoptosis compared to the differentiated phenotype that is physiologically important for smooth muscle contraction. Since many apoptosis-inducing drugs cause cardiotoxicity in cancer patients, and because PAH patients already have a weakened heart, we focus on finding biological mechanisms that may reverse pulmonary vascular remodeling without promoting cardiotoxicity. We found two agents, dexrazoxane and pifithrin-α, that selectively inhibit cardiac muscle apoptosis without affecting the drug-induced apoptosis of the proliferating pulmonary vascular cells. Thus, we propose that the addition of apoptosis-inducing drugs and cardioprotectants to PAH therapies may be effective in treating patients and preventing right heart failure.

  1. Warfarin therapy in a dog with acute arterial thrombosis and pyometra.

    Science.gov (United States)

    Arai, Shiori; Callan, Mary Beth

    2014-11-01

    This report describes the presentation of acute arterial thrombosis causing triparesis in a 6-year-old female Chihuahua with pyometra and its successful management in combination with warfarin therapy. This is the first case report of a dog with arterial thrombosis associated with pyometra.

  2. 子宫动脉栓塞治疗子宫瘢痕妊娠11例%Clinical application of uterine artery embolization in treating uterine scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    李统怀; 郑红枫

    2011-01-01

    Objective To evaluate uterine artery embolization in treating uterine scar pregnancy. Methods During the period from November 2007 to February 2010, 11 patients with uterine scar pregnancy were encountered in authors' hospital. All the patients had a history of lower uterine segment cesarean section. Four patients had to receive an emergency uterine artery embolization due to acute massive vaginal bleeding. The other 7 patients received intravenous chemotherapy with MTX (0.4 mg/kg/day, every 5 days as a treatment course). Emergency uterine artery embolization had to be carried out in three patients as they developed acute massive vaginal bleeding (blood loss ≥ 100 ml/hour) during the course of chemotherapy, while subsequent uterine artery embolization was performed in the remaining 4 patients after they had completed two courses of treatment when their blood HCG showed no significant decrease. The clinical results were analyzed. Results Remarkable decrease in serum HCG was seen in all 11 patients after interventional management. The vaginal bleeding in 7 patients was significantly reduced within half an hour after uterine artery embolization. The uterus together with intact fertility was successfully preserved in all 11 patients. Conclusion For the treatment of uterine scar pregnancy complicated by massive vaginal bleeding (blood loss ≥ 500 ml/24 h) and/or abnormal elevation of serum HCG (blood β-HCG ≥ 20 000 IU/L), ectopic pregnancy with the mass diameter ≥ 5 cm, uterine artery embolization treatment is very safe and effective. This technique can well preserve female patient's uterus and fertility ability. It is of value to employ this treatment in clinical practice.%目的 探讨子宫动脉栓塞治疗在子宫瘢痕妊娠中的临床应用价值.方法 2007年11月- 2010年2月收治子宫下段剖宫产术后子宫瘢痕妊娠11例,其中4例因阴道大出血入院后急诊行子宫动脉栓塞治疗;另7例患者行MTX静脉化疗(每天剂量为0

  3. Rare occurrence of simultaneous coronary artery perforation and intracoronary thrombus formation following angioplasty

    Institute of Scientific and Technical Information of China (English)

    Su-Yan Bian; Liu-Fa Duan

    2013-01-01

    Both coronary artery perforation and intracoronary thrombus formation are life-threatening complications of percutaneous coronary interventions, which rarely occur simultaneously during angioplasty. We herein report a case of stent-related, left circumflex artery perforation, and subsequently acute left main artery thrombosis after the leakage was embolized with 7 microcoils. Intracoronary thromboectomy and systemic anticoagulant therapy were carefully used with good results. This case also represents some of our uncertainties regarding the best management of the patient.

  4. 子宫动脉栓塞术治疗胎盘植入13例临床观察%Clinical observation on the treatment of uterine artery embolization for 13 cases of placenta accrete

    Institute of Scientific and Technical Information of China (English)

    林进; 刘楚芹

    2012-01-01

    Objective To evaluate the clinical efficacy of the uterine artery embolization for placenta accrete.Methods Gelatin sponge particles were used for embolism of bilateral uterine artery by Seldinger technique for 13 cases of placenta accrete.Results 13 patients were successfully treated with surgical,the surgery time was from 35 to 90 minutes,at an average of 45 minutes,the placental expulsion time was from 5 to 30 days,at an average of 15 days.Uterine involution was normal postoperative.Conclusion The efficacy of uterine artery embolization treating placental implantation is significant without complications,and the reproductive function can be retained.%目的 探讨子宫动脉栓塞术治疗胎盘植入的临床疗效.方法 采用Seldinger技术对13例胎盘植入产妇行双侧子宫动脉栓塞,采用明胶海绵颗粒栓塞血管.结果 13例患者手术均成功,手术时间35 ~ 90分钟,平均45分钟,胎盘排出时间5~30天,平均15天,术后子宫复旧正常.结论 子宫动脉栓塞治疗胎盘植入疗效显著,保留了患者生育功能,无明显并发症.

  5. TREATMENT OF VERTEBRAL-ARTERY TYPE CERVICAL SPONDYLOPATHY WITH NEEDLE-KNIFE THERAPY

    Institute of Scientific and Technical Information of China (English)

    LI Dianning; YE Ping

    2002-01-01

    In the present paper, 62 cases of vertebral-artery type cervical spondylopathy were treated with needie-knife therapy (acupotomy). After 2- 6 sessions of treatment, 23 cases (37. 1%) were cured, 19 (30. 7%)showed marked improvement, 15 (24.2%) had some improvement and 5 (8.1 % ) failed in the treatment. The total effective rate was 91.9 %. It indicates that acupotomy therapy is a highly effective remedy for treating vertebral-artery type cervical spndylopathy.

  6. Pharmacoeconomic analysis of ischemic stroke therapy in patients with arterial hypertension

    Directory of Open Access Journals (Sweden)

    Mashin V.V.

    2010-09-01

    Full Text Available Pharmacoeconomic parameters have been examined in patients with ischemic stroke who have suffered from arterial hypertension, depending on use of antihypertensive therapy. The role of antihypertensive therapy as a factor that significantly reduces the treatment costs and improves stroke outcome has been proved. The research results show the importance of integrated analysis of clinical and economical factors in the treatment of patients with arterial hypertension

  7. Removal of Gross Air Embolization from Cardiopulmonary Bypass Circuits with Integrated Arterial Line Filters: A Comparison of Circuit Designs.

    Science.gov (United States)

    Reagor, James A; Holt, David W

    2016-03-01

    Advances in technology, the desire to minimize blood product transfusions, and concerns relating to inflammatory mediators have lead many practitioners and manufacturers to minimize cardiopulmonary bypass (CBP) circuit designs. The oxygenator and arterial line filter (ALF) have been integrated into one device as a method of attaining a reduction in prime volume and surface area. The instructions for use of a currently available oxygenator with integrated ALF recommends incorporating a recirculation line distal to the oxygenator. However, according to an unscientific survey, 70% of respondents utilize CPB circuits incorporating integrated ALFs without a path of recirculation distal to the oxygenator outlet. Considering this circuit design, the ability to quickly remove a gross air bolus in the blood path distal to the oxygenator may be compromised. This in vitro study was designed to determine if the time required to remove a gross air bolus from a CPB circuit without a path of recirculation distal to the oxygenator will be significantly longer than that of a circuit with a path of recirculation distal to the oxygenator. A significant difference was found in the mean time required to remove a gross air bolus between the circuit designs (p = .0003). Additionally, There was found to be a statistically significant difference in the mean time required to remove a gross air bolus between Trial 1 and Trials 4 (p = .015) and 5 (p =.014) irrespective of the circuit design. Under the parameters of this study, a recirculation line distal to an oxygenator with an integrated ALF significantly decreases the time it takes to remove an air bolus from the CPB circuit and may be safer for clinical use than the same circuit without a recirculation line.

  8. Primary stenting as emergency therapy in acute basilar artery occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Spreer, Joachim; Arnold, Sebastian; Klisch, Joachim; Schumacher, Martin [Section of Neuroradiology, University Hospital Freiburg, Breisacher Strasse 64, 79106 Freiburg (Germany); Els, Thomas; Hetzel, Andreas; Huppertz, Hans-Juergen; Oehm, Eckhardt [Department of Neurology, University Hospital Freiburg, Freiburg (Germany)

    2002-09-01

    In three patients with acute occlusion of the basilar artery intra-arterial fibrinolysis resulted in only partial recanalization and revealed severe stenosis as the underlying cause. Application of micro-stents without previous dilatation resulted in vessel re-opening. Two patients had an excellent clinical outcome. One patient died 10 days after the stroke due to brainstem infarction. Emergency primary stent application may improve the outcome in acute basilar artery occlusion, if intra-arterial thrombolysis fails to re-establish a sufficient flow. (orig.)

  9. Predictive Factors of Downstaging of Hepatocellular Carcinoma Beyond the Milan Criteria Treated with Intra-arterial Therapies

    Energy Technology Data Exchange (ETDEWEB)

    Bova, Valentina; Miraglia, Roberto, E-mail: rmiraglia@ismett.edu; Maruzzelli, Luigi [Mediterranean Institute for Transplantation and Advanced Specialized Therapies, (ISMETT), Department of Diagnostic and Interventional Radiology (Italy); Vizzini, Giovanni Battista [Mediterranean Institute for Transplantation and Advanced Specialized Therapies, (ISMETT), Department of Hepatology (Italy); Luca, Angelo [Mediterranean Institute for Transplantation and Advanced Specialized Therapies, (ISMETT), Department of Diagnostic and Interventional Radiology (Italy)

    2013-04-15

    This study was designed to analyze the clinical results in patients suitable for liver transplantation with hepatocellular carcinoma (HCC) who exceeded Milan criteria, which underwent intra-arterial therapies (IAT), to determine predictive factors of successful downstaging. A total of 277 consecutive patients with cirrhosis and HCC were treated by IAT (transarterial oily chemoembolization, transarterial chemoembolization, transarterial embolization) in a single center. Eighty patients exceed the Milan criteria. Patients with infiltrative HCC, hypovascular HCC, and portal vein thrombosis were excluded, with a final study population of 48 patients. Tumor response to IAT was evaluated with CT and/or MRI according to modified RECIST criteria. Successful downstaging was defined as a reduction in the number and size of viable tumors to within the Milan criteria, and serum alpha-fetoprotein (AFP) <100 ng/mL, for at least 6 months. Nineteen patients (39 %) had their tumors successfully downstaged; 29 patients (61 %) did not. Multivariate analysis showed that AFP level <100 ng/mL and 3-year calculated survival probability using the Metroticket calculator were the only independent predictors of successful downstaging (p < 0.023 and p < 0.049 respectively). Biological characteristics of HCC as AFP levels <100 ng/mL and high 3-year calculated survival probability may predict a good response to downstage after IAT.

  10. Transcatheter arterial embolization is the first-line therapy of choice in peptic ulcer bleeding not responding to endoscopic therapy

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jakobsen, Mark; Nielsen, Michael Milek

    2015-01-01

    comorbidity index (CCI). Results. One hundred and eighteen patients were included. Patients treated with TAE had a higher CCI (mean: 2.33 vs 1.42; p = .003), and more severe anemia (mean: 6.8 vs 7.9 g/dl; p = .007) compared with patients treated with surgery. Surgery was associated with a higher rate...... years at a university hospital were included. Primary hemostasis, rebleeding rate, mortality, and complications were assessed. Mortality was compared between groups after adjustment for age, comorbidity, and anemia using logistic regression analyses. Comorbidity was quantified using the Charlson...

