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PubMed2004

Bronchoscopic closure of bronchopleural fistula using gelfoam.

Management of a persistent bronchopleural fistula (BPF) can be a therapeutic challenge. The etiological factors responsible for BPF include pulmonary tuberculosis, post-thoracic resection surgeries, trauma, malignancy, necrotising infections and rupture of lung abscess. The immediate management of BPF is drainage of the pleural cavity with insertion of an intercostal drainage tube. Patients with BPF may also require surgical intervention in the form of a wedge resection or lobectomy or muscle flap surgery. We report a case of a peripheral BPF secondary to a bacterial infection, which was successfully managed by the instillation of gelfoam via flexible bronchoscopy.

Bronchial Fistula↗

PubMedDate not supplied

[The effect of gelfoam embolism in vascular conduction and critical pressure in the isolated canine lobe].

Pulmonary pressure-flow curves, hemodynamic and blood gas parameters in West's zone II condition were obtained in nine isolated in situ left lower lobes (LLL) before (condition A), and after 15, 30 and 60 minutes of lobar gelfoam embolization (GE) (condition B) in order to know the natural history of this model. After GE a decrease in PaO2 and lobar O2 were noticed (p less than 0.05). Vascular conductance (p less than 0.001) and lobar blood flow decreased (p less than 0.05), accompanied by a significant increase in the inflow (p less than 0.01) and in the mean closing pressures (p less than 0.01). These parameters did not change during the time of observation at condition B. Nor the cardiac output or the minimal closing pressure changed in relation to condition A. LLL angiographic findings showed evidence of arterial occlusion and the pattern of obstruction was not homogeneous. Lobes histology showed occluded arteries of more than 300 micrometers of diameter. We concluded that in this canine model of increased pulmonary vascular resistance, pulmonary vascular conductance and mean closing pressure change, remain stable during 60 minutes after GE allowing us to know the natural history of the preparation. Condition than allow to perform and evaluate other interventions on lung vascular mechanics in the experimental setting of pulmonary embolization.

Animals↗

PubMed1985

Preoperative Gelfoam embolization of supratentorial meningiomas.

Intracranial meningiomas are often highly vascular and a successful outcome depends upon surgical resection. Preoperative embolization of supratentorial meningiomas, which have a major blood supply from the external carotid artery, has been advocated to reduce intraoperative bleeding and thus facilitate surgical extirpation. The authors carried out transfemoral, Gelfoam embolization preoperatively in eight patients with supratentorial meningiomas. In seven of the cases, post-embolization, contrast-enhanced, computerized tomography was carried out. Areas of low-density tumour necrosis were identified in five. In three of the eight patients, post-embolization angiography demonstrated elimination of the tumour blush and in the other five, the blush was reduced in intensity. Histologic evidence of tumour embolization was identified in each case to a varying degree. Preoperative embolization resulted in an identifiable radiologic change in the majority of these tumours, but the authors could not determine, in this small series, whether intraoperative bleeding was reduced.

Adult↗

PubMed1978

Clots, oxycel, gelfoam, barium, and cyanoacrylates in transcatheter embolization of rat kidney.

Transcatheter arterial embolization is an interesting technique; its usefulness in urology has not yet been well assessed. The properties and characteristics of some embolic materials among the more commonly used were investigated by means of a new experimental model, i.e., transcatheter embolization of rat kidney. Autologous clots and Oxycel were found to give a transient embolization, whereas Gelfoam, barium, and cyanoacrylates did not allow recanalization or revascularization. Only barium was found in venous vessels. The findings are discussed in view of the clinical application of the embolic materials considered.

Animals↗

PubMed1982

Gelfoam powder embolization of the hepatic artery in liver metastases of carcinoid tumors.

Five patients with liver metastases of carcinoid tumors were treated with transcatheter embolization of the liver arteries with gelfoam powder. In three of four patients with flushing symptoms, these symptoms disappeared immediately after the treatment. One patient remained free of symptoms for 6 months. Another patient was free of symptoms at 1-month control but 1 year later he again had slight symptoms. The third patient had slight recurring symptoms at 1-month control. Liver angiograms performed on four patients 1 month after the embolization showed recanalized arteries and reduced vascularity of the tumors.

Aged↗

PubMed1981

Characteristics of synthesis and distribution of 3H-fucose-containing glycoproteins by marrow stromal cells cocultured with hemopoeitic cells in gelfoam sponges. An electron microscope radioautographic study.

Gelfoam sponge cultures of stromal cells, derived from guinea pig marrow-depleted bone fragments, support the growth of myeloid precursors in the absence of exogenous stimulants. EM radioautographic studies were undertaken to identify active synthesis and distribution of 3H-fucose-containing glycoproteins within the 3-D organization of cultured hemopoietic tissue. Labeling of 5-14 day cultures with tritiated fucose for 20 min revealed an intracellular localization of silver grains over the endoplasmic reticulum and Golgi bodies of all stromal cells. Cumulative labeling (1-48 h) of similar cultures indicated that (i) silver grains subsequently accumulated in plasma membranes, large cytoplasmic granules and also within lipid droplets, (ii) primitive and myeloid cells were also labeled. Localized extracellular concentrations of silver grains were facilitated by the multiple inter-stromal cell contacts and by the accumulation of fine labeled cytoplasmic processes. Mechanisms whereby stromal cells may actively influence physiochemical changes in the hemopoietic inductive microenvironment are suggested.

Animals↗

PubMed1964