RESUMO
In recent years preoperative transcatheter embolization has been used widely in the management of kidney tumors. However, the effective clinical usefulness of this method has not yet been proved. Forty cases of kidney tumors treated by preoperative embolization and radical nephrectomy are reviewed and compared with a homogeneous group of patients who did not undergo preoperative embolization. Intraoperative blood loss, postoperative complication, and survival rate were statistically evaluated according to tumor stage. Advantages and disadvantages of preoperative transcatheter embolization of kidney tumors are reviewed.
Assuntos
Embolização Terapêutica/métodos , Neoplasias Renais/terapia , Nefrectomia , Cuidados Pré-Operatórios , Adenocarcinoma/terapia , Embolização Terapêutica/efeitos adversos , Humanos , Complicações Pós-OperatóriasRESUMO
The so called temporary embolization by percutaneous injection of autologous clot can be envisaged as the method of choice in selected cases of massive renal bleeding. The goals of this technique are to occlude the bleeding vessels until a satisfactory hemostasis is achieved and to preserve as far as possible the renal parenchyma by adopting a completely reabsorbable embolic material as the autologous clot. After a review of the literature a case is presented where a temporary embolization was performed in a young woman with brisk postoperative bleeding in a solitary kidney. The procedure was successful and the renal function was not impaired.
Assuntos
Embolização Terapêutica/métodos , Hemorragia/terapia , Nefropatias/terapia , Adulto , Embolização Terapêutica/efeitos adversos , Feminino , Fibrinólise , Humanos , Complicações Pós-Operatórias/terapia , Radiografia , Artéria Renal/diagnóstico por imagem , Fatores de TempoAssuntos
DNA de Neoplasias/análise , Fenretinida/uso terapêutico , Citometria de Fluxo , Neoplasias da Bexiga Urinária/tratamento farmacológico , Neoplasias da Bexiga Urinária/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Aneuploidia , Diploide , Estudos de Viabilidade , Feminino , Fenretinida/efeitos adversos , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Projetos Piloto , Neoplasias da Bexiga Urinária/genéticaRESUMO
A series of 56 percutaneous transcatheter renal angioplasties, carried out in an endourological unit, is reviewed and compared with radiological series. The results were inferior for fibrosclerotic lesions (77 vs. 90%) and nonostial atherosclerosis (67.8 vs. 75%), but slightly superior for ostial lesions (33 vs. 20-30%) in the endourological series as compared with the radiological series. Conversely, morbidity was significantly inferior (8.9 vs. 18.6%). The endourological series compares well with the radiological series in the literature. Percutaneous transcatheter renal angioplasty should be considered a procedure belonging both to interventional radiology and to endourology. Owing to the technical difficulties and the complication rate, it should not be performed in outpatients and a surgical support team should be available in the event of a threatening renal complication.
Assuntos
Angioplastia Coronária com Balão/métodos , Obstrução da Artéria Renal/terapia , Artéria Renal , Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/instrumentação , Arteriosclerose/terapia , Feminino , Fibrose , Seguimentos , Humanos , Hipertensão Renovascular/terapia , Cálculos Renais/terapia , Masculino , Recidiva , Artéria Renal/patologia , Obstrução da Artéria Renal/etiologiaRESUMO
We report 2 cases of successful treatment of priapism by transcatheter embolization of the internal pudendal arteries. Recovery of penile blood flow was confirmed by Doppler flowmetry and potency was preserved. Embolization with autologous clot is at least partially reversible and interventional angiography warrants consideration in the treatment of priapism.
Assuntos
Embolização Terapêutica/métodos , Priapismo/terapia , Adulto , Idoso , Angiografia , Humanos , Masculino , Pênis/irrigação sanguínea , Priapismo/diagnóstico por imagem , Fluxo Sanguíneo Regional , UltrassonografiaRESUMO
For varicocele correction, the occlusion of the internal spermatic vein is commonly performed, leaving the testis without its major pathway. Microsurgery offers the possibility to create a new venous drainage to the testis by anastomosing the internal spermatic vein with the inferior epigastric vein. Both stumps of the epigastric vein can be alternatively used, according to the different pathogenic mechanism of the varicocele. Eight patients with left varicocele were operated on using this new technique, with satisfactory results.
Assuntos
Microcirurgia , Testículo/irrigação sanguínea , Varicocele/cirurgia , Humanos , Masculino , Escroto/irrigação sanguínea , Veias/cirurgiaRESUMO
Six cases of renal bleeding which were successfully treated by transcatheter embolization with autologous clot are described and illustrated. The problems of clot lysis and consequent vessel recanalization are discussed both from an experimental and clinical point of view. It is concluded that clot embolization is suitable treatment for renal bleeding and, in selected cases, is preferable to open surgery.
Assuntos
Embolização Terapêutica/métodos , Hemorragia/terapia , Nefropatias/terapia , Acidentes de Trânsito , Adolescente , Adulto , Cateterismo , Feminino , Hemorragia/diagnóstico por imagem , Hemorragia/etiologia , Humanos , Rim/lesões , Cálculos Renais/complicações , Nefropatias/diagnóstico por imagem , Nefropatias/etiologia , Masculino , Pessoa de Meia-Idade , Radiografia , Recidiva , Artéria Renal/diagnóstico por imagemRESUMO
Priapism can be successfully treated by unilateral or bilateral percutaneous transcatheter occlusion of the internal pudendal arteries. Occlusion should be reversible in order to avoid impotence. Embolization with autologous clot satisfies this requirement because of the clot lysis and consequent vessel recanalization. Three cases are extensively described which demonstrate the feasibility of the method and the ability to preserve sexual potency. The rationale for using interventional angiography in priapism is also discussed.
Assuntos
Embolização Terapêutica , Pênis/irrigação sanguínea , Priapismo/terapia , Adulto , Idoso , Artérias , Humanos , Artéria Ilíaca , MasculinoRESUMO
A case is described of idiopathic priapism successfully treated by transcatheter embolization of the left internal pudendal artery with autologous clots. The rationale for the use of this new approach in the treatment of priapism is discussed briefly.
Assuntos
Embolização Terapêutica , Pênis/irrigação sanguínea , Priapismo/terapia , Idoso , Artérias , Humanos , MasculinoRESUMO
Venography has recently been introduced in routine diagnostic evaluation of varicocele, and a pathogenetic classification based on venographic findings has been proposed. Transcatheter sclerotization of the internal spermatic vein completes the angiographic management of varicocele. After venographic classification of 56 cases, the patients with type-1 varicocele (reno-spermatic reflux) were treated by transcatheter sclerotization (group A, 25 patients) or high inguinal surgical ligation (group B, 15 patients). The results were quite similar, whereas the cost/benefit ratio was favorable to sclerotherapy.