  11. Embolic Stroke due to a Common Carotid Artery Thrombus in a Young Patient with Severe Iron-Deficiency Anemia without Thrombocytosis

    Science.gov (United States)

    2016-01-01

    This case report describes a 41-year-old previously healthy male who presented with stuttering transient ischemic symptoms and radiographic evidence of a left common carotid artery thrombus as well as acute and subacute ischemic infarcts in the left middle cerebral artery territory. An exhaustive stroke work-up did not provide a plausible etiology for his symptoms. His complete blood count and iron studies, however, revealed evidence of severe iron-deficiency anemia without reactive thrombocytosis. His stool guaiac test was positive. He was discharged home on oral antithrombotic agents and aggressive iron replacement therapy with a plan for repeat vascular imaging in 3 months and a colonoscopy. This case report suggests that severe iron-deficiency anemia with or without reactive thrombocytosis should be viewed as a possible hematologic condition associated with thrombotic tendencies and a risk factor for ischemic stroke, especially in young adults. Aggressive iron supplementation and short-term antithrombotic therapy with follow-up vascular imaging are a reasonable treatment for these patients. PMID:27752375

  12. COMPLICATION ANALYSIS OF INTRACRANIAL ANEURYSM EMBOLIZATION WITH CONTROLLABLE COILS

    Institute of Scientific and Technical Information of China (English)

    王大明; 凌锋; 王安顺

    2004-01-01

    Objective To explore the causes, prevention, and management of the complications during intracranial aneurysm embolization with controllable coils (mechanical detachable spiral, MDS; and Guglielmi detachable coil, GDC). Methods Retrospective review of 120 cases with 125 intracranial aneurysms embolized with controllable coils from March 1995 to July 1999 was conducted. The 20 accidents (in 18 cases) including aneurysm rupture, over-embolization, protrusion of coil end into the parent artery, and thrombosis of the parent artery were analyzed. Results Among the 20 accidents, there were 6 aneurysm ruptures, 6 over-embolizations (in 5cases), 6 coil protrusions, and 2 thromboses (one was secondary to coil protrusion). The embolizationrelated mortality was 3.33% (4/120), the permanent neurological deficit was 1.67% (2/120), and the transitory neurological deficit was 3.33% (4/120). The occurrence and outcome of the complications were related to the embolizing technique, the pattern of aneurysm and its parent artery, the imperfection of embolic materials, and the observation and management during embolization. Conclusion Skilled embolizing technique, better understanding of the angio-anatomy of an aneurysm and its parent artery, correct judgement and management during embolization, and improvement of embolic materials are beneficial to the reduction of complications and to the melioration of the outcome of complications.

  13. Time courses of PIVKA-II and AFP levels after hepatic artery embolization and hepatic artery infusion against hepatocellular carcinoma: relation between the time course and tumor necrosis.

    Science.gov (United States)

    Kishi, K; Sonomura, T; Mitsuzane, K; Nishida, N; Kimura, M; Satoh, M; Yamada, R; Kodama, N; Kinoshita, M; Tanaka, H

    1992-01-01

    We examined 35 untreated patients with unresectable hepatocellular carcinoma who exhibited positivity for both plasma PIVKA-II and serum AFP, and studied the weekly course of these markers from the pre-TAE or -HAI period to the third week of treatment. We correlated changes in these markers with the tumor necrosis rate and the time course on X-ray CT images. One week after TAE, the tumor necrosis rate and the time course of PIVKA-II showed a significant correlation (r = 0.7), while the correlation was between the time course of AFP and the tumor necrosis rate was insignificant (r = 0.2). At two and three weeks after TAE, both the time course of AFP and PIVKA-II showed significant correlations with the tumor necrosis rate. In 16 patients with tumor necrosis rates of not less than 90%, the mean of the actual half-life (AHL) of PIVKA-II was 3.2 days, the shortest was 1.83 days, and 75% of all AHLs clustered from two days to four days, while the mean and shortest AHLs of AFP were six days and 2.98 days, respectively, exhibiting a broader distribution. On the other hand, in three out of the nine cases of hepatocellular carcinoma complicated with portal tumor thrombi, PIVKA-II increased after HAI in spite of a reduction in tumor size. It was suggested that the PIVKA-II level requires careful interpretation in cases of portal vein obstruction after intensive hepatic arterial infusion of anticancer agents.

  14. Clinical effectiveness of bilateral uterine artery embolization in treatment of postpartum hemorrhage and nursing experience%双侧子宫动脉栓塞介入治疗在产后大出血治疗中的疗效及护理体会

    Institute of Scientific and Technical Information of China (English)

    胡勇

    2014-01-01

    Objective To evaluate the clinical effectiveness and safety of bilateral uterine artery embolization in the treatment of postpartum hemorrhage , and summarized the clinical nursing experience . Methods A retrospective analysis of 26 patients who underwent bilateral uterine artery embolization for postpartum hemorrhage.Placenta previa group (experimental group) 16 cases, placental abruption group (control group) 10 cases.In preoperative, intraoperative and postoperative , close observation and careful nursing were given to them.Observed and analyzed the clinical curative effect and nursing effect of two groups of patients . Results Underwent bilateral uterine artery embolization , the embolization success rate of experimental group was 93.75%(15/16), the embolization success rate of control group was 100%(10/10) .The embolization successrate had no significant difference between two groups of patients (P >0.05).Both of two groups had a good effectof hemostasis.The complication rate had no significant difference between two groups of patients (P >0.05). Conclusions The threshold for bilateral uterine artery embolization in women with PPH (caused by placentaprevia and placental abruption) should be low, as it was associated with a high clinical effectiveness rate and alow complication rate.Close observation and standardize the nursing was very important to ensure curative effect .%Objective To evaluate the clinical effectiveness and safety of bilateral uterine artery embolization in the treatment of postpartum hemorrhage , and summarized the clinical nursing experience . Methods A retrospective analysis of 26 patients who underwent bilateral uterine artery embolization for postpartum hemorrhage.Placenta previa group (experimental group)16 cases, placental abruption group (control group)10 cases.In preoperative, intraoperative and postoperative , close observation and careful nursing were given to them.Observed and analyzed the clinical curative

  15. Spontaneous occlusion of cerebral arteriovenous malformation following partial embolization with Onyx.

    Science.gov (United States)

    Nas, Omer Fatih; Ozturk, Kerem; Gokalp, Gokhan; Hakyemez, Bahattin

    2017-02-01

    Management options for brain arteriovenous malformations (AVMs) are surgery, radiosurgery, and endovascular embolization. The aim of partial embolization in endovascular treatment is to make total resection possible. However, increased risk of bleeding in partial embolization creates some controversies about treatment options. Spontaneous total occlusion of cerebral AVMs following partial obliteration with embolization agents is a rarely seen condition. We present a case with an AVM vanishing from right posterior cerebral artery which spontaneously occluded following partial embolization with Onyx liquid agent.

  16. Amniotic fluid embolism

    Directory of Open Access Journals (Sweden)

    Kiranpreet Kaur

    2016-01-01

    Full Text Available Amniotic fluid embolism (AFE is one of the catastrophic complications of pregnancy in which amniotic fluid, fetal cells, hair, or other debris enters into the maternal pulmonary circulation, causing cardiovascular collapse. Etiology largely remains unknown, but may occur in healthy women during labour, during cesarean section, after abnormal vaginal delivery, or during the second trimester of pregnancy. It may also occur up to 48 hours post-delivery. It can also occur during abortion, after abdominal trauma, and during amnio-infusion. The pathophysiology of AFE is not completely understood. Possible historical cause is that any breach of the barrier between maternal blood and amniotic fluid forces the entry of amniotic fluid into the systemic circulation and results in a physical obstruction of the pulmonary circulation. The presenting signs and symptoms of AFE involve many organ systems. Clinical signs and symptoms are acute dyspnea, cough, hypotension, cyanosis, fetal bradycardia, encephalopathy, acute pulmonary hypertension, coagulopathy etc. Besides basic investigations lung scan, serum tryptase levels, serum levels of C3 and C4 complements, zinc coproporphyrin, serum sialyl Tn etc are helpful in establishing the diagnosis. Treatment is mainly supportive, but exchange transfusion, extracorporeal membrane oxygenation, and uterine artery embolization have been tried from time to time. The maternal prognosis after amniotic fluid embolism is very poor though infant survival rate is around 70%.

  17. Novel Hydrogel Material as a Potential Embolic Agent in Embolization Treatments

    Science.gov (United States)

    Zhou, Feng; Chen, Liming; An, Qingzhu; Chen, Liang; Wen, Ying; Fang, Fang; Zhu, Wei; Yi, Tao

    2016-08-01

    We report a novel graphene-oxide (GO) enhanced polymer hydrogel (GPH) as a promising embolic agent capable of treating cerebrovascular diseases and malignant tumors, using the trans-catheter arterial embolization (TAE) technique. Simply composed of GO and generation five poly(amidoamine) dendrimers (PAMAM-5), our rheology experiments reveal that GPH exhibits satisfactory mechanical strength, which resist the high pressures of blood flow. Subcutaneous experiments on Sprague-Dawley (SD) rats demonstrate the qualified biocompatibility of GPH. Finally, our in vivo experiments on New Zealand rabbits, which mix GPH with the X-ray absorbing contrast agent, Iohexol, reveal complete embolization of the artery. We also note that GPH shortens embolization time and exhibits low toxicity in follow-up experiments. Altogether, our study demonstrates that GPH has many advantages over the currently used embolic agents and has potential applications in clinical practice.

  18. Patient Dose During Carotid Artery Stenting With Embolic-Protection Devices: Evaluation With Radiochromic Films and Related Diagnostic Reference Levels According to Factors Influencing the Procedure

    Energy Technology Data Exchange (ETDEWEB)

    D' Ercole, Loredana, E-mail: l.dercole@smatteo.pv.it [Fondazione IRCCS Policlinico San Matteo, Department of Medical Physics (Italy); Quaretti, Pietro; Cionfoli, Nicola [Fondazione IRCCS Policlinico San Matteo, Department of Radiology (Italy); Klersy, Catherine [Fondazione IRCCS Policlinico San Matteo, Biometry and Clinical Epidemiology Service, Research Department, (Italy); Bocchiola, Milena [Fondazione IRCCS Policlinico San Matteo, Department of Medical Physics (Italy); Rodolico, Giuseppe; Azzaretti, Andrea [Fondazione IRCCS Policlinico San Matteo, Department of Radiology (Italy); Lisciandro, Francesco [Fondazione IRCCS Policlinico San Matteo, Department of Medical Physics (Italy); Cascella, Tommaso; Zappoli Thyrion, Federico [Fondazione IRCCS Policlinico San Matteo, Department of Radiology (Italy)

    2013-04-15

    To measure the maximum entrance skin dose (MESD) on patients undergoing carotid artery stenting (CAS) using embolic-protection devices, to analyze the dependence of dose and exposure parameters on anatomical, clinical, and technical factors affecting the procedure complexity, to obtain some local diagnostic reference levels (DRLs), and to evaluate whether overcoming DRLs is related to procedure complexity. MESD were evaluated with radiochromic films in 31 patients (mean age 72 {+-} 7 years). Five of 33 (15 %) procedures used proximal EPD, and 28 of 33 (85 %) procedures used distal EPD. Local DRLs were derived from the recorded exposure parameters in 93 patients (65 men and 28 women, mean age 73 {+-} 9 years) undergoing 96 CAS with proximal (33 %) or distal (67 %) EPD. Four bilateral lesions were included. MESD values (mean 0.96 {+-} 0.42 Gy) were <2 Gy without relevant dependence on procedure complexity. Local DRL values for kerma area product (KAP), fluoroscopy time (FT), and number of frames (N{sub FR}) were 269 Gy cm{sup 2}, 28 minutes, and 251, respectively. Only simultaneous bilateral treatment was associated with KAP (odds ratio [OR] 10.14, 95 % confidence interval [CI] 1-102.7, p < 0.05) and N{sub FR} overexposures (OR 10.8, 95 % CI 1.1-109.5, p < 0.05). Type I aortic arch decreased the risk of FT overexposure (OR 0.4, 95 % CI 0.1-0.9, p = 0.042), and stenosis {>=} 90 % increased the risk of N{sub FR} overexposure (OR 2.8, 95 % CI 1.1-7.4, p = 0.040). At multivariable analysis, stenosis {>=} 90 % (OR 2.8, 95 % CI 1.1-7.4, p = 0.040) and bilateral treatment (OR 10.8, 95 % CI 1.1-109.5, p = 0.027) were associated with overexposure for two or more parameters. Skin doses are not problematic in CAS with EPD because these procedures rarely lead to doses >2 Gy.

