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At least 487 records · Page 27Linked to original sources
PubMed1997

Selective chemoembolization in the management of hepatic metastases in refractory colorectal carcinoma: a phase II trial.

PURPOSE: Metastatic involvement of the liver frequently determines the evolution of the clinical picture in colorectal cancer patients. We examined the efficacy and toxicity of chemoembolization in this setting, identifying prognostic factors to define patients most likely to benefit from the procedure. METHODS: Forty patients underwent chemoembolization of metastatic liver lesions from colorectal carcinoma. Selective angiography of the hepatic artery was performed to identify the feeding vessels of the metastatic lesions. The injected chemoemulsion consisted of 1,000 mg of 5-fluorouracil, 10 mg of mitomycin C, and 10 ml of ethiodized oil in a total volume of 30 ml. Gelfoam embolization then followed, until stagnation of blood flow was achieved. Patients were evaluated for response, overall survival, and toxicities. RESULTS: Overall median survival from date of first chemoembolization was ten months. Factors that predicted a longer median survival included favorable performance status (24 months), serum alkaline phosphatase and lactate dehydrogenase levels less than three times normal (24 and 12 months, respectively), and metastatic disease confined to the liver (14 months). Most patients tolerated the procedure well. The most common side effects were transient fevers, abdominal pain, and fatigue. Three patients died within one month from the procedure. CONCLUSION: This study suggests that chemoembolization of hepatic metastases in colorectal cancer should be further evaluated; it may be beneficial in patients who have failed systemic chemotherapy, have a good performance status, and have metastatic disease confined to the liver.

Abdominal Pain↗
PubMed1981

Preoperative arterial occlusion in renal tumors: 3 years experience.

The authors describe their experience in preoperative embolization of 42 renal neoplasms. In all cases but one Gelfoam has been used for arterial occlusion with just a few and transient complications. Good hemostatic effect and décollement have been obtained irrespective of the diameter and vascularization of the tumor. To avoid late décollement difficulties and reduce the duration of clinical sequels the authors prefer, at present, to resort to surgery within 24 hours of embolization.

Adult↗
PubMed1995

Intracavitary treatment of intrasellar cystic craniopharyngeomas with 90-Yttrium by trans-sphenoidal approach--a technical note.

Intracavitary irradiation of intrasellar cystic craniopharyngeomas by stereotactic cyst puncture and injection of radioactive solutions is not yet possible. Therefore we designed a new method which allows such intracavitary irradiation. Its principle is a transphenoidal approach with only a small bony opening of the sella floor, followed by cyst puncture, exclusion of cyst leakage by Metrizamid injection under x-ray control, injection of Y-90-colloid solution at a dosage which delivers a radiation of 200 Gy to the cyst wall, and finally tight closure of the puncture site using fibrin glue and gelfoam. This method has been used in three patients with good results (follow-up 12-15 months) and without complications. Even though long-term follow-up is not yet available, our preliminary results suggest that this method will be useful for future patients with intrasellar cystic craniopharyngeomas.

Adolescent↗
PubMedDate not supplied

Hemobilia--successful treatment by angiographic embolization.

Hemobilia after major liver trauma is a difficult problem to manage. We report a case of an 18-year-old male who sustained major liver trauma. Bleeding was controlled at laparotomy. Seventeen days after surgery hematemesis and intermittent bleeding from the drain occurred. Hepatic artery angiography demonstrated a pseudoaneurysm of one of the branches. Gelfoam embolization successfully controlled the bleeding. Review of the literature reveals that hemobilia has been treated by a conservative means as well as by surgery. Hepatic angiography to localize the site of bleeding and then embolization to control the hemorrhage now constitute the preferred method of treatment.

Adolescent↗
PubMed1982

Embolization of bleeding transverse pancreatic artery aneurysms.

In patients with pancreatitis and blood loss, bleeding from visceral artery aneurysms should be suspected, especially in cases complicated by pseudocyst or abscess formation. We report of a patient with a transverse pancreatic artery aneurysm which was successfully embolized. In addition, decompression of the gastric varices associated with isolated splenic vein occlusion was performed successfully by Gelfoam embolization of 80% of the spleen.

Adult↗
PubMed1985

Complications of renal tumor embolization.

