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At least 1,315 records · Page 73Linked to original sources
PubMed1995

[Experimental study on embolic materials for simultaneous segmental embolization through transarterial route].

To determine suitable embolic materials for simultaneous arterioportal embolization through the arterial route, transcatheter arterial embolization (TAE) using iodized oil (Lipiodol) mixed with monomeric n-butyl-2-cyanoacrylate, with absolute ethanol, or mixed with Gelfoam powder was carried out in 14 dogs. Following TAE, the distribution of Lipiodol in hepatic artery, peribiliary plexus, and portal vein was analyzed by soft tissue x-ray radiography and en bloc silver impregnation. As a result, Lipiodol mixed with absolute ethanol, and Gelfoam powder was considered to be the most reasonable embolic materials for this purpose.

Animals↗
PubMed1996

Evaluation of efficient chemoembolization mixtures by magnetic resonance imaging therapy monitoring: an experimental study on the VX2 tumor in the rabbit liver.

To find effective chemoembolization mixtures, we tested combinations of carboplatin with the embolizates Spherex and Gelfoam in comparison to a therapy with NaCl-solution, a treatment with the cytostatic drug only, and a therapy with each of the embolizates alone. The experiments were carried out using as a model the VX2 tumor in the liver of male chinchilla rabbits (five for each group). Carboplatin was revealed by the 3-(4,5-dimethylthiazole-2)-yl-2,5-diphenyltetrazolium bromide test to be a potent cytostatic drug for VX2 rabbit tumor cells. We used magnetic resonance imaging to examine the tumor volume and signal intensity enhancement up to 15 min after Gd-DTPA administration within the tumor and liver before and after the different therapies. These parameters allowed us to evaluate tumor growth and vitality as well as liver injury for the different therapy types. The results found by magnetic resonance imaging corresponded very well to those obtained by histological analysis of the tumors. The chemoembolization therapies were significantly more efficient than the other therapies, as indicated by the reduction of signal intensity enhancement after contrast agent administration within the tumor and by the histologically determined necrotic fraction after therapy. In addition, we found a significant decrease of the tumor volume and no significant live injury for a therapy with Carboplat and Gelfoam.

Animals↗
PubMed1996

Initial experience with the use of preoperative transarterial chemoembolization in the treatment of liver metastasis.

We retrospectively evaluated the influence of preoperative Transarterial Chemoembolization (TAE) on technique and complications, tumour histology, and disease-free survival after surgery for hepatic metastasis. In a 2-year period, a total of 23 patients were treated. In a first group of 14 patients, preoperative TAE was performed; in a second group of 9 patients only surgical resection was done. Extensive tumour necrosis was seen in the majority of patients treated with TAE; in tumours with an important fibrotic component, embolization was less effective. No significant effect was seen on operating time, transfusion requirement or perioperative complication rate. In the group of patients who underwent TAE, survival rate was 93% after a mean follow-up period of 15.5 months (SD: 12.5); recurrence was seen in only 8% of the survivors. In the second group, however, mortality was 33% after a median follow-up of 17.5 months (SD: 10), and recurrence was present in 66.7% of the survivors. These results indicate that preoperative TAE reduces the recurrence rate in the first postoperative year. Thereby survival may be improved in patients with resectable metastatic liver cancer.

Antineoplastic Agents↗
PubMed1996

Interventional radiology in the treatment of blunt liver trauma: case report with review of literature.

Hepatic trauma remains one of the most serious problems in abdominal injury. Whenever possible a non-resectional approach is clearly preferred. Refinements of interventional radiology as an adjunct to surgery in blunt liver trauma may play an increasingly vital role in reducing mortality. The literature is reviewed with reference to the diagnostic procedure and the treatment strategy in blunt liver trauma.

Adult↗
PubMed1996

FDG-PET evaluation of therapeutic effects on VX2 liver tumor.

