Uterine arterial embolization for treatment of uterine leiomyoma: Initial experience with 1-Year Follow-up

Thirty-three consecutive patients with previously untreated hepatocellular carcinoma (HCC) and 6 patients with recurrent HCC were treated with transcatheter arterial embolization (TAE). The patients were not eligible for surgical resection or percutaneous ethanol injection. TAE was performed with Lipiodol Ultra-Fluid, epidoxorubicin and Gelfoam, with a mean of 1.7 treatments per patient. CT was performed 15 days after TAE. The mean cumulative survival was 14.2 months in patients with previously untreated HCC. The survival of patients stages Okuda I and II did not differ significantly (p > 0.05); tumor size did not affect survival (p > 0.05). Two patients with recurrent HCC died 7.0 and 9.3 months after the diagnosis of tumor recurrence; the remaining 4 patients are still alive with a maximum follow-up of 22.5 months from the diagnosis of HCC recurrence. Ten complications occurred in 8 patients, and were controlled by medical therapy. Eleven patients died during the study; no death was related to TAE. The series was not randomized, but comparison with the natural history of HCC suggests that TAE is effective as palliative treatment of advanced or recurrent HCC.

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Endoscopic transcervical odontoidectomy for pediatric basilar invagination and cranial settling

Journal of Neurosurgery Pediatrics ◽

10.3171/ped/2008/1/4/337 ◽

2008 ◽

Vol 1 (4) ◽

pp. 337-342 ◽

Cited By ~ 42

Author(s):

Matthew J. McGirt ◽

Frank J. Attenello ◽

Daniel M. Sciubba ◽

Ziya L. Gokaslan ◽

Jean-Paul Wolinsky

Keyword(s):

Pediatric Patients ◽

Pediatric Population ◽

Tube Feeding ◽

Basilar Invagination ◽

Craniocervical Junction ◽

Consecutive Series ◽

Initial Experience ◽

Prolonged Intubation ◽

Alternative Approach

✓ Pediatric basilar invagination and cranial settling have traditionally been approached through a transoral–transpharyngeal route with or without extended maxillotomy or mandibulotomy for resection of the anterior portion of C-1 and the odontoid. The authors hypothesize that application of a recently described endoscopic transcervical odontoidectomy (ETO) technique would allow an alternative approach for the treatment of ventral pathological entities at the craniocervical junction in pediatric patients. The authors performed ETO in a consecutive series of pediatric patients presenting with myelopathy or bulbar dysfunction resulting from basilar invagination or cranial settling. All clinical, radiographic, surgical, and follow-up data were prospectively collected. The initial experience with ETO in the pediatric population is analyzed and outcomes are reported. Three patients required ETO for basilar invagination and 1 required ETO with anterior C-1 arch and distal clivus resection for cranial settling. All patients presented with myelopathy. One patient was wheelchair bound with severe quadriparesis. The mean age was 14 ± 3 years (mean ± standard deviation [SD]) in the 2 male and 2 female patients. The ETO and posterior fusion were performed as a 2-stage procedure in 2 (50%) and as a single-stage procedure in 2 (50%) cases. Prolonged intubation or postoperative placement of a gastrostomy tube was not needed in any case. The postoperative hospitalization lasted 9 ± 4 days (mean ± SD). At last follow-up (mean 5 months), head and neck pain had resolved and motor strength had improved or stabilized in all cases. All 4 children were independently functioning and ambulatory at the last follow-up. In the authors' initial experience, ETO has allowed ventral brainstem decompression without the need for prolonged intubation, worsening dysphagia requiring enteral tube feeding, or prolonged hospitalization, and has resulted in cosmetically appealing results. The ETO technique allows an alternative approach for the treatment of ventral pathological entities at the craniocervical junction in pediatric patients.

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Selective Arterial Embolization of Renal Angiomyolipomas with a N-Butyl Cyanoacrylate-Lipiodol Mixture: Efficacy, Safety, Short- and Mid-Term Outcomes

Journal of Clinical Medicine ◽

10.3390/jcm10184062 ◽

2021 ◽

Vol 10 (18) ◽

pp. 4062

Author(s):

François-Victor Prigent ◽

Kévin Guillen ◽

Pierre-Olivier Comby ◽

Julie Pellegrinelli ◽

Nicolas Falvo ◽

...

Keyword(s):

Arterial Embolization ◽

Volume Reduction ◽

Renal Angiomyolipoma ◽

Cyanoacrylate Glue ◽

Selective Arterial Embolization ◽

Before And After ◽

The Mean ◽

Magnetic Resonance Imaging Mri ◽

Postembolization Syndrome

Selective arterial embolization (SAE) for renal angiomyolipoma (rAML) is effective to treat or prevent bleeding. We report our experience using a cyanoacrylate–Lipiodol mixture. We performed a single-center retrospective review of all rAMLs embolized with cyanoacrylate glue between July 2014 and June 2020. Demographics, tuberous sclerosis complex (TSC) status, clinical presentation, angiography features, and follow-up data were recorded. Pre- and post-procedure rAML sizes and volumes were estimated from computed tomography (CT) or magnetic resonance imaging (MRI) studies. Kidney function was assessed before and after the procedure. We identified 24 patients (22 females and 2 males, mean age 51 years) treated for 27 AMLs, either prophylactically (n = 20) or as an emergency (n = 4). Technical success was achieved for 25/27 AMLs; two patients, each with a single AML, required nephrectomy and repeated embolization, respectively. Major complications occurred in three patients and minor complications such as postembolization syndrome in 15 patients. AML volume reduction after embolization was 55.1% after a mean follow-up of 15 months (range, 1–72 months). Factors associated with greater volume reduction were a smaller percentage of fat (p = 0.001), larger initial rAML volume (p = 0.014), and longer follow-up (p = 0.0001). The mean creatinine level did not change after SAE. Embolization of rAMLs with a mixture of cyanoacrylate and Lipiodol is feasible, safe, and effective in significantly decreasing tumor volume.

