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At least 919 records · Page 51Linked to original sources
PubMed1999

Iatrogenic hemobilia: management with transarterial embolization using gelfoam particles.

Four patients with life threatening bleeding hemobilia from the hepatic artery were successfully treated with transarterial embolization with small gelfoam particles with no recurrence of bleeding on follow-up study. The iatragenic hemobilia occurred inadvertently during surgery in two patients, with liver biopsy in one patient and percutaneous transhepatic biliary drainage procedure in another patient. Transarterial embolization appears safe and may be regarded as a life-saving treatment for bleeding hemobilia.

Adult↗
PubMed1999

The effect of gelfilm in the prevention of fibrosis in the middle ear of the animal model.

HYPOTHESIS: Gelfilm offers protection against fibrosis in the middle ear when used in combination with Gelfoam. BACKGROUND: Gelfoam is used routinely as a support structure in the middle ear cleft when ossicular reconstruction and tympanic membrane grafts are performed. It has been recognized that fibrosis may occur in this setting if the middle ear mucosa is denuded. Materials have been used to protect the mucosa in an attempt to prevent scar bands, adhesions, and fibrosis and its potential detriment on hearing. These materials have included Teflon, Silastic, and Gelfilm. Concerns have arisen regarding this mode of therapy and its benefit. METHODS: This study looks at the effects of implanting Gelfoam independently and Gelfoam and Gelfilm concurrently in the bulla cavity of the Mongolian Gerbil. The temporal bones were harvested and evaluated histologically using hemotoxylin and eosin staining for fibrosis. RESULTS: Results demonstrated a decrease in the amount of fibrosis in the animals in which Gelfilm was used to protect the denuded mucosa. No evidence of fibroblast ingrowth or scar bands penetrating the Gelfilm was identified. CONCLUSION: These results suggest that Gelfoam can be used safely in the middle ear cleft to support ossicular prosthesis and tympanic membrane grafts when Gelfilm is used to protect denuded mucosa.

Animals↗
PubMed1999

Gelfoam as a barrier to prevent polymethylmethacrylate-induced thermal injury of the spinal cord: in vitro and in vivo studies in pigs.

Gelatin sponge (Gelfoam; Upjohn, Kalamazoo, MI, U.S.A.) is commonly used as an interpositional barrier to shield the spinal cord from thermal injury during vertebral reconstruction with polymethylmethacrylate bone cement. The aim of this study was to record epidural and intradural temperatures during polymethylmethacrylate reconstruction of vertebral corpectomy defects. Three surgical techniques (subtotal corpectomy, total corpectomy with insertion of a Gelfoam barrier, and total corpectomy with no barrier) were compared in vivo and in vitro in a porcine model. As expected, total corpectomy defects cemented without a Gelfoam barrier produced the highest epidural temperatures in vivo (52.8 degrees C) and in vitro (58 +/- 2 degrees C). The Gelfoam barrier provided some protection against heat transfer, but peak temperatures and absolute temperature increases were significantly higher than in defects with an intact posterior cortex (p < 0.05). These results indicate that an intact posterior cortex provides the best protection against heat transfer, whereas the use of a Gelfoam barrier appears to provide only partial protection against thermal injury.

Animals↗
PubMed1976

[Primary healing of intraoral bone defects under the effect of local and general antibacterial prophylaxis].

On the basis of 4,700 cases, experience is reported which has been gained over 15 years with a method developed in Tübingen for the primary filling of intraoral bone defects which are big and/or especially jeoplardized by infection. To find an optimum antibacterial prophylaxis for undisturbed primary healing, the operative removal of a lower wisdom tooth is used as an example to compare groups of cases in which either only local prophylaxis of additional general prophylaxis was applied. Comparison of the results with the findings of other authors shows that local implantation of antibacterial substances is superior to an exclusively antibiotic general therapy and that the best results may be expected by simultaneous implantation and general therapy. The findings also cast a light on the importance of exact technical skills in the treatment of wounds and on the considerable influence of the type of gelatine sponge on the stabilization of blood coagulation.

Administration, Topical↗
PubMedDate not supplied

Experimental and clinical studies on liver regeneration following transcatheter portal embolization.

