Transarterial Embolization in the Management of Intractable Haemorrhage

2020 ◽  
pp. 1-5
Author(s):  
Evi Comploj ◽  
Alexander Pycha ◽  
Emanuela Trenti ◽  
Salvatore Palermo ◽  
Matteo Bonatti ◽  
...  
Keyword(s):  
Clinical Success ◽  
Transarterial Embolization ◽  
Long Term Results ◽  
Haemorrhagic Cystitis ◽  
Median Hospital Stay ◽  
Radiation Induced ◽  
Additional Therapy ◽  
Continuous Bleeding

<b><i>Introduction:</i></b> The purpose of this study was to evaluate the effectiveness and long-term results of selective transarterial iliac embolization (STIE) in patients with intractable bladder haemorrhage (IBH). <b><i>Methods:</i></b> Twenty-five patients with a median age of 84 (range 65–94) years underwent STIE because of IBH between 2002 and 2020. The median follow-up time was 3 (mean 13.9) months. Patients were treated because of bleeding bladder or prostate cancer, radiation-induced haemorrhagic cystitis, and other conditions. Success was defined as technical success (feasibility to embolize bilateral hypogastric arteries or neoplastic arteries) and as clinical success (absence of further or additional therapy). <b><i>Results:</i></b> Twenty-five patients with a median age of 84 years with a median hospital stay of 7 days were embolized at our institution. In total, 60% required additional therapy. Only 20% had minor complications, but no complication major was seen; 60% needed an additional therapy because of continuous bleeding. Our 30-day, 90-day, 6-month, and 12-month mortality rates were 28, 44, 64, and 76%, respectively. <b><i>Conclusions:</i></b> STIE in IBH is a safe, well-tolerated, and feasible procedure for palliating haematuria patients in poor general condition. Major complications are very rarely seen. However, patients often need additional therapy after STIE.

scholarly journals Transarterial embolization for renal angiomyolipomas: A single centre experience in 79 patients

2017 ◽  
Vol 45 (2) ◽  
pp. 706-713 ◽  
Author(s):  
Chengen Wang ◽  
Min Yang ◽  
Xiaoqiang Tong ◽  
Jian Wang ◽  
Haitao Guan ◽  
...  
Keyword(s):  
Medical Records ◽  
Clinical Success ◽  
Tumour Size ◽  
Transarterial Embolization ◽  
Arterial Embolization ◽  
Success Rates ◽  
Single Centre Experience ◽  
Computed Tomography Scans

Objective To evaluate the long-term efficacy and safety of selective arterial embolization (SAE) in the treatment of renal angiomyolipomas (AMLs). Methods This was a retrospective review of medical records and imaging findings from patients with renal AMLs who attended our clinic and received SAE between January 2007 and January 2014. Only patents with complete medical records, preoperative computed tomography scans using typical imaging and follow-up data were included. Results A total of 79 patients were enrolled in the study. Technical and clinical success rates were 100% and 91% ( n = 72), respectively. Only two patients experienced major complications. Post-embolization syndrome (i.e. fever, abdominal pain, nausea or vomiting) was reported in 68 (86%) patients, but all symptoms were mild and resolved with conservative measures. Mean radiological and clinical follow-up periods were 16.8 and 35.9 months, respectively. In 75 (95%) patients, tumours decreased in size; mean ± SD tumour size significantly decreased from 8.4 ± 3.5 cm pre-embolization to 6.7 ± 3.0 cm post-embolization . Conclusions This study provides long-term evidence that SAE is a safe and effective method in the treatment of patients with renal AMLs.

scholarly journals The Coronal Tooth Fractures: Preliminary Evaluation of a Three-Year Follow-Up of the Anterior Teeth Direct Fragment Reattachment Technique Without Additional Preparation

2017 ◽  
Vol 11 (1) ◽  
pp. 266-275 ◽  
Author(s):  
Lo Giudice G ◽  
Alibrandi A. ◽  
Lipari F ◽  
Lizio A ◽  
Lauritano F ◽  
...  
Keyword(s):  
Clinical Success ◽  
Adhesive System ◽  
Resin Cement ◽  
Long Term Results ◽  
Preliminary Evaluation ◽  
Invasive Approach ◽  
Anterior Teeth ◽  
Tooth Preparation

