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1.
Zhonghua Er Ke Za Zhi ; 58(4): 319-323, 2020 Apr 02.
Artículo en Chino | MEDLINE | ID: mdl-32234140

RESUMEN

Objective: To summarize the experience of arterial duct (AD) stenting in children with ductus-dependent hypoplastic right heart syndrome (HRHS). Methods: Seven children including 4 cases of pulmonary atresia with intact ventricular septum (PA-IVS) with HRHS and 3 cases of critical pulmonary stenosis (CPS)-IVS with HRHS underwent AD stenting in Qingdao Women and Children's Hospital between January 2012 and January 2019. During the same period, 9 patients of PA-IVS with HRHS received Blalock Taussig (B-T) shunt. Two groups of children on the operation time, hospital stay time, intensive care time and mortality were compared.T test or Mann-Whitney U test was used for comparison between the two groups. Results: There was no significant difference in the age (18 (7-100) vs. 17 (1-142) d, U=31.000, P>0.05) and weight ((3.8±1.1) vs. (3.7±1.3) kg, t=0.272, P>0.05) between the AD stenting group and the B-T group.The operation time ((108±7) vs. (160±49) min, t=-4.304), intensive care time ((3.4±1.0) vs. (6.3±4.5) d, t=-8.692) and total hospitalization time ((10.3±1.0) vs. (26.3±1.0) d, t=-7.822) in the AD stenting group were differed significantly compared with the B-T group (all P<0.05). The transcutaneous oxygen saturation improved significantly (0.723±0.125 vs. 0.926±0.005, t=-6.044, P<0.05) after AD stenting. The diameter of AD stent ranged from 3.5 to 4.0 mm, and the length of AD stent was 16-21 mm. There were no complications such as vascular injury, acute thrombus, catheter spasm and death in the AD stenting group. The mortality of children in the B-T group was 3 in 9 cases. Three cases in the AD stenting group received pulmonary valvulotomy and bilateral Glenn operation at 6, 9 and 9 months after AD stenting, respectively. Conclusions: AD stenting is a feasible, effective, safe and minimally invasive procedure for children with ductus-dependent HRHS. It can even be used as an alternative to B-T shunt.


Asunto(s)
Cateterismo Cardíaco , Cardiopatías Congénitas/cirugía , Stents , Humanos , Lactante , Recién Nacido , Atresia Pulmonar , Estenosis de la Válvula Pulmonar , Estudios Retrospectivos , Resultado del Tratamiento
2.
J Laryngol Otol ; 134(3): 270-271, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32122421

RESUMEN

BACKGROUND: Endoscopic frontal sinus surgery is frequently complicated by post-operative stenosis and obstruction of the frontal sinus outflow tract, resulting in recurrent disease. Frontal sinus stents may help prevent re-occlusion of the frontal neo-ostia. OBJECTIVE: This paper presents a simple and cost-effective approach to frontal sinus stenting using modified Silastic nasal splints. RESULTS AND CONCLUSION: The current technique provides an effective, reliable and inexpensive method for achieving post-operative frontal sinus outflow tract patency.


Asunto(s)
Endoscopía/instrumentación , Seno Frontal/cirugía , Procedimientos Quírurgicos Nasales/instrumentación , Enfermedades de los Senos Paranasales/cirugía , Stents , Constricción Patológica/etiología , Constricción Patológica/prevención & control , Endoscopía/métodos , Seno Frontal/patología , Humanos , Obstrucción Nasal/etiología , Obstrucción Nasal/prevención & control , Procedimientos Quírurgicos Nasales/métodos , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Recurrencia , Resultado del Tratamiento
5.
Ther Adv Cardiovasc Dis ; 14: 1753944720911329, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32168991

