Preoperative arterial embolization of large liver hemangiomas.

PURPOSE: We aimed to investigate the efficacy and safety of preoperative selective intra-arterial embolization (PSIAE) in the surgical treatment of large liver hemangiomas. METHODS: Data of 22 patients who underwent resection of large liver hemangiomas were retrospectively analyzed. PSIAE was performed in cases having a high risk of severe blood loss during surgery (n=11), while it was not applied in cases with a low risk of blood loss (n=11). RESULTS: A total of 19 enucleations and six anatomic resections were performed. Operative time, intraoperative bleeding amount, Pringle period, and blood transfusion were comparable between the two groups (P > 0.05, for all). The perioperative serum aspartate transaminase level was not different between groups (P = 1.000). Perioperative total bilirubin levels were significantly increased in the PSIAE group (P = 0.041). Postoperative hospital stay was longer in the PSIAE group. Surgical complications were comparable between groups (P = 0.476). CONCLUSION: Patients who underwent PSIAE due to a high risk of severe blood loss during resection of large liver hemangiomas had comparable operative success as patients with a low risk of blood loss who were operated without PSIAE. Hence, PSIAE can be used for the control of intraoperative blood loss, especially in surgically difficult cases.

[Percutaneous endovascular removal of intracardiac migrated port A catheter in a child with acute lymphoblastic leukemia]. / Remoção endovascular percutânea de cateter totalmente implantável com migração intracardíaca em criança com leucemia linfoblástica aguda.

A 2-year-old boy with acute lymphoblastic leukemia was presented with peripherally inserted central catheter dysfunction. Radiological examinations revealed a catheter remnant in the right atrium extending into pulmonary vein. The catheter remnant was successfully removed from the right atrium by percutaneous endovascular intervention without any complications.

Percutaneous endovascular removal of intracardiac migrated port A catheter in a child with acute lymphoblastic leukemia.

A 2-year-old boy with acute lymphoblastic leukemia was presented with peripherally inserted central catheter dysfunction. Radiological examinations revealed a catheter remnant in the right atrium extending into pulmonary vein. The catheter remnant was successfully removed from the right atrium by percutaneous endovascular intervention without any complications.

Percutaneous endovascular removal of intracardiac migrated port A catheter in a child with acute lymphoblastic leukemia / Remoção endovascular percutânea de cateter totalmente implantável com migração intracardíaca em criança com leucemia linfoblástica aguda / Retirada por vía intravenosa percutánea de catéter Port-A debido a la migración intracardiaca en niño con leucemia linfoblástica aguda

A 2-year-old boy with acute lymphoblastic leukemia was presented with peripherally inserted central catheter dysfunction. Radiological examinations revealed a catheter remnant in the right atrium extending into pulmonary vein. The catheter remnant was successfully removed from the right atrium by percutaneous endovascular intervention without any complications.

Menino com dois anos de idade com leucemia linfoblástica aguda foi apresentado com disfunção de cateter central perifericamente inserido. O exame radiológico revelou um fragmento do cateter no átrio direito que se estendia até a veia pulmonar. O fragmento foi removido com sucesso por intervenção endovascular percutânea, sem qualquer complicação.

Paciente del sexo masculino, de 2 años de edad, con leucemia linfoblástica aguda que se presentó con una disfunción del catéter central de inserción periférica. Los exámenes radiológicos acusaron un resto de catéter en la aurícula derecha, extendiéndose hacia la vena pulmonar. El catéter fue retirado con éxito de la aurícula derecha por vía intravenosa percutánea sin complicaciones.

Chemoembolization for neuroendocrine liver metastasis.

The liver is the most common site for neuroendocrine tumor metastasis. The characteristic feature of these tumors is related to the secretion of biologically active compounds in large amounts. Systemic chemotherapy has limited success in treating patients with neuroendocrine liver metastasis. Surgical management remains the only potentially curative option for these patients. According to the high incidence of recurrence after surgery, the role of intra-arterial therapy (IATs) in neuroendocrine tumor metastasis has been evolved. This review evaluates the potential role of IATs in the light of current literature.

Spontaneous thrombosis of a saccular iliac artery aneurysm induced by overlapping self-expandable bare metallic stents.

Isolated iliac artery aneurysms are rare lesions. Prompt diagnosis and timely intervention are essential in their management. In elderly patients with coexisting medical problems, endovascular procedures are preferred to avoid the risks of morbidity and mortality associated with general anesthesia and surgery. We report a case of a true saccular external iliac artery aneurysm that underwent spontaneous thrombosis after treatment with placement of two overlapping bare self-expandable metallic stents only.

Intractable postpartum hemorrhage resulting from uterine artery pseudoaneurysm: superselective arteriographic embolization via the collateral route.

We present a patient with intractable postpartum hemorrhage resulting from uterine artery pseudoaneurysm despite bilateral hypogastric artery ligation who was successfully treated by an endovascular approach via the collateral route. Although there is a good argument for postponing surgery until transcatheter embolization has been attempted, this case shows that embolization can still be successful even if the iliac vessels have been ligated.