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Biomedical subjects

R Uflacker

Publications and source records attributed to R Uflacker.

At least 37 records · Page 2Linked to original sources
PubMed1988

Embolization to reverse severe recurrent hepatic encephalopathy.

Five patients with porto-systemic shunts, four spontaneous and one surgically created, presenting severe recurrent hepatic encephalopathy rebel to clinical treatment were angiographically examined. A spontaneous splenic-renal veins shunt was observed in four cases and a mesocaval shunt was identified in the remaining patient. Two thirds embolization of the spleen was able to control hepatic encephalopathy in two patients. Percutaneous transhepatic portography and selective embolization of the shunt was performed in two other patients with good results. Percutaneous transcaval embolization of the mesocaval shunt succeeded to control hepatic encephalopathy in the remaining patient. Splenic embolization is able to control hepatic encephalopathy in patients with splenomegaly and spontaneous porto-systemic shunt. Direct embolization of the shunt is also able to control hepatic encephalopathy as should be expected.

Aged↗
PubMed1987

Chronic portosystemic encephalopathy: embolization of portosystemic shunts.

Operative ligation of portosystemic shunts is effective in controlling chronic portosystemic encephalopathy (CPSE) but is associated with significant mortality. Review of the records of five patients with CPSE treated with radiologic occlusion procedures showed that these are suitable alternatives to surgery. Three patients had alcoholic cirrhosis, one had hepatic fibrosis from schistosomiasis, and one had post-necrotic cirrhosis. All had CPSE with progressive, severe cerebral impairment refractory to clinical treatment. Four patients had a spontaneous splenorenal shunt, and one had a surgically created mesocaval shunt (MCS). Partial splenic embolization was performed in two patients, direct shunt embolization was performed via percutaneous transhepatic portography in two other patients, and an MCS embolization was performed in one patient through the inferior vena cava. In four patients embolization controlled the CPSE. In the remaining patient it could not be evaluated because of his premature death from intraabdominal bleeding, a late complication of the procedure. Interventional radiologic procedures are effective in the control of CPSE in selected patients.

Chronic Disease↗
PubMed1986

Carotid-cavernous fistulas: embolization through the superior ophthalmic vein approach.

Five patients aged 17-33 years with traumatic carotid-cavernous fistulas (CCFs) were treated by antegrade embolization through a superior ophthalmic vein approach, using cutdown technique on the upper eyelid. CCFs had recurred after prior treatment by multivessel ligation in three patients. Embolization through the ophthalmic vein resulted in long-term cure in three patients. The remaining patients were successfully treated by embolization through the arterial approach after failure of the ophthalmic vein technique. This is a new and rewarding technique to treat patients with CCFs, especially when there has been carotid ligation, provided the ophthalmic vein is thickened and arterialized.

Adolescent↗
PubMed1986

Intravascular foreign bodies: percutaneous retrieval.

Percutaneous retrieval of an intravascular foreign body was performed in 20 patients. There were 14 through-the-needle intravenous catheter fragments. In four patients the embolized foreign body was a broken diagnostic catheter. One patient had a ventriculovenous broken catheter and another patient had a bullet in the pulmonary circulation. Eight foreign bodies were located in the superior vena cava, six in the pulmonary artery, two in the right side of the heart, one in the subclavian vein, one in the thoracic aorta, and two in the aortoiliac segment. Percutaneous retrieval was successful in 95% of the attempts. In one case the procedure was performed to dislodge the foreign body into a better position for surgical retrieval.

Adolescent↗
PubMed1986

Transcatheter embolisation of arterial aneurysms.

Eleven cases of bleeding aneurysms and pseudoaneurysms, with and without arterio-venous fistula, involving different vascular territories were treated by transcatheter embolisation and the results are reported. Gelfoam was used in two cases and steel coils in the remaining nine cases. Embolisation by the steel-coil technique proved to be very efficient. The experience in these 11 cases shows that it is usually not necessary to embolize the aneurysm cavity but simply to occlude the feeding proximal vessel, consequently sparing the weak aneurysmic wall the risk of rupture and allowing the aneurysms to clot as a result of reduced or occluded blood flow.

Adolescent↗
PubMed1985

Treatment of portal vein obstruction by percutaneous transhepatic angioplasty.

A case of extrahepatic portal hypertension and gastric variceal bleeding due to portal vein occlusion, most probably secondary to chronic pancreatitis, was treated by percutaneous transhepatic angioplasty. After the portal angioplasty there was marked clinical improvement, with control of the variceal bleeding and significant reduction of the pressure gradient within the portal system.

Angioplasty, Balloon↗
PubMed1985

Bronchial artery embolization in the management of hemoptysis: technical aspects and long-term results.