Objective: The aim of this research is to describe and to analyse the long-term results and the clinical steps of direct fragment reattachment technique with no additional tooth preparation, used to treat crown fracture. This technique achieves the clinical success, combining satisfactory aesthetic and functional results with a minimally invasive approach. Methods: The 3 years follow-up included 9 patients (5 males, 4 females) with coronal fracture. In all the cases the fragment was available and intact. The authors illustrate the adhesive procedure used. Under local anaesthesia and after positioning the rubber dam, both the tooth and the fragment surface were etched, rinsed and applied by the adhesive system in order to obtain the retention of the fractured part to the tooth without additional tooth preparation or resin cement. Results: The statistical analysis shows the good performances of direct fragment reattachment technique. After 36 months, in 22.2% of the cases, the detachment was observed of the bonded fragment and in 11.1% of patients, complications were recorded. Conclusion: Our clinical experience shows how the ultra-conservative procedure used is fast, easy and offers a long term predictability; it also allows good functional and aesthetic outcomes.

Arterial embolization with Onyx of head and neck paragangliomas

2015 ◽  
Vol 8 (6) ◽  
pp. 626-635 ◽  
Author(s):  
Caterina Michelozzi ◽  
Anne Christine Januel ◽  
Victor Cuvinciuc ◽  
Philippe Tall ◽  
Fabrice Bonneville ◽  
...  
Keyword(s):  
Head And Neck ◽  
Skull Base ◽  
Transarterial Embolization ◽  
Arterial Embolization ◽  
Long Term Results ◽  
Complete Regression ◽  
Ethylene Vinyl Alcohol ◽  
Volume Stability

ObjectTo report the morbidity and long term results in the treatment of paragangliomas by transarterial embolization with ethylene vinyl alcohol (Onyx), either as preoperative or palliative treatment.MethodsBetween September 2005 and 2012, 18 jugulotympanic, 7 vagal, and 4 carotid body paragangliomas (CBPs) underwent Onyx embolization, accordingly to our head and neck multidisciplinary team's decision. CBPs were embolized preoperatively. Jugulotympanic and vagal paragangliomas underwent surgery when feasible, otherwise palliative embolization was carried out alone, or in combination with radiotherapy or tympanic surgery in the case of skull base or tympanic extension. Treatment results, and clinical and MRI follow-up data were recorded.ResultsIn all cases, devascularization of at least 60% of the initial tumor blush was obtained; 6 patients underwent two embolizations. Post-embolization, 8 patients presented with cranial nerve palsy, with partial or complete regression at follow-up (mean 31 months, range 3–86 months), except for 2 vagal and 1 hypoglossal palsy. 10 patients were embolized preoperatively; 70% were cured after surgery and 30% showed residual tumor. 19 patients received palliative embolization, of whom 5 underwent radiotherapy and 3 received tympanic surgery post-embolization. Long term follow-up of palliative embolization resulted in tumor volume stability (75%) or extension in intracranial or tympanic compartments. Onyx embolization of CBPs resulted in more difficult surgical dissection in 2 of 4 cases.ConclusionsOnyx embolization is a valuable alternative to surgery in the treatment of jugulotympanic and vagal paragangliomas; tympanic surgery or radiosurgery of the skull base should be considered in selected cases. Preoperative Onyx embolization of CBPs is not recommended.

scholarly journals Long-term results of super-selective trans-catheter embolization of the vesical arteries for the treatment of intractable bladder haematuria

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Maria Tsitskari ◽  
Stavros Spiliopoulos ◽  
Chrysostomos Konstantos ◽  
Konstantinos Palialexis ◽  
Lazaros Reppas ◽  
...  
Keyword(s):  
Clinical Success ◽  
Arterial Embolization ◽  
Long Term Results ◽  
Angiographic Embolization ◽  
Selective Embolization ◽  
Internal Iliac ◽  
Anterior Division ◽  
Proximal Occlusion

