Embolization by superselective arteriography from the femoral route in neuroradiology. Review of 60 cases. 1. Technique, indications, complications.
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Angiography↗
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Results for “Gelatin Sponge, Absorbable”
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Experimental immune complex arteritis under embolization with gelatin sponge powder: a new model for induction.
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Animals↗
A pre-operative chemoembolization therapy using lipiodol, cisplatin and gelatin sponge for hepatocellular carcinoma.
The significance of pre-operative transcatheter arterial chemoembolization therapy using lipiodol, cisplatin and gelatin sponge (Gelfoam) for the prevention of the recurrence of hepatocellular carcinoma (HCC) was evaluated. On the 103 patients who underwent radical operations for HCC with a tumor size less than 10 cm, 52 patients received no pre-operative therapy (group C), and 51 patients received pre-operative chemoembolization using lipiodol, a chemotherapeutic agent and Gelfoam. Of these 51 patients, 37 patients received a combination of lipiodol, cisplatin and Gelfoam (group A), while the remaining 14 patients received lipiodol, adriamycin and Gelfoam (group B). The disease-free survival rates after surgery were compared between group A, group B and group C. The 2-year disease-free survival rates in group A, group B and group C were 72%, 46% and 54%, respectively. These rates therefore suggest that pre-operative chemoembolization using lipiodol, cisplatin and Gelfoam is a useful method to prevent the recurrence of HCC after surgery.
Adult↗
Localized intra- and retroperitoneal gas collections following intraoperative use of surgical gelatine sponge.
Following recent intra- or retroperitoneal surgery, four children in whom hemostasis was obtained by means of abundant use of surgical gelatine sponge, displayed unusual bubbly air collections in the region of the operation. Three of them had vague inflammatory symptoms and signs, while in the fourth the gas was discovered incidentally. The connection between the radiological finding and the hemostatic agent is presented. In the typical case manifesting a mild clinical course, knowledge of this association helps to guard against the diagnosis of abscess, and subsequent unnecessary reoperation can be avoided.
Child↗
Pancreatic tissue damage by transcatheter arterial embolization for hepatoma.
We analyzed the serial changes in serum pancreatic enzyme activities by transcatheter arterial embolization (TAE) in 20 hepatoma patients with liver cirrhosis in an attempt to evaluate the incidence of the pancreatic tissue damage by TAE. Serum amylase activities increased in two (10%) cases, elastase 1 levels in six (30%) cases, and trypsin and pancreatic secretory trypsin inhibitor (PSTI) levels in each of five (25%) cases. Consequently, TAE resulted in the elevation of at least more than one serum pancreatic enzyme in eight (40%) of 20 cases, although none had clinical symptoms related to pancreatitis. When the adverse effect on the pancreatic tissue was compared among 6 cases of the superselective TAE and 14 cases of the nonsuperselective TAE, which were performed from the segmental and the nonsegmental hepatic arteries, respectively, the elevation of serum pancreatic enzymes was caused only by nonsuperselective TAE, not by superselective TAE. The volumes of Spongel and Lipiodol used or the injected doses of the anticancer agent mitomycin C were not different between the two groups. These results indicate that TAE for the treatment of hepatoma frequently causes pancreatic tissue damage, and the position of the inserted catheter tip is very important to avoid the pancreatic tissue damage by TAE.
Adult↗
Hepatic infarction and gallbladder necrosis complicating arterial embolization for bleeding duodenal ulcer.
A case of severe duodenal hemorrhage in a septic renal allograft recipient is presented in which successful occlusion of the gastroduodenal artery by Gelfoam emboli also resulted in severe hepatic infarction and gallbladder necrosis. These complications were caused by reflux of emboli from the gastroduodenal artery into the distal branches of the hepatic artery.
Adult↗
Transcatheter embolization of hepatic arteriovenous fistulas for control of hemobilia.
Two cases of traumatic hemobilia are presented in which hemorrhage was controlled by transcatheter vascular occlusion with stainless steel coils. Embolic therapy was safely performed without liver necrosis, despite the presence of portal hypertension in 1 patient. The technique is a useful alternative to surgery, which did not control hemorrhage in 1 case.
Adult↗
Selective chemoembolization in the management of hepatic metastases in refractory colorectal carcinoma: a phase II trial.
PURPOSE: Metastatic involvement of the liver frequently determines the evolution of the clinical picture in colorectal cancer patients. We examined the efficacy and toxicity of chemoembolization in this setting, identifying prognostic factors to define patients most likely to benefit from the procedure. METHODS: Forty patients underwent chemoembolization of metastatic liver lesions from colorectal carcinoma. Selective angiography of the hepatic artery was performed to identify the feeding vessels of the metastatic lesions. The injected chemoemulsion consisted of 1,000 mg of 5-fluorouracil, 10 mg of mitomycin C, and 10 ml of ethiodized oil in a total volume of 30 ml. Gelfoam embolization then followed, until stagnation of blood flow was achieved. Patients were evaluated for response, overall survival, and toxicities. RESULTS: Overall median survival from date of first chemoembolization was ten months. Factors that predicted a longer median survival included favorable performance status (24 months), serum alkaline phosphatase and lactate dehydrogenase levels less than three times normal (24 and 12 months, respectively), and metastatic disease confined to the liver (14 months). Most patients tolerated the procedure well. The most common side effects were transient fevers, abdominal pain, and fatigue. Three patients died within one month from the procedure. CONCLUSION: This study suggests that chemoembolization of hepatic metastases in colorectal cancer should be further evaluated; it may be beneficial in patients who have failed systemic chemotherapy, have a good performance status, and have metastatic disease confined to the liver.
