RESUMO
A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and prevent it from migrating to the pulmonary circulation.
Assuntos
Cimentos Ósseos/efeitos adversos , Embolia/etiologia , Filtros de Veia Cava , Veia Cava Inferior , Vertebroplastia/efeitos adversos , Adenocarcinoma/secundário , Feminino , Humanos , Veia Ilíaca , Vértebras Lombares/cirurgia , Neoplasias Pulmonares/patologia , Pessoa de Meia-Idade , Embolia Pulmonar/prevenção & controle , Radiografia , Neoplasias da Coluna Vertebral/secundário , Trombose Venosa/diagnóstico por imagem , Vertebroplastia/métodosRESUMO
Percutaneous vertebroplasty (PVP) has been used widely to treat pain caused by osteolytic spinal lesions, whereas vertebroplasty for osteoblastic spinal lesions is less known. The purpose of this study is to describe PVP as a highly effective miniinvasive procedure to treat painful osteoblastic metastatic spinal lesions. Four patients with painful osteoblastic metastatic spinal lesions were treated by PVP in the authors' department, and immediately relief of pain was achieved in all of them. The findings from this study may encourage more studies of PVP in palliative treatment of patients with osteoblastic lesions.
Assuntos
Osteoblastos/patologia , Dor/prevenção & controle , Neoplasias da Coluna Vertebral/terapia , Vertebroplastia/métodos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoblastos/diagnóstico por imagem , Dor/etiologia , Medição da Dor , Cuidados Paliativos , Radiografia Intervencionista , Neoplasias da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/secundário , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Vertebroplastia/efeitos adversosRESUMO
Cerebral lipiodol embolism (CLE) is an extremely rare complication of transcatheter arterial chemoembolization for hepatocellular carcinoma. To our knowledge, only 11 cases have been previously reported. We recently encountered two cases of CLE in our clinical work. Reviewing the 11 cases in the literature and the two cases in our report indicates that large dose lipiodol infusion and absence of particulate embolization should be avoided. The presence of a right-to-left shunt and inferior phrenic artery injection seems to increase the risk of CLE. More caution should be taken in these situations.
Assuntos
Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/métodos , Óleo Etiodado/uso terapêutico , Neoplasias Hepáticas/terapia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The ovine superficial femoral artery was used for testing the efficacy of percutaneous arterial closure devices (PACDs) in their developmental stage. Two topical devices containing chitostan, one staple-mediated PACD and a porcine small intestinal submucosa plug, were tested by follow-up angiography in 37 sheep. Absence or presence of bleeding and time to bleeding cessation were the main criteria for evaluation of PAVD efficacy. The results of these tests directed modification of individual PACDs and improved their efficacy.