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At least 271 records · Page 15Linked to original sources
PubMed1982

Experimental percutaneous renal embolization using BCG-saturated gelfoam.

Adult mongrel dogs (20-25 kg) were used to evaluate the administration of Bacillus Calmette-Guerin (BCG) in conjunction with total renal embolization for possible application in the management of metastatic renal cell carcinoma (RCC). Kidneys were surgically removed at 1, 2, and 3 weeks postembolization, examined grossly and microscopically, and then compared with kidneys embolized in the same manner without BCG. The procedure stimulated the reticuloendothelial system more than did renal embolization alone, and although a high dose (6 X 10(8) organisms) of BCG was administered, no complications were encountered. These results warrant a clinical trial of this technique in patients with advanced RCC.

Adenocarcinoma↗
PubMedDate not supplied

Transcatheter arterial embolization in unresectable hepatocellular carcinoma.

Seven hundred thirty-nine patients with unresectable hepatocellular carcinoma have been treated by transcatheter arterial chemoembolization using gelatin sponge particles soaked in a solution of Mitomycin C and Adriamycin. This therapy can be equal or superior to surgical resection and serves both as embolic therapy and targeted chemotherapy.

Antineoplastic Agents↗
PubMedDate not supplied

Transcatheter hepatic segmental arterial embolization using lipiodol mixed with an anticancer drug and Gelfoam particles for hepatocellular carcinoma.

Transcatheter hepatic segmental arterial chemoembolization using Lipiodol mixed with an anticancer drug followed by the injection of Gelfoam particles, introduced into the tumor-bearing hepatic segment as the target area (segmental Lipiodol-TAE), was carried out in 54 patients with hepatocellular carcinoma (HCC), 7 of whom were later resected. In 5 of the resected 7 cases, complete necrosis was histologically verified. No death due to HCC was encountered in 47 nonoperated cases, and better therapeutic results were obtained with segmental Lipiodol-TAE. It was concluded that this technique does not adversely affect normal tissues, and it does reinforce the effect of TAE.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Hepatic artery infusion and chemoembolization in the management of liver metastases.

Hepatic metastases rather than the primary neoplasm usually dictate the course of the disease and patient's survival. For unresectable disease, intraarterial infusion of chemotherapy, embolization, and chemoembolization are viable alternatives. Intraarterial therapy for hepatic metastases is based on the dual blood supply of the normal liver (portal vein, 75%, and hepatic artery, 25%) and that of the tumors (hepatic artery, 90%). Intraarterial infusion delivers a higher concentration of chemotherapy, whereas chemoembolization adds ischemia and increased contact time with the tumor. Selective vascular occlusion for infusion, redistribution of the blood supply and pulsatile flow enhance the delivery of therapeutic agents to the liver.

Antineoplastic Agents↗
PubMedDate not supplied

Arterial embolization in the management of liver metastases.

Hepatic arterial embolization has been shown to be a safe and effective method for the palliation of symptoms in patients with metastatic disease, particularly those with secondary deposits from endocrine tumors. This review examines the indications for the procedure, discusses some aspects of technique, and assesses the potential benefits and complications of the method.

Embolization, Therapeutic↗
PubMedDate not supplied

Expanding role of emergency embolization in the management of severe blunt hepatic trauma.

Emergency embolization using Gelfoam particles alone, or in combination with stainless steel coils or epinephrine, was attempted in 4 patients with severe blunt hepatic trauma complicated by hypovolemic shock to control exsanguinating hemorrhage. Angiography prior to embolization revealed extravasation in all cases. None of the patients rebled or required further intervention. Postembolization course was uneventful in each case. Embolization could become the treatment of choice for more unstable and complicated patients than previously considered.

Adult↗
PubMedDate not supplied

The biocompatibility of compressed collagen foam plugs.

The tissue reaction to reexpanded, purified bovine collagen sponge placed percutaneously into the lung, pleural space, liver, kidney, and muscle was studied in dogs and rabbits. In addition, the biocompatibility and radiopacity of tantalum-treated collagen foam plugs was examined. No adverse effects were found. We believe that collagen plugs may be of use in occluding needle tracts from biopsy sites to prevent complications such as bleeding or pneumothoraces.

Animals↗
PubMedDate not supplied

Transcatheter arterial chemoembolization with anticancer drug in iodized oil for primary hepatic carcinoma.

Transcatheter arterial chemoembolization using a suspension of anticancer drug in iodized oil combined with Gelfoam embolization was performed in 85 patients with advanced primary hepatic carcinoma. Long-term retention of iodized oil in the tumor was observed in 90% of the cases, and changes in tumor size were observable by abdominal X-ray film on follow-up studies. There was a decrease of tumor size in all cases and the overall 1-year survival rate was 43%. In tumors whose diameter was less than 20 cm and in patients without portal vein thrombosis the survival rate was nearly 60%. Combined treatment with anticancer drug in iodized oil and Gelfoam embolization of the proper hepatic artery was superior to use of the suspension alone. There was also better detection of small cancer nodules by the suspension as compared to conventional angiography.

Adult↗
PubMedDate not supplied

Hemobilia: transcatheter occlusive therapy and long-term follow-up.

Eight patients with life-threatening hemobilia were treated by percutaneous transcatheter occlusive therapy. The bleeding was caused by a traumatic pseudoaneurysm of the hepatic artery in 6 cases (auto accident in 4, surgery in 1, biliary drainage in 1) and a true aneurysm of the hepatic artery in 2 (unknown etiology in 1 and mycotic in 1). Arterial catheterization was used in all cases except for one in which a direct percutaneous puncture was performed. Gelfoam alone was used as embolic material in 3 patients. In 1 patient each, the material used was gelfoam plus coils, coils alone, blood clot, n-butyl-cyanoacrylate and an occluding balloon catheter. In all cases the bleeding stopped and did not recur during the follow-up period which ranged from 9 months to 14 years. This experience indicates that transcatheter occlusive therapy is an effective method for the treatment of severe hemobilia.