UNLABELLED: Transplanted VX2 liver tumor in the rabbit is an experimental liver tumor model in which 18F-2-fluoro-2-deoxy-D-glucose (FDG) accumulates to a 3.5-fold level that surrounds normal liver tissue. In this study, changes in FDG uptake were assessed in this liver tumor model after transcatheter arterial embolization (TAE) and radiotherapy. METHODS: Fifteen rabbits bearing VX2 liver tumors were treated with TAE with gelatin sponges 1 day before the FDG study, and 18 rabbits received local irradiation with electron beams at a dose of 12-36 Gy 1-10 days before the FDG study. In the FDG study, serial arterial blood sampling was performed to determine arterial input (AI), and 1 hr after tracer injection, normal liver tissue and tumor tissue were excised to measure radioactivity. The tumor FDG level per AI and the tumor-to-normal liver ratio were assessed. Dynamic PET images were obtained in 20 of the 46 rabbits. RESULTS: Tumor FDG uptake was significantly decreased 1 day after TAE (from 3.54 to 0.83 in the tumor-to-normal liver ratio) and 5 days after 30 Gy of irradiation (from 3.54 to 1.28). The decrease in tumor FDG uptake was dose-dependent, especially in the relatively low dose range (12-24 Gy). The untreated tumors could be clearly distinguished from the surrounding normal liver tissue, while the embolized tumors or the irradiated tumors were not clearly delineated. Histological analysis showed that the decrease in tumor FDG after treatment agreed well with the decrease in number of viable tumor cells. CONCLUSION: The VX2 liver tumor is an appropriate experimental tumor model for evaluating the change in FDG uptake in various therapeutic modalities. Moreover, the therapeutic effects can be assessed 1 day after TAE and 5 days after irradiation. Further clinical trials for the early evaluation of therapeutic effects on liver tumors using FDG-PET are warranted.

Animals↗
PubMedDate not supplied

Palliative chemoembolization of hepatocellular carcinoma with mitoxantrone, Lipiodol, and Gelfoam. A phase II study.

Transcatheter chemoembolization, in conjunction with various drugs, has been widely used for palliative treatment of hepatocellular carcinoma. A phase II study was carried out on mitoxantrone chemoembolization. High risk cirrhotic patients were excluded from this study. Fourteen mg/m2 mitoxantrone and up to 20 ml Lipiodol were injected, followed by Gelfoam embolization as indicated. Thirty-seven patients (33 with cirrhosis) were treated. Sixty-nine cycles were delivered, with mean (+/-SD) Lipiodol and emulsified mitoxantrone doses of 11.3+/-3.8 ml and 11.8+/-5.2 mg, respectively. Thirteen, 16, and 8 patients received one, two, and three cycles, respectively, with time intervals of 123+/-60 days. Thirty patients received Gelfoam embolization at the first cycle, 9 at the second and 4 at the third. No treatment-related deaths occurred. Complications were mild and transient, including nausea/vomiting in most cases, fever over 38 degrees C 67%, pain 74%, ascites 8%, jaundice 3%, bleeding 3%, pancreatitis 3%, myelosuppression 44%, diarrhea 5%. Treatment response rate was 49% (including 16% minor responses) with 16% early progressions. With a median follow-up of 12 months, the 12-month response duration and survival rates were 56% and 79% respectively. Transcatheter chemoembolization with mitoxantrone appears to be a promising method for the palliation of advanced hepatocellular carcinoma, and deserves to be evaluated in well controlled randomized studies.

Antineoplastic Agents↗
PubMed1996

[Portal embolization using lipiodol-gelatin sponge].

Gelatin sponge moistened with lipiodol was prepared for use in portal embolization to improve percutaneous transhepatic portal embolization as preoperative management of patients undergoing extensive liver resection. For one sheet of gelatin sponge (20 x 60 x 7mm)0.5ml of lipiodol was used. Five sheets cut to 2mm square pieces and mixed with physiological saline solution were injected into the right portal vein. This embolic material proved safer and more reliable than gelatin sponge mixed with water-soluble contrast medium, because it provided sufficient opacification to grasp the extent of embolization and prevented back flow.

