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At least 199 records · Page 11Linked to original sources
PubMed1980

Spinal osseous angioma: gelfoam embolization.

An osseous spinal angioma presented with severe back pain and cord compression. Severe hemorrhage occurred during surgical decompression, but after preoperative embolisation of the feeding vessels a second operation was successful. Osseous spinal angioma seldom presents backache of a severe nature or medullary compression. In such case, surgical intervention may be attempted without pre-operative embolization of the feeding vessels.

Adult↗
PubMed2002

The effect on the middle-ear cavity of an absorbable gelatine sponge alone and with corticosteroids.

The objectives of this study were to establish whether there is an obvious difference between intact mucosa and abraded mucosa of the middle-ear cavity in respect to the potential side effects from the application of absorbable gelatine sponge (Gelfoam) and to investigate if Gelfoam combined with corticosteroid ointment (cortimycine, sterile 1% hydrocortisone acetate) can reduce the occurrence of these effects. Twenty Albino rats were used in the study. These animals were divided into four groups, with ten ears in each group. In group A, the middle-ear mucosa was kept intact, and Gelfoam was inserted into the middle-ear cavity. In group B, the middle-ear mucosa was abraded, and Gelfoam was inserted. In group C, Gelfoam with corticosteroid was implanted over the intact mucosa, and in group D, the mucosa was abraded prior to the insertion of Gelfoam with corticosteroid. The changes were evaluated 8 weeks postoperatively. In group A, there was a minimal increase in fibroblastic activity, vascular proliferation with mild to moderate fibrosis and all but two tympanic membranes were perfectly normal. However, in group B, we encountered a significant increase in fibroblastic activity, vascular proliferation and fibrosis, and we observed that all tympanic membranes were moderately to severely thickened. These histopathologic changes related to Gelfoam were noted to be decreased in group C and especially in group D. As previously reported in the literature, Gelfoam was found to promote the formation of connective tissue in the middle-ear cavity regardless of the status of the mucosa. The unwanted effects of this material may be decreased if it is combined with corticosteroids in the middle-ear cavity.

Adrenal Cortex Hormones↗
PubMed2006

Portal vein embolization induces compensatory hypertrophy of remnant liver.

AIM: To evaluate the effectiveness and safety of different portal vein branch embolization agents in inducing compensatory hypertrophy of the remnant liver and to offer a theoretic basis for clinical portal vein branch embolization. METHODS: Forty-one adult dogs were included in the experiment and divided into four groups. Five dogs served as a control group, 12 as a gelfoam group, 12 as a coil-gelfoam group and 12 as an absolute ethanol group. Left portal vein embolization was performed in each group. The results from the embolization in each group using different embolic agents were compared. The safety of portal vein embolization (PVE) was evaluated by liver function test, computed tomography (CT) and digital subtraction angiography (DSA) of liver and portal veins. Statistical test of variance was performed to analyze the results. RESULTS: Gelfoam used for PVE was inefficient in recanalization of portal vein branch 4 wk after the procedure. The liver volume in groups of coil-gelfoam and absolute ethanol increased 25.1% and 33.18%, respectively. There was no evidence of recanalization of embolized portal vein, hepatic dysfunction, and portal hypertension in coil-gelfoam group and absolute ethanol group. CONCLUSION: Portal vein branch embolization using absolute ethanol and coil-gelfoam could induce atrophy of the embolized lobes and compensatory hypertrophy of the remnant liver. Gelfoam is an inefficient agent.

Angiography, Digital Subtraction↗
PubMed2005

Hepatic arterial chemoembolization for hepatocellular carcinoma: comparison of survival rates with different embolic agents.