BACKGROUND/AIMS: We studied compensatory hypertrophy following transcatheter portal embolization experimentally in dogs and clinically under the condition of cholestasis. METHODOLOGY: Experimental study: Sixteen dogs were used for this study. Transcatheter portal embolization was performed in the left lobes (70% of the total liver) using Gelfoam powder in dogs with 2-week obstructive jaundice. Liver weight, liver blood flow and the intracellular adenosine triphosphate content of isolated hepatocytes were measured after transcatheter portal embolization. Clinical Study: transcatheter portal embolization of the right portal branch was performed in 13 patients with cancer of the biliary tract and 3 patients with hepatocellular carcinoma before (extended) right lobectomy, using Gelfoam powder and thrombin. Six patients who had a total bilirubin level > 5 mg/dLunderwent a percutaneous transhepatic biliary drainage before transcatheter portal embolization. Liver function tests, a volumetric study with computed tomography and immunohistochemical staining for profilerating cell nuclear antigen and apoptosis in the resected livers were performed. RESULTS: Experimental study: The weight ratio of the non-embolized lobes to the total liver, 2 weeks after transcatheter portal embolization in the dogs with jaundice, was significantly lower than that of the normal dogs with transcatheter portal embolization (40.5 +/- 4.5% vs. 47.6 +/- 3.2%), but significantly larger than that of the dogs without transcatheter portal embolization. The cellular adenosine triphosphate content and tissue blood flow in the embolized lobes were significantly lower than those in the nonembolized lobes in the normal and cholestatic livers. Clinical study: The postoperative course in all patients was uneventful, with no serious complication or liver dysfunction. Extended right lobectomy with caudate lobectomy was equivalent to 65% before transcatheter portal embolization and to 56% after, transcatheter portal embolization owing to compensatory hypertrophy of the left lobe. However, there was no significant difference in liver volume in the patients with or without obstructive jaundice. Apoptosis was observed in the embolized lobe. CONCLUSIONS: Preoperative transcatheter portal embolization with percutaneous transhepatic biliary drainage for the purpose of liver regeneration would be useful for treating extended hepatectomy with obstructive jaundice.

Animals↗
PubMed1976

Comparison of a microcrystalline collagen preparation and gelatin foam in extraction wounds.

A microcrystalline collagen preparation and a gelatin foam were compared relative to their effects on hemostasis and healing in molar extraction sockets in cats. The agents were essentially equivalent in both hemostasis and the inflammatory response that accompanied healing. Healing was slightly retarded in comparison to that seen in untreated control sockets in a previous study. It appears likely that the inflammatory response was caused by oral contamination, which is unavoidable in this type of procedure, rather than by the agents themselves.

Alveolar Process↗
PubMed1975

Therapeutic transluminal arterial embolization for bleeding in the upper part of the gastrointestinal tract.

Diagnosis and the treatment of gastrointestinal bleeding by selective and superselective technique and the perfusion of vasopressors have been noted to have significant success. Transluminal embolization of a bleeding site represents an alternative method in patients who represent a poor operative risk and in those in whom vasopressor therapy has failed. The potential risks include intestinal ischemia and vary with the anatomic site.

Adult↗
PubMed1976

Selective arterial embolization in duodenal bleeding.

Severe, unremitting bleeding of the upper gastrointestinal tract could be controlled by Gelfoam embolization of the posterior pancreaticoduodenal artery. The technique and indications of the method are presented.

Catheterization↗
PubMed2000

Angiographic embolization of bilateral internal iliac arteries to control life-threatening hemorrhage after blunt trauma to the pelvis.

Angiographic embolization of bleeding pelvic vessels is increasingly used in patients with pelvic injuries. Temporary angiographic embolization of bilateral internal iliac arteries (TAEBIIA) is occasionally necessary. From November 1991 to March 1998, 30 consecutive patients (mean age of 43 years, mean Injury Severity Score of 25) with complex pelvic fractures underwent TAEBIIA to control severe hemorrhage not responding to subselective embolization. Angiography revealed multiple sources of pelvic bleeding in 28 (93%) patients. In the two remaining patients, no bleeding was identified but TAEBIIA was done empirically. Thirteen patients had laparotomies before TAEBIIA with unsuccessful bleeding control, and the remaining 17 had TAEBIIA as the primary treatment. After TAEBIIA 90 per cent of patients had successful clinical (27 of 30) and radiographic (25 of 28) control of bleeding. Of the three patients who continued to bleed after TAEBIIA two were successfully re-embolized and one died of acute cardiac failure before any further intervention was attempted. TAEBIIA had a success rate of 97 per cent (29 of 30) in controlling pelvic hemorrhage without significant complications related to it. TAEBIIA is a safe and effective alternative to subselective embolization in controlling retroperitoneal bleeding in selected patients with blunt pelvic trauma.