RESUMEN

BACKGROUND: The objective of this review is to provide a practical update on endpoint selection for noninferiority (NI) studies in percutaneous coronary intervention studies. METHODS: A PubMed search was conducted for predefined terms to explore the use of NI designs and intrapatient comparisons to determine their current importance. Sample size calculations for the most frequently used endpoints with NI hypotheses were done to increase statistical awareness. RESULTS: Reported NI trials, with the most frequently chosen clinical endpoint of major adverse cardiac events (MACE), had NI margins ranging from 1.66% to 5.00%, resulting in patient populations of 400-1500 per treatment group. Clinical study endpoints comprising of MACE complemented with rates of bleeding complications and stent thrombosis (ST) are suggested to conduct a statistically and clinically meaningful NI trial. Study designs with surrogate endpoints amenable to intrapatient randomizations, are a very attractive option to reduce the number of necessary patients by about half. Comparative clinical endpoint studies with MACE and ST/bleeding rates to study a shortened dual antiplatelet therapy (DAPT) in coronary stent trials are feasible, whereas ST as the sole primary endpoint is not useful. CONCLUSIONS: Expanded composite clinical endpoints (MACE complemented by ST and bleeding rates and intrapatient randomization for selected surrogate endpoints) may be suitable tools to meet future needs in device approval, recertification and reimbursement.


Asunto(s)
Enfermedad de la Arteria Coronaria/terapia , Determinación de Punto Final , Estudios de Equivalencia como Asunto , Intervención Coronaria Percutánea , Proyectos de Investigación , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/mortalidad , Trombosis Coronaria , Quimioterapia Combinada , Hemorragia/inducido químicamente , Humanos , Intervención Coronaria Percutánea/efectos adversos , Intervención Coronaria Percutánea/instrumentación , Inhibidores de Agregación Plaquetaria/administración & dosificación , Inhibidores de Agregación Plaquetaria/efectos adversos , Factores de Riesgo , Tamaño de la Muestra , Stents , Factores de Tiempo , Resultado del Tratamiento
6.
Orv Hetil ; 161(11): 437-439, 2020 Mar.
Artículo en Húngaro | MEDLINE | ID: mdl-32148094

RESUMEN

A 79-year-old male patient was operated with Bentall procedure, thoracic aorta-aortic interposition and stent graft implantation for aortic dissection type A. Because of the persistent false lumen a chronic, 60 mm thoraco-abdominal post-dissection aortic aneurysm developed, which we managed with a new endovascular treatment, the so-called "candy-plug" technique. Thoracic endovascular aortic repair (TEVAR) can induce the thrombosis of the false lumen and the aortic remodelling via the covering of the proximal intimal tear. However, the thrombosis of the false lumen is often - in 60% of the cases - incomplete. In these cases we have to prepare for the persistent expansion of the aorta, which can be managed only with high-risk open or endovascular repair. Hence a new solution with lower risk was investigated, which combines TEVAR and the false lumen closure devices. Such a new treatment is the "candy-plug" technique, which was performed in our case. This minimally invasive technique, which excludes the circulation of the false lumen and stops the progression of the aneurysm expansion, can be an effective and safe solution for the treatment of the chronic post-dissection aortic aneurysms. Orv Hetil. 2020; 161(11): 437-439.


Asunto(s)
Aneurisma Disecante/cirugía , Implantación de Prótesis Vascular , Prótesis Vascular , Procedimientos Endovasculares/métodos , Stents , Anciano , Aneurisma Disecante/diagnóstico por imagen , Aortografía , Humanos , Masculino , Estudios Retrospectivos , Resultado del Tratamiento
8.
Gastrointest Endosc ; 91(2): 286-287, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32036938
10.
Medicine (Baltimore) ; 99(6): e19099, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32028435

RESUMEN

We determined the clinical effectiveness and long-term outcomes in patients with distal biliary obstruction (DBO) secondary to pancreatic carcinoma (PC) who were treated by self-expanded metallic stent (SEMS) insertion with or without high-intensity focused ultrasound (HIFU) ablation.From January 2014 to December 2018, consecutive patients with DBO secondary to PC underwent SEMS insertion with or without HIFU ablation in our center. The long-term outcomes were compared between the 2 groups.During the included period, 75 patients underwent SEMS insertion with (n = 34) or without (n = 41) HIFU ablation in our center. SEMS insertion was successfully performed in all patients. Liver function was significantly improved after SEMS insertion in both groups. An average of 2.9 HIFU treatment sessions per patient were performed. Twenty patients (stent + HIFU group: 7; stent-only group: 13) experienced stent dysfunction (P = .278). The clinical response rate to HIFU ablation was 79.4%. The median stent patency was significantly longer in the stent with HIFU group than in the stent-only group (175 vs 118 days, P = .005). The median survival was significantly longer in the stent with HIFU group compared with the stent-only group (211 versus 136 days, P = .004). An Eastern Cooperative Oncology Group (ECOG) Performance Status of 3 (hazard ratio: 0.300; P = .002) and subsequent HIFU ablation (hazard ratio: 0.508; P = .005) were associated with prolonged survival.HIFU ablation following stent insertion can prolong the stent patency and survival for patients with DBO secondary to PC.