Abstract Purpose To evaluate the feasibility, safety and long-term efficacy of super-selective trans-catheter arterial embolization for the management of intractable bladder bleeding. Materials and methods The records of 20 patients with intractable haematuria referred urgently for selective arterial embolization after failed conventional therapy, between 2013 and 2018, were retrospectively analyzed. Primary outcomes were technical (cessation of extravasation and/or stasis of flow within the target vessel) and clinical (bleeding control) success. Secondary outcomes included complication and re-intervention rates. Results Technical success was 90% (18/20 cases), as in 2 cases, embolization was not feasible. Super-selective embolization of the vesical arteries was feasible in 15/18 cases (83.3%). Selective proximal occlusion of the anterior division of the internal iliac artery was performed in two cases (11%) and embolization of the anterior division after coil blockage of the posterior division was performed in one case (5%). Bilateral and unilateral embolization was performed in 10 and 8 cases, respectively. Peri-procedural mortality rate was 5% (1/18 patients). One possible procedure-related death occurred due to myocardial infarction ten days following non-target embolization of the buttocks and the anterior abdominal wall. Mean time follow up was 35 ± 15 months. Bleeding reoccurred in three patients (16.6%), all successfully managed (one conservatively and two with further embolization). Clinical success was 85% (17/20 cases). During follow up 11 more patients died, due to underlying conditions not related to bleeding or the procedure. Conclusions Super-selective angiographic embolization is feasible, safe and effective to control refractory, life threatening bladder bleeding and should be considered as a first line treatment, as to obviate the need for emergency surgery.

Long-term results in direct carotid-cavernous fistulas after treatment with detachable balloons

1996 ◽  
Vol 84 (3) ◽  
pp. 400-404 ◽  
Author(s):  
Adam I. Lewis ◽  
Thomas A. Tomsick ◽  
John M. Tew ◽  
Michael A. Lawless
Keyword(s):  
Transarterial Embolization ◽  
Rectus Muscle ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Content Type ◽  
Pseudoaneurysm Formation ◽  
Carotid Cavernous Fistulas

✓ Transarterial embolization of direct carotid—cavernous fistulas (CCFs) using detachable balloons is the best initial option for occlusion of the fistula and preservation of the internal carotid artery. However, the long-term safety and efficacy of this treatment is unknown. The authors reviewed the long-term outcome of 87 patients with 88 direct CCFs occluded by detachable balloons. Clinical follow up was obtained in 48 (83%) of 58 patients treated with latex balloons (mean follow-up period 10 years, range 5.9–15.5 years) and 28 (97%) of 29 patients treated with silicone balloons (mean follow-up period 4 years, range 1–6.6 years). Two patients were treated with both balloon types. There were no late recurrent symptoms of cranial bruit, proptosis, chemosis, or arterialized conjunctiva in patients treated with either latex or silicone balloons. Diplopia improved in all patients; however, five patients required shortening of the lateral rectus muscle. Delayed ischemia occurred in three patients: one patient had a transient ischemic episode 5 years after treatment with latex balloons and two patients (85 and 90 years old) who had ruptured spontaneous intracavernous aneurysms suffered cerebral infarctions 6 weeks and 4 months, respectively, after treatment with silicone balloons. There were five deaths in the series unrelated to balloon treatment. These results show that after transarterial embolization of direct CCFs using either silicone or latex detachable balloons, the long-term risks are low for fistula recurrence, symptomatic foreign body reaction, symptomatic pseudoaneurysm formation, and cerebral ischemia.