PURPOSE: The optimal embolic agent for transhepatic arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) has not been identified. This study reports outcomes of TACE for HCC with Gelfoam powder and polyvinyl alcohol (PVA). MATERIALS AND METHODS: Eighty-one patients underwent 152 TACE sessions with Gelfoam powder (n = 41) or polyvinyl alcohol (PVA) and Ethiodol (n = 40) as the embolic agent. Chemotherapeutic drugs were the same for all patients (50 mg cisplatin, 20 mg doxorubicin, 10 mg mitomycin-c). The groups were compared based on number of TACE sessions, maximum tumor size, bilirubin level, aspartate and alanine aminotransferase levels, Child-Pugh score, Model for End-stage Liver Disease score, and hepatitis B or C virus positivity. The number of cases of each Child class in each group was also evaluated. Survival starting from the first TACE session was calculated according to Kaplan-Meier analysis. Forty-eight patients died during the study period, 19 received transplants, and 14 were alive at the end of the study period. RESULTS: The groups were statistically similar in all categories regarding liver function, Child-Pugh score, tumor size, hepatitis status, and percentage of patients with Child class A, B, and C disease. The number of TACE sessions was significantly greater for the Gelfoam powder group (mean, 2.2) versus the PVA group (mean, 1.6; P = .01). Overall survival was similar between groups whether patients who received transplants were included in the analysis (mean, 659 days +/- 83 with Gelfoam powder vs 565 days +/- 71 with PVA; P = .42) or were excluded (mean, 519 days +/- 80 with Gelfoam powder vs 511 days +/- 75 with PVA; P = .93). CONCLUSION: In similar patient groups, survival after treatment of HCC with TACE with Gelfoam powder or PVA and Ethiodol was similar.

Antineoplastic Agents↗
PubMed1998

Significance of a diastolic notch in the uterine artery flow velocity waveform induced by uterine embolisation in the pregnant ewe.

OBJECTIVE: To investigate the relation between placental embolisation and the diastolic notch in the uterine artery flow velocity waveform of pregnant ewes under general anaesthesia. METHODS: Seven pregnant ewes at a gestation 16 to 17 weeks were anaesthesized and microbeads of gelfoam were injected into the uterine artery; changes in the uterine circulation were assessed by Doppler velocimetry. RESULTS: Gelfoam embolisation reduced uterine blood flow in a dose-dependent manner, from a mean (95%, CI) of 568 mL/min (495-641) to 159 mL/min (131-187) after the injection of 30 mg of gelfoam, and increased the uterine vascular resistance from 135 mmHg x min x L(-1)(103-167) to 498 mmHg x min x L(-1) (422-574). A diastolic notch in uterine artery flow velocity waveform was observed after 20 mg to 25 mg of gelfoam in two ewes and after injection of 30 mg of gelfoam in all seven animals. Injection of 30 mg of gelfoam increased the pulsatility index to 2.4 (1.9-2.9) from 0.6 (0.5-0.7). The mean uterine vascular resistance at the time of the appearance of a diastolic notch was 414 mmHg x min x L(-1)(377-451). CONCLUSION: These findings suggest that an elevated pulsatility index and the presence of a diastolic notch in the uterine artery flow velocity waveform are indicators of increased uterine vascular resistance and impaired uterine circulation.

Animals↗
PubMed1981

Experimental renal infarcts: angiographic and histologic studies.

The renal arteries in three groups of four dogs were occluded to induce renal infarcts using Gelfoam, Gelfoam and steel coil, and barium suspension. Each agent was evaluated for its effect on renal renin output, arteriographic appearance, and the extent of renal infarct produced. Gelfoam embolization produced incomplete infarcts with hypertrophy of remaining viable tissue. Renal infarcts were more extensive with the combination of Gelfoam and coil than with Gelfoam alone. Barium embolization produced the most diffuse and extensive renal infarct. Renal vein plasma renin levels from the embolized kidney were significantly elevated in the Gelfoam-plus-coil dogs, but arterial pressures were significantly higher in only two of four of these dogs 10 weeks after embolization.