Embolization, Therapeutic↗
PubMed1995

Gelfoam/Gelfilm patching following the removal of ventilation tubes.

A follow-up study to document the rate of tympanic membrane perforation following surgical removal of ventilation tubes with Gelfoam/Gelfilm patching in paediatric patients is presented. The initial study performed at The Hospital for Sick Children with no patching following ventilation tube removal had a perforation rate of 10.3%. This follow-up study used Gelfoam/Gelfilm patching of perforations at the time of ventilation tube removal performed between January 1993 and May 1994 at the same hospital. There was sufficient follow-up on 155 ears with (4.5%) documented perforations, a significant difference from the the no-patching technique.

Adolescent↗
PubMed1996

Direct intraoperative sclerotherapy of an aneurysmal bone cyst of the sphenoid.

A young boy presented with a symptomatic aneurysmal bone cyst of the left great wing of the sphenoid bone. Arterial embolization had failed to produce thrombosis, and the lesion could not be resected surgically. Direct intraoperative sclerotherapy resulted in immediate thrombosis of 80% of the volume of the vascular malformation with no progression of symptoms. Two years later, the symptoms had completely resolved, and CT scans showed total ossification of the lesion.

Arteriovenous Malformations↗
PubMed1996

Selective arterial embolization in the management of internal bleeding caused by trophoblastic diseases.

OBJECTIVE: To evaluate the efficacy and safety of selective arterial embolization in the management of internal bleeding caused by trophoblastic diseases. PATIENTS AND METHODS: Four patients with internal bleeding caused by trophoblastic diseases were diagnosed with arteriography and treated with selective arterial embolization as a life-saving measure. Effect of controlling bleeding was assessed by follow-up arteriogram and clinical observation. RESULTS: The embolization successfully controlled the bleeding in all patients. Operation time was short with a mean of 42 minutes. The shock was corrected dramatically. Fever and pain were common complications. CONCLUSION: Selective arterial embolization is a life-saving measure in the management of internal bleeding caused by trophoblastic diseases.

Adult↗
PubMed1996

[Oral surgical procedures during anticoagulant therapy].

Minor oral surgery, in patients being treated with anticoagulant therapy, constitutes a problem for the oral and maxillofacial surgeon. 77 patients getting coumarin underwent 168 oral surgical procedures (tooth extraction, apicoectomy, crown-lengthening, excision of lesions) without lowering the dose of anticoagulant. Local hemostasis was achieved in all cases by silk suture. For tooth extraction gelfoam was used as well. In 12 patients who presented with postoperative bleeding, it was controlled in all by gauze pressure with tranexamic acid and/or biologic glue and/or surgical splinting. Postoperative bleeding was not correlated with the international normalized ratio (INR), but with degree of local inflammation. The study shows that interruption of anticoagulant therapy in such cases is not justified, and the use of tranexamic acid or biological glue can control bleeding.

Adult↗
PubMed1996

[Arterial embolization in chronic hemorrhage from uterine neoplasms].

Transcatheter embolization of the internal iliac arteries because of chronic bleeding from unresectable carcinoma of the uterus was performed in 8 patients aged 36-67. Hemorrhage was brought under control in all cases by application of a spectrum of procedures: bilateral combined, distal and proximal occlusion using autoblood clots, Gelfoam, Ivalon and steel coils although there was one recurrence 5 months after treatment, no bleeding occurred during an 11 month-4 year follow-up. Trancatheter embolization proved effective in the management of chronic bleeding from unresectable carcinoma of the uterus.

Adult↗
PubMed1997

Grafting of cultured microglial cells into the lesioned spinal cord of adult rats enhances neurite outgrowth.