Adult↗
PubMed2000

Percutaneous obliteration of duodenal fistula.

High output external duodenal fistula is a difficult condition to treat and despite the advances in nutritional care, morbidity and mortality remain high. Although, non surgical methods (e.g. endoscopy, fistuloscopy and percutaneous injection of substances) have been reported sporadically in the treatment of enterocutaneous fistulae, gelfoam has not been tried. We present a case of duodenal fistula following blunt abdominal trauma which persisted for 14 weeks on conservative management. Percutaneous obliteration of the duodenal fistula was successfully performed using gelfoam injection through a catheter. This procedure is simple, safe and cheap and further experience may demonstrate that it is an easy and more practical tool in dealing with this problem.

Abdominal Injuries↗
PubMed1975

A comparative evaluation of Avitene and gelfoam for hemostasis in experimental canine prostatic wounds.

Microcrystalline collagen has been reported to be an effective hemostatic agent in brain, liver, kidney, etc. This experimental study in dogs and rats shows that microcrystalline collagen is a more effective hemostat in prostatic hemorrhage than is purified gelatin solution. No gross or histologic evidence of tissue damage or calcification was induced by microcrystalline collagen or purified gelatin solution. Wafers of microcrystalline collagen that are placed in rat bladders dissolve and do not induce calculogenesis.

Animals↗
PubMedDate not supplied

Superselective embolization for bleeding from duodenal diverticulum: a case report.

Duodenal diverticulum is a well-known pathological entity. The majority of patients with this condition are asymptomatic. Although hemorrhage has been described, it is an infrequent complication. We report a patient who presented with massive upper gastrointestinal bleeding with hypovolemic shock, originating from a duodenal diverticulum. The diagnosis was made by emergency angiography. Superselective arterial embolization was performed with a successful outcome. To the best of our knowledge, superselective embolization for hemorrhage originating from a duodenal diverticulum has not previously been described in the literature.

Angiography↗
PubMed2000

[Rapid production of gelatin sponge particles for transcatheter arterial embolization: pumping method].

We devised a simple "pumping" method to make gelatin sponge particles for transcatheter arterial embolization. As the frequency of pumping increased, the number of particles 0.2-1.6 mm in diameter increased, whereas no particles of more than 3.2 mm in diameter were present after 20 pumpings. After passing through the microcatheter, particles of less than 0.2 mm in diameter were relatively increased by about 10 points in both the pumping and cutting methods. It was histologically demonstrated that the size of embolized arteries corresponded well to the size of particles. These results suggest that our "pumping" method offers sufficient quality for transcatheter arterial embolization.

Animals↗
PubMed2001

Transcatheter therapy of intravisceral bleeding.

Intravisceral bleeding is a life-threatening situation demanding fast and active steps to control, unless it stops spontaneously as in a few lucky patients. A surgical approach is a major intervention with its associated procedural risks when the site is in organs other than the spleen. The transcatheter approach helps in precise location and embolization of the bleeding site; it is a more practical approach that has been known for the past 2 decades to be effective and provide good long-term results. However, the transcatheter approach has been reported in fewer than 200 cases in the literature. Our small series of 43 cases shows initial success of 95% and a fatal early recurrence of only 2.4%. Non-hemorrhagic etiology (sepsis, head injury, etc.) was the major cause of early death (14.6%) among the successfully embolized cases. Long-term follow-up shows recurrence (4.8%) only in the group of chronic etiology. Transcatheter embolization of intravisceral bleeding with Gel-Foam and/or poly-vinyl alcohol particles is a swift, effective and precise method of treatment without major operational hazards.

Embolization, Therapeutic↗
PubMed1998

[Embolotherapy of craniofacial tumors and vascular diseases: assessing the effect of different embolic agents].

To assess the effect of different embolic agents in curing craniofacial tumors and vascular diseases, 21 patients who were treated by intra-arterial embolization were divided into three groups: gelfoams, bletilla striatas and coils. The results showed that 8 cases of preoperative patients in gelfoams group had a good effect and bleeding were reduced during operation. One patient had vascular recanalization at 1 month after embolization with gelfoam. All patients in bletilla striatas had ideal effect. In coils group, collateral supplying arteries were found in 3 patients at once after embolization and the others had a good effect. In conclusion, craniofacial tumors and vascular diseases were fit to embolotherapy. The selection of embolic agents should be gelfoam in preoperative embolization and bletilla striata in palliative treatment There were not severe complications.

Adolescent↗