  19. Doses to Carotid Arteries After Modern Radiation Therapy for Hodgkin Lymphoma

    DEFF Research Database (Denmark)

    Maraldo, M.V.; Brodin, Nils Patrik; Aznar, Marianne Camille

    2013-01-01

    Hodgkin lymphoma (HL) survivors are at an increased risk of stroke because of carotid artery irradiation. However, for early-stage HL involved node radiation therapy (INRT) reduces the volume of normal tissue exposed to high doses. Here, we evaluate 3-dimensional conformal radiation therapy (3D-C...

  20. Pulmonary embolism; Lungenarterienembolie

    Energy Technology Data Exchange (ETDEWEB)

    Sudarski, Sonja; Henzler, Thomas [Heidelberg Univ., Universitaetsmedizin Mannheim (Germany). Inst. fuer Klinische Radiologie und Nuklearmedizin

    2016-09-15

    Pulmonary embolism (PE) requires a quick diagnostic algorithm, as the untreated disease has a high mortality and morbidity. Crucial for the diagnostic assessment chosen is the initial clinical likelihood of PE and the individual risk profile of the patient. The overall goal is to diagnose or rule out PE as quickly and safely as possible or to initiate timely treatment if necessary. CT angiography of the pulmonary arteries (CTPA) with multi-slice CT scanner systems presents the actual diagnostic reference standard. With CTPA further important diagnoses can be made, like presence of right ventricular dysfunction. There are different scan and contrast application protocols that can be applied in order to gain diagnostic examinations with sufficient contrast material enhancement in the pulmonary arteries while avoiding all kinds of artifacts. This review article is meant to be a practical guide to examine patients with suspected PE according to the actual guidelines.

  1. Endovascular Thrombin Injection for a Pulmonary Artery Pseudoaneurysm: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Jin Ho; Shin, Ji Hoon; Yoon, Hyun Ki [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    Massive hemoptysis caused by pulmonary artery pseudoaneurysms is uncommon, and endovascular treatment such as coil embolization is the first choice for treating pulmonary artery pseudoaneurysms. Various embolic agents could be used according to the angiographic findings, yet embolization with thrombin injection is very rare. Herein, we describe a case of a pulmonary artery pseudoaneurysm that was successfully treated by endovascular thrombin injection using a microcatheter because of the difficulty in performing a coil embolization due to a short feeding artery.

  2. Uterine Fibroid Embolization (UFE)

    Science.gov (United States)

    ... embolization. This occurs when fibroids located inside the uterine cavity detach after embolization. Women with this problem may require a procedure called D & C (dilatation and curettage) to ... who undergo uterine fibroid embolization, normal menstrual cycles resume after the ...

  3. Developments in pulmonary arterial hypertension-targeted therapy for chronic thromboembolic pulmonary hypertension.

    Science.gov (United States)

    Hadinnapola, Charaka; Pepke-Zaba, Joanna

    2015-10-01

    Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease characterised by the presence of organised chronic thromboembolic material occluding the proximal pulmonary arteries and a vasculopathy in the distal pulmonary arterial tree. Pulmonary endarterectomy (PEA) is a potential cure for many patients with CTEPH. However, PEA is not suitable for patients with a significant distal distribution of chronic thromboembolic material or with significant comorbidities. Also, a proportion of patients are left with residual CTEPH post PEA. Until recently, pulmonary arterial hypertension-targeted therapies have been used off licence to treat patients with inoperable or residual CTEPH. The CHEST1 study investigated the use of riociguat and was the first randomised controlled trial to show efficacy in inoperable or residual CTEPH. In this review, we explore the pathophysiology of CTEPH and review the current trial evidence for pulmonary arterial hypertension-targeted therapies. We also include a discussion of physiological considerations that require further investigation.

  4. Long-term fate of left atrial thrombi and incidence of cerebral embolism under continuous anticoagulation therapy; MR-tomographische Evaluation der Inzidenz zerebraler Embolien bei Patienten mit Vorhofflimmern und linksatrialen Thromben

    Energy Technology Data Exchange (ETDEWEB)

    Strach, K.; Meyer, C.; Hackenbroch, M.; Schild, H.; Sommer, T. [Radiologische Universitaetsklinik Bonn (Germany); Tiemann, K. [Medizinische Universitaetsklinik und Poliklinik II, Bonn (Germany); Haase, J. [Klinik Rotes Kreuz, Frankfurt/Main (Germany); Pizulli, L. [Petruskrankenhaus, Bonn (Germany); Omran, H. [St. Marien-Hospital, Bonn (Germany)

    2005-12-15

    Purpose: Patients (pts.) with atrial fibrillation (AF) and atrial thrombi are known to have an increased risk for cerebral embolism. However, little is known about the clinical course of atrial thrombi and the incidence of cerebral embolism in those patients during anticoagulation therapy. The high sensitivity of MR imaging (MRI) including diffusion-weighted imaging (DWI) suggests that this technique could provide an improved estimate of cerebral embolism associated with the presence of left atrial thrombi. The aims of this prospective study were to evaluate (1) the prevalence of clinically silent and apparent cerebral embolism in pts. with newly diagnosed AF and atrial thrombi using MRI/DWI, (2) the long-term fate of atrial thrombi under continued anticoagulation therapy and (3) the incidence of cerebral embolism during a follow-up period of 12 months with continuous anticoagulation therapy. Materials and methods: The study group consisted of 32 pts. with (1) newly diagnosed AF and evidence of left atrial (LA) thrombi detected by TEE and (2) a new start of anticoagulation therapy [International Normalized Ratio (INR) 2.0-3.0]. 19 pts. with (1) newly diagnosed AF and no evidence of atrial thrombi and (2) an equivalent anticoagulation regimen served as the control group. In both groups (a) MRI/DWI studies of the brain (weeks 0, 4, 8, 12, 20, 28, 36, 44, and 52), (b) transesophageal echocardiographic studies (TEE) for assessment of LA-Thrombi (weeks 0 and 52) and (c) clinical neurological assessments (weeks 0, 20 and 52) were performed. Results: In the study group (AF and LA-Thrombi) 11 out of 32 pts. (34%) displayed signs of acute (n=8) or chronic (n=3) cerebral embolism in the initial MRI studies. In 4 out of 32 pts.(13%), MRI/DWI depicted new or additional cerebral emboli (n=12) during the follow-up period despite continuous anticoagulation therapy. 2 (n=2/4; 50%) of these patients had clinically apparent neurological deficits. In the control group 1 out of 19 pts

  5. Coronary air embolism treated with aspiration catheter.

    Science.gov (United States)

    Patterson, M S; Kiemeneij, F

    2005-05-01

    Coronary air embolism remains a recognised complication of coronary catheterisation despite a strong emphasis on prevention. Current treatment consists of supportive measures with 100% oxygen and analgesia. Recent case reports describe the use of mechanical treatments aimed at dispersing or removing the air embolus with variable success. A case of coronary air embolism causing an acute coronary syndrome is described that was definitively treated with an aspiration system. The effectiveness of the aspiration system in the distal section of an obtuse marginal artery indicates that such dedicated aspiration systems may prove useful in the standard treatment of air embolism.

  6. 31P MR spectroscopic imaging in preoperative embolization therapy of meningiomas; Phosphor-31-MR-spektroskopische Bildgebung bei praeoperativer Embolisationstherapie von Meningeomen

    Energy Technology Data Exchange (ETDEWEB)

    Blankenhorn, M. [Psychiatrische Universitaetsklinik, Ulm (Germany). Abteilung III; Bachert, P.; Kaick, G. van [Deutsches Krebsforschungszentrum Heidelberg (Germany). Forschungsschwerpunkt Radiologische Diagnostik; Semmler, W. [Freie Univ. Berlin (Germany). Inst. fuer Diagnostikforschung; Ende, G. [Zentralinstitut fuer Seelische Gesundheit, Mannheim (Germany). NMR-Forschung in der Psychiatrie; Tronnier, V. [Neurochirurgische Klinik, Klinikum der Universitaet, Heidelberg (Germany); Sartor, K. [Neurologische Klinik, Klinikum der Universitaet, Heidelberg (Germany). Abt. Neuroradiologie

    1999-06-01

    Purpose: {sup 31}P MR spectroscopic imaging ({sup 31}P SI) was evaluated in a clinical study as a method for monitoring presurgical devascularization of meningiomas. The aim was to assess noninvasively metabolic alterations in tumor and in healthy brain tissue before and after embolization. Methods: Localized {sup 31}P MR spectra of the brain were obtained by means of 2D-SI (voxel size: 36 cm{sup 3}) using a 1,5-T whole-body MR tomograph. Results: Eleven of 19 patients with intracranial meningiomas examined in this study underwent preoperative embolization therapy; eight patients were examined before and after treatment. After embolization, alterations of pH and of the concentrations of high-energy phosphates (nucleoside-5`triphosphate=NTP, phosphocreatine=PCr), inorganic phosphate (P{sub i}), and membrane constituents were observed in the tumors. A tendency of [P{sub i}] increase and decrease of [NTP], [PCr], and pH predominated, which is explained by ischemic processes after tumor devascularization. Conclusion: {sup 31}P SI is applicable in clinical studies and detects alterations of phosphate metabolism in a meningioma after embolization. (orig.) [Deutsch] Ziel: Die {sup 31}P-MR-spektroskopische Bildgebung ({sup 31}P-SI) wurde im Rahmen der praeoperativen Embolisationstherapie von Patienten mit Meningeomen als Methode zur Therapieverlaufskontrolle klinisch geprueft. Ziel der Studie war die nichtinvasive Erfassung von Veraenderungen im Metabolismus der Tumoren vor und nach Embolisation im Vergleich zum gesunden Hirngewebe. Methoden: Lokalisierte {sup 31}P-MR-Spektren des Gehirns wurden mit 2D-SI (Voxelgroesse: 36 cm{sup 3}) an einem 1,5-T-Ganzkoerper-MR-Tomographen aufgenommen. Ergebnisse: Elf von insgesamt 19 untersuchten Patienten unterzogen sich einer praeoperativen Embolisation, bei acht Patienten konnte eine Verlaufskontrolle durchgefuehrt werden. Nach Embolisation wurden Veraenderungen des pH und der Konzentrationen von energiereichen Phosphaten (Nukleosid

  7. 大面积脾动脉栓塞术并发症预防及处理措施%Measures for prevention and treatment of complications after massive splenic artery embolization

    Institute of Scientific and Technical Information of China (English)

    裴敏; 王琨; 朱杰; 蔡维波; 李松

    2011-01-01

    Objective To evaluate the measures for prevention and treatment of complications after massive splenic artery embolization.Methods The clinical data of measures for prevention and treatment of complications in 32 patients by a single splenic embolization with area more than 75% during January 2007 to December 2009 were retrospertively reviewed ad analyzed. Results All 32 patients showed various degree of embolism syndrome. Among them, there were 5 patients ( 15% ) with severe abdominal pain, one patient ( 30% ) with small amount of left pleural effusion, 3 patients ( 9% ) with thrombosis in splenic vein and portal vein , one patient ( 3% ) with splenic and perisplenic abscess, one patient ( 3 % ) with chylous ascites, one patient ( 3% ) with ectopic embolism and 3 patients( 9% )with intractahle hiccup. There were no complications as splenic: rupture and pancreatitis. Conclusion It is important to grasp the measures for prevention and treatment of contingent complications in patients after massive splenic artery emholization, and it may reduce the occurrence of complications, and active and effective treatment should immediately he taken as soon as possible, thus it can relieve suffering and promote early recovery of these patients.%目的 探讨大面积脾动脉栓塞术并发症的预防及处理措施.方法 回顾分析2007年1月至2009年12月间对脾脏一次性栓塞面积大于75%的32例患者的并发症的预防、发生及处理措施.结果 32例患者,均发生不同程度的栓塞后综合征.其中剧烈腹痛5例,左侧少量胸水1例,脾静脉、门静脉血栓3例,脾及脾周脓肿1例,乳糜性腹水1例,异位栓塞1例,顽固性呃逆3例.未发生脾脏破裂、胰腺炎等并发症.结论 掌握大面积脾动脉栓塞后可能发生的并发症的预防及处理措施,可减少并发症的发生,并尽早采取积极有效治疗方法,减轻患者痛苦,促进患者早日康复.

