Adrenal obliteration by balloon-occluded retrograde venous ethanol injection in a swine model.

PURPOSE: To evaluate the effects of adrenal obliteration by balloon-occluded retrograde venous ethanol injection. MATERIAL AND METHODS: We inserted a micro-balloon catheter into the left adrenal vein of six pigs and retrogradely injected absolute ethanol (0.06 ml/kg) under balloon occlusion. Two pigs were sacrificed on day 3, 7, and 14 after the procedure, respectively. We evaluated adrenal cortical and medullary hormones of the left renal vein, venograms, magnetic resonance imaging scans obtained before and after the procedure, autopsy and microscopic findings, and the weight of the bilateral adrenal glands. RESULTS: The hormone levels were extremely high on day 3 after the procedure. Post-procedure, partially-enhanced parenchyma and shaggy veins were observed. On the post-mortem examination, the left adrenal glands showed hemorrhage and adhesion on the third and seventh day and fatty proliferation 14 days after the procedure. Microscopic examination revealed hemorrhagic necrosis on day 3, inflammatory cell infiltration on day 7, and partial fibrosis 14 days after the procedure. The weight of the left adrenal gland on day 14 was lower than that of the right gland. CONCLUSIONS: This procedure elicited partial adrenal infarction with a high catecholamine concentration in the left renal vein.

Surgical resection of twenty-three cases of brain meningioma.

The aim of this study was to report the effectiveness of MRI scanning during brain meningioma resection surgery in the canine and feline. The subjects were 23 cases from 2006 to 2008 in canines and feline diagnosed with meningioma. All were between 8 and 16 years of ages. There were 12 males and 11 females. An appropriate craniotomy was performed for each case according to the initial MRI taken to diagnose meningioma prior to the surgery. Once the dura mater was exposed, an MRI biopsy needle was placed in the tumor as a guide. The first MRI sequence during the surgery was performed with this needle to confirm the location of the tumor. This MRI image was also processed and displayed by multi planar reconstruction to reveal the tumor extent in three dimensions. A Sonopet was applied to the middle of the tumor to destroy the inner part and release pressure from the entire tumor. Creating some space between the brain tissue and tumor, we treated blood vessels and carefully resected them. This procedure was repeated until complete removal of the tumor was confirmed by MRI. Sixteen of the 23 cases survived for more than 2 years postoperatively. The other seven died due to other disorders within 2 years. Our method with MRI navigation during the surgery improved our surgical performance and contributed to a prolonged survival time for the patients. In order to perform multiple MRI procedures smoothly during the surgery, it is necessary to have skillful assistants.