Asunto(s)
Colestasis/etiología , Ultrasonido Enfocado de Alta Intensidad de Ablación , Neoplasias Pancreáticas/complicaciones , Implantación de Prótesis , Stents , Anciano , Colestasis/cirugía , Femenino , Ultrasonido Enfocado de Alta Intensidad de Ablación/métodos , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/mortalidad , Modelos de Riesgos Proporcionales , Implantación de Prótesis/métodos , Estudios Retrospectivos , Análisis de Supervivencia
11.
Zhonghua Yi Xue Za Zhi ; 100(5): 378-381, 2020 Feb 11.
Artículo en Chino | MEDLINE | ID: mdl-32074783

RESUMEN

Objective: To compare the safety and efficacy of photodynamic therapy (PDT) and esophageal stent implantation in improving dysphagia caused by malignant obstruction of middle and advanced esophageal cancer. Methods: A total of 45 patients treated in the Affiliated Hospital of Qingdao University and Qingdao Huangdao District Central Hospital from January 2017 to January 2018 were retrospectively analyzed, of which 34 cases were males and 11 cases were females, 29 cases with the age beyond 60 years old, 41 cases were squamous carcinoma, 4 were adenocarcinoma. PDT was applied to 20 patients and 25 patients received esophageal carotid stenting implantation. There was no significant difference in gender, age, pathological type, location and stage between the two groups. Before treatment, 3 days, 1 month and 3 months after treatment, dysphagia was compared according to Stooler grading criteria, and also the time that patients experienced dysphagia again post treatment. Results: There were no statistical differences between the two groups in dysphagia grade change in 3 days, 1 month and 3 months after treatment (all P>0.05), The stent groups showed advantages towards the PDT group 3 days after treatment in patients with Stooler grading 0 (40%(10/25) vs 0(0/20), P<0.05). No significant differences were found between two groups with Stooler grading 0 (P>0.05) in 1 month and 3 months after treatment. Obstruction symptoms occurred earlier in the stent group compared with the PDT group (P<0.05). Conclusion: Esophageal stent can relieve the symptoms of dysphagia immediately after the implantation, while photodynamic therapy can also prolong the time of esophageal re-obstruction in addition to the immediate effect, with proved safety and efficacy in the treatment of middle and advanced esophageal cancer.


Asunto(s)
Trastornos de Deglución , Neoplasias Esofágicas , Fotoquimioterapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuidados Paliativos , Estudios Retrospectivos , Stents , Resultado del Tratamiento
12.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(1): 177-180, 2020 Feb 18.
Artículo en Chino | MEDLINE | ID: mdl-32071483

RESUMEN

OBJECTIVE: To summarize the preliminary experience of hybrid operation for the treatment of symptomatic long-segment chronic internal carotid artery occlusion (CICAO) without stump. METHODS: Clinical data of 12 patients of symptomatic long-segment CICAO without stump undergoing hybrid operation treatment from July 2015 to December 2017 were retrospectively analyzed. The safety and efficacy of hybrid operation for the treatment of symptomatic long-segment CICAO without stump were preliminarily assessed. CICAO was defined as occlusion time being more than 4 weeks. The primary outcome was defined as any stroke (including ischemic or hemorrhagic) or deaths from any cause after hybrid operation within 30 days. The secondary outcome was defined as successful revascularization and occurrence of >50% in-stent restenosis during the follow-up period. RESULTS: In this group, the symptomatic long-segment CICAO of 11 patients were successfully recanalized. Technical success rate was 91.7% (11/12). The main complication rate was 8.3% (1/12). This patient encountered iatrogenic internal carotid artery cavernous sinus fistula caused by micro-guide wire in the midway of the hybrid operation, the proximal segment of this internal carotid artery was ligated and the iatrogenic internal carotid artery cavernous sinus fistula disappeared in the following digital subtraction angiography image. No patient encountered hemorrhagic stroke and ischemic stroke. No death complications occurred. In this group 10 patients of them were followed up. The follow-up period ranged from 10 to 32 months [mean, (19±9) months]. During the follow-up period, 1 patients developed in-stent restenosis and improved after reoperation of percutaneous transluminal angioplasty by the right size balloon without stenting treatment. CONCLUSION: Hybrid operation for the treatment of highly screened patients with symptomatic long-segment CICAO without stump is safe and effective, could reduce the incidence of complications and improve procedural success rate.


