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At least 685 records · Page 38Linked to original sources
PubMed1980

Transcatheter embolization of intrahepatic arterial aneurysms.

Four patients with intrahepatic arterial aneurysms were treated with transcatheter embolization. Two patients had multiple aneurysms, and two had single aneurysms; in two the aneurysms were post-traumatic, and in the other two they were mycotic. Either Gelfoam or isobutyl-2-cyanocrylate was used to occlude the hepatic artery branches. It is concluded that transcatheter embolization is a safe and effective method for the management of these aneurysms and can be used as an alternative to surgery.

Adult↗
PubMed1980

Hepatic arterial redistribution for intraarterial infusion of hepatic neoplasms.

An aberrant hepatic artery occurs in approximately half of the population. With increased use of selective intraarterial chemotheraphy for hepatic neoplasms, an aberrant artery becomes a significant obstacle. Occlusion of the artery was attempted to redistribute the entire hepatic arterial flow from multiple arteries to a single artery to facilitate the effect of infusion. There were six hepatic artery variations found in the ten patients evaluated for this study. The aberrant left hepatic artery was embolized in five patients, and a replaced right hepatic artery was embolized in six; one patient had embolization of two hepatic arteries. The standard embolization method used Gelfoam and a coil to achieve proximal occlusion of the hepatic artery. Redistribution of hepatic flow through intrahepatic collaterals was achieved in all cases.

Antineoplastic Agents↗
PubMed1980

Transcatheter gelfoam embolization in abdominal, retroperitoneal, and pelvic hemorrhage.

Clinical experience with Gelfoam embolization for arterial hemorrhage in 55 patients is described. This technique controlled hemorrhage in 51 patients (92.7%). Two patients (3.6%) died of complications related to embolization. Gelfoam can be a permanent occluding agent which does not require subselective catheter position for effectiveness and safety. The advantages of Gelfoam are its availability, low cost, the ease and speed with which it can be applied through conventional catheters, and its safety and effectiveness if properly applied. The data presented here, and those in the literature, indicate that transcatheter therapeutic embolization for arterial bleeding below the diaphragm is by far the safest and most effective method available.

Abdominal Injuries↗
PubMed1981

Therapeutic embolization of the renal artery with Gianturco coils: limitations and technical pitfalls.

The Gianturco coil, with or without Gelfoam, is particularly popular and effective in occluding renal arteries to control bleeding, devascularize tumors, close arteriovenous fistulas, and infarct kidneys in end-stage renal disease. However, without special precautions, successful embolization can suddenly be transformed into catastrophe. Representative reports of complications from medical centers across North America are used to illustrate the initial technical pitfalls of coil placement, as well as the more delayed complications that produce deviations from the usual postinfarction syndrome.

Abscess↗
PubMed1981

Gelatin sponge in therapeutic neuroradiology: a subject review.

Gelatin sponge (Gelfoam) has been used extensively in transcatheter vascular occlusions. Its main disadvantage has been its biodegradable characteristics. In the present era of multiple and various embolic agents, the use of Gelfoam in therapeutic transvascular embolization is reevaluated. Its use as microparticles to obtain occlusion at the precapillary or capillary level in neoplastic conditions, or as a temporary block to protect normal territory, and its use in the control of hemorrhage are discussed.

Embolization, Therapeutic↗
PubMed1981

Systemic embolization as a complication of transhepatic venography.

Many patients with cirrhosis and portal hypertension demonstrate a right-to-left shunt, caused by development of anastomoses connecting the high-pressure periesophageal veins with the low-pressure bronchial and/or pulmonary veins at the level of the pulmonary hili. These anastomoses from the pathway by which small Gelfoam particles injected into the coronary or short gastric veins may embolize the systemic arterial circulation. Such embolization could have serious consequences, but reports of such complications have not been found by the authors.

Adult↗
PubMed1982

Diagnostic and interventional angiography in acute gastrointestinal hemorrhage.

The use of vasopressin infusion or arterial embolization in the treatment of 87 patients with gastrointestinal hemorrhage is reviewed. A bleeding point was identified angiographically in 46 patients (53%), with a higher success rate in those with upper gastrointestinal hemorrhage (63%) than in those with lower (39%) gastrointestinal hemorrhage. Vasopressin infusion in 33 patients completely stopped hemorrhage in 14 and slowed hemorrhage pending surgery in another 5. Gelfoam embolization was successful as definitive therapy in 12 of 15 patients. Mortality as a result of hemorrhage or its sequelae was 40% in patients with upper gastrointestinal hemorrhage and 21% in those with lower gastrointestinal hemorrhage.

Acute Disease↗
PubMed1982

Angiographic diagnosis and treatment of hemobilia.

Hemobilia (bleeding from the biliary tract) may be secondary to trauma, inflammatory disorders, gallstones, or tumor. Although it used to be rare, it is becoming more frequent due to trauma, including iatrogenic causes. The etiology is established by selective angiography, which also facilitates embolic occlusion of the arterial branches supplying the lesion. Nonsurgical control is preferable to surgical management. Two cases are reported, emphasizing the etiologic and therapeutic aspects of interventional studies of the liver.

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↗
PubMed1983

Peripheral hepatic artery embolization for primary and secondary hepatic neoplasms.