There is contrasting in vitro and in vivo evidence regarding glial cell involvement in central nervous system (CNS) regeneration. This study has investigated the histological events that follow implantation of either microglia, mixed microglia/astrocytes, or astrocytes into the injured adult rat spinal cord. We have conducted an immunohistochemical characterization of the cellular profiles within and neuritic extension into various grafts consisting of gelfoam (GF) matrices impregnated with cultured microglia and/or astrocytes. After 2-5 weeks, prominent neuritic growth was observed into OX-42-immunoreactive (IR) microglial implants. These grafts were infiltrated by numerous host cellular elements including microvasculature and Schwann cells, and they demonstrated conspicuous laminin IR. Often, the patterns for laminin and OX-42 IR in microglial grafts were overlapping, suggesting partial expression of laminin on transplanted microglial cells. Mixed grafts of microglia and astrocytes demonstrated presence of neurites and laminin-IR elements with similar intensity as microglial grafts, while astroglial implants showed the least amount of neurite ingrowth. Some control implants consisting of cell-free GF showed marginal in-growth of neurites in areas of infiltrating OX-42-IR host cells. Collectively, our findings support a neurite growth-promoting role of activated microglia and suggest that microglia may counteract mechanisms that inhibit CNS regeneration. It remains to be determined whether the observed neurite growth-promoting effects are mediated directly by grafted and/or endogenous microglia, or whether this occurs via the recruitment of host Schwann cells.

Animals↗
PubMed1996

Theoretic and experimental aspects of regional liver infusion.

Pharmacokinetic theory of hepatic arterial infusion chemotherapy predicts that parameters, such as hepatic blood flow, hepatic drug extraction, and extrahepatic drug clearance, may potentially be manipulated to enhance the selectivity of hepatic artery drug administration. In practice, diminution of hepatic blood flow through the use of degradable starch microspheres or gelatin sponge embolization has been accomplished and has improved drug selectivity. Likewise, augmentation of hepatic drug extraction improves the pharmacokinetic advantages of regional chemotherapy for liver tumors. Development of optimal hepatic infusion chemotherapy approaches can be undertaken rationally and in an expeditious fashion by applying pharmacokinetic principles to create innovative treatment regimens and by testing them in preclinical and phase I investigations.

Antineoplastic Agents↗
PubMed1996

Pharmacokinetic, angiographic, and histologic comparison of catheter-directed chemoembolization versus systemic chemotherapy in a canine model.

Chemotherapy with selective intraarterial embolization may promote sustained contact of the drug with the tumor and thus could be more effective in the treatment. In this phenomenon, pharmacokinetics of a drug such as mitomycin C (MMC) play a significant role in guiding the therapy. Therefore, we have compared the pharmacokinetics of MMC and assessed angiographic, morphologic, and histologic changes in the kidney following intravenous MMC versus renal artery infusion with and without embolization with embolic agents, Rhizoma Bletillae (RB) and Gelfoam (GF). Dogs randomly divided into four groups underwent selective infusion protocols. Blood samples from renal and common iliac veins were analyzed for MMC levels. Angiography and pathology were performed at 4 days. Intravenous MMC (IV-MMC) caused significantly lower renal vein MMC levels than intraarterial MMC (IA-MMC) and GF + MMC. RB + MMC produced the lowest MMC levels in both veins (p < 0.05). Common iliac MMC levels were not significantly different after IV-MMC, IA-MMC, or GF + MMC. Angiographic and histologic studies showed extensive bleeding, necrosis, and vasculitis with thrombosis of the target kidneys after RB + MMC, GF + MMC, or IA-MMC, but not IV-MMC. Selective Rhizoma Bletillae chemoembolization can decrease systemic levels of MMC. Gelfoam does not provide sustained local release of MMC or decrease systemic levels of MMC compared with intravenous infusion. Selective renal MMC infusion without an effective embolic agent does not reduce systemic levels compared with intravenous delivery.

Adjuvants, Pharmaceutic↗
PubMed1977

Percutaneous embolization for the management of hepatic artery aneurysms.

The significant mortality and morbidity of hepatic artery aneurysms indicate the need for new approaches to therapy. Seven cases of intrahepatic aneurysms diagnosed by percutaneous arteriography over a 7-yr period are discussed. Three patients were treated surgically and 4 by percutaneous embolization. The latter method appears to enjoy certain advantages and it may prove to be the treatment of choice for this often fatal condition.

Adolescent↗