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Transcatheter Arterial Embolization with N-butyl-2 Cyanoacrylate Glubrans 2 for the Treatment of Acute Renal Hemorrhage Under Coagulopathic Condition

10.21203/rs.3.rs-26879/v1 ◽

2020 ◽

Author(s):

Maofeng Gong ◽

Xu He ◽

Boxiang Zhao ◽

Jie Kong ◽

Tao Wang ◽

...

Keyword(s):

Transcatheter Arterial Embolization ◽

Clinical Success ◽

Arterial Embolization ◽

Hemodynamic Instability ◽

Attractive Alternative ◽

Safe Alternative ◽

Renal Hemorrhage ◽

Active Hemorrhage ◽

Significant Difference

Abstract Background:The efficacy and safety of transcatheter arterial embolization (TAE) using the N-butyl-2 cyanoacrylate (NBCA) Glubran2 in the treatment of acute renal hemorrhage (RH) under coagulopathic conditionsarestill no consensus.Methods: Between February 2014 and June 2019, 8 patients underwent TAE with the NBCA Glubran2 for acute RH under coagulopathic conditions. Coagulopathy was defined as abnormal values of prothrombin time and activated partial thromboplastin time and/or a reduced platelet count.Angiograms and medical records were retrospectively reviewed to determine technical/clinical success, complications and recurrent hemorrhage after TAE, and follow-up outcomes were assessed.Results: Of note, one patient presented with severe coagulopathy, and three presented with severe RH and hemodynamic instability. The NBCA Glubran2 was employed as a sole embolic material in sixpatients. In the remaining two patients, it was employed for secondary embolization.Under coagulopathic conditions, due to the use of the NBCA Glubran2, both technical success and clinical success for acute RH were achieved in all patients. Duringa mean follow-up time of 30.1 months (range, 3-84 months), neither persistent nor recurrent active hemorrhage required repeat endovascular or surgical treatment for hemostasis. No Glubran2related complications occurred mid-TAE pro-cedure. In addition, renal function information was available for all patients, and there was no significant difference between the serum creatinine levels [(83.8 ± 15.5) vs (85.8 ± 32.2) μmol/L] before and one week after Glubran2 embolization (p=0.89; CI, -34.5 to 30.5).Conclusions: The present findings suggest that TAE with the NBCA Glubran2 may be a safe alternative treatment for the management of RH under coagulopathic conditions. In particular, this method appears to be a potentially attractive alternative when con-ventional embolic materials fail in patients with ongoing hemodynamic instability or even under severe coagulopathic conditions.

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Intrauterine myelomeningocele repair Postnatal results and follow-up at 3.5 years of age — initial experience from a single reference service in Brazil

Child s Nervous System ◽

10.1007/s00381-011-1662-z ◽

2011 ◽

Vol 28 (3) ◽

pp. 461-467 ◽

Cited By ~ 18

Author(s):

Wagner Jou Hisaba ◽

Sérgio Cavalheiro ◽

Carlos Gilberto Almodim ◽

Carolina Peixoto Borges ◽

Tereza Cristina Carbonari de Faria ◽

...

Keyword(s):

Initial Experience ◽

Reference Service ◽

Myelomeningocele Repair

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Treatment of dural arteriovenous fistula using ethylene vinyl alcohol (Onyx) arterial embolization as the primary modality: short-term results

Journal of Neurosurgery ◽

10.3171/jns-07/12/1120 ◽

2007 ◽

Vol 107 (6) ◽

pp. 1120-1125 ◽

Cited By ~ 56

Author(s):

Andrew P. Carlson ◽

Christopher L. Taylor ◽

Howard Yonas

Keyword(s):

Arteriovenous Fistula ◽

Vinyl Alcohol ◽

Dural Arteriovenous Fistula ◽

Clinical Symptoms ◽

Arterial Embolization ◽

Primary Treatment ◽

Embolic Agent ◽

Ethylene Vinyl Alcohol ◽

Treatment Agent

Object A dural arteriovenous fistula (DAVF) typically involves meningeal feeding arteries and can cause clinical symptoms ranging from tinnitus to rupture of draining cortical or parenchymal veins. Surgical treatment may be technically demanding. Ethylene vinyl alcohol (Onyx, ev3 Neurovascular) has several properties that make it potentially useful as a primary treatment agent for DAVF. Onyx is expected to be a permanent embolic agent. It should have a decreased risk of catheter retention when compared with other permanent embolic materials. Methods The authors report a series of six patients with symptomatic DAVF who were treated initially with transarterial Onyx embolization and other endovascular techniques. Results Five patients had complete occlusion of their DAVF noted on the follow-up angiogram obtained between 2 and 4 months. One patient had residual filling via a small arterial branch that was stable on follow-up angiography. None of the patients had worsening of neurological function. One case was complicated by a retained catheter fragment. Conclusions Transarterial Onyx embolization and other endovascular methods can angiographically obliterate DAVF. In some cases, embolization allowed occlusion of multiple arterial feeding arteries from a single arterial injection. Technically, the embolization was optimized when a microcatheter position immediately adjacent to the point(s) of fistulization was achieved.

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