Long-term Results with the Palmaz Stent in the Superficial Femoral Artery

1995 ◽  
Vol 2 (2) ◽  
pp. 161-167 ◽  
Author(s):  
Patrice Bergeron ◽  
Jean J. Pinot ◽  
Vincent Poyen ◽  
Huber Benichou ◽  
Patrick Khanoyan ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Primary Patency ◽  
Long Term Results ◽  
Secondary Patency ◽  
Critical Ischemia

Purpose: Femoral stenting has demonstrated inconsistent and often disappointing long-term results. To compare our experience, we retrospectively analyzed a series of patients who had Palmaz balloon-expandable stents placed exclusively for superficial femoral artery (SFA) lesions. Methods: From January 1990 to November 1993, 39 patients were evaluated for claudication (79%) or critical ischemia in 42 limbs. The culprit lesions were confined to the SFA: 24 (57%) occlusions and 18 (43%) stenoses, including 3 restenotic lesions. Stenting was elective in 12 (29%) cases: the 3 restenoses and 9 chronic, calcified occlusions. The remaining stents were applied for postangioplasty residual stenosis or angioscopic findings of thrombogenic luminal irregularities. A total of 55 prostheses were successfully implanted. All patients were maintained on ticlopidine and followed by routine duplex scanning. Follow-up angiography was performed in 28 (72%) patients between 4 and 45 months. Results: In the postprocedural period, two acute thromboses (4.8%) occurred within 48 hours in patients who had long occlusions and poor runoff; no other major complications were encountered, for a clinical success rate of 95%. Follow-up evaluation ranged from 4 months to 4 years with a mean of 25 months. The restenosis rate was 19% (34% in occlusions; 10% in stenotic lesions, p = NS). At 24 months, cumulative primary patency was 77% and secondary patency 89%. Conclusions: Palmaz stents performed well in the SFA, demonstrating a low acute thrombosis rate and good long-term patency. The incidence of restenosis is likely to be greater in occlusions than in stenoses.

scholarly journals Fixed Prosthetic Restorations With Sandblasted Surface Implants: Long-term Results of a Clinical Study

2021 ◽  
Author(s):  
Eugenio Velasco-Ortega ◽  
Alvaro Jimenez-Guerra ◽  
Ivan Ortiz-Garcia ◽  
Jesus Moreno-Muñoz ◽  
Enrique Nuñez-Marquez ◽  
...  
Keyword(s):  
Clinical Success ◽  
Standard Procedure ◽  
Clinical Results ◽  
Clinical Findings ◽  
Long Term Results ◽  
Marginal Bone Loss ◽  
Implant Surface ◽  
Single Crowns

Abstract Sandblasting is a standard procedure used for treating the implant surface to enhance the osseointegration with known clinical success. This retrospective cohort study aimed to evaluate the long-term clinical outcomes of sandblasted implants. Two hundred fifty-five MG Osseous screw implants were placed in 81 patients using a two-stage surgical technique and conventional loading protocol (three-months). Implant and prosthetic clinical findings were evaluated during a 15-years follow-up. Four implants were lost during the healing period, and 103 fixed prostheses were placed over the 251 implants left: 58 single-crowns, 31 partially fixed bridges, and 14 full-arch fixed restorations. Fourteen implants were lost during the follow-up period. Clinical results indicated an implant survival rate of 92.9%. 11.8% of implants showed peri-implantitis as the primary biological complication. The mean marginal bone loss was 1.76 ± 0.38 mm, ranging from 0.9 to 2.8 mm. The most frequent complication was mechanical prosthodontic complications (20.9%). Sandblasted surface implants inserted in both maxillary and mandibular areas produce favorable outcomes and stable tissue conditions when a delayed loading protocol is followed.

Long-term results of endoscopic third ventriculostomy: an outcome analysis

2015 ◽  
Vol 123 (6) ◽  
pp. 1456-1462 ◽  
Author(s):  
Sonja Vulcu ◽  
Leonie Eickele ◽  
Giuseppe Cinalli ◽  
Wolfgang Wagner ◽  
Joachim Oertel
Keyword(s):  
Success Rate ◽  
Endoscopic Third Ventriculostomy ◽  
Clinical Success ◽  
Obstructive Hydrocephalus ◽  
Clinical Success Rate ◽  
Long Term Results ◽  
Third Ventriculostomy ◽  
Long Term Follow Up

