Immediate microsurgical repair of an accidentally damaged lower pole aberrant renal vessel.
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Biomedical subjects
Publications and source records attributed to L Giuliani.
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Transcatheter arterial embolization is a useful technique to manage urological tumors. Herein we describe a new embolic material (isobutyl-2-cyanoacrylate) in 5 cases of renal cancer embolization and in 1 case of bilateral hypogastric embolization for bladder cancer hemorrhage. Isobutyl-2-cyanoacrylate provides a complete, distal and irreversible embolization, making it suitable material in cancer embolization.
Three patients with severe haemorrhage from inoperable bladder cancer were treated by selective transcatheter embolisation of both internal iliac arteries. The technical details, results and a rare complication are described. Both gelatin foam and isobutyl-2-cyanoacrylate (IBC) are suitable embolic materials, but we prefer IBC when possible in patients with tumour.
Prolactin (PRL) pituitary reserve was measured in 8 patients with prostatic adenoma and 11 patients with prostatic carcinoma. The PRL reserve was significantly higher in these patients compared to an age-matched control group of 6 subjects. A possible role for PRL-inhibiting drugs in the management of oestrogen-resistant carcinomas of the prostate is suggested.
A case of massive vesical and vaginal bleeding due to a primitive uterine cancer that relapsed hemorragically after bilateral hypogastric embolization and required an additional embolization of all arterial sources supplying the tumor is reported.
The presence of estrogen-binding sites in human renal cell carcinomas appears certainly demonstrated. The authors analyze the clinical contributions which may be obtained from this finding and the possibility of using the ERP assay currently for the screening of patients with estrogen-dependent tumors.
Isobutyl-2-cyanoacrylate and N-butyl-2-cyanoacrylate were used in experimental trans-catheter embolization of rat kidneys and in two patients as preoperative embolization of renal carcinoma. The agents produced an efficient and lasting embolization, with no evident complication; however, their usage is difficult and an appropriate dosage is also difficult.
Preoperative localization of parathyroid adenomas by various methods is today in increasing clinical use. The practical value of the methods is discussed, with particular reference to the PTH radioimmunoassay on selective venous samplings, which is the most reliable. The authors report on their 38 cases with suspected primary hyperparathyroidism during the last six years.
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In a case of renovascular hypertension, autotransplantation has enabled the patient to recover a normal blood pressure. For the revascularization of the kidney this procedure was a treatment of choice.
The technique of embolization of renal cell carcinoma is assessed on the basis of the authors' experience. The procedure is usually envisaged in case of hypervascularized extracapsular tumors, with the purpose of obtaining the preoperative occlusion of the renal artery. Nevertheless, it cannot replace surgery, which can accomplish it with much more safety. The technique of embolization itself, which should be as selective as possible, is also discussed and its clinicobiological (immunological) implications are introduced.
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