Angiography↗
PubMed1997

Evaluation of particulate embolic materials with MR imaging, scanning electron microscopy, and phase-contrast microscopy.

PURPOSE: To analyze the properties and embolic effect of microfibrillar collagen (MFC), Gelfoam powder, and polyvinyl alcohol (PVA) materials that are used in embolization procedures in the head and neck. METHODS: The shape and surface of these embolic agents were examined with scanning electron microscopy and phase-contrast microscopy. The mean number of areas of T2-weighted high signal intensity was measured on MR images in a rat embolization model to estimate the embolic effect. RESULTS: By scanning electron microscopy and phase-contrast microscopy, MFC appears fibriform and has various sizes and an irregular surface. Gelfoam is of uniform size and has a smooth surface. PVA materials are granulated and have a rough surface. MFC is somewhat suspendable and its shape changes moderately after suspension. Gelfoam is very suspendable and its shape changes rapidly. PVA showed only mild swelling. The embolic effect of MFC was the lowest of the materials examined. Large PVA particles (250 to 500 microns) showed a lesser embolic effect than Gelfoam or small PVA particles (50 to 150 microns) or medium-sized PVA particles (150 to 250 microns). No significant differences were observed among the embolic effects of Gelfoam, small PVA particles (50 to 150 microns), and medium PVA particles (150 to 250 microns). CONCLUSIONS: MFC and large PVA particles (250 to 500 microns) should be used for embolization of vascular anatomy involving potentially dangerous anastomoses. Gelfoam, PVA particles of 150- to 250-micron diameter, and PVA particles of 50- to 150-micron diameter are adequate for embolization involving homogeneous and peripheral anatomy.

Animals↗
PubMed1989

A pre-operative chemoembolization therapy using lipiodol, cisplatin and gelatin sponge for hepatocellular carcinoma.

The significance of pre-operative transcatheter arterial chemoembolization therapy using lipiodol, cisplatin and gelatin sponge (Gelfoam) for the prevention of the recurrence of hepatocellular carcinoma (HCC) was evaluated. On the 103 patients who underwent radical operations for HCC with a tumor size less than 10 cm, 52 patients received no pre-operative therapy (group C), and 51 patients received pre-operative chemoembolization using lipiodol, a chemotherapeutic agent and Gelfoam. Of these 51 patients, 37 patients received a combination of lipiodol, cisplatin and Gelfoam (group A), while the remaining 14 patients received lipiodol, adriamycin and Gelfoam (group B). The disease-free survival rates after surgery were compared between group A, group B and group C. The 2-year disease-free survival rates in group A, group B and group C were 72%, 46% and 54%, respectively. These rates therefore suggest that pre-operative chemoembolization using lipiodol, cisplatin and Gelfoam is a useful method to prevent the recurrence of HCC after surgery.

Adult↗
PubMed1986

Embolization of the left gastric artery in the absence of angiographic extravasation.

Nine high-risk patients with endoscopic evidence of bleeding from the left gastric artery territory without angiographic extravasation were embolized to prevent rebleeding. Three were embolized with Gelfoam particles, 1 with Gianturco coils, and 5 with Gelfoam plus coils. Three patients rebled; 2 were embolized with Gelfoam only, and the third with coils only. No rebleeding occurred in the 5 patients treated with Gelfoam plus coils. No ischemic complications occurred. We conclude that embolization of the left gastric artery, despite absence of extravasation, is effective in preventing rebleeding in high-risk patients and that both Gelfoam and coils be used.

Adult↗
PubMedDate not supplied

The size of gelatin sponge particles: differences with preparation method.

