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At least 325 records · Page 18Linked to original sources
PubMed1981

External carotid-cavernous fistula in an infant.

A 7-week-old infant developed a nontraumatic fistula of the external carotid artery and the cavernous sinus. Therapeutic embolization produced an uncomplicated clinical and angiographic cure. Treatment was prompted by the availability of new methods of treatment and our hope of preventing irreversible anatomic and visual sequelae.

Arteriovenous Fistula↗
PubMed1978

Gel foam embolization of a functioning pheochromocytoma.

For the first time, to our knowledge, a patient with a functioning pheochromocytoma was subjected to gel foam embolization for physiologic destruction of the tumor. The operation, 24 hours later, provided an uneventful anatomic removal of the infarcted tumor. Observation was considered as a possible alternative to surgical excision. Experience gained may allow testing of the validity of a nonoperative approach in selected cases.

Embolization, Therapeutic↗
PubMed1979

Selective embolization for control of gastrointestinal hemorrhage.

Transcatheter embolization using Gelfoam plugs or autologous clot is an alternative or adjunct to the conventional management of gastrointestinal hemorrhage. During a 12 month period we successfully treated 10 patients who had massive gastrointestinal hemorrhage with selective embolization; 6 patients had upper gastrointestinal hemorrhage and 4 had bleeding from the colon. Most of these patients were critically ill and were poor surgical candidates. Hemorrhage was controlled by selective catheterization of the bleeding vessel, followed by injection of Gelfoam pledgets. Since the procedure was accomplished with ease and prolonged hemostasis obtained, we recommend it for gastrointestinal hemorrhage, especially in patients who are poor surgical risks or are unresponsive to vasopressin infusion, or both. Operative intervention for the primary disease could subsequently be performed electively, if necessary, days or weeks after transcatheter embolization.

Adult↗
PubMed1980

Definitive treatment of selected vascular injuries and post-traumatic arteriovenous fistulas by arteriographic embolization.

Arteriographic embolization of carefully selected post-traumatic arteriovenous fistulas or bleeding vessels is a useful, safe alternative to direct surgical treatment, particularly in cases in which the involved vessel is not a critical artery and may be obliterated safely without fear of distal ischemia. The embolization procedure is readily accomplished at the time of diagnostic arteriography. It is ideally suited to treat lesions that are not readily accessible for surgical correction or in patients in whom surgery is thought to be too hazardous. The ease, efficacy and excellent long-term results achieved with arteriographic embolization and the lack of complications related to the procedure suggest that it should be used more frequently in treating carefully selected surgically accessible lesions.

Adolescent↗
PubMed1980

Management of post-traumatic vascular malformations of the liver by catheter embolization.

Trauma to the liver occasionally produces vascular malformations, usually pseudoaneurysms of the hepatic artery and sometimes arteriovenous fistulas. Hemorrhagic complications, usually in the form of hemobilia, can result, and portal hypertension is a late complication of an arterial-portal vein fistula. The true incidence of these post-traumatic lesions is apparently much higher than previously realized, and they can regress spontaneously. A case is presented in which both complications appeared simultaneously after a stab wound to the liver. Treatment using selective arterial catheterization and embolization with thrombogenic material was successful. The literature on the use of catheter embolization in hepatic trauma is reviewed. We suggest that catheter embolization be added to the standard therapeutic armamentarium for these lesions. Selective catheter embolization is suggested as the initial therapeutic maneuver in treating both of these lesions because of the relatively low morbidity, the great precision available in limiting the area of devascularization and the good expectation of success on the basis of the reported results of this technique in other traumatized organs, as well as the initially promising reports of its use in hepatic lesions. It should be considered at the time of diagnostic arteriography.

Adult↗
PubMed1980

Hepatic and splenic infarctions: complications of therapeutic transcatheter embolization.

Two cases are described in which therapeutic transcatheter Gelfoam embolization was complicated by fatal hepatic infarction in one patient and splenic infarction with abscess formation in another patient. These are unusual complications of this widely used therapeutic technique. The probable pathophysiology of these complications is discussed and suggestions for managing and avoiding them are made.

Abscess↗
PubMed1981

Transhepatic embolization in patients with acute variceal hemorrhage.