  8. Angiographic manifestation and transcatheter arterial embolization of proper esophageal artery in hemoptysis%咯血患者的食管固有动脉造影表现和栓塞治疗

    Institute of Scientific and Technical Information of China (English)

    江森; 朱晓华; 孙兮文; 支文祥; 揭冰; 尤正千; 虞栋; 彭刚

    2008-01-01

    Objective To investigate the angiographic manifestation of the proper esophageal artery (PEA),the hish risk factom for the presence of the anomalous PEA in hemoptysis and to evaluate the safety of transcatheter aaefial embolization(TAE) of the PEA using gelatin sponge(GS).Methods Selective esophageal arteriography WSS performed in forty-three patients with hemoptysis,including 15 cases of pulmonary tuberculosis,18 cases of bmnchiectasis,7 cases of posttuberculous bronchiectasis and three cases of lung cancer. One case experienced failure of bronchial arterial embolization. The angiographic manifestation of the PEAs Was studied.The complications of the procedure and clinical results were observed in the patients who underwent TAE using GS.Results Thirty-nine PEAs were catheterized selectively in 37 patients(86.0%).Eighteen anomalous PEAs(46.2%)were catheterized selectively in 17 patients (45.9%).The anomalous PEAs showed tortuosity,dilatation,hyperplasia,shunting with pulmonary artery and anastomosis with the bronchial artery.All lesions involved basal segment of inferior pulmonary lobar. Bronchiectasis Was the most frequent disease for PEA abnormality. No complications occurred and satisfactory curative effect Was achieved with TAE of the anomalous PEAs.Conclusions It is necessary to perform selective proper esophageal arteriography when the lesion involves basal segment of inferior pulmonary lobar in hemoptysis.Supplemental TAE of the anomalous PEA using GS is safe and valuable in the management of hemoptysis.%目的 观察咯血患者的食管固有动脉(PEA)血管造影表现,分析出现异常PEA的高危因素,评价明胶海绵(GS)栓塞PEA的安全性.方法 对接受动脉栓塞治疗的43例咯血患者行选择性PEA造影术,包括肺结核15例,单纯性支气管扩张18例,结核性支气管扩张7例,支气管肺癌3例.1例1次支气管动脉栓塞术后无效.对发现异常的PEA行GS经导管内栓塞.观察选择性PEA插管的结果,分析PEA

  9. Antiplatelet therapy for stable coronary artery disease in atrial fibrillation patients taking an oral anticoagulant

    DEFF Research Database (Denmark)

    Lamberts, Morten; Gislason, Gunnar H.; Lip, Gregory Y. H.

    2014-01-01

    Background The optimal long-term antithrombotic treatment of patients with coexisting atrial fibrillation and stable coronary artery disease is unresolved, and commonly, a single antiplatelet agent is added to oral anticoagulation. We investigated the effectiveness and safety of adding antiplatelet...... or thromboembolism, whereas risk of bleeding is increased significantly. The common practice of adding antiplatelet therapy to oral VKA anticoagulation in patients with atrial fibrillation and stable coronary artery disease warrants reassessment........23-1.82]) or clopidogrel (hazard ratio, 1.84 [95% confidence interval, 1.11-3.06]) was added to VKA. Conclusions In atrial fibrillation patients with stable coronary artery disease, the addition of antiplatelet therapy to VKA therapy is not associated with a reduction in risk of recurrent coronary events...

  10. Septic Pulmonary Embolism Requiring Critical Care: Clinicoradiological Spectrum, Causative Pathogens and Outcomes

    Directory of Open Access Journals (Sweden)

    Deng-Wei Chou

    Full Text Available OBJECTIVES: Septic pulmonary embolism is an uncommon but life-threatening disorder. However, data on patients with septic pulmonary embolism who require critical care have not been well reported. This study elucidated the clinicoradiological spectrum, causative pathogens and outcomes of septic pulmonary embolism in patients requiring critical care. METHODS: The electronic medical records of 20 patients with septic pulmonary embolism who required intensive care unit admission between January 2005 and December 2013 were reviewed. RESULTS: Multiple organ dysfunction syndrome developed in 85% of the patients, and acute respiratory failure was the most common organ failure (75%. The most common computed tomographic findings included a feeding vessel sign (90%, peripheral nodules without cavities (80% or with cavities (65%, and peripheral wedge-shaped opacities (75%. The most common primary source of infection was liver abscess (40%, followed by pneumonia (25%. The two most frequent causative pathogens were Klebsiella pneumoniae (50% and Staphylococcus aureus (35%. Compared with survivors, nonsurvivors had significantly higher serum creatinine, arterial partial pressure of carbon dioxide, and Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores, and they were significantly more likely to have acute kidney injury, disseminated intravascular coagulation and lung abscesses. The in-hospital mortality rate was 30%. Pneumonia was the most common cause of death, followed by liver abscess. CONCLUSIONS: Patients with septic pulmonary embolism who require critical care, especially those with pneumonia and liver abscess, are associated with high mortality. Early diagnosis, appropriate antibiotic therapy, surgical intervention and respiratory support are essential.

  11. Effects of massage therapy on sleep quality after coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Flavia Baggio Nerbass

    2010-01-01

    Full Text Available INTRODUCTION: Having poor sleep quality is common among patients following cardiopulmonary artery bypass graft surgery. Pain, stress, anxiety and poor sleep quality may be improved by massage therapy. OBJECTIVE: This study evaluated whether massage therapy is an effective technique for improving sleep quality in patients following cardiopulmonary artery bypass graft surgery. METHOD: Participants included cardiopulmonary artery bypass graft surgery patients who were randomized into a control group and a massage therapy group following discharge from the intensive care unit (Day 0, during the postoperative period. The control group and the massage therapy group comprised participants who were subjected to three nights without massage and three nights with massage therapy, respectively. The patients were evaluated on the following mornings (i.e., Day 1 to Day 3 using a visual analogue scale for pain in the chest, back and shoulders, in addition to fatigue and sleep. Participants kept a sleep diary during the study period. RESULTS: Fifty-seven cardiopulmonary artery bypass graft surgery patients were enrolled in the study during the preoperative period, 17 of whom were excluded due to postoperative complications. The remaining 40 participants (male: 67.5%, age: 61.9 years ± 8.9 years, body mass index: 27.2 kg/m² ± 3.7 kg/m² were randomized into control (n = 20 and massage therapy (n = 20 groups. Pain in the chest, shoulders, and back decreased significantly in both groups from Day 1 to Day 3. The participants in the massage therapy group had fewer complaints of fatigue on Day 1 (p=0.006 and Day 2 (p=0.028 in addition, they reported a more effective sleep during all three days (p=0.019 when compared with the participants in the control group. CONCLUSION: Massage therapy is an effective technique for improving patient recovery from cardiopulmonary artery bypass graft surgery because it reduces fatigue and improves sleep.

  12. Influence of percutaneous transhepatic fundus vein embolism and splenic arterial embolism on portal hemodynamics in hepatocirrhosis%胃底静脉栓塞及脾动脉栓塞对门脉血流动力学的影响

    Institute of Scientific and Technical Information of China (English)

    杨艳; 朱曙光; 杨秀成; 盖伟; 柴同海; 刘春安

    2008-01-01

    Objective To study influence of percutaneous transhepatic fundus venous embolism (PTVE) and partial splenic embolism(PSE) on portal hemodynamics. Methods FINE and PSE were performed on 43 patients with portal hypertension. Free portal pressure (FPP) was determined, respectively, before and after VINE and after PTVE + PSE. At the same time, color Doppler ultrasonic angiography was used to measure diameter and maximal blood flow rate of portal vein (PV) and splenic vein (SV). Average rates of these venae were calculated and volumes of blood flow were estimated. Results FPP was respectively, before and after PTVE (P > 0.05). FPP was significantly different from that before operation (P 0.05).PTVE+PSE后FPP明显下降(P<0.05).PV、SV直径明显缩小、血流速度显著改善(P<0.05).结论 联合PTVE及PSE在快速有效的降低门脉压力的同时并不影响门脉平均血流量.在显著改善食管静脉曲张的同时能较好的维持肝脏灌流,对相应症状的改善有重要意义.

  13. TREATMENT OF VERTEBRAL-ARTERY TYPE CERVICAL SPONDYLOPATHY WITH NEEDLE-KNIFE THERAPY

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    In the present paper,62 cases of vertebral-artery type cervical spondyiopathy were treated with needle-knife therapy (acupotomy).After 2-6 sessions of treatment,23 cases (37.1%) were cured,19(30.7%) showed marked improvement,15(24.2%) had some improvement and 5(8.1%) failed in the treatment.The total effective rate was 91.9%.It indicates that acupotomy therapy is a highly effective remedy for treating vertabral-artery type cervical spndylopathy.

  14. Dissections of the cervical brain supplying arteries; Dissektionen der zervikalen hirnversorgenden Gefaesse

    Energy Technology Data Exchange (ETDEWEB)

    Jensen-Kondering, U. [Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Klinik fuer Radiologie und Neuroradiologie

    2015-12-15

    Dissections of the cervical brain supplying arteries are rare but are an important cause of stroke in young and middle aged patients. Furthermore, recognition of dissections is crucial to prevent recurring embolic events by adequate choice of therapy. In this article the anatomical and pathophysiological basics, diagnostic and treatment options will be discussed with an emphasis on cross sectional imaging and typical imaging findings.

  15. Super-selective renal artery embolization for the treatment of acute renal hemorrhage%超选择性动脉栓塞治疗急性肾出血

    Institute of Scientific and Technical Information of China (English)

    朱彬

    2011-01-01

    目的 探讨超选择性肾动脉栓塞治疗急性肾出血的价值.方法 采用4 F导管或(和)2.7 F微导管注入钢圈或(和)微钢圈、聚乙烯醇颗粒超选择性肾动脉栓塞治疗17例严重肾出血患者.5例患者于术前行多层螺旋CT血管造影(CTA)检查,9例患者于术后4 d~54个月行CT平扫、增强扫描与CTA检查.结果 17例患者均一次性介入治疗成功.术前CT增强扫描和CTA可见出血灶、动静脉畸形、动脉瘤等异常征象.术后CT可见栓塞动脉所支配的肾组织出现不同程度的梗死、萎缩,肾边缘收缩、凹陷.4例可见对侧正常肾代偿性增大.术后CTA见异常血管消失,弹簧钢圈无移位.结论 超选择性肾动脉栓塞治疗急性肾出血安全、可靠.CTA对发现术前出血部位及术后疗效评估有重要意义.%Objective To evaluate super-selective renal artery embolization in treating acute renal hemorrhage. Methods A total of 17 patients with massive renal bleeding were enrolled in this study. After super-selective renal artery catheterization with 4 F and/or 2.7 F catheter was accomplished, renal artery embolization with microcoils, coils and/or PVA particles was carried out. Preoperative CTA was performed in five patients. Plain CT scanning and contrast-enhanced CTA were employed in nine patients at 4 days to 54 months after treatment. Results Technical success was achieved in all of the 17 cases. Pre-interventional CT scan showed abnormal signs of hemorrhage, arteriovenous malformation, aneurysm, etc. Post-interventional CT scan showed different degrees of renal infarction, renal atrophy, peripheral contraction and depression of the kidney which were located in the areas originally supplied by embolized artery. Compensatory hypertrophy of the contralateral normal kidney occurred in four cases. Abnormal blood vessels disappeared in postinterventional CTA. No coil displacement was seen. Conclusion For the treatment of acute renal hemorrhage super

  16. 40例支气管动脉栓塞术治疗大咯血的临床分析%The role of Bronchial Artery Embolization in Massive Hemoptysis:a case Series of 40 Patients

    Institute of Scientific and Technical Information of China (English)

    郑宏

    2013-01-01

    目的评价支气管动脉栓塞术治疗大咯血的临床疗效及影响疗效的因素。方法40例(男27例,女13例)大咯血患者,咯血量300ml -2000ml/24h,其中支气管扩张19例,肺癌5例,肺结核3例,肺血管畸形7例,肺间质纤维化1例,病因不明5例。采用改良Seldinger方法行选择性支气管动脉栓塞治疗。栓塞材料使用明胶海绵颗粒,主干血管或血管粗大者选用合适的微弹簧栓塞。结果35例一次栓塞成功,3例两次栓塞成功,1例肺癌咯血栓塞后出血量明显减少,1例栓塞后5天大咯血窒息死亡,术中无死亡病例。栓塞术后即时止血率87.5%,近期复发率5%,中远期复发率17.5%。结论支气管动脉栓塞术是一种安全有效的治疗大咯血的措施。%Objective To evaluate the effect of bronchial artery embolization on massive hemoptysis and analyze the associated factors that affect the results .Meth-ods 40 patients(male 27 and female 13)with hemoptysis from 300 ml to 2000 ml per 24 h were included.The etiologies of hemoptysis were as follows:bronchiectasis(19 cases),lung cancer(5 cases),tuberculosis(3 cases),arteriovenous malformation(7 cases),pulmonary interstitial fibrosis(1 case),and cryptogenic hemoptysis(5 ca-ses).Modified Seldinger method was applied for selective bronchial artery embolization.Particles of Gelfoam were used,while trunk vessels were obturated using micro coils.Results Embolization was successfully completed once in 35 patients,which was twice in 3 patients.The hemoptysis amount was reduced in one patient with lung cancer and died 5 days later due to massive hemoptysis.There was no patient dead during embolization.The immediate control of hemoptysis was 87.5%,short-term re-lapse was 5%,and moderate-long-term relapse was 17.5%.Conclusion Bronchial artery embolization is effective and safe for treatment of massive hemoptysis .