PURPOSE: To assess whether the size distribution of gelatin sponge particles differed according to the method used to make them and the type of original sheet. METHODS: Gelatin sponge particles of approximately 1-1.5 x 1-1.5 x 2 mm were made from either Spongel or Gelfoam sheets by cutting with a scalpel and scissors. Particles were also made of either Spongel or Gelfoam sheets by pumping with two syringes and a three-way stopcock. The size distribution of the particles in saline was compared among the groups. RESULTS: (1) Cutting versus pumping: When Spongel was used, cutting produced lower rates of smaller particles < or = 500 microm and larger particles > 2000 microm compared with pumping back and forth 30 times (1.1% vs 37.6%, p < 0.0001; 2.2% vs 14.4%, p = 0.008). When Gelfoam was used, cutting produced lower rates of smaller and larger particles compared with pumping (8.5% vs 20.4%, p = 0.1809; 0% vs 48.1%, p < 0.0001). (2) Spongel versus Gelfoam: There was no significant difference in the size distribution of the particles between Spongel and Gelfoam (p = 0.2002) when cutting was used. CONCLUSION: The size distribution of gelatin sponge particles differed according to the method used to make them. More uniform particle sizes can be achieved by cutting than by pumping.

Animals↗
PubMed1977

Biocompatibility and bioabsorption of microfibrillar collagen hemostat in experimental animals.

The effects of Microfibrillar Collagen Hemostat (MCH) and Gelfoam after surgical implantation into incision sites of the liver, kidney, and brain were studied in beagle dogs, rabbits, and beagle dogs, respectively. The results of these experimental animal studies suggest that MCH is comparable to Gelfoam with respect to biocompatibility, rate of bioassimilation, and a lack for adverse systemic effects. The brain, liver, and kidney tissues responded comparably to MCH and Gelfoam with a mild to moderate infiltration of macrophages and mononuclear cells. Most of the hemostatic compound had disappeared from the incision sites by Day 28 and completely disappeared by Day 84. The tissue degree response was interpreted as a factor in the process of bioassimilation of the two hemostatic materials. Both hemostatic compounds contributed to adhesion formation in the experimental models. The incidence of adhesions was somewhat lower for MCH than for Gelfoam, but both produced more adhesions than were found at the control sites. The adhesions were only to the adjacent structures and always localized to the surgical site. When MCH or Gelfoam is used under conditions similar to those in the present experimental study, where tissue approximation is impaired, and where growth of granulation tissue is stimulated by the physical presence of the hemostatic compound, there is the possibility for increased incidence of adhesion formation. However, when an intraperitoneal absorbable hemostatic compound is desired, the present studies in experimental animals suggest that MCH will be safe by exhibiting minimal tissue reaction.

Absorption↗
PubMed1995

Micro-bead embolization of uterine spiral arteries and changes in uterine arterial flow velocity waveforms in the pregnant ewe.

The aim of the present study was to simulate the pathological uteroplacental circulation observed in complicated human pregnancies in the pregnant ewe and to analyze its velocimetric changes. Four pregnant ewes at 16-17 weeks of pregnancy were used in the study. Micro-beads (Gelfoam) were administered stepwise into the uterine artery and changes in the uterine circulation were assessed by Doppler velocimetry. Gelfoam administration successfully embolized the uterine spiral arteries located in the decidual segment. The Gelfoam embolization decreased the uterine blood flow dose-dependently from 550 +/- 48 ml/min (mean +/- SD) to 142 +/- 12 ml/min and reciprocally increased the uterine vascular resistance from 139 +/- 12 mmHg min l-1 to 540 +/- 46 mmHg min l-1 at 0 mg and 30 mg Gelfoam, respectively. It dose-dependently attenuated the pregnancy-related physiological elevation in diastolic flow velocity, while the systolic flow velocity was unaffected, resulting ina dose-dependent increase in the pulsatility index from 0.5 +/- 0.2 to 3.2 +/- 0.7 at 0 mg and 30 mg Gelfoam, respectively. The pulsatility index linearly correlated with the uterine vascular resistance, giving a high correlation coefficient of r = 0.947. It could be concluded that the uterine arterial pulsatility index is an indicator of uterine vascular resistance.

Animals↗