Abdominal Pain↗
Hemobilia--successful treatment by angiographic embolization.
Hemobilia after major liver trauma is a difficult problem to manage. We report a case of an 18-year-old male who sustained major liver trauma. Bleeding was controlled at laparotomy. Seventeen days after surgery hematemesis and intermittent bleeding from the drain occurred. Hepatic artery angiography demonstrated a pseudoaneurysm of one of the branches. Gelfoam embolization successfully controlled the bleeding. Review of the literature reveals that hemobilia has been treated by a conservative means as well as by surgery. Hepatic angiography to localize the site of bleeding and then embolization to control the hemorrhage now constitute the preferred method of treatment.
Adolescent↗
Localization of gelfoam emboli after partial splenic embolization utilizing 99mTc-labeled emboli.
Partial splenic embolization using 99mTc-labeled Gelfoam was employed to manage of four renal transplant patients with thrombocytopenia and leukopenia. In each patient the individual Gelfoam particles could be seen on the persistence scope of a gamma camera as they arrived in the spleen. This allowed the precise location of each Gelfoam particle to be defined immediately. Gamma camera imaging of the 99mTc Gelfoam particles in the spleen proved as accurate as selective splenic arteriography in determining the amount of spleen embolized. No ectopic 99mTc Gelfoam particles were found as judged by total body gamma camera imaging obtained immediately after the partial splenic embolization procedure was completed.
Adolescent↗
Embolization of bleeding transverse pancreatic artery aneurysms.
In patients with pancreatitis and blood loss, bleeding from visceral artery aneurysms should be suspected, especially in cases complicated by pseudocyst or abscess formation. We report of a patient with a transverse pancreatic artery aneurysm which was successfully embolized. In addition, decompression of the gastric varices associated with isolated splenic vein occlusion was performed successfully by Gelfoam embolization of 80% of the spleen.
Adult↗
Materials and methods for transcatheter vascular occlusion: some personal, practical views.
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Catheterization↗
The treatment of hyperparathyroidism by transcatheter techniques.
Gelfoam embolization of parathyroid adenomas causes temporary remission of hypercalcemia, but collateral circulation revascularizes the gland. Embolization with silicone permanently infarcts the gland, but is associated with all the risks of capillary bed occlusion. The staining of parathyroid adenomas with contrast material avoids the risks of particulate embolization and appears to produce permanent ablation. We carried out embolization or staining procedures in 14 parathyroid adenomas. In three of the four cases in which Gelfoam embolization was performed, hypercalcemia recurred within six months to two years; in the fourth case, in which persistent normocalcemia has been found, intense staining had been demonstrated before embolization. In eight of the remaining 10 cases, adequate staining was achieved, and normocalcemia has been maintained in all up to 36 months.
Adenoma↗
The treatment of hyperparathyroidism by transcatheter techniques: a surgeon's view.
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Contrast Media↗
Transhepatic embolization of varices.
Percutaneous transhepatic embolization of varices (PTEV) has proved to be effective in the control variceal bleeding, particularly in Child's Class C Category patients whose bleeding was not adequately controlled by pitressin perfusions. PTEV, using Gel-Foam soaked in sodium tetradecyl sulfate, controlled acute variceal bleeding in 71--95% of patients and appears to be more effective as an embolizing agent than bucrylate, which controlled 43--57%. Considering the poor condition of the patients particularly during acute bleeding episodes, PTEV is a relatively safe therapeutic procedure that buys time for the surgeons to perform a decompressive shunt electively as definitive surgery. A one-year recurrent bleeding rate of 30% and a two year recurrence of 37.5% was noted. Thus, for long term control of variceal bleeding, a surgical decompressive shunt is recommended in addition to PTEV.
Catheterization↗
Embolization of glomus tumors of the carotid: temporary or definitive?
The authors describe the use of preoperative embolization of glomus tumors in 7 patients. In two cases a nonresorbable substance (IBCA) was used for the embolization, and no subsequent operation was needed. They therefore suggest that embolization could be a definitive treatment and an alternative to surgery.
Adult↗
Blood supply of experimental liver tumors after intraarterial embolization with gelfoam powder and absolute ethanol.
Twenty rats with implanted liver tumor were studied. Following baseline angiography, the hepatic artery was embolized with Gelfoam powder or ethanol (n = 12) while the controls (n = 8) did not undergo embolization. Postmortem Microfil perfusion was performed in all livers. Filling of tumor lakes from the portal vein was seen more often in embolized animals than in controls, indicating the potential role of the portal venous system in the supply of dearterialized hepatic tumors. We discuss the possible clinical implication of our results.
Animals↗
Selective arterial embolization of idiopathic priapism.
We report a case of idiopathic priapism that was only identified as high-flow or arterial priapism after drainage of the corpora cavernosa. Following failure of conservative and surgical treatment attempts, two consecutive embolizations of a unilateral penile artery were performed with gelgoam particles.
Adult↗