  17. Response to pulmonary arterial hypertension drug therapies in patients with pulmonary arterial hypertension and cardiovascular risk factors.

    Science.gov (United States)

    Charalampopoulos, Athanasios; Howard, Luke S; Tzoulaki, Ioanna; Gin-Sing, Wendy; Grapsa, Julia; Wilkins, Martin R; Davies, Rachel J; Nihoyannopoulos, Petros; Connolly, Susan B; Gibbs, J Simon R

    2014-12-01

    The age at diagnosis of pulmonary arterial hypertension (PAH) and the prevalence of cardiovascular (CV) risk factors are increasing. We sought to determine whether the response to drug therapy was influenced by CV risk factors in PAH patients. We studied consecutive incident PAH patients (n = 146) between January 1, 2008, and July 15, 2011. Patients were divided into two groups: the PAH-No CV group included patients with no CV risk factors (obesity, systemic hypertension, type 2 diabetes mellitus, permanent atrial fibrillation, mitral and/or aortic valve disease, and coronary artery disease), and the PAH-CV group included patients with at least one. The response to PAH treatment was analyzed in all the patients who received PAH drug therapy. The PAH-No CV group included 43 patients, and the PAH-CV group included 69 patients. Patients in the PAH-No CV group were younger than those in the PAH-CV group (P < 0.0001). In the PAH-No CV group, 16 patients (37%) improved on treatment and 27 (63%) did not improve, compared with 11 (16%) and 58 (84%) in the PAH-CV group, respectively (P = 0.027 after adjustment for age). There was no difference in survival at 30 months (P = 0.218). In conclusion, in addition to older age, CV risk factors may predict a reduced response to PAH drug therapy in patients with PAH.

  18. Spontaneous coronary artery dissection: current insights and therapy

    OpenAIRE

    2008-01-01

    Spontaneous coronary artery dissection (SCAD) is a very rare cause of acute coronary syndromes in young otherwise healthy patients with a striking predilection for the female gender. The pathological mechanism has not been fully clarified yet. However, several diseases and conditions have been associated with SCAD, such as atherosclerosis, connective tissue disorders and the peripartum episode. In this paper we present a review of the literature, discussing the possible mechanisms for SCAD, t...

  19. 肾大出血超选择性动脉插管栓塞的价值(附15例报道)%Value of superselective arterial embolization for renal hemorrhage (report of 15 cases)

    Institute of Scientific and Technical Information of China (English)

    李豪胜; 廖长梅; 王寿明

    2013-01-01

    Objective To evaluate the value of superselective renal arterial embolization for renal hemorrhage. Methods 15 cases with traumatic or iatrogenic renal hemorrhage were examined by selective renal arterial angiography from 2006 March to 2011 Janu ary. Postoperative condition was observed 3d followed by superselective arterial embolization through guidance of steel coil. And re sidual renal function was evaluated by ultrasound and CT at 1,3,6,and 12 Months after the treatment. Results 11 cases were con firmed with renal arterial pseudoaneurysms and 4 cases with arteriovenous fistula by DSA in 15 cases. The successful rate of the tar get artery superselective catheterization was 100% (15/15). The rates of stopping bleeding at 24— 48 h and 72 h after operation were 80% (12/15) and 20% (3/15) respectively. The successful rate of disposable embolization was 100% (15/15). The residual renal function of all cases kept good at 1 year after operation. Conclusion Arterial angiography can rapidly and accurately diagnose the pathogeny of renal hemorrhage and the bleeding artery. The hemostatic curative effect of superselective catheterization was sure, and it should be used as the preferred method of diagnosis and treatment on renal hemorrhage.%目的 评价超选择性肾动脉插管栓塞对肾大出血的价值.方法 对该院2006年3月至2011年1月15例外伤性或医源性肾大出血进行选择性肾动脉造影检查,对出血动脉超选择性插管后以弹簧钢圈实施栓塞,术后3 d内观察止血情况,1、3、6、12个月行超声、CT等检查评价残肾功能.结果 15例经肾动脉血管造影(DSA)检查证实为假性动脉瘤11例、同时伴动-静脉瘘4例,靶动脉超选择性插管栓塞成功率100%(15/15),术后24~48 h及72 h停止出血分别为80%(12/15)、20%(3/15),一次性栓塞止血成功率100%(15/15).术后1年残肾功能良好100%(15/15).结论 动脉造影可迅速、准确诊断肾大出血原因及出血动脉,靶动脉超选

  20. Peripheral artery disease: potential role of ACE-inhibitor therapy

    Directory of Open Access Journals (Sweden)

    Giuseppe Coppola

    2008-12-01

    Full Text Available Giuseppe Coppola, Giuseppe Romano, Egle Corrado, Rosa Maria Grisanti, Salvatore NovoDepartment of Internal Medicine, Cardiovascular and Nephro-Urological Diseases, Chair of Cardiovascular Disease, University of Palermo, Palermo, ItalyAbstract: Subjects with peripheral arterial disease (PAD of the lower limbs are at high risk for cardiovascular and cerebrovascular events and the prevalence of coronary artery disease in such patients is elevated. Recent studies have shown that regular use of cardiovascular medications, such as therapeutic and preventive agents for PAD patients, seems to be promising in reducing long-term mortality and morbidity. The angiotensin-converting-enzyme (ACE system plays an important role in the pathogenesis and progression of atherosclerosis, and ACE-inhibitors (ACE-I seem to have vasculoprotective and antiproliferative effects as well as a direct antiatherogenic effect. ACE-I also promote the degradation of bradykinin and the release of nitric oxide, a potent vasodilator; further, thay have shown important implications for vascular oxidative stress. Other studies have suggested that ACE-I may also improve endothelial dysfunction. ACE-I are useful for reducing the risk of cardiovascular events in clinical and subclinical PAD. Particularly, one agent of the class (ie, ramipril has shown in many studies to able to significantly reduce cardiovascular morbidity and mortality in patients with PAD.Keywords: atherosclerosis, peripheral arterial disease, endothelial dysfunction, ACE-inhibitors

  1. [Modern approaches to the use of neurotropic physical therapy in arterial hypertension].

    Science.gov (United States)

    Orekhova, E M; Konchugova, T V; Kul'chitskaya, D B; Korchazhkina, N B; Egorova, L A; Chuich, N G

    2016-01-01

    The development and introduction into clinical practice of non-pharmacological methods for the prevention and treatment of arterial hypertension is a primary objective of modern physical therapy, especially as regards the neurotropic influences. This article was designed to report the results of the investigation into the hypotensive effect of transcerebral magnetic therapy obtained during the treatment of 60 patients presenting with arterial hypertension. The study included the comparative examination of two randomly formed groups containing 30 patients each. The patients of the main group received transcerebral magnetic therapy (to the frontal region) while those in the group of comparison were given magnetotherapy at the collar region. The study has demonstrated that transcerebral magnetic therapy given to the patients of the main group was a more efficient treatment than magnetotherapy at the collar region since it produced a more pronounced hypotensive effect irrespective of the initial hemodynamic type.

  2. Embolização intra-arterial pré-operatória de tumor do corpo carotídeo Preoperative intraarterial embolization of carotid body tumor

    Directory of Open Access Journals (Sweden)

    Gaudêncio Espinosa

    2006-09-01

    Full Text Available Os autores relatam um caso de tumor de corpo carotídeo (paraganglioma em um paciente de 74 anos de idade, submetido a embolização intra-arterial com micropartículas esféricas, de polivinil acetato, com casca de polivinil álcool (PVAc + PVA, previamente à ressecção do tumor. O estudo angiográfico demonstrou massa altamente vascularizada na bifurcação carotídea esquerda, sendo a embolização pré-operatória utilizada no intuito de diminuir a vascularização e reduzir a perda sangüínea, aumentando a segurança do tratamento cirúrgico. O estudo histopatológico confirmou a presença de trombose e isquemia tecidual.The authors report a case of carotid body tumor (paraganglioma in a 74-year-old male patient, submitted to intraarterial embolization with spherical core/shield polyvinyl acetate and polyvinyl alcohol (PVAc + PVA microparticles prior to surgical excision. Angiography has demonstrated a highly vascularized mass in the left carotid bifurcation, and preoperative embolization was used in order to decrease vascularity, reduce blood loss and improve safety of surgical treatment. Microscopic study confirmed presence of thrombosis and tissue ischemia.

  3. Applied research of selective bronchial arterial embolization for severe hemoptysis%选择性支气管动脉栓塞对大咯血的治疗应用研究

    Institute of Scientific and Technical Information of China (English)

    巩曰红; 常刚; 裴维芳; 张晓燕; 李洪福

    2012-01-01

    目的 观察选择性支气管动脉栓塞对大咯血患者的临床疗效.方法 选择因大咯血住院患者38例,其中反复咯血31例,支气管扩张27例,支气管肺囊肿4例,不明原因4例,肺结核3例.均经胸部影像学检查或纤维支气管镜、支气管动脉造影明确诊断,且均行选择性支气管动脉栓塞治疗.结果 患者栓塞次数最多3次,支气管动脉造影均表现为血管畸形,给予选择性支气管动脉栓塞治疗,35例出血立即减少.8例患者治疗后24h再次复发咯血,其中1例患者经保守治疗无效后行右上肺切除术,5例患者经保守治疗后有效,2例患者经保守治疗后无效行再栓塞治疗,1周内咯血完全消失,总有效率97.4%( 37/38).随访1年,再次复发大咯血13例,11例每次咯血及年总咯血量较治疗前减少50%以上,2例再咯血患者经多次栓塞剂栓塞保守治疗无效后行右上肺切除术,总有效率94.7%(36/38).治疗后3例短时间内轻微胸痛,2例肩痛,3例伴胸闷,3例腹股沟皮下淤血,对症处理后短期内好转. 结论 选择性支气管动脉栓塞治疗急性或反复发生的大咯血疗效显著,可以避免患者外科手术的风险,对复发患者再次治疗也安全有效,值得临床推广应用.%Objective To observe the clinical curative effect of selective bronchial arterial embolization for severe hemoptysis.Methods Thirty-eight hospitalized patients with severe hemoptysis was enrolled in this study.Of which 31 patients were recurrent hemoptysis,27 patients were with bronchiectasis,4 patients were with bronchial lung cysts,4 patients had unknown causes,3 patients were with tuberculosis.All patients were diagnosed by chest imaging examination,fiber bronchoscopy,bronchial arteriography,and they were all treated by selective bronchial arterial embolization.Results The most times of embolization was 3,and bronchial arterial imaging were performed for vascular malformation.After having bronchial arterial

  4. Embolization of trauma-associated pelvic hemorrhage: Feasibility of super-selective catheterization in heavily injured patients as a damage control for life-threatening pelvic bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Park, Joon Young; Yim, Nam Yeol; Kim, Jae Kyu; Kim, Ook Hyoung; Kang, Yang Jun; Jung, Hye Doo; Kim, Seul Kee; Yoon, Woong [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2016-04-15

    To determine the efficacy of embolization with super-selective catheterization of the internal iliac arterial branches to treat heavily injured trauma patients with pelvic arterial bleeding. A retrospective analysis was performed using the medical records of 37 patients who underwent trans-arterial embolization for trauma-associated pelvic arterial hemorrhage in a regional trauma center between July 2010 and July 2013. In each patient, hemodynamic stability, embolization level, elapsed time for trans-arterial embolization, clinical outcome and embolization-related complications were evaluated. Comparison of elapsed time, and presence of complication was done according to embolization level. Transarterial embolization was conducted in 37 patients. Hemodynamic stability of each patient was classified into hemodynamic stable (n = 9), and unstable (n = 28). Twenty-nine of 37 patients underwent embolization after super-selective catheterization of more than 2nd order branch of internal iliac artery with a microcatheter, and 8 patients underwent proximal internal iliac artery embolization without super-selective catheterization. The mean elapsed procedure time for super-selective embolization (34.76 ± 20.0 minutes) was not significantly longer than proximal internal iliac artery embolization (33.87 ± 16.73 minutes, p = 0.215). Pelvic arterial embolization with super-selective catheterization is a safe and feasible treatment for heavily injured patients with trauma-associated pelvic arterial bleeding.