Adolescent↗
PubMed1986

Emphysematous cholecystitis: complication of hepatic artery embolization.

We report a case of acute emphysematous cholecystitis that occurred following hepatic artery embolization for hepatocellular carcinoma but was cured by conservative therapy. In view of its pathogenesis, emphysematous cholecystitis seems likely to be a complication of hepatic artery embolization.

Aged↗
PubMed1986

Embolization of the left gastric artery in the absence of angiographic extravasation.

Nine high-risk patients with endoscopic evidence of bleeding from the left gastric artery territory without angiographic extravasation were embolized to prevent rebleeding. Three were embolized with Gelfoam particles, 1 with Gianturco coils, and 5 with Gelfoam plus coils. Three patients rebled; 2 were embolized with Gelfoam only, and the third with coils only. No rebleeding occurred in the 5 patients treated with Gelfoam plus coils. No ischemic complications occurred. We conclude that embolization of the left gastric artery, despite absence of extravasation, is effective in preventing rebleeding in high-risk patients and that both Gelfoam and coils be used.

Adult↗
PubMed1987

Partial splenic embolization for painful splenomegaly.

Therapeutic splenic embolization has been commonly performed for hypersplenism, tumor palliation, and other indications, but has not been reported as a therapy specifically for pain relief. We describe 1 patient with chronic pain secondary to severe splenomegaly in whom surgery was contraindicated. Selective partial splenic embolization achieved a pain-free state for the patient without significant complications.

Adult↗
PubMedDate not supplied

Embolotherapy for small bowel hemorrhage from metastatic renal cell carcinoma: case report.

Embolization for control of hemorrhage in the small bowel carries a significant risk of bowel infarction. A case is presented where severe gastrointestinal hemorrhage from a hypervascular renal cell carcinoma metastasis to the jejunum was effectively controlled by superselective embolization of mesenteric tumor supply arteries with Gelfoam particles. Adjacent normal mesenteric arteries remained open. It is concluded that in specific instances where direct mesenteric feeders to a tumor can be catheterized, such embolization can be performed safely.

Aged↗
PubMedDate not supplied

Segmental embolotherapy for hepatic cancer: keys to success.

Transcatheter chemoembolization using Lipiodol (Lp) mixed with chemotherapeutic agents followed by Gelfoam particle injection only to the tumor-bearing hepatic segment (segmental Lp transcatheter hepatic artery embolization) (TAE) was applied to more than 100 patients with hepatocellular carcinoma and metastatic liver cancer. For segmental Lp-TAE, knowledge of the variations of intrahepatic arterial anatomy is important. Furthermore, the catheters and guidewires, volume of Lp, kinds and dose of chemotherapy, preparation of the mixture of Lp and chemotherapy (Lp-emulsion), method of injection of Lp-emulsion and Gelfoam particles, as well as the follow-up computed tomography examination are key items to the success of the procedure and are reviewed.

Antineoplastic Agents↗
PubMedDate not supplied

Postoperative recurrence of hepatocellular carcinoma: results of transcatheter arterial chemoembolization.

A retrospective analysis was made of the effect of transcatheter arterial chemoembolization (TACE) in 87 patients with recurrent hepatocellular carcinoma (HCC). In contrast to the predominantly single nodular HCC (60.2%) on preoperative angiography, recurrent HCC showed a multinodular pattern in 54.2%. Preoperative TACE had significantly prolonged the interval between surgery and recurrence. One- and 2-year survival rates after TACE of the 87 recurrent HCCs were 74.7% and 55.%, respectively, which were not significantly different from those of a control group of 206 patients with HCC in Child's class A, who were treated with TACE only. We believe that TACE is an effective measure in the management of preoperative and recurrent HCC.

Adolescent↗
PubMedDate not supplied

Effects of hepatic artery embolization with Lipiodol and gelatin sponge particles on normal swine liver.

In order to evaluate the effects of hepatic artery embolization (HAE) with Lipiodol (Lp) and gelatin sponge particles (GSP) on swine liver tissue, we embolized the hepatic arteries of 3 pigs with GSP, 9 with Lp, and 9 with Lp + GSP. None of the pigs embolized with GSP died spontaneously during the 4-week experimental period. One pig embolized with 1 ml/kg Lp and three pigs with 2 ml/kg Lp died within 2 h. Two pigs embolized with 0.5 ml/kg Lp + GSP died the following day. The portal vein pressure (PVP) and wedge hepatic vein pressure (WHVP) values before HAE, immediately after, 1 h after, and 4 weeks after HAE showed no remarkable change in the GSP group. Remarkable and temporary elevation was observed in the more than 0.2 ml/kg Lp group. Remarkable and continuous elevation was observed in the 0.2 ml/kg Lp + GSP and 0.5 ml/kg Lp + GSP groups. Gross and histological studies demonstrated no liver damage in the GSP and Lp group. Liver infarction, circular coagulation necrosis with pseudocapsule, and liver atrophy were found in the Lp + GSP group 4 weeks after HAE. The incidence of infarction, circular coagulation necrosis, and liver atrophy in the livers embolized with 0.2 ml/kg Lp + GSP and 0.5 ml/kg Lp + GSP were 67%, 100%, and 75%, respectively. In conclusion, when the hepatic artery is embolized with Lp + GSP, the volume of Lp should be limited to less than 0.1 ml/kg.

Animals↗