Eighteen patients underwent peripheral arterial embolization with Gelfoam powder for treatment of primary or metastatic hepatic neoplasms. Except for two cases in which the patients could not undergo long-term arterial infusion, all cases were treatment failures from intravenous chemotherapy, intra-arterial chemotherapy, or, in some cases, intra-arterial chemotherapy plus radiation therapy. Fourteen patients had good symptomatic relief from the procedure. Four of these patients are alive at 3, 5, 6, and 18 months following the procedure. Four patients died within 2 weeks following embolization, three of progression of disease and one of aspiration pneumonia. Of the patients showing symptomatic relief, 10 died of progression of cancer 2 to 14 months following embolization, with a median survival of 5 months. Based on the results in this small group of patients, it would seem that transcatheter hepatic dearterialization is often successful palliative therapy in patients who are not responsive to traditional therapies. Because of the low procedural morbidity, transcatheter embolization is superior to surgical dearterialization.

Carcinoma, Hepatocellular↗
PubMed1983

Gallbladder infarction following hepatic transcatheter arterial embolization. Angiographic study.

Gallbladder infarction developing after transcatheter arterial embolization (TAE) in patients with malignant hepatic tumors was studied by comparing preoperative angiographic and postoperative macroscopic and histological findings. Eight patients demonstrated occlusion of the cystic artery or its branches by embolic materials on post-TAE angiograms. Surgery revealed infarction of the gallbladder in 6 patients; no infarction was noted in the other 2, although branches of the cystic artery were occluded on the post-TAE angiogram. Due to recanalization of the occluded artery, the infarcted area could be assessed only by follow-up angiography. No patient experienced perforation of the gallbladder as a result of infarction. The authors suggest that patients with post-TAE infarction of the gallbladder can be treated conservatively if they are kept under close observation.

Angiography↗
PubMed1983

Digital subtraction angiography: limitations for the detection of pulmonary embolism.

Perfusion lung scanning, magnification pulmonary arteriography, and digital subtraction angiography (DSA) were performed prior to and following Gelfoam embolization of selected pulmonary arteries in eight canines. The sites of embolization were identified in 75% of perfusion lung scans, in 93% of magnification pulmonary arteriograms, in 75% of arterial phase DSA studies, and 100% of parenchymal phase DSA examinations. With technological advances, DSA has the potential to become the examination of choice for the evaluation of patients suspected of having pulmonary emboli.

Angiography↗
PubMed1984

Gelfoam powder embolization of the left gastric artery in treatment of massive small-vessel gastric bleeding.

Gelfoam (gelatin foam) powder was used for embolization therapy of massive gastric bleeding from small vessels in 14 patients with severe underlying medical problems. Bleeding was controlled in 10 patients with lesions localized in areas supplied by the embolized left gastric artery. In four patients with concurrent lesions in other portions of the stomach, bleeding decreased only (3 patients) or did not respond to embolization (1 patient). Complications developed in 2 patients with compromised vascular supply of the stomach: superficial ischemic ulcers that healed, and a large ulcer that perforated and required surgery. Microscopic studies demonstrated Gelfoam powder penetration mostly into vessels 100 to 200 microns in diameter and only occasionally into smaller vessels 50 to 60 microns, with occlusion of approximately 10 to 15% of the vasculature. It is concluded that Gelfoam fragments are the primary embolic material to be used for occlusion of the left gastric artery. Use of Gelfoam powder should be limited to occasional patients who have only little chance of responding to Gelfoam fragment embolization. Potential candidates for Gelfoam powder embolization include patients with major coagulopathies and/or uremia who massively hemorrhage from small-vessel lesions localized in upper portions of the stomach, exhibit significant mucosal hypervascularity, and do not respond to selective vasopressin treatment. An uncompromised vascular supply of the stomach is a precondition of a safe left gastric artery embolization.

Adult↗
PubMed1985

Hepatocellular carcinoma detected by iodized oil. Use of anticancer agents.

Transcatheter arterial embolization (TAE) was performed in 97 patients with hepatocellular carcinoma. Ethiodol (iodized oil) containing an anticancer drug was infused via the hepatic artery followed by Gelfoam particles. The Ethiodol emulsion was selectively retained in the tumor vessels and also remained in the small daughter nodules that could not be detected by angiography or computed tomography (CT) prior to TAE. Ethiodol remained in the tumor for more than 1 year. Following TAE, main tumors and small daughter nodules appeared as areas of markedly high density on CT. In most patients there was a reduction in the tumor size following TAE, and serum alpha-fetoprotein levels were reduced in all patients whose initial levels had exceeded 400 ng/ml. This method is considered to be effective not only for treatment of hepatic tumor but also useful for evaluation of post-TAE changes in the tumor and diagnosis of small daughter nodules, due to the long-term accumulation of Ethiodol in tumor vessels.

Adult↗
PubMed1985

Absolute ethanol injection of the adrenal artery: hypertensive reaction.

Transcatheter injection of 0.4 ml of absolute ethanol into the adrenal artery was performed in three Rhesus monkeys. The injection produced a mean increase of 60 mmHg in systolic blood pressure and 50 mmHg in diastolic blood pressure within two minutes. Hypertension was accompanied by cardiac arrhythmias (two monkeys) and sinus tachycardia (one monkey). These changes were probably related to an acute catecholamine release. Embolization of the inferior phrenic artery with Gelfoam powder produced only a mild blood pressure elevation in three monkeys (6 mmHg systolic pressure and 10 mmHg diastolic pressure).

Adrenal Glands↗