  5. [Intra-arterial thrombolysis of acute mesenteric ischemia].

    Science.gov (United States)

    Nathan, N; Wintringer, P; Bregeon, Y; Cassat, C; Le Blanche, A; Boulanger, J P; Feiss, P

    1995-01-01

    A 73-year-old man with pre-existing cardiac failure, coronary artery and chronic obstructive pulmonary disease was presented for an acute mesenteric ischaemia, resulting from an embolic obstruction of the superior mesenteric artery. An intra-arterial fibrinolysis with a bolus of 250 000 units of streptokinase, followed by an infusion of 150 mg rtPA with adequate heparin dosage was performed 10 hours after the first symptoms. An abdominal guarding occurred 24 hours later, despite radiological improvement, justifying emergency surgery which confirmed the partial efficiency of the medical therapy. Unfortunately, a cardiogenic shock occurred preoperatively and the patient died five days later from intractable cardiovascular failure.

  6. 支气管动脉栓塞术围手术期迷走神经反射的回顾性临床分析%Retrospectively analysis of the vagus nerve reflex in bronchial artery embolization

    Institute of Scientific and Technical Information of China (English)

    付志刚; 余成新; 张晓磷; 李海涛; 韩强; 亓小虎; 赵文江

    2016-01-01

    目的:探讨大咯血患者支气管动脉栓塞术(BAE)围手术期迷走神经反射的原因及处理方法。方法收集本院大咯血患者112例,其中9例在介入栓塞术围手术期出现迷走神经反射。结果9例均表现为混合型迷走神经反射,5例迷走神经反射出现在支气管动脉栓塞过程中,1例出现在术毕拔鞘过程中,1例出现在压迫止血过程中,2例出现在患者刚返回病房后。经阻断迷走神经、升压、扩容等对症处理后好转,未出现死亡等严重不良后果。结论 BAE 围手术期迷走神经反射与患者紧张度过高、不规范操作密切相关,一旦发现迷走神经反射,及时予以阿托品阻断迷走神经,必要时升压、扩容处理。%Objective To evaluate the cause and the treatment of the vagus nerve reflex in patients with hemoptysis during bron-chial artery embolization (BAE).Methods 1 12 patients with much hemoptysis were enrolled,9 of whom represented vagus nerve reflex in the process of interventional embolization.Results In 9 patients with mixed vagal reflex,5 occurred in the process of bron-chial artery embolization,1 in removing of sheath,1 in hemostasis by compression and 2 in returning to the ward.The intraoperative vagus reflex during BAE was related to over tension and unnormolized operation,and it improved by block of vagus nerve,raising blood pressure and fluid expansion without serious complications.Conclusion Vagus nerve reflex during BAE should be noticed, and early detection and timely intervention may improve its prognosis.

  7. Long-term therapy of interferon-alpha induced pulmonary arterial hypertension with different PDE-5 inhibitors: a case report

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    Baumann Gert

    2005-09-01

    Full Text Available Abstract background Interferon alpha2 is widely used in hepatitis and high-risk melanoma. Interferon-induced pulmonary arterial hypertension as a side effect is rare. Case presentation We describe a melanoma patient who developed severe pulmonary arterial hypertension 30 months after initiation of adjuvant interferon alpha2b therapy. Discontinuation of interferon did not improve pulmonary arterial hypertension. This patient could be treated successfully with phosphodiesterase-5 inhibitor therapy. Conclusion This is only the 5th case of interferon-induced pulmonary arterial hypertension and the first documented case where pulmonary arterial hypertension was not reversible after termination of interferon alpha2 therapy. If interferon alpha2 treated patients develop respiratory symptoms, pulmonary arterial hypertension should be considered in the differential diagnosis. For these patients phosphodiesterase-5 inhibitors, e.g. sildenafil or vardenafil, could be an effective therapeutic approach.

  8. Opportunity choice of surgical resection of carotid body tumor after transcathter superselective embolization of feeding artery: A color Doppler ultrasonic observation%颈动脉体瘤超选择性动脉栓塞治疗后外科切除术的时机选择:彩色多普勒超声观察

    Institute of Scientific and Technical Information of China (English)

    叶有强; 梁建深; 郭辉; 林志东; 王思阳

    2012-01-01

    Objective To investigate the opportunity choice of surgical resection of carotid body tumor (CBT) after transcathter superselective embolization of feeding artery with color Doppler ultrasound observation (CDU). Methods Tran-stheter embolization of tumor feeding artery was performed on 22 CBT patients before surgical operation. CDU was used to measure the peak systolic velocity (PSV) and resistance index (RI) of blood flow of feeding artery before and 1,2,4 days after embolization, respectively. Statistical analysis of these data was performed. Results One and 2 days after embolization, PSV and RI of tumor feeding artery were lower than those before embolization (both P0. 05). Conclusion CDU is valuable for the judgment of involvement aera, feeding artery and collateral pathways of CBT, as well as for the opportunity choice of surgical resection. Surgical resection of CBT may be safely performed within 2 days after transtheter superselective arterial embolization of feeding artery.%目的 利用彩色多普勒超声(CDU)观察经导管超选择性动脉栓塞治疗颈动脉体瘤(CBT)后的外科切除时机.方法 对22例外科切除术前CBT患者行经导管超选择性肿瘤供血动脉栓塞.于栓塞术前、术后1、2、4天分别采用CDU检测肿瘤供血动脉的峰值血流速度(PSV)和阻力指数(RI),并进行统计学分析.结果 栓塞术后1、2天,CBT供血动脉的PSV、RI均低于术前(P均<0.01),而栓塞术后4天PSV、RI与术前比较差异无统计学意义(P均>0.05).结论 CDU对判断CBT侵犯范围、供血血管、侧支循环状况及选择手术时机均具有临床应用价值.栓塞术后2天内可能为安全切除CBT的手术时机.

  9. Pneumatic compression for embolic protection during upper extremity endovascular intervention.

    Science.gov (United States)

    Cassar, Andrew; Barsness, Gregory W; Wysokinski, Waldemar E; Gifford, Shaun M; Bower, Thomas C; Edwards, William D; Gulati, Rajiv

    2014-01-01

    Embolic protection devices are occasionally employed during endovascular interventions to prevent complications caused by embolic debris. However, these devices have imperfect efficacy, confer risk of endovascular trauma, and are expensive. We report a patient with giant cell arteritis and symptomatic axillary artery stenosis, with a perceived elevated risk of distal embolization during endovascular intervention. We describe a straightforward embolic protection technique of brachial pressure cuff inflation during endovascular intervention and aspiration of displaced thrombotic material from the static column of blood. This novel, effective, and cost-free technique could also be employed in other vascular beds during endovascular intervention.

  10. An unusual cause of ischemic stroke - Cerebral air embolism

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    Vinit Suri

    2014-01-01

    Full Text Available Air embolism is a preventable, often undiagnosed but potentially treatable cause of ischemic stroke with a high morbidity and mortality. It is usually iatrogenic ocurring especially in patients in ICU setting. We describe the case and neuroimaging of a patient with ischaemic stroke due to air embolism during manipulation of central venous line. We also review the literature with respect to aetiology, incidence pathophysiology, diagnosis, and treatment options for venous and air embolism. Cerebral air embolism should be considered in patients with sudden neurological deterioration after central venous or arterial manipulations or certain neurological procedures. Prevention, as well as early diagnosis and management, may reduce morbidity and mortality.

  11. 血管内栓塞治疗颅内前交通动脉瘤189例%Endovascular embolization for anterior communicating artery aneurysms:Clinical analysis in 189 cases

    Institute of Scientific and Technical Information of China (English)

    刘佳强; 李真保; 方兴根; 吴德刚; 赵心同; 陈三送; 狄广福; 陈建民; 赖年升

    2015-01-01

    目的:总结前交通动脉瘤经血管内栓塞治疗的经验和体会。方法:回顾性分析我院经血管内栓塞治疗的189例前交通动脉瘤的临床资料,造影随访3~24个月。结果:成功栓塞前交通动脉瘤189例,致密栓塞161例;瘤体少量显影12例;瘤颈少量残留16例。术中并发脑血管痉挛12例;血栓形成6例;术中破裂3例,2例因出血死亡。单纯弹簧圈栓塞治疗146例,支架辅助弹簧圈栓塞治疗宽颈动脉瘤43例。术后92例造影随访3~24个月均无再出血,14例复发,23例支架辅助治疗患者随访中均未见复发及再出血。结论:血管内栓塞治疗前交通动脉瘤疗效可靠。支架辅助弹簧圈栓塞可降低宽颈前交通动脉瘤的复发率。早期治疗,合理应用各种辅助技术,正确处理术中并发症可有效提高治疗质量并减少预后不良。%Objective:To summarize the experience of endovascular embolization in treatment of anterior communicating artery aneurysm .Methods: The clinical data were retrospectively examined in 189 cases with anterior communicating artery aneurysm undergone treatment in our hospital .Results: Endo-vascular embolization achieved in the total 189 cases,in which 161 were complete occlusion,12 were near-complete occlusion at the body and 16,at the neck of aneurysm.Intraoperatively complicated cerebral vasospasm occurred in 12 cases,thrombosis in 6,and rupture in 3.Two deaths occurred.146 cases were managed with simple coiling embolization,and 43 with stent-assisted coil delivery to wide-necked intracranial aneurysm.By angiographic results after surgery,follow-up in 3 to 24 months showed no re-bleeding in 92 cases,yet relapse occurred in 23,and no recurrence and re-bleeding occurred in 23 cases managed with stent-assisted coil.Conclusion: Endovascular embolization can be reliable and effective for anterior communicating artery aneurysm .Stent-assisted coil delivery may reduce the

  12. Computed tomography of acute pulmonary embolism: state-of-the-art

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    Zhang, Long Jiang; Lu, Guang Ming [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Meinel, Felix G.; McQuiston, Andrew D.; Ravenel, James G. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Schoepf, U.J. [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States)

    2015-09-15

    Multidetector computed tomography (CT) plays an important role in the detection, risk stratification and prognosis evaluation of acute pulmonary embolism. This review will discuss the technical improvements for imaging peripheral pulmonary arteries, the methods of assessing pulmonary embolism severity based on CT findings, a multidetector CT technique for pulmonary embolism detection, and lastly, how to avoid overutilization of CT pulmonary angiography and overdiagnosis of pulmonary embolism. (orig.)