Asunto(s)
Arteria Carótida Interna , Estenosis Carotídea , Angioplastia , Humanos , Estudios Retrospectivos , Stents , Resultado del Tratamiento
13.
Medicine (Baltimore) ; 99(5): e18981, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32000431

RESUMEN

RATIONALE: Congenital absence of the right coronary artery with acute myocardial infarction (AMI) is a rare clinical situation that may lead to death. We report a case of successful percutaneous coronary intervention for congenital absence of the right coronary artery with AMI. PATIENT CONCERNS: A 53-year-old woman had a 7-day history of chest discomfort that had worsened over 10 hours. She was diagnosed as having myocardial infarction and was admitted to hospital. DIAGNOSIS: Coronary angiography showed absence of the right coronary artery; the left anterior descending (LAD) branch sent out the right ventricular branch and the posterior descending branch. The LAD branch was occluded and there was diffuse stenosis of the middle right ventricular branch and severe stenosis of the distal circumflex branch. INTERVENTIONS: Percutaneous coronary intervention was performed. One stent was implanted in the LAD branch and another implanted in the right ventricular branch. OUTCOMES: The patient was discharged 3 weeks after surgery. The follow-up showed that the patient was asymptomatic without recurrence. LESSONS: Although absence of the right coronary artery with AMI is a fatal condition, percutaneous coronary intervention remains an effective treatment.


Asunto(s)
Anomalías de los Vasos Coronarios/cirugía , Infarto del Miocardio/cirugía , Intervención Coronaria Percutánea , Angiografía Coronaria , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico por imagen , Stents
14.
Medicine (Baltimore) ; 99(3): e18718, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011448

RESUMEN

BACKGROUND AND AIM: Biliary obstruction can impair the effectiveness of neo-adjuvant chemotherapy. This study was designed to compare biliary stenting with covered self-expandable metal stents (FCSEMS) and plastic stents (PS) in patients with biliary obstruction caused by borderline resectable pancreatic cancer (BRPC) who were undergoing neo-adjuvant chemotherapy during preoperative biliary drainage. METHODS: This single-center, comparative, randomized, superiority study was designed to compare FCSEMS with PS for drainage of biliary obstruction of BRPC. Twenty two eligible patients providing informed consent will be randomized 1:1 by computer to either FCSEMS or PS for endoscopic retrograde biliary drainage (ERBD). All subsequent clinical interventions, including crossover to alternative procedures, will be at the discretion of the treating physician based on standard clinical care. The primary outcomes will be the rates and causes of stent dysfunction during preoperative biliary drainage. Other outcomes include time required for ERBD, adverse events related to ERBD, period from ERBD to surgery, percentage of patients able to undergo surgery, operation time, intraoperative bleeding volume, postoperative adverse events, and postoperative hospitalization. Subjects, treating clinicians, and outcome assessors will not be blinded to assignment. DISCUSSION: This study is intended to determine whether FCSEMS or PS is the better biliary stent for ERBD for management of patients with biliary obstruction of BRPC, a common clinical dilemma that has not yet been investigated in randomized trials. TRIALS REGISTRATION: UMIN-CTR, Identifier: UMIN000030473. Registered July 10, 2017, Wakayama Medical University Hospital.