In 121 renal tumor embolizations with four different embolic agents (Gelfoam, Ivalon, ethanol, coils) the mean complication rate was 9.9%, with a mortality of 3.3%. Because of the large embolized tumor mass and the severely impaired health of patients, the complication rate in palliative embolizations was about four times as high as in preoperative procedures. Complications most commonly encountered were renal failure and unintentional embolization of nontarget organs.

Adult↗
PubMed1983

Total therapeutic embolization of the kidney for hypertension in a child with a mycotic aneurysm.

A 7-year-old boy with bacterial endocarditis developed renal artery mycotic aneurysm and diffuse distal occlusions of the renal branches. Blood pressure in the patient returned to normal after obliteration of flow to the left kidney with Gelfoam, Ivalon, and a Gianturco coil. An end loop of the coil used for embolization remained in the lumen of the aorta against its lateral side. Improper coil placement did not result in complications; the boy later died due to neurologic and pulmonary complications. We discuss the therapeutic potential of renal embolization, as well as the risks of particulate and ethanol embolization, in the treatment of renal vascular hypertension from mycotic aneurysms.

Aneurysm, Infected↗
PubMed1984

Neurologic sequelae following transcatheter embolization to control massive perineal hemorrhage.

A case of exsanguinating perineal hemorrhage resulting from rupture of a pseudoaneurysm of the right internal pudendal artery is presented. Transcatheter embolization of Gelfoam and wire coils proved to be life saving, but subsequent neurologic sequelae developed, including loss of sensation over the right side of the scrotum, penis, and medial thigh. Urinary incontinence developed as well. Fortunately, the paresthesias were temporary.

Aneurysm↗
PubMedDate not supplied

Therapeutic embolization of aneurysmal bone cyst.

Results of therapeutic embolization of aneurysmal bone cysts in five patients are described. Transcatheter arterial embolization was performed with Ivalon and Gelfoam particles and Gianturco coils. The postembolization period was characterized by complete relief of pain and decrease in size of the aneurysmal bone cyst in all patients. In patients whose follow-up was longer than 12 months, sclerosis and recalcification of bone were present. There were no complications.

Adolescent↗
PubMedDate not supplied

Expanding role of emergency embolization in the management of severe blunt hepatic trauma.

Emergency embolization using Gelfoam particles alone, or in combination with stainless steel coils or epinephrine, was attempted in 4 patients with severe blunt hepatic trauma complicated by hypovolemic shock to control exsanguinating hemorrhage. Angiography prior to embolization revealed extravasation in all cases. None of the patients rebled or required further intervention. Postembolization course was uneventful in each case. Embolization could become the treatment of choice for more unstable and complicated patients than previously considered.

Adult↗
PubMed1988

Transluminal penile venoablation for impotence: a progress report.

Based on theoretical advantages and successful pilot experiments in dogs, therapeutic transluminal penile venoablation underwent clinical trials in 13 impotent men. Catheter access to the penile venous structures was gained via (1) direct percutaneous puncture of the deep dorsal penile vein, (2) cut-down over the dorsal vein of the penis, or (3) retrograde catheterization of internal or external pudendal veins from a femoral vein. Alternatively, needle access only was gained into (4) the preprostatic plexus or the pudendal vein, (5) the superficial penile vein, or (6) the crura. Once venous access had been gained, selective venography was performed to clarify the relevant anatomy in each case. After catheterization, venoocclusion was produced by embolization with combinations of coils and Gelfoam, followed by sclerosant. Results to date indicate high feasibility of access by a variety of methods, and the safety of transluminal venoablation. Clinical efficacy to date seems only moderate. Eight of 13 patients report subjective improvement in the quality of erections after a mean follow-up period of 5.2 +/- 2.4 months. With regard to sexual activity, 2 patients are considered cured, 2 improved sufficiently for sexual intercourse, and 9 were insufficiently improved for intercourse. Of the nine failures, two were considered cures for 3 weeks, but then relapsed for unknown reasons. Two of the 4 patients that regained potency had concomittant unilateral or bilateral pudendal arterial occlusions. Technical modifications for improving results are under continuing investigation.

Adult↗
PubMedDate not supplied

Embolization of a mesenteric artery aneurysm: case report.

Gelfoam embolization of a jejunal artery branch aneurysm was performed using an open-ended guidewire. The outflow vessel was embolized first, followed by occlusion of the feeding artery, to exclude collateral filling.