  13. Acute paraplegia following embolization of spinal dural arteriovenous fistula

    Institute of Scientific and Technical Information of China (English)

    HUANG Cheng-guang; QI Xiang-qian; CHEN Huai-rui; L(U) Li-quan; WU Xiao-jun; BAI Ru-lin; LU Yi-cheng

    2011-01-01

    Embolization therapy has been used as the initial treatment for spinal dural arteriovenous fistula (SDAVF) only for certain patients or in certain medical institutions due to its minimal invasiveness, but the recurrence of embolization remains a clinical challenge. The recurrent patient usually exhibits a gradual onset of symptoms and progressive deterioration of neurological function. Developing paraplegia several hours after embolization is commonly seen in patients with venous thrombosis-related complications, for which anticoagulation therapy is often administered. This article reports on a SDAVF patient who had weakness of both lower extremities before embolization and developed complete paraplegia several hours after embolization therapy, later confirmed by angiography as fistula recurrence. The symptoms were relieved gradually after second embolization. The pathophysiology of this patient is also discussed.

  14. Intra-arterial adenoviral mediated tumor transfection in a novel model of cancer gene therapy

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    Siemionow Maria

    2006-08-01

    Full Text Available Abstract Background The aim of the present study was to develop and characterize a novel in vivo cancer gene therapy model in which intra-arterial adenoviral gene delivery can be characterized. In this model, the rat cremaster muscle serves as the site for tumor growth and provides convenient and isolated access to the tumor parenchyma with discrete control of arterial and venous access for delivery of agents. Results Utilizing adenovirus encoding the green fluorescent protein we demonstrated broad tumor transfection. We also observed a dose dependant increment in luciferase activity at the tumor site using an adenovirus encoding the luciferase reporter gene. Finally, we tested the intra-arterial adenovirus dwelling time required to achieve optimal tumor transfection and observed a minimum time of 30 minutes. Conclusion We conclude that adenovirus mediated tumor transfection grown in the cremaster muscle of athymic nude rats via an intra-arterial route could be achieved. This model allows definition of the variables that affect intra-arterial tumor transfection. This particular study suggests that allowing a defined intra-tumor dwelling time by controlling the blood flow of the affected organ during vector infusion can optimize intra-arterial adenoviral delivery.

  15. 彩超评价甲状腺动脉栓塞治疗甲亢前后外周动脉的变化%Assessing the change of peripheral arteries after thyroid-artery-embolism treatment on hyperthyroidism with colour doppler ultrasonography

    Institute of Scientific and Technical Information of China (English)

    吴云

    2012-01-01

    Objective To explore the value of assessing the change of peripheral arteries after thyroid-artery-embolism treatment on hyperthyroidism with colour doppler ultrasonography.Methods 43 hyperthyroidism patients were treat with thyroid artery embolism; resistent index ( RI ), pulsatility index ( PI ) of common carotid artery ( CCA ),internal carotid artery ( ICA ),external carotid artery ( ECA ),renal artery( RA ),and carotid artery intima-media thicknes( IMT ) were measured before and 1,3 months after the operation with colour doppler ultrasonography.Results pulsatility index,resistance index of ICA and RA and IMT of carotid artery of the hyperthyroid group before treatment was significantly higher than that of control group ( P< 0.05 ),while resistance index of ECA was significantly lower than that of the control group( P< 0.05 ).3 months after the treatment,pulsatility index,resistance index of ICA and RA and IMT of carotid artery of ICA and RA was significantly lower than that before treatment ( P < 0.05 ); resistance index of CCA wasn't statistically different between the hyperthyroid group and the control group and didn' t significantly differ from that before the treatment ( P > 0.05 ).Conclusion color Doppler ultrasound has important value for the clinical-efficacy assessment of thyroid-artery-embolism treatment on hyperthyroidism.%目的 探讨彩色多普勒超声评价甲状腺动脉栓塞治疗甲亢后外周动脉变化的价值.方法 43例甲亢患者行甲状腺动脉栓塞治疗,于术前及术后1、3个月用彩色多普勒超声观察测量颈总动脉(CCA)、颈内动脉(ICA)、颈外动脉(ECA)、肾动脉(RA)搏动指数(PI)与阻力指数(RI)以及颈动脉内-中膜厚度( IMT).结果 甲亢组治疗前外周动脉搏动指数、ICA和RA阻力指数以及颈动脉内-中膜厚度明显高于对照组(P<0.05~0.01),ECA阻力指数明显低于对照组(P<0.05).治疗3个月后,搏动指数、ICA和RA阻

  16. Long-term results of endovascular therapy for proximal subclavian arterial obstructive lesions

    Institute of Scientific and Technical Information of China (English)

    WANG Ke-qin; LIAO Chuan-jun; ZHANG Yang; WANG Zhong-gao; YANG Bao-zhong; YUAN Chao; ZHANG Wang-de; YUAN Biao; XING Tong; SONG Sheng-han; LI Tan

    2010-01-01

    Background Endovascular therapy is a treatment option for localized occlusion of the subclavian artery. In this report the long-term experience with 59 patients is presented.Methods Between June 1998 and September 2008, we used endovascular therapy to treat 61 subclavian arterial obstructive lesions in 59 patients (46 males and 13 females, 34-82 years of age with a mean age (61.9±11.0) years). Twenty patients (34%) had clinical symptoms due to vertebrobasilar insufficiency, 26 (44%) had disabling arm ischemia, and 13 (22%) had both symptoms. We performed all procedures under local anesthesia. The approaches were from the femoral artery (n=47), brachial artery (n=\\, involving bilateral subclavian disease) or both (n=11). Sixty stents were implanted. All patients were followed-up at 1,3, 6, and 12 months post-procedure, and annually thereafter. Results We achieved technical success in 58 (95.1%) arteries, all of which were stented. There were three technical failures; two were due to the inability to cross over an occlusion, necessitating the switch to an axillo-axillary bypass, and the third was due to shock after digital subtraction angiography and prior to stenting. Arterial stenosis pre- and post-stenting was (83.6±10.8)% and (2.5±12.5)% (P <0.01). Clinical success was achieved in 55 of the 59 patients (93.4%). Of the four clinical failures, three were technical and the remaining patient had a stent thrombosis. Systolic blood pressure difference between the two brachial arteries was (44.7±18.5) vs. (2.2±3.9) mmHg (P <0.01). Primary patency was 98% at 12 months, 93% at 24 months, and 82% at 5 years. Five patients were lost to follow-up by 12 months post-stenting. Significant recurrent obstruction developed in five patients with resumption of clinical symptoms. The overall survival rate was 98.2% at 12 months, 89.5% at 24 months, and 84.5% at 5 years.Conclusions Endovascular therapy for proximal subclavian arterial obstructive lesions is effective and

  17. [Ruptured pseudoaneurysm of the renal artery associated with segmental arterial mediolysis].

    Science.gov (United States)

    Mizutani, Kosuke; Kikuchii, Mina; Kondo, Hiroshi; Moriyama, Yoji; Tsuchiya, Tomohiro; Masahiro, Nakano; Hidetoshi, Ehara; Deguchii, Takashi; Shinoda, Ikuo

    2008-07-01

    We present a 71-year-old woman with spontaneous perinephric hematoma due to a rupture of pseudoaneurysm of the right renal artery on the fourth day after radical cystectomy and bilateral ureterocutaneostomy for bladder cancer. This patient received steroid therapy for chronic rheumatoid arthritis for several years. The digital subtraction angiography of the right renal artery showed two pseudoaneurysms in the anterior inferior segmental branch and the posterior inferior segmental branch. Transarterial coil embolization of the right renal artery proximally and distally to the two aneurysms was performed without complications. Moreover, the additional angiography showed typical string-of-beads appearance and small aneurysms in abdominal visceral arteries, suggesting segmental arterial mediolysis (SAM) as a possible etiology. Differential diagnoses of SAM are discussed.

  18. 不同类型子宫瘢痕妊娠动脉栓塞治疗前后病灶血流变化的研究%Study on hemodynamic changes of pregnancy tissue material before and after the artery embolization in different types of cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    陈莉婷; 陈向东; 汪洪

    2016-01-01

    study. Patients in TypeⅠ, typeⅡ and type Ⅲ were corresponding to group A(38 cases), B(46 cases), C(40 cases), respectively. All patients underwent curettage treatment at 72h after bilateral uterine artery embolization. The clinical results of the three groups were compared, including efficiency of therapy, decreasing of blood β-HCG and flow resistance index in pregnancy tissue material.Results(1)The effective rate of the group A, B, C were 95.00%, 95.83% and 100.00% individually, there were no significant differences among the three groups(P>0.05). The total effective rate was 96.88%. (2)The mean time of flow resistance index decreased by 50% were (42.65±13.17) h in group A, (56.31±16.25) h in group B, and (29.72±9.26) h in group C. There were statistically significant differences(P0.05) between group A and group B. There were significant differences between group A and group C and between group B and group C(P<0.05).ConclusionUterine artery embolization has good effect in all kinds of cesarean scar pregnancy. However, further research is needed to determine the individual implementation plan for the treatment.

  19. Clinical evolution of mediastinitis in patients undergoing adjuvant hyperbaric oxygen therapy after coronary artery bypass surgery

    Science.gov (United States)

    do Egito, Julyana Galvão Tabosa; Abboud, Cely Saad; de Oliveira, Aline Pâmela Vieira; Máximo, Carlos Alberto Gonçalves; Montenegro, Carolina Moreira; Amato, Vivian Lerner; Bammann, Roberto; Farsky, Pedro Silvio

    2013-01-01

    ABSTRACT Objective: To evaluate the use of hyperbaric oxygen therapy as an adjunctive treatment in mediastinitis after coronary artery bypass surgery. Methods: This is a retrospective descriptive study, performed between October 2010 and February 2012. Hyperbaric oxygen therapy was indicated in difficult clinical management cases despite antibiotic therapy. Results: We identified 18 patients with mediastinitis during the study period. Thirty three microorganisms were isolated, and polymicrobial infection was present in 11 cases. Enterobacteriaceae were the most prevalent pathogens and six were multi-resistant agents. There was only 1 hospital death, 7 months after the oxygen therapy caused by sepsis, unrelated to hyperbaric oxygen therapy. This treatment was well-tolerated. Conclusion: The initial data showed favorable clinical outcomes. PMID:24136762

  20. Is cardiac resynchronization therapy for right ventricular failure in pulmonary arterial hypertension of benefit?

    Science.gov (United States)

    Rasmussen, Jason T; Thenappan, Thenappan; Benditt, David G; Weir, E Kenneth; Pritzker, Marc R

    2014-12-01

    Pulmonary arterial hypertension is a manifestation of a group of disorders leading to pulmonary vascular remodeling and increased pulmonary pressures. The right ventricular (RV) response to chronic pressure overload consists of myocardial remodeling, which is in many ways similar to that seen in left ventricular (LV) failure. Maladaptive myocardial remodeling often leads to intraventricular and interventricular dyssychrony, an observation that has led to cardiac resynchronization therapy (CRT) for LV failure. CRT has proven to be an effective treatment strategy in subsets of patients with LV failure resulting in improvement in LV function, heart failure symptoms, and survival. Current therapy for pulmonary arterial hypertension is based on decreasing pulmonary vascular resistance, and there is currently no effective therapy targeting the right ventricle or maladaptive ventricular remodeling in these patients. This review focuses on the RV response to chronic pressure overload, its effect on electromechanical coupling and synchrony, and how lessons learned from left ventricular cardiac resynchronization might be applied as therapy for RV dysfunction in the context of pulmonary arterial hypertension.