Control of acute variceal bleeding by transhepatic embolization was investigated in 14 patients with alcoholic liver disease. In these patients hemorrhage was unresponsive to general supportive measures, intravenous vasopressin and balloon tamponade. Embolization was performed using Gelfoam and a synthetic polymer, bucrylate. Acute hemorrhage was arrested in 86 percent of patients. Rebleeding after transhepatic embolization occurred in 35 percent of patients. There were three deaths from intraabdominal hemorrhage related directly to transhepatic embolization (21 percent). Six patients (43 percent) left the hospital alive. In a group of cirrhotic patients in whom transhepatic embolization was employed after traditional modes of therapy had failed to control variceal hemorrhage, mortality and rebleeding rates were high.

Bucrylate↗
PubMed1983

Evaluation of hemostatic agents in experimental splenic lacerations.

Avitene, Collastat, Gelfoam, and Surgicel were evaluated for their effectiveness in the control of hemorrhage from an experimental splenic laceration. Effectiveness was determined by measuring the amount of blood loss per kilogram of body weight until complete hemostasis was achieved and by determining mortality from hemorrhage. The study group in which Collastat, a collagen hemostatic sponge, was used had the smallest amount of blood loss. This group was also the only one with no deaths from breakthrough bleeding. The degrees of reaction in the spleens of the surviving animals 3 weeks after treatment were not significantly different when each of the various agents were compared. We believe that Collastat is the preferred topical hemostatic agent.

Animals↗
PubMed1992

Primary treatment of hepatocellular carcinoma by arterial chemoembolization.

Two hundred and ninety-one patients with hepatocellular carcinoma were treated by chemoembolization (CE), using ethiodized oil, doxorubicin, and a gelatin sponge. Patients with thrombosis of either the portal vein or a main branch were excluded. The mortality rate in the first 2 months after treatment was 7% in noncirrhotic patients, 2.8% in patients with class A cirrhosis, 8% in patients with class B cirrhosis, and 37% in patients with class C cirrhosis. The tumor diameter remained the same in 55.3% of patients, was reduced by up to 50% in 20% of the patients, was reduced by more than 50% in 7.3% of the patients, and almost completely disappeared in 1.8% of the patients. The diameter of the tumor increased in 15.6% of patients. Forty-three patients underwent a resection or transplantation after chemoembolization. Histologic examination of the specimens revealed significant necrosis of the tumor. The long-term survival rate at 2 years was 49% for class A cirrhotics, 29% for class B cirrhotics, and 9% for class C cirrhotics. Complications included cholecystitis (10%), vasculitis (14%), renal decompensation (13%), an increase in ascites (14%), and jaundice (12%). Chemoembolization is an effective and safe initial treatment for hepatocellular carcinoma. It is effective in producing tumor necrosis and reducing the size of the tumor. Improvement in survival was noted when patients who underwent chemoembolization were compared with an historical series of untreated patients, and resection and transplantation are kept as options.

Adolescent↗
PubMed1992

Endobronchial closure of a postpneumonectomy bronchopleural fistula.

Successful permanent endobronchial closure of a serious postpneumonectomy bronchopleural fistula is reported in a patient with a delayed diagnosis of Mycobacterium fortuitum-cheloni infection. Increasing experience, improved plugging agents, and a review of the literature suggest that in selected patients, this procedure can avoid complex repeat operations and reverse life-threatening situations. Although atypical mycobacterial infections occur with infrequency, they are difficult to treat and may lead, as in this patient, to a misdiagnosis. Operations on granulomatous tissues are prone to heal poorly, thus inviting tissue breakdown and chronic fistulas.

Bronchial Fistula↗
PubMed1993

Surgical damage stimulates proliferation of dopamine uptake sites in normal mouse brain.

To test the hypothesis that proliferation of host dopaminergic tissue in response to injury plays an important role in the response to intrastriatal grafting, we transplanted autologous adrenal medullary to striatum in normal C57-black mice and compared this procedure with transplantation of non-dopaminergic tissue (frontal cortex) or a non-cellular matrix (Gelfoam). [3H]Mazindol autoradiography revealed that all three protocols resulted in a marked proliferation of dopamine uptake sites 10 months after transplantation.

Adrenal Medulla↗