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At least 829 records · Page 46Linked to original sources
PubMed1977

Emergency embolization in blunt hepatic trauma.

The right hepatic artery in a patient with traumatic liver tear was embolized with Gelfoam to stop an otherwise uncontrollable hemorrhage. The procedure was probably life saving in this patient. Transient elevated transaminase and bilirubin levels returned to normal 3 weeks after embolization. A repeat hepatic arteriogram 4 months after embolization demonstrated good revascularization of the right hepatic lobe from the left hepatic, left gastric, and gastroduodenal arteries. This case demonstrates the therapeutic value and safety of selective hepatic arterial branch embolization in massive life-threatening hemorrhage.

Adolescent↗
PubMed1978

Isobutyl 2-cyanoacrylate (bucrylate) in obliteration of gastric coronary vein and esophageal varices.

Percutaneous transhepatic portography was performed in 22 patients with liver cirrhosis and portal hypertension. All patients had bled or were bleeding from presumed esophageal varices. One or more veins feeding esophageal varices were occluded with bucrylate. Follow-up examination in eight patients 1-12 months later showed recanalization of previously obliterated veins in six; however, these veins were markedly smaller than before the procedure. In patients where veins were still occluded, new veins had opened up and carried blood to the esophageal varices, which were filled to a lesser degree than before. In our experience, bucrylate is superior to Gelfoam, thrombin, and Etolein in producing venous occlusion.

Adult↗
PubMed1978

New technique for localization of therapeutic emboli using radionuclide labeling.

A sensitive method for localizing the resting place of catheter-injected therapeutic gelatin emboli is described. Surgical gelatin (Gelfoam) is labeled with 99mTc and each embolus observed on the persistence scope of a gamma camera after injection. This technique reduces the chance of obstructing blood vessels other than those intended. Two cases of embolization, one arterial and one venous, are illustrated.

Adult↗
PubMed1978

Pitfalls of transhepatic portal venography and therapeutic coronary vein occlusion.

Coronary vein occlusions via transhepatic portography for bleeding esophageal varices was attempted in 24 patients. Problems occurred that either prevented the attempt or resulted in less than adequate occlusion. These included blood flow in the left gastric (coronary) vein toward the liver due to occluded or stenotic splenorenal shunts, spontaneous left gastric vein to inferior vena cava shunts, and failure of powdered Gelfoam and heat-treated autogenous clot to cause permanent occlusion. Of 89 total transhepatic portographies, 65 for diagnosis and 24 for occlusion, major complications occurred in two.

Catheterization↗
PubMed1979

Pyloroduodenal bleeding and intraarterial vasopressin: clinical results.

Intraarterial vasopressin infusions were given to 46 patients with pyloroduodenal hemorrhage. Hemorrhage was angiographically and clinically controlled in 15 patients, with recurrent bleeding in five. Bleeding was not controlled in 31 patients; seven of these underwent Gelfoam embolization, with bleeding controlled in three. It is concluded that intraarterial vasopressin infusions are not as effective in controlling pyloroduodenal hemorrhage as in other areas of the gastrointestinal tract.

Adolescent↗
PubMed1979

Transhepatic obliteration of esophageal varices using the stainless steel coil.

Coronary veins in seven of eight patients with bleeding esophageal varices were successfully catheterized and embolized with Gelfoam followed by multiple steel coils. Bleeding immediately ceased in all seven, but recurred within 1 month in six. One had not rebled on 3 month follow-up. Therefore, steel coils do not prevent recurrent bleeding any more effectively than other embolic materials used for this purpose.

Catheterization↗
PubMed1981

Vascular occlusive agents.

The authors have reviewed the experimental literature about the different agents used for endovascular embolization: clots, tissues, duramater, Gelfoam, oxydized cellulose, Ivalon, beads, microspheres, cyanoacrylates, silicone, barium. Each occlusive agent was studied in regard to its physical properties, injection methods, characteristics of obstruction, vascular reaction, and toxicity. The level and quality of obstruction obtained depend on many factors which are discussed.

Animals↗
PubMed1981

Therapeutic embolization of the gastroduodenal artery in hepatic artery infusion chemotherapy.

Transcatheter embolization of the gastroduodenal artery with Gelfoam was performed in 12 patients undergoing percutaneous hepatic artery catheterization for infusion chemotherapy of metastatic liver disease. The purpose of the embolization was to prevent chemotherapeutic drugs from reaching the stomach and duodenum and thereby inducing gastrointestinal toxicity in patients in whom the catheter tip could not be satisfactorily positioned beyond the gastroduodenal origin. Embolization proved safe and effective in eight cases. Three other patients experienced clinical problems that may or may not have been related to embolization. The final patient had a significant complication (necrosis of the pancreatic head and gastric mucosa) that was felt to be directly related to the embolization. Transcatheter gastroduodenal occlusion may help reduce gastrointestinal toxicity of intraarterial infusion chemotherapy. However, it may on occasion be associated with significant complications, particularly in patients who are debilitated due to metastatic disease.

Adult↗
PubMed1982

Transcatheter embolization of abdominal aortic aneurysms.