Seventy-five patients with hemoptysis were treated with bronchial artery embolization (BAE). The procedure was performed with Hexabrix (sodium methylglucamine ioxaglate), Mikaelson catheters, and Gelfoam particles. Angiographic evaluation of the bronchial artery anatomy revealed ten different configurations, which are described. The embolization attempt failed in three cases (4%); eight additional patients (10.7%) were excluded from the series because of inadequate data. In the remaining 64 patients, 41 underwent BAE alone and 23 underwent either chemotherapy or surgery in addition to embolization. Immediate control of hemoptysis was achieved in 49 of 64 patients (76.6%). Long-term control of hemoptysis was achieved in 46 of the 56 patients included in the long-term follow-up (82.1%). Eight of the 64 patients were lost to follow-up, which ranged from one to 47 months (mean 24.8 months). Hemoptysis recurred in 12 of 56 patients (severe in 10, mild in 2) (21.4%). Twelve patients died (21.4%), five of them due to hemoptysis (8.9%). None of the patients who died of hemoptysis had responded to initial BAE. It is concluded that BAE is an effective treatment for immediate control of life-threatening hemoptysis, allowing long-term control of bleeding in the majority of patients.

Adult↗
PubMed1984

Management of traumatic hematuria by selective renal artery embolization.

Angiography and selective renal arterial embolization were performed in 17 patients with traumatic lesions of the kidney and hematuria. Of the patients 8 had retroperitoneal extravasation of contrast medium owing to rupture, 6 had traumatic arteriovenous fistulas and 5 had pseudoaneurysms. Immediate control of hemorrhage was achieved in 16 patients (94.1 per cent), while delayed control was obtained in 1. Hematuria recurred in 4 of the 17 patients (23.5 per cent) and resulted in total nephrectomy in 3 (17.6 per cent) despite repeated embolization in 2. Embolization alone was successful in 14 patients (82.4 per cent). According to the followup preservation of renal function and viable parenchyma was excellent in all embolized patients. Our results indicate that transcatheter embolization should be performed in patients with renal trauma and uncontrollable hematuria before any surgical attempt is made.

Adolescent↗
PubMed1983

Percutaneous transhepatic obliteration of gastroesophageal varices using absolute alcohol.

Eleven patients underwent percutaneous transhepatic portography and esophageal variceal sclerosis. Absolute alcohol was used. Only two patients rebled in the follow-up period; both individuals died. Two additional patients died without further bleeding. The remaining seven patients survived from 13 to 19 months without rebleeding. Absolute alcohol is useful as a sclerosing agent for varices and may produce a more permanent and distal occlusion of gastroesophageal varices.

Adult↗
PubMed1983

Management of massive hemoptysis by bronchial artery embolization.

Massive hemoptysis is a major clinical and surgical problem with a mortality of 80%, which is most often related to asphyxiation. Thirty-three patients with massive hemoptysis underwent selective bronchial arteriography and treatment by embolization or surgery. Lasting control of hemoptysis was achieved in 27 of 33 patients (81.8%) at follow-up ranging from one to 24 months. Hemoptysis recurred in six of 33 patients (18.2%). Mortality related to hemoptysis was three of 33 patients (9.0%), and overall mortality was six of 33 patients (18.2%). Seven patients underwent surgical treatment in addition to bronchial artery embolization. Patients with mycetoma suffered the highest relapse of bleeding and the highest mortality in this series. In these patients, bronchial artery embolization may be effective in the control of acute bleeding, but permanent control of hemoptysis is achieved only by later surgery. Bronchial artery embolization is an effective way to control massive hemoptysis with a low recurrence rate and reduced mortality among severely ill patients. Although we have had no unfavorable sequelae, reports of neurological damage following bronchial angiography indicate care in avoiding obstruction of the artery of Adamkiewicz.

Adult↗
PubMed1981

Angiography in primary myomas of the alimentary tract.

Fifteen cases of smooth muscle tumor of the alimentary tract were collected for analysis from several institutions. The findings showed that angiography is the best method available for diagnosis and evaluation of such tumors but is unable to differentiate benign from malignant lesions unless arterial invasion is detected. Computer tomography, ultrasound, and angiography are compared in the diagnosis of one case. Additionally, the angiographic pattern of a leiomyoblastoma is presented, presumably for the first time.

Adult↗
PubMed1980

Resolution of mesenteric angina with percutaneous transluminal angioplasty of a superior mesenteric artery stenosis using a balloon catheter.

A case of resolution of mesenteric angina is reported with percutaneous transluminal angioplasty of a superior mesenteric artery stenosis, using the Grüntzig technique with a balloon catheter. Technical aspects are described. Short-term follow-up reveals symptomatic relief, disappearance of the abdominal bruit, and normalization of d-xylose absorption.

Angina Pectoris↗