Aneurysm↗
PubMed1986

Transcatheter treatment of myelomatous AV shunting causing high-output failure.

Intraarterial digital subtraction arteriography (DSA) was performed in a 39-year-old man with multiple myeloma, high-output congestive heart failure unresponsive to correction of anemia, and a pelvic bruit suspicious for an arteriovenous malformation. DSA revealed extensive neovascularity of all the visualized skeletal structures with rapid arteriovenous shunting in the pelvis. Temporary embolization of both hypogastric arteries with Gelfoam and autologous clot produced immediate and dramatic clinical relief of the shortness of breath, orthopnea, and hyperdynamic circulation. Following return of symptoms, repeat permanent occlusion with Ivalon and Gianturco coils produced minimal clinical response, but a decrease in cardiac output from approximately 23 L/min to 19 L/min. The etiology of congestive heart failure in myeloma, the implications of the use of intraarterial DSA, and the arteriographic findings in myeloma are discussed.

Adult↗
PubMedDate not supplied

Embolotherapy for small bowel hemorrhage from metastatic renal cell carcinoma: case report.

Embolization for control of hemorrhage in the small bowel carries a significant risk of bowel infarction. A case is presented where severe gastrointestinal hemorrhage from a hypervascular renal cell carcinoma metastasis to the jejunum was effectively controlled by superselective embolization of mesenteric tumor supply arteries with Gelfoam particles. Adjacent normal mesenteric arteries remained open. It is concluded that in specific instances where direct mesenteric feeders to a tumor can be catheterized, such embolization can be performed safely.

Aged↗
PubMedDate not supplied

Bronchial arteriography and embolotherapy for hemoptysis in patients with cystic fibrosis.

Bronchial arteriography and embolotherapy were performed to control hemoptysis in 11 patients with advanced stages of cystic fibrosis. Two patients suffered massive, 1 moderate, and 8 mild but recurrent hemoptysis. The embolization procedures were performed with Gelfoam, Ivalon, and coils in one to four separate procedures. Altogether, 19 of 20 procedures were successful, with follow-up periods ranging from 9 months to 8 years. No serious complications were encountered except for one femoral artery pseudoaneurysm which required surgical repair. Rapid digital subtraction angiography and "roadmapping" were considered helpful in avoiding the complication of reflux embolization and expediting the procedures. Bronchial embolization is a life-saving procedure for severe hemoptysis in patients with cystic fibrosis and is considered safe enough to include the indications of moderate and mild/recurrent hemoptysis to improve the quality of life in these patients.

Adolescent↗
PubMed1979

Effects of culture conditions on the synthesis of human chorionic gonadotropin by placental organ cultures.

Culture conditions for maintaining first trimester human placenta in organ culture, which enhance the secretion of human chorionic gonadotropin (hCG), are described. Nutrient medium, oxygen tension and Gelfoam support matrix influence the synthesis of hCG by these cultures. Placental tissue remained viable for the duration of experiments (12 days) as judged by the incorporation of tritiated thymidine into DNA and the lack of release of incorporated [125I]iododeoxyuridine. Optimal conditions for hCG synthesis in placental organ culture included an atmosphere of 95% air and 5% Co2 (approximately 20% O2), CMRL 1066 medium containing fetal human or bovine serum, insulin, hydrocortisone and retinal acetate. Multiple pieces of placenta could be cultured in the same dish with an additive effect on hCG secretion. The functional responsiveness of these placental cultures was demonstrated by modulation of hCG synthesis with theophylline and 3'5' dibutyryl cyclic AMP.

Bucladesine↗
PubMed1980

Visualization of cellular aggregates cultured on a three dimensional collagen sponge matrix.

A one-step vital stain is described for the macroscopic visualization of histotypic cell aggregates in fetal rat lung organotypic cultures. Organotypic cultures are incubated in 0.05%-0.1% 2,3,5'-triphenyl tetrazolium chloride (TTC) in culture medium (37 degrees C). Living cells reduce the tetrazole to a water-insoluble red colored formazan. Cell aggregates appear as densely stained foci against the lighter background of the Gelfoam substrate. Stained cultures may be scanned macroscopically to determine the degree of reaggregation and assess cell viability. Identification of aggregates by TTC staining improves the efficiency of tissue processing for electron microscopy and does not alter the ultrastructural appearance of the cultured cells.

Animals↗