  1. Experimental Study of Applying Trisacryl Gelatin Microspheres to Uterine Arterial Embolization for Guinea Pig%应用三丙烯微球行豚鼠子宫动脉栓塞术的实验研究

    Institute of Scientific and Technical Information of China (English)

    谭国胜; 郭文波; 向贤宏; 范惠双; 杨建勇

    2011-01-01

    [目的]探讨应用三丙烯微球(Embosphere)行正常豚鼠子宫动脉栓塞术的可行性.[方法]25只成年雌性豚鼠随机分为两组.子宫动脉铸型组10只,用于行盆腔血管造影及血管铸型术,了解雌性豚鼠子宫动脉起源、行程、长度、直径及分支等解剖学特征;子宫动脉栓塞组(UAE组)15只,用于行双侧子宫动脉微球栓塞的技术研究及病理分析.[结果]双侧子宫动脉主干由髂内动脉发出,于同侧宫角旁的结缔组织中迂曲上行并发出8-10支弓状支,主干和弓状支的血管直径分别为(0.32±0.027)mm及(0.14±0.01)mm.UAE组15只豚鼠成功行双侧子宫动脉栓塞术.术中(40~120)μm及(100~300)μm Embosphere的用量分别为(0.033±0.003)mL和(0.015±0.002)mL.病理切片可见子宫动脉弓状支、浆膜下二级分支及部分三级分支动脉内均有栓塞微球存在,子宫肌层及内膜无缺血坏死病理改变.[结论]应用三丙烯微球栓塞豚鼠子宫动脉具有可行性,栓塞效果良好,可应用于豚鼠子宫肌瘤模型UAE的基础研究.%[Objective]To explore the feasibility of applying trisacryl gelatin microspheres (Embosphere) to uterine arterial embolization (UAE) on normal guinea pig.[Methods]Twenty-five female adult guinea pigs were divided into two groups: one group was 10 guinea pigs for uterine artery casting mould, which were used to make pelvic angiography and vascular casting mould, and to demonstrate the anatomy characteristics of uterine arteries' source, running shape, length, diameter and branches of female adult guinea pig; Another group was 15 guinea Pigs for UAE, which were used to practice technical research and make pathological analysis by bilateral uterine arterial embolization with microspheres.[Results]The trunks of uterine arteries were erupted by internal iliac arteries, running up circuitously in the connective tissue beside the cornu uteri, and erupted 8 to 10 arcuate branches.The trunk and arcuate branches

  2. 子宫瘢痕妊娠行双侧子宫动脉栓塞的护理配合%The nursing cooperation of bilateral uterine artery embolization in patients with uterine scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    尹青

    2015-01-01

    Objective To investigate the nursing cooperation of bilateral uterine artery embolization in patients with uterine scar pregnancy.Methods23 patients with uterine scar pregnancy in our hospital from February 2012 to May 2013 were selected, who received treatment of bilateral uterine artery embolization and chemotherapy, and received the appropriate care measures at the period of treatment, surgery and postoperative conditions the occurrence of complications in patients were observed. ResultsAll patients were operated successfully, no bleeding peri-curettage, no vaginal bleeding after curettage, no abnormal echo in ultrasound examination.Conclusion The bilateral uterine artery chemoembolization uterine of patients with scar pregnancy combined coordination of scientific comprehensive nursing, can ensure the normal operation and reduce the incidence of postoperative complications.%目的:探讨子宫瘢痕妊娠行双侧子宫动脉栓塞的护理配合。方法选择2012年2月~2013年5月我院收治的23例子宫瘢痕妊娠患者,予以双侧子宫动脉化疗栓塞术治疗,同时在治疗前后予以患者相应护理措施,观察患者手术情况及术后并发症发生情况。结果所有患者手术均成功,术后清宫术中无大出血,清宫术后无阴道大量流血、彩超检查无异常回声。结论在子宫瘢痕妊娠行双侧子宫动脉化疗栓塞术中应用科学全面的护理配合,能够保证手术的正常进行,减少术后并发症的发生。

  3. Progress of transformational therapy in colorectal liver metastases

    Institute of Scientific and Technical Information of China (English)

    Fang Xiang; Xianli Yin

    2015-01-01

    Colorectal cancer liver metastases (CLM) treatment is very important given the high incidence of colorectal cancer with liver metastases, which are primarily treated by surgical resection. Transformational therapy such as systemic chemotherapy, hepatic arterial infusion (HAI), portal vein embolization (PVE), ablation therapy, and targeted therapy, should be applied to CLM patients who are unable to undergo immediate surgery to improve patients’ survival and quality of life.

  4. Clinical Application of Partial Splenic Embolization

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    Yong-Song Guan

    2014-01-01

    Full Text Available Partial splenic embolization (PSE is one of the intra-arterial therapeutic approaches of diseases. With the development of interventional radiology, the applications of PSE in clinical practice are greatly extended, while various materials are developed for embolization use. Common indications of PSE include hypersplenism with portal hypertension, hereditary spherocytosis, thalassemia, autoimmune hemolytic anemia, splenic trauma, idiopathic thrombocytopenic purpura, splenic hemangioma, and liver cancer. It is also performed to exclude splenic artery aneurysms from the parent vessel lumen and prevent aneurysm rupture, to treat splenic artery steal syndrome and improve liver perfusion in liver transplant recipients, and to administer targeted treatment to areas of neoplastic disease in the splenic parenchyma. Indicators of the therapeutic effect evaluation of PSE comprise blood routine test, changes in hemodynamics and in splenic volume. Major complications of PSE include the pulmonary complications, severe infection, damages of renal and liver function, and portal vein thrombosis. The limitations of PSE exist mainly in the difficulties in selecting the arteries to embolize and in evaluating the embolized volume.

  5. Clinical application of partial splenic embolization.

    Science.gov (United States)

    Guan, Yong-Song; Hu, Ying

    2014-01-01

    Partial splenic embolization (PSE) is one of the intra-arterial therapeutic approaches of diseases. With the development of interventional radiology, the applications of PSE in clinical practice are greatly extended, while various materials are developed for embolization use. Common indications of PSE include hypersplenism with portal hypertension, hereditary spherocytosis, thalassemia, autoimmune hemolytic anemia, splenic trauma, idiopathic thrombocytopenic purpura, splenic hemangioma, and liver cancer. It is also performed to exclude splenic artery aneurysms from the parent vessel lumen and prevent aneurysm rupture, to treat splenic artery steal syndrome and improve liver perfusion in liver transplant recipients, and to administer targeted treatment to areas of neoplastic disease in the splenic parenchyma. Indicators of the therapeutic effect evaluation of PSE comprise blood routine test, changes in hemodynamics and in splenic volume. Major complications of PSE include the pulmonary complications, severe infection, damages of renal and liver function, and portal vein thrombosis. The limitations of PSE exist mainly in the difficulties in selecting the arteries to embolize and in evaluating the embolized volume.

  6. Embolization of brain arteriovenous malformations with ethylene vinyl alcohol copolymer:technical aspects

    Institute of Scientific and Technical Information of China (English)

    GAO Kun; YANG Xin-jian; MU Shi-qing; LI You-xiang; ZHANG You-ping; L(U) Ming; WU Zhong-xue

    2009-01-01

    Background Endovascular therapy plays an important role in the treatment of brain arteriovenous malformations (BAVMs).Ethylene vinyl alcohol copolymer (Onyx) is a novel liquid embolic material.This study aimed to summarize our experience of using Onyx for embolization of BAVMs with the focus on embolization technique.Methods From September 2003 to November 2007,115 patients (43 women and 72 men,with a mean age of 29 years)with BAVMs were endovascularly treated with Onyx in our department.The following features of all AVMs were evaluated prior to treatment:type of nidus and shunt,draining veins,and feeding arteries.A total of 196 endovascular procedures were performed.Results The course of endovascular treatment was completed in 88 patients.Additional sessions were planned in 27 patients.Of the 88 patients,total occlusion was obtained in 23 patients (26.1%),near-total (>80% of the original volume) occlusion was obtained in 35 patients (39.8%) and partial occlusion (<80% of the original volume) was obtained in 30 patients (34.1%) using embolization as the sole therapeutic technique.Mean volume reduction was 72% (range 30%-100%) in 115 patients.Thirty four patients (38.6%,34/88) underwent radiosurgical treatment.Additional embolization sessions were planned in 27 patients.Complications occurred in 19 patients (16.5%,19/115),leading to death in one patient (mortality 0.9%) and permanent disabling in 3 patients (morbidity 2.6%).Conclusions Onyx was shown to be feasible and safe for embolization of BAVMs.Proper use of the Onyx injection technique largely improved the endovascular treatment of BAVMs.Large AVMs can be adequately reduced in size through the use of additional treatment.

  7. The efficiency analysis of thrombolytic rt-PA combined with intravascular interventional therapy in patients with acute basilar artery occlusion

    Science.gov (United States)

    Xianxian, Zhao; Chengsong, Yue; Qiang, Mei; Fei, Wei; Lin, Shen; Huiyan, Ding; Zili, Gong

    2017-01-01

    In order to further optimize the treatment strategy for the patients with acute basilar artery occlusion, we were dedicated to study the therapeutic effects and influential factors in the process of treated basilar artery occlusion with thrombolytic combined vascular interventional therapy. 75 patients with acute basilar artery occlusion treated with arterial thrombolytic therapy were analyzed retrospectively. In accordance with the discharge records of patients, their short-term curative effect with 24-hour treatment and 14-days treatment were evaluated. Our data showed that the survival condition of the patients with acute acute basilar artery occlusion were visibly improved by combination thrombolytic and interventional therapy. Moreover, their BI scores were remarkably improved, while NIHSS and mRS scores were evidently reduced. These data proved that our treatment strategy was able to improve the survival condition of patients with acute basilar artery occlusion. Furthermore, our data showed that coagulation related factors remarkably improved in the patients, when they treated by combination thrombolytic therapy with interventional therapy. In addition, our results suggested that the patients' bilateral Babinski(+), revascularization and coma symptom were closely related to their prognosis after treated the patients with combination thrombolytic and vascular interventional therapy, and the difference was statistically significant (pBabinski(+), and revascularization in the patients with acute basilar artery occlusion have an appreciable impact on the patients' prognosis. PMID:28123346

  8. A review of intraoperative goal-directed therapy using arterial waveform analysis for assessment of cardiac output.

    Science.gov (United States)

    Mehta, Neil; Fernandez-Bustamante, Ana; Seres, Tamas

    2014-01-01

    Increasing evidence shows that goal-directed hemodynamic management can improve outcomes in surgical and intensive care settings. Arterial waveform analysis is one of the different techniques used for guiding goal-directed therapy. Multiple proprietary systems have developed algorithms for obtaining cardiac output from an arterial waveform, including the FloTrac, LiDCO, and PiCCO systems. These systems vary in terms of how they analyze the arterial pressure waveform as well as their requirements for invasive line placement and calibration. Although small-scale clinical trials using these monitors show promising data, large-scale multicenter trials are still needed to better determine how intraoperative goal-directed therapy with arterial waveform analysis can improve patient outcomes. This review provides a comparative analysis of the different arterial waveform monitors for intraoperative goal-directed therapy.

  9. A Review of Intraoperative Goal-Directed Therapy Using Arterial Waveform Analysis for Assessment of Cardiac Output

    Directory of Open Access Journals (Sweden)

    Neil Mehta

    2014-01-01

    Full Text Available Increasing evidence shows that goal-directed hemodynamic management can improve outcomes in surgical and intensive care settings. Arterial waveform analysis is one of the different techniques used for guiding goal-directed therapy. Multiple proprietary systems have developed algorithms for obtaining cardiac output from an arterial waveform, including the FloTrac, LiDCO, and PiCCO systems. These systems vary in terms of how they analyze the arterial pressure waveform as well as their requirements for invasive line placement and calibration. Although small-scale clinical trials using these monitors show promising data, large-scale multicenter trials are still needed to better determine how intraoperative goal-directed therapy with arterial waveform analysis can improve patient outcomes. This review provides a comparative analysis of the different arterial waveform monitors for intraoperative goal-directed therapy.

  10. Fat embolism syndrome

    OpenAIRE

    Jacob George; Reeba George; Dixit, R; Gupta, R C; Gupta, N.

    1997-01-01

    Fat embolism syndrome, an important contributor to the development of acute respiratory distress syndrome, has been associated with both traumatic and nontraumatic disorders. Fat embolization after long bone trauma is probably common as a subclinical event. Fat emboli can deform and pass through the lungs, resulting in systemic embolization, most commonly to the brain and kidneys. The diagnosis of fat embolism syndrome is based on the patient’s history, supported by clinical signs of pulmonar...

  11. Association of Morning Blood Pressure Surge with Carotid Artery