OBJECT Endoscopic third ventriculostomy (ETV) is the procedure of choice in the treatment of obstructive hydrocephalus. The excellent clinical and radiological success rates are well known. Nevertheless, very few papers have addressed the very long term outcomes of the procedure in very large series. The authors present a large case series of 113 patients who underwent 126 ETVs, and they highlight the initial postoperative outcome after 3 months and long-term follow-up with an average of 7 years. METHODS All patients who underwent ETV at the Department of Neurosurgery, Mainz University Hospital, between 1993 and 1999 were evaluated. Obstructive hydrocephalus was the causative pathology in all cases. RESULTS The initial clinical success rate was 82% and decreased slightly to 78% during long-term follow-up. Long-term success was analyzed using Kaplan-Meier curves. Overall, ETV failed in 31 patients. These patients underwent a second ETV or shunt treatment. A positive impact on long-term success was seen for age older than 6 months, and for obstruction due to cysts or benign aqueductal stenosis. The complication rate was 9% with 5 intraoperative and 5 postoperative events. CONCLUSIONS The high clinical success rate in short-term and long-term follow-up confirms ETV’s status as the gold standard for the treatment of obstructive hydrocephalus, especially for distinct pathologies. The patient’s age and underlying pathology may influence the outcome. These factors should be considered carefully preoperatively by the surgeon.

scholarly journals ENDOVASCULAR TREATMENT OF ISCHEMIC HEART DISEASE IN PATIENTS WITH MULTIVESSEL CORONARY ARTERY DISEASE: IMMEDIATE AND LONG-TERM RESULTS

2012 ◽  
Vol 67 (7) ◽  
pp. 8-14
Author(s):  
E. R. Khairutdinov ◽  
Z. Kh. Shugushev ◽  
D. A. Maksimkin ◽  
A. G. Faibushevich ◽  
G. I. Veretnik ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endovascular Treatment ◽  
Clinical Success ◽  
Long Term Results ◽  
Multivessel Coronary Artery Disease ◽  
Incomplete Revascularization ◽  
Artery Disease

Immediate and long-term results of endovascular treatment of multivessel coronary artery disease by using different revascularization strategies were analyzed in 171 patients. Duration of follow up ranged from 12 to 18 months. Complete myocardium revascularization was performed in 63 patients, culprit vessel revascularization ― in 86 pts and incomplete revascularization ― in 22 pts. Results of this study showed that strategy of complete and culprit vessel revascularization in patients with multivessel coronary artery disease has comparable immediate and long-term results. Strategy of incomplete revascularization reduce immediate clinical success and lead to increased number of myocardial infarctions and needs of coronary artery bypass surgery in long-term follow-up period.   

Genioglossus advancement and hyoid myotomy: short-term and long-term results

2003 ◽  
Vol 117 (6) ◽  
pp. 482-486 ◽  
Author(s):  
C. Neruntarat
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Clinical Success ◽  
Sleep Apnoea ◽  
Long Term Results ◽  
Short Term ◽  
Obstructive Sleep ◽  
The Mean

Successful results of genioglossus advancement and hyoid myotomy with suspension (GAHM) in the treatment of obstructive sleep apnoea (OSA) have been reported. However, there have been few studies of long-term results. Forty-six patients with hypopharyngeal obstruction underwent GAHM. Patients had a mean age of 40.1 ± 4.2 years and a mean body mass index (BMI) of 28.9 ± 2.1 kg/m2. The mean follow-up was 39.4 ± 5.7 monthswith a range of 37 to 46 months. The mean pre-operative RDI, short-term RDI, and long-term RDI were 47.9 ± 8.4, 14.2 ± 3.9, 18.6 ± 4.1, respectively. The mean post-operative LSAT, short-term LSAT, and long-term LSAT were 81.2 per cent ± 2.9 per cent, 88.8 per cent ± 2.7 per cent and 87.2 per cent ± 3.1 per cent, respectively. The changein BMI was significantly different in the patients with, and without, recurrence (2.1 ± 0.3 vs 0.4 ± 0.2.kg/m2, <0.05). Thirty (65.2 per cent) patientshad long-term clinical success, and six (16.7 per cent) patients with short-term success failedlong-term. GAHM appears to be an effective procedure and results in long-term success. However,patients with weight gain are at risk of recurrence.

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