Asunto(s)
Colestasis/etiología , Colestasis/cirugía , Neoplasias Pancreáticas/complicaciones , Stents , Procedimientos Quirúrgicos del Sistema Biliar , Quimioterapia Adyuvante , Humanos , Neoplasias Pancreáticas/terapia , Plásticos , Cuidados Preoperatorios , Estudios Prospectivos , Proyectos de Investigación , Stents Metálicos Autoexpandibles , Método Simple Ciego
15.
Aktuelle Urol ; 51(1): 14-16, 2020 02.
Artículo en Alemán | MEDLINE | ID: mdl-32018327
16.
Medicine (Baltimore) ; 99(8): e19316, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32080148

RESUMEN

OBJECTIVE: To investigate the effect of edaravone on depression relief in symptomatic patients with intracranial stenosis and its relationship with the expression of sex hormones. METHODS: We recruited 112 patients with symptomatic intracranial arterial stenosis from Renmin Hospital, Wuhan University, between October 2014 and October 2017. All patients were divided into the traditional or experimental (traditional treatment + intravenous infusion of edaravone 30 mg twice a day for 14 days) treatment groups. The general clinical data were collected, and neurological functional recovery using the Modified Rankin Scale (mRS) and National Institute of Health stroke scale (NIHSS) scores were recorded. Symptom Checklist 90 (SCL-90) was used to assess the general psychological changes of the patient, followed by the 24 Hamilton Depression Scale (HAMD) to examine the incidence of post-stroke depression (PSD). This divided the patients into the mild, moderate, and severe depression groups. Next, we measured the serum protein expression of the sex hormones estradiol (E2), testosterone (T), follicle stimulating hormone (FSH), prolactin (PRL), and luteinizing hormone (LH). RESULTS: The mRS and NIHSS scores were significantly lower in the experimental group than in the control group (P < .05). There was no significant difference in SCL90 score before intervention (P > .05); the scores were significantly lower in the experimental group after intervention (P < .05). There was a significant difference in SCL-90 and HAMD scores between groups before treatment (P < .05), with significantly lower scores in the experimental group post-treatment (P < .05). The incidence of depression was significantly reduced in the experimental group post-treatment. Furthermore, the expression of E2 and FSH was significantly higher (P < .01) and lower (P < .001), respectively, in women than in men in the experimental group post-treatment. Interestingly, the expression of T was significantly lower in men in the experimental group post-treatment (P < .001). CONCLUSION: Edaravone significantly improved the clinical efficacy of stent implantation in intracranial artery stenosis treatment by alleviating depression and reducing the incidence of PSD.


Asunto(s)
Arteriopatías Oclusivas/terapia , Encéfalo/irrigación sanguínea , Depresión/tratamiento farmacológico , Edaravona/uso terapéutico , Fármacos Neuroprotectores/uso terapéutico , Stents , Estradiol/sangre , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Hormona Luteinizante/sangre , Masculino , Persona de Mediana Edad , Prolactina/sangre , Índice de Severidad de la Enfermedad , Testosterona/sangre
17.
Vasc Health Risk Manag ; 16: 67-73, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32110032

RESUMEN

Endarterectomy of common femoral artery lesions (CFA) carries favorable long-term results and is currently still considered the gold standard for treating these lesions. Although routine stenting has been considered an option for treating the CFA, it has yielded conflicting results and is currently reserved for a bailout of suboptimal endovascular results. Newer therapies with atherectomy or lithoplasty in conjunction with pharmacologic anti-proliferative therapies are promising with less bailout stenting and dissections but randomized trials are needed to confirm their effectiveness and safety.


Asunto(s)
Endarterectomía , Procedimientos Endovasculares/métodos , Arteria Femoral/cirugía , Enfermedad Arterial Periférica/terapia , Anciano , Angioplastia/instrumentación , Aterectomía , Endarterectomía/efectos adversos , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/instrumentación , Femenino , Arteria Femoral/diagnóstico por imagen , Arteria Femoral/fisiopatología , Humanos , Masculino , Enfermedad Arterial Periférica/diagnóstico por imagen , Enfermedad Arterial Periférica/fisiopatología , Stents , Resultado del Tratamiento , Grado de Desobstrucción Vascular
18.
Curr Urol Rep ; 21(1): 3, 2020 Jan 18.
Artículo en Inglés | MEDLINE | ID: mdl-31960193

