Embolization with more diluted glue-lipiodol in patients with massive hemoptysis: single center experience results.

OBJECTIVE: The aim of the study was to demonstrate the efficacy and safety of bronchial artery embolization (BAE) with more diluted N-butyl-2- cyanoacrylate (NBCA) in patients with massive hemoptysis. PATIENTS AND METHODS: In this retrospective study, there are 48 patients who underwent NBCA and BAE for massive hemoptysis between March 2018 and September 2021. Demographic data, technical and clinical results, immediate hemoptysis control, recurrent hemoptysis and complications were evaluated. RESULTS: The technical success rate and immediate hemoptysis control were achieved in 97.9% and 93.7%, respectively. The 3 patients who were exitus within the first 10 days were removed from the follow-up range. During the follow-up period (range, 5 months-42 months; median, 27.5 months), recurrent hemoptysis was found in 3 of the 45 patients (6.6 %). Since 1 patient refused and one patient died within the first 24 hours, repeated BAE procedures were performed in 4 patients. A total of 55 sessions of BAE with NBCA was performed to 48 patients. The underlying diseases causing hemoptysis were determined to be bronchiectasis (n=16), tuberculosis (n=8), neoplasm (n=7), aspergilloma (n=3), and arteriovenous malformation (n=2). In 4 patients, bronchiectasis and tuberculosis were present together and in 8 patients, the cause could not be specified. CONCLUSIONS: In conclusion, BAE with more diluted NBCA is a safe and effective embolization method. In addition, the use of more diluted NBCA reduces the recurrence rates in patients with hemoptysis.

Does ligation of internal iliac artery for postpartum hemorrhage affect clitoral artery blood flow and postpartum sexual functions?

OBJECTIVE: To investigate whether internal iliac artery ligation (IIAL) for postpartum hemorrhage (PPH) affects the sexual life in the postpartum period or significantly reduces the clitoral artery blood flow. STUDY DESIGN: The women who underwent IIAL due to PPH during cesarean section (CS) were compared with healthy postpartum women delivered by CS between October 2014 and February 2016 in the Gaziantep Women's Health and Maternity Hospital, Gaziantep, Turkey. Clitoral Doppler flow measurements and the Female Sexual Function Index questionnaire (FSFIQ) were performed in all women in the 3rd and 6th postpartum months. This study was registered at ClinicalTrials.gov with the identification number NCT02409602. RESULTS: Mean age, gravidity and parity, body mass index (BMI), first sexual intercourse after childbirth, and education years were similar in both groups. There was no statistically significant difference in the measurements of RI, PI, PSV, EDV, and S/D between the study and control groups in the 3rd month. Lack of statistical significance was also noted between the study and control groups values in the 6th month, as well as between the 3rd and 6th month's values within both the study group and the control group. Additionally, there were no statistically significant differences in the total FSFI scores including sexual desire, sexual arousal, lubrication, orgasm, sexual satisfaction, and pain domain scores between the study and control groups in the 3rd month; between the study and control groups 6th months; whereas all scores were higher in the 6th month compared to the 3rd month within each group. CONCLUSION: IIAL does not affect the blood flow of the dorsal clitoral artery between the 3rd and 6th months postpartum and between the women who underwent IIAL due to PPH and healthy postpartum women. The sexual function scores were significantly higher in the 6th month compared to the 3rd month in both groups.

Stent-assisted coiling in endovascular treatment of 500 consecutive cerebral aneurysms with long-term follow-up.

BACKGROUND AND PURPOSE: Stent-assisted coil embolization has become one of the most preferred techniques in the treatment of wide-neck intracranial aneurysms; however, long-term patency and safety of the self-expanding neurostents and their role in durability of the endovascular treatment has remained ambiguous. We sought to retrospectively examine the long-term results of self-expanding stent usage in conjunction with coil embolization in treatment of wide-neck cerebral aneurysms. MATERIALS AND METHODS: We coiled 500 wide-neck cerebral aneurysms with different types of self-expanding neurostent assistance in 468 patients. Patient and aneurysm characteristics, pharmacologic therapy protocol, complications, and initial occlusion grades were analyzed. Patients underwent angiographic follow-up at 6 months to 7 years after treatment. DSA or MRA images of all patients were analyzed to assess the occlusion rate of aneurysms and patency of the parent artery. RESULTS: Enterprise (n = 340), Solitaire (n = 98), Wingspan (n = 41), LEO (n = 16), and Neuroform (n = 5) stent systems were used in this series. Stent-related thromboembolic events occurred in 21 patients and intraoperative rupture occurred in 4 patients. Initially, complete occlusion was achieved in 42.2% of the aneurysms, and, according to the last follow-up data, the rate had progressed to 90.8%. Recanalization rate at 6 months was 8%, whereas the late recanalization rate was 2%. CONCLUSIONS: The use of stents in endovascular treatment provides high rates of complete occlusion and low rates of recurrence at a long-term follow-up study.

Severe semilobar holoprosencephaly and lissencephaly associated with cebocephaly in a newborn.

Holoprosencephaly is frequently accompanied by midline facial abnormalities such as hypotelorism, cyclopia, etmocephaly and cebocephaly. Cebocephaly is a very rare congenital anomaly combining with semilobar holoprosencephaly. Chromosomal analysis shows normal karyotyping. Lissencephaly and holoprosencephaly are rare associations, that have not been reported yet with cebocephaly. Herein we present the first case of cebocephaly with severe semilobar holoprosencephaly and lissencephaly.

A preterm infant with prolonged respiratory problems due to Ritscher-Schinzel syndrome.

Ritscher-Schinzel also known as cranio-cerebello-cardiac (3C) syndrome is a very rare clinical entity. The striking features of this syndrome are cerebellar, cardiac and craniofacial abnormalities. Life threatening features of this syndrome are generally associated with cardiac abnormalities. We here present prolonged respiratory problems due to pulmonary hypertension in a preterm baby with Ritscher-Schinzel syndrome.