Utility of low-dose gelatin sponge particles and 5% ethanolamine oleate iopamidol mixture in retrograde transvenous obliteration (GERTO) for gastric varices

Objective: To determine the utility of low-dose gelatin sponge particles and 5% ethanolamine oleate iopamidol (EOI) mixture in retrograde transvenous obliteration (GERTO) for gastric varices (GV). Methods: 57 consecutive patients who underwent balloon-occluded retrograde transvenous obliteration (B-RTO) for GV were divided into three groups with Hirota’s grade by balloon-occluded retrograde transvenous venography. Hirota’s Grade 1 patients were assigned to G1 group and underwent treatment with 5% EOI. Grade ≥ 2 patients prior to August 2015 were G ≥ 2 group treated with 5% EOI, and those treated thereafter were GERTO group. The amount of EOI used per unit GV volume (EOI/GV ratio), the times to embolization and recurrence rate of GV were evaluated. Results: The EOI/GV ratio was 0.66 ± 0.19 in G1, 1.5 ± 0.8 in G ≥ 2, and 0.58 ± 0.23 in GERTO (G ≥ 2 vs GERTO, p < 0.0001). The times to embolization were 26.5 ± 10.5 min for G1, 39.2 ± 26.8 for G ≥ 2, and 21.4 ± 9.4 for GERTO (G ≥ 2 vs GERTO, p = 0.005). The recurrence rate was not significantly different in any of the groups. Conclusion: GERTO was performed in lower amount of sclerosants and in less time compared to conventional B-RTO in Hirota’s grade ≥2. Advances in knowledge: Feasibility of low-dose gelatin sponge particles and 5% EOI mixture as sclerosants for GV.

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Comparison of Uterine Necrosis After Uterine Artery Embolization with Soluble Gelatin Sponge Particles or Tris-acryl Gelatin Microspheres in Swine

CardioVascular and Interventional Radiology ◽

10.1007/s00270-021-02905-2 ◽

2021 ◽

Author(s):

Hirotatsu Sato ◽

Tetsuo Sonomura ◽

Saeko Onishi ◽

Masataka Koike ◽

Ryota Tanaka ◽

...

Keyword(s):

Uterine Artery Embolization ◽

Uterine Artery ◽

Gelatin Sponge ◽

Artery Embolization ◽

Gelatin Microspheres ◽

Gelatin Sponge Particles

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Idiopathic granulomatous mastitis: challenges of treatment in iranian women

BMC Surgery ◽

10.1186/s12893-021-01210-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Leyla Shojaee ◽

Nasrin Rahmani ◽

Siavash Moradi ◽

Asieh Motamedi ◽

Gholamali Godazandeh

Keyword(s):

Recurrence Rate ◽

Low Dose ◽

Unknown Origin ◽

Surgical Excision ◽

Chronic Inflammatory Disease ◽

High Dose ◽

Granulomatous Mastitis ◽

Idiopathic Granulomatous Mastitis ◽

Results Of Treatment ◽

Information Treatment

Abstract Background and objective As a chronic inflammatory disease of an unknown origin, the treatment of granulomatous mastitis has always been controversial. According to some researchers, surgical treatment and certain medications, especially steroids, are more effective in treating the disease. This study aimed at evaluating the results of treatment in a group of patients with granulomatous mastitis. Materials and methods This longitudinal cohort study evaluated the treatment outcomes of 87 patients with pathology-confirmed granulomatous mastitis referred to the surgical clinic of Central Hospital in Sari, Iran. Demographic, clinical, and pathological information, treatment methods and results, and the recurrence rate were analyzed. Findings A total of 87 female patients with granulomatous mastitis aged 22–52 years with a mean age of 34 years were evaluated. All patients had palpable masses; the breast masses were painful in 48.3% of patients, and 55.2% of patients suffered from erythema and inflammation, and8% had fistulas and ulcers at the inflammation site. The patients were followed-up for an average duration of 26 months (8–48 months) after treatment and recovery. The overall recurrence rate was 24.1%, and the recurrence rate was 29.4% in patients underwent surgery, 34.8% in patients received high-dose prednisolone, and 17% in those received low-dose prednisolone together with drainage (p < 0.001). Conclusions According to the results, the low-dose prednisolone plus drainage was more effective with a lower recurrence rate than only surgical excision or high-dose prednisolone. In fact, the use of minimally invasive methods such as drainage plus low-dose steroids is a more effective method with fewer side effects than the other two methods.

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Diaphragmatic weakness after transcatheter arterial chemoembolization of the right inferior phrenic artery for treatment of hepatocellular carcinoma: a comparison of outcomes after N-butyl cyanoacrylate versus gelatin sponge embolization

Acta Radiologica ◽

10.1177/0284185120981771 ◽

2020 ◽

pp. 028418512098177

Author(s):

Seung Yeon Noh ◽

Dong Il Gwon ◽

Suyoung Park ◽

Woo Jin Yang ◽

Hee Ho Chu ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Complete Response ◽

Gelatin Sponge ◽

Inferior Phrenic Artery ◽

Gelatin Sponge Particles ◽

Phrenic Artery ◽

The Right ◽

Diaphragmatic Weakness ◽

Arterial Chemoembolization

Background The inferior phrenic artery (IPA) is the most common extrahepatic feeder for hepatocellular carcinoma (HCC) during transhepatic arterial chemoembolization (TACE). Purpose To compare the incidence of diaphragmatic weakness in patients with HCC after TACE of the right IPA conducted using either N-butyl cyanoacrylate (NBCA) or gelatin sponge particles. Material and Methods Medical records of 111 patients who underwent TACE of the right IPA using NBCA were retrospectively reviewed and compared with data from 135 patients with IPA embolization using gelatin sponge particles. Results The incidence of diaphragmatic weakness after the initial TACE procedure did not significantly differ between the groups (NBCA group 16.2%; gelatin sponge group 20.7%; P = 0.458). Five patients in the NBCA group and 11 in the gelatin sponge group showed spontaneous resolution of diaphragmatic weakness after a mean period of 3.5 months. Diaphragmatic weakness developed after the initial follow-up visit in 17 patients from the gelatin sponge group due to repeated TACE of the right IPA (mean 2.4 sessions; range 2–4 sessions), while it spontaneously developed without additional TACE procedures in one patient from the NBCA group. Permanent diaphragmatic weakness was less common in the NBCA than in the gelatin sponge group (12.6% and 25.2%, respectively; P = 0.017). The complete response rate did not significantly differ between the groups (NBCA group 16.2%; gelatin sponge group 25.9%; P = 0.065). Conclusion Use of NBCA rather than gelatin sponge particles for TACE of the right IPA resulted in a lower incidence of permanent diaphragmatic weakness.

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