RESUMO
Venous malformations are congenital anomalies of the vascular system. The injection of bleomycin (a cytotoxic, antitumour drug) into the lesion is a safe and effective treatment for low-flow (venous and lymphatic) malformations, but its use systemically has been associated with pulmonary fibrosis. Intralesional injection of bleomycin is considered to have a lower risk, but caution should be used when planning treatment, with particular regard to respiratory function. Electroporation is the temporary application of an electrical field across a tissue to increase (briefly) the permeability of the cell membrane in that tissue. We successfully treated a venous malformation in a patient with severe respiratory compromise with a low dose of bleomycin into the lesion, which we augmented using electroporation. To the best of our knowledge, this is the first reported use of bleomycin electrosclerotherapy in the management of a venous malformation.
Assuntos
Antibióticos Antineoplásicos/administração & dosagem , Bleomicina/administração & dosagem , Eletroquimioterapia/métodos , Escleroterapia/métodos , Malformações Vasculares/tratamento farmacológico , Idoso , Bochecha , Humanos , Injeções Intralesionais , MasculinoAssuntos
Bleomicina/efeitos adversos , Hiperpigmentação/induzido quimicamente , Malformações Vasculares/tratamento farmacológico , Adulto , Bleomicina/uso terapêutico , Pré-Escolar , Feminino , Seguimentos , Humanos , Hiperpigmentação/diagnóstico , Injeções Intralesionais , Masculino , Medição de Risco , Estudos de Amostragem , Malformações Vasculares/diagnósticoRESUMO
In the past decade, the neuroradiological diagnosis and treatment of cerebrovascular diseases has undergone significant advances. With the introduction of varying diagnostic and interventional neuroradiological techniques and advances in the materials used for endovascular treatment, increasingly complex diagnostic and therapeutic neuroradiological procedures are being performed on extremely sick patients. As the interventional neuroradiology field expands, the neuroanaesthetist will become more involved in management of patients undergoing neuroradiological procedures. This produces challenges for the neuroanaesthetist, and understanding the anaesthetic implications of the current developments in neuroradiology is important in the management of these patients. This review provides an overview of diagnostic and therapeutic neuroradiological procedures, with special reference interventional neuroradiology, and the anaesthetic management of patients undergoing these procedures.