Four patients are reported with unresected abdominal aortic aneurysms in whom axillary bifemoral bypass surgery was performed with subsequent transcatheter embolization of steel coils and Gelfoam. Three embolization procedures resulted in complete thrombosis of the abdominal aortic aneurysm and one resulted in partial thrombosis.

Aged↗
PubMed1984

Normal intraoperative spinal sonography.

The normal intraoperative sonographic features of the spinal canal, spinal cord, conus medullaris, and cauda equina are described and illustrated. Important observations concerning the normal spinal cord include its highly reflective dorsal and ventral surfaces, its uniform hypoechogenicity, and the presence of a central echo. Other easily identified structures within the spinal canal include the dura-arachnoid layer, subarachnoid space, denticulate ligament, dorsal arachnoid septations, and the roots of the cauda equina. In addition the sonographic appearance of commonly encountered iatrogenically introduced material including Gelfoam, Pantopaque, cottonoid pledgets, suture material, Harrington rods, and freeze-dried dura is also demonstrated. These normal images can serve as a baseline for the interpretation of various pathologic conditions of the spinal canal and its contents as seen with intraoperative spinal sonography.

Cauda Equina↗
PubMed1987

Pulmonary artery false aneurysms secondary to Swan-Ganz pulmonary artery catheters.

Several complications from the use of balloon-tipped flow-directed (Swan-Ganz) pulmonary artery catheters are recognized. One infrequent but life-threatening complication is false aneurysm formation associated with rupture or dissection of the pulmonary artery. We report 10 cases of catheter-induced pulmonary artery false aneurysms identified during a 9-year period. Initial presentation was radiologic in six patients and clinical (hemoptysis) in four. Later chest radiographic findings consisted of a well-defined, persistent pulmonary nodule or mass (three patients) or focal, dense parenchymal consolidation (six patients) that either persisted (two patients) or evolved into a nodule or mass (four patients) adjacent to the catheter tip. Cavitation of a pulmonary mass developed in one case. Two of eight deaths were caused by pulmonary artery false aneurysm formation and rupture with subsequent fatal hemorrhage. In one patient who survived, the false aneurysm was shown by pulmonary angiography and embolized with coils and Gelfoam. We conclude that pulmonary artery false aneurysms are life-threatening complications of pulmonary artery catheters and have characteristic chest radiographic findings.

Aged↗
PubMed1988

Arteriovenous malformations of the kidneys: ablation with alcohol.

Ablation of renal arteriovenous malformations with absolute alcohol was performed in seven patients with massive hematuria. In three patients, total occlusion of the malformations was accomplished by ablation of two arterial branches. In the remaining four patients, the malformations were partially occluded by ablation of one or two arterial branches. In addition to ablation with alcohol, two of the four patients underwent subselective embolization with Gelfoam (absorbable gelatin sponge) under epinephrine pharmacoangiography, which resulted in the disappearance of the remaining malformations. None of the patients had serious complications from ablation with alcohol, although dyspnea and headache occurred in one patient with marked arteriovenous shunting. During long-term follow-ups, hematuria disappeared in six patients. In the remaining patient hematuria recurred but did not require treatment. These data suggest that alcohol ablation is useful and safe in the treatment of renal arteriovenous malformations.

Adult↗
PubMed1988

Arterial embolization of adrenal tumors: results in nine cases.

Adrenal arterial embolization was performed in nine patients, four with inoperable adrenal cortical carcinoma and five with metastatic adrenal tumors. Embolic agents used were polyvinyl alcohol foam (Ivalon) in seven patients, stainless steel coils in four, ethanol in three, and surgical gelatin (Gelfoam) in two. In eight patients, embolization was performed for palliation, either to decrease tumor bulk (all patients), suppress tumor hormonal function (three patients), or relieve pain (four patients). One patient had an embolization to facilitate subsequent adrenalectomy. In four patients in whom it was possible to assess the effect of embolization on tumor bulk by follow-up CT, a striking reduction in size has occurred in one, the lesions remained stable in size for 12 months in two, and the tumor continued to increase in size in the fourth. A striking reduction in the production of the cortisol for 12 months was seen in two of three patients with Cushing syndrome. This reduction was considered due at least in part to embolization. Adrenal embolization resulted in effective palliation of pain in three of four patients and may have contributed to palliation in the fourth. Apart from a hypertensive episode in one patient, the cause of which was unclear, no serious side effects occurred. Adrenal arterial embolization may play an effective role without serious side effects in palliation of pain and reduction of hormone production in inoperable adrenal lesions.

Adrenal Gland Neoplasms↗
PubMed1998

Benign obstruction of the hepatic inferior vena cava complicated by hepatocellular carcinoma: combined interventional management.

