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Biomedical subjects

M M Rosenblatt

Publications and source records attributed to M M Rosenblatt.

4 recordsLinked to original sources
PubMed1997

Embolotherapy of large pulmonary arteriovenous malformations: long-term results.

BACKGROUND: The purpose of this study was to document the long-term results of transcatheter embolotherapy of large pulmonary arteriovenous malformations (PAVMs). METHODS: From a data base of 221 consecutive patients with PAVMs treated by embolotherapy between 1978 and 1995, 45 patients with 52 PAVMs, supplied by feeding arteries 8 mm in diameter or larger, were selected for a retrospective investigation. RESULTS: Of 45 patients with 52 large PAVMs, 38 patients (84%) with 44 PAVMs (85%) were cured by the first embolotherapy (mean follow-up, 4.7 years). Acute periprocedural complications included self-limited pleurisy (31%), angina secondary to air embolus (2%), and paradoxical embolization of a device during deployment (4%). None of these events led to short- or long-term sequelae. Seven patients (16%) had persistence of the PAVM attributable to either recanalization (n = 4) or interim accessory artery growth (n = 3). Two of these patients presented with ischemic stroke several years after the initial treatment. Persistent PAVMs (n = 8) were retreated successfully by a second procedure (n = 7), or a third procedure (n = 1) (mean follow-up, 5.9 and 5.3 years, respectively). CONCLUSIONS: Embolotherapy of large PAVMs results in permanent occlusion in an overwhelming majority of patients. Continued patency due to recanalization or accessory artery growth is easily detected and treated.

Adolescent↗
PubMed1994

Clinical results of transvenous systemic embolotherapy with a neuroradiologic detachable balloon.

PURPOSE: To evaluate the efficacy of transvenous systemic embolotherapy with a neuroradiologic detachable balloon. MATERIALS AND METHODS: As part of a clinical trial, a detachable silicone balloon was used to occlude pulmonary arteriovenous malformations (PAVMs) in 35 patients and varicocele in 14 patients. In patients with PAVM, the indications for embolotherapy were prophylaxis against paradoxic embolization (n = 35) and dyspnea, fatigue, or both (n = 26); in patients with varicocele, they were pain or a discomforting lesion (n = 8) or infertility (n = 6). RESULTS: Balloon embolotherapy was successful in 79 (98%) of the 81 lesions in which it was attempted; 29 (37%) of these 79 balloons were used in conjunction with coils. Ninety-six (97%) of 99 balloons were successfully placed; the three technical failures had no substantial clinical sequelae, and in all three, occlusion was eventually achieved with either detachable balloons or coils. Of six late deflations, five occurred in balloons placed adjacent to coils; only one, which occurred between 1 day and 21 days after placement, resulted in recanalization. CONCLUSION: Transvenous embolization with this detachable balloon was relatively simple and provided cross-sectional occlusion of PAVMs and varicocele.

Angiography, Digital Subtraction↗
PubMedDate not supplied

Treatment of ureteral obstructions with the Wallstent endoprosthesis: preliminary results.

PURPOSE: To evaluate the efficacy of the Wallstent endoprosthesis in the treatment of ureteral strictures. PATIENTS AND METHODS: Wallstents with diameters of 10 mm were placed across five malignant and six benign ureteral strictures in eight patients. All patients were believed to have poor surgical options, and their strictures were being maintained with catheter drainage. Ten lesions involved ureteroenteric anastomoses, and one malignancy involved the midureter. RESULTS: Three stents (two patients) across malignant disease remained patent until the time of patient death (3-5 months); the remaining two stents (one patient) became occluded within 1 month. Only one of six stents placed for benign disease remained patent at 11 months. All occlusions in benign strictures resulted from ingrowth of hyperplastic urothelium and granulation tissue. Complete obstruction was usually present only focally within the stent. The malignant occlusions were caused by tumor ingrowth and granulation tissue. No major complications were directly related to the stents, but two infections occurred. CONCLUSION: Wallstent endoprostheses are ineffective in providing long-term relief in patients with benign ureteroenteric strictures. Further evaluation of their role in malignant strictures is needed.

Adult↗