RESUMEN

PURPOSE OF REVIEW: In the setting of kidney transplantation, the ureter is a common source for complications. As a result, prevention of ureteral complications and their management is of crucial importance. In this context, the purpose of this review is to summarize recent literature on the ureter in the kidney transplant setting with a special focus on new findings. We conducted a PubMed and Medline search over the last 10 years to identify all new publications related to ureteroneoimplantations, stents and management of complications in the kidney transplant setting. RECENT FINDINGS: Performance of the "Lich-Gregoir" technique for ureteroneocystostomy seems to be favourable in regard to postoperative complications when compared with other methods described in the literature. Moreover, major urologic complications can be further reduced by ureteral stenting. A new approach for management of ureteral strictures in renal transplants is presented. We discussed the usage of a ureteral stent covered with a biostable polymer aiming to prevent tissue ingrowth into the lumen as a new option for management of ureteral stricture in the kidney transplant setting.


Asunto(s)
Trasplante de Riñón/métodos , Uréter/cirugía , Obstrucción Ureteral/terapia , Derivación Urinaria/efectos adversos , Derivación Urinaria/métodos , Anastomosis Quirúrgica/efectos adversos , Constricción Patológica , Humanos , Stents , Obstrucción Ureteral/etiología
19.
BMC Neurol ; 20(1): 9, 2020 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-31914955

RESUMEN

BACKGROUND: Venous sinus stenosis (VSS) is a type of cerebral venous vascular disease. Cerebral autoregulation is an indicator of cerebral arterial function. The cerebral circulatory system is composed of the venous system and arterial system. Impaired venous function may affect arterial function. Thus, cerebral venous stenosis may influence cerebral autoregulation. CASE PRESENTATION: In this case, a 50-year-old woman with transient blindness and headache was admitted to the hospital. The patient was diagnosed with VSS. A stent was placed at the stenosis. The stent released the intravenous pressure and remitted the patient's symptoms. Measurements of dynamic cerebral autoregulation (dCA) were performed at 3 time points: before stenting, after stenting, and 3 months later. The dCA gradually improved after stenting. CONCLUSION: VSS may have an influence on cerebral autoregulation, and effective treatment improves cerebral autoregulation in patients with VSS.


Asunto(s)
Senos Craneales/patología , Senos Craneales/cirugía , Homeostasis , Procedimientos Neuroquirúrgicos/métodos , Venas Cerebrales/patología , Trastornos Cerebrovasculares/patología , Trastornos Cerebrovasculares/fisiopatología , Trastornos Cerebrovasculares/cirugía , Constricción Patológica , Senos Craneales/fisiopatología , Femenino , Humanos , Persona de Mediana Edad , Procedimientos Neuroquirúrgicos/instrumentación , Stents , Resultado del Tratamiento
20.
Cancer Radiother ; 24(1): 60-63, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31980360

RESUMEN

Hemosuccus Pancreaticus (HP) is a very rare upper gastro-intestinal haemorrhagic event whose causes can be aneurismal lesions, acute and chronic pancreatic inflammatory conditions, and pancreatic masses. We present 2 cases of patients who underwent stereotactic radiotherapy for pancreatic lesions who manifested signs of HP after treatment. Two male patients were diagnosed with an inoperable locally advanced pancreatic cancer and underwent 8 cycles of chemotherapy followed by stereotactic radiotherapy to the pancreatic lesion delivering 40Gy in 8 fractions. The first patient complained of melena and had a necrotic tumoural mass with a new aneurysmal bulge 3 months after the SBRT. A stent was placed in the aneurysmal lesion, however, a few days later, the bleeding occurred again and the patient died. The other patient had local tumour progression 12 months after SBRT with a pancreatic mass eroding the near vessels. He developed a fast and massive bleeding. HP may occur after SBRT. Inflammation of the tumour mass can lead to erosion of the vessels with subsequent bleeding. The radiotherapy treatment may have contributed to the HP genesis. The treatment is complex and consists of the placement of a stent or surgery.


Asunto(s)
Hemorragia Gastrointestinal/etiología , Neoplasias Pancreáticas/radioterapia , Radiocirugia/efectos adversos , Adenocarcinoma/radioterapia , Aneurisma/cirugía , Progresión de la Enfermedad , Resultado Fatal , Humanos , Masculino , Arteria Mesentérica Superior/cirugía , Persona de Mediana Edad , Stents
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