OBJECTIVE: The risk of hepatocellular carcinoma is increased with benign obstruction of the hepatic inferior vena cava (IVC). The purpose of this study was to assess the usefulness of combined interventional treatment for benign obstruction of the hepatic IVC associated with hepatocellular carcinoma. MATERIALS AND METHODS: In a retrospective review of 51 patients with benign obstruction of the hepatic IVC, hepatocellular carcinoma was detected in 15 patients coincidentally or during the follow-up period. Obstruction of the IVC was treated with percutaneous transluminal balloon angioplasty in five patients and metallic stent placement in two patients. Immediate postprocedural and follow-up venacavography was performed to evaluate the effectiveness of this interventional management. Hepatocellular carcinomas were managed with transcatheter chemoembolization in all 15 patients using an emulsion of 3-12 ml of an iodized oil and 20-50 mg of doxorubicin hydrochloride. Gelfoam embolization was performed in three patients. Transcatheter chemoembolizations were repeated in seven patients. Initial response and long-term response to treatment were evaluated by monitoring the level of serum alpha-fetoprotein and by follow-up CT and angiography. RESULTS: During the follow-up period (1-8 years), the IVC was widely open except in one patient who developed moderate stenosis. Clinical symptoms of vena caval obstruction disappeared in all patients. After initial transcatheter chemoembolization, complete remission of the tumor occurred in six patients and partial remission occurred in seven patients. Five of the seven patients who underwent further chemoembolizations remained unchanged or in remission. CONCLUSION: Radiologic interventional treatment plays a significant role in managing both kinds of lesions in patients with benign obstruction of the hepatic IVC complicated by, hepatocellular carcinoma. A follow-up regimen should be designed to detect small hepatocellular carcinoma as early as possible after obstruction of the hepatic IVC is diagnosed.

Adult↗
PubMed1999

A comprehensive approach using MR imaging to diagnose acute segmental mesenteric ischemia in a porcine model.

OBJECTIVE: Acute mesenteric ischemia is a lethal disease that lacks a noninvasive diagnostic test. We evaluated the abilities of contrast-enhanced MR angiography, MR oximetry, and real-time interactive MR imaging to diagnose segmental mesenteric ischemia in a porcine model. MATERIALS AND METHODS: Segmental mesenteric ischemia was created by subselective Gelfoam embolization of the mesenteric circulation in eight pigs. Conventional digital subtraction angiography (DSA), MR oximetry, and real-time interactive MR imaging of the small bowel were performed before and after embolization. Changes in the perfusion pattern seen on DSA established the regions of true ischemia. Postembolization DSA and MR angiography were compared with this gold standard. RESULTS: Both MR angiography and DSA had high sensitivity (91% and 100%, respectively) for detecting ischemic regions. The difference was not statistically significant (p > .2). MR angiography yielded lower specificity than DSA (80% and 90%, respectively; p < .01). After embolization, the oxygen saturation in the superior mesenteric vein (SMV) dropped significantly (p < .005). After embolization, the SMV also showed oxygen saturation significantly lower than that in the inferior vena cava (p < .005). In two of the animals, segmental hypomotility of the small bowel was observed. CONCLUSION: MR oximetry is capable of detecting oxygen desaturation caused by segmental ischemia. A loss of oxygen saturation in the SMV relative to that in the inferior vena cava provides a convenient marker of mesenteric ischemia. Contrast-enhanced MR angiography has sensitivity and specificity approaching those of DSA. Both MR techniques hold promise for the detection of acute mesenteric ischemia.

Angiography, Digital Subtraction↗
PubMedDate not supplied

Clinical and experimental studies on the incorporation of materials applied as covering for the labyrinth window.

From among the materials used for covering the labyrinth window, of the foreign materials gelfoam proved ideal from clinical and experimental points of view, while of the materials of interstitial origin, fascia, perichondrium, and periosteum seem to be suitable for covering the labyrinth window, resp. for transplantations in the tympanic cavity.

Adipose Tissue↗
PubMedDate not supplied

The release of histamine from the pars flaccida mast cells one cause of otitis media with effusion?

In this experimental study in the rat, compound 48/80--a potent degranulating drug of mast cells--was instilled in the external auditory meatus towards the tympanic membrane. Moreover, effusion material was produced in the attic space by blocking the tympanic isthmus with a piece of Gelfoam applied through the tympanic bulla. Both these procedures caused a degranulation of the pars flaccida mast cells and subsequently histamine was detected in the rinsing fluid collected from the middle ear cavity. A possible direct cause of the effusion material in the middle ear cavity may be a degranulation of the pars flaccida mast cells, thus resembling an allergic reaction Type I.

Animals↗
PubMedDate not supplied

The site of initial production and transport of effusion materials in otitis media serosa. A study on rat middle ear cavity.

The aim of this experimental study was to localize the site of the initial production of effusion in the middle ear cavity. Via the tympanic bulla the passage between the lateral attic compartment and the rest of the middle ear (isthmus tympanicus) was blocked with Gelfoam and/or the Eustachian tube likewise with a polyethylene tube in both normal and sympathectomized rats. Effusion was thus produced in the attic, while concomitantly dilated vessels were seen in the pars flaccida, which after a couple of days gradually withdrew in a medial direction to form a retraction pocket. Sympathectomy did not prevent the production of effusion. The stream of effusion was nasal to the promontorium and the tensor tympani muscle. Its transport seems to be influenced by the ventilation through the tympanic tube.

Animals↗