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1.
Cardiovasc Intervent Radiol ; 42(12): 1695-1701, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31538233

RESUMO

PURPOSE: To retrospectively evaluate the results of sclerotherapy for venous malformations, with emphasis on patient satisfaction, complications and predictors of positive response to treatment. MATERIALS AND METHODS: Three hundred and nine patients were treated with ethanol sclerotherapy for venous malformations in our center between the years 2000 and 2014. All of them were sent a self-assessment questionnaire for evaluation of their satisfaction and treatment complications. In total, 153 patients (mean age 21, range 6 weeks to 67 years) responded to the questionnaire. We analyzed clinical and imaging data from the medical records of these patients. RESULTS: Sixty-four (42%) patients had venous malformations in the lower extremities, 35 (23%) in head and neck regions, 33 (22%) in the trunk, 14 (9%) in the upper extremities and 5 (3%) in the buttock and genitalia. Complete relief of swelling, pain, functional and esthetic complaints was reported in 23%, 22%, 17% and 12% of patients, respectively. Thirty-eight (25%) patients reported being very satisfied with treatment outcomes, 55 (36%) were satisfied, 49 (32%) were not satisfied and 11 (7%) were very unsatisfied. We did not find significant correlations between patient satisfaction and demographics characteristics, lesion location, lesion size, tissue involvement or total sclerosant quantity. The rate of class 3 complications was 7% and that of class 4 complications was 2%. CONCLUSION: Ethanol sclerotherapy is an effective treatment for venous malformations. Nonetheless, this treatment has a significant complication rate. Patient satisfaction is independent of lesion characteristics and is not as high as may be expected.


Assuntos
Etanol/uso terapêutico , Satisfação do Paciente/estatística & dados numéricos , Soluções Esclerosantes/uso terapêutico , Escleroterapia/métodos , Malformações Vasculares/terapia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
2.
Foot Ankle Clin ; 24(3): 495-504, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31370999

RESUMO

Minimally invasive treatment can offer an earlier recovery with less pain and scarring compared with traditional open surgeries. The goals of minimally invasive surgery are to debride degenerative tendon, stimulate healing, and, when appropriate, repair damaged tendon. Sclerotherapy and prolotherapy have been shown to reduce neovascularization and pain. Percutaneous stripping and endoscopic debridement are better options for diffuse tendinopathy. Plantaris release can be useful in diffuse disease in patients with primarily medial-sided Achilles pain. Overall, minimally invasive surgery provides similar benefits as open procedures with reduced complications and morbidity.


Assuntos
Tendão do Calcâneo/cirurgia , Endoscopia/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Tendinopatia/cirurgia , Tenotomia/métodos , Desbridamento , Humanos , Soluções Esclerosantes/uso terapêutico
3.
J Craniofac Surg ; 30(8): e796-e799, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31403517

RESUMO

Vascular malformations (VMs) are benign lesions of blood vessels originated from an error in vascular morphogenesis during the embryologic phase. Generally, when located in the head and neck region VMs occurs in lips, tongue, buccal mucosa, gums, or palate. The VMs are usually asymptomatic, varies in size and may cause facial asymmetries. Different therapeutic modalities are available to treat VMs, which include surgical excision, cautery, cryotherapy, laser therapy, and sclerosing agents. The authors report 2 patients with extensive VM in the tongue treated with intralesional injection of a low-dose solution of monoethanolamine oleate (MO) and lidocaine. The first patient was a 69-year-old male patient and the 2nd a 65-year-old woman. In both patients, it were performed weekly application of 1:1 MO (Ethamolin) with Lidocaine (lidocaine 3% 1:50,000) in the amount of 0.1 mL of the solution per cm3 of lesion, with a total of 12 applications for each patient at the end of the treatment, with good results and without complications. It is important to be alert in which situation sclerotherapy should be used and that small doses of the sclerotherapeutic agent is essential for the prevention of complications after the procedure. Therefore, these patients showed that the sclerotherapy with MO may be an effective and simple treatment for extensive oral benign vascular lesions. In both patients, there was a great improvement in the clinical aspect of the lesions and patient's satisfaction.


Assuntos
Lidocaína/uso terapêutico , Ácidos Oleicos/uso terapêutico , Soluções Esclerosantes/uso terapêutico , Doenças da Língua/tratamento farmacológico , Malformações Vasculares/tratamento farmacológico , Idoso , Feminino , Humanos , Injeções Intralesionais , Terapia a Laser , Lidocaína/administração & dosagem , Masculino , Ácidos Oleicos/administração & dosagem , Escleroterapia , Língua , Resultado do Tratamento
4.
Medicine (Baltimore) ; 98(26): e16201, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261565

RESUMO

BACKGROUND: To compare the efficacy and safety of the modified sandwich method with lauromacrogol in the treatment of gastric variceal bleeding (GVB) caused by liver cirrhosis with the traditional sandwich method no accompanied by lauromacrogol via a meta-analysis. METHODS: The Cochrane Library, Pubmed, the China National Knowledge Infrastructure (CNKI) database, the Chinese Wanfang database, and the Chongqing VIP database were searched to identify cohort studies comparing modified to traditional sandwich method in the treatment of GVB with liver cirrhosis. The relative risk for hemostasis rate, gastric varices (GV) remission rate, re-bleeding rate, the incidence of post-operative complications (pain, fever, ulcer or erosion, ectopic embolism), and all-cause mortality were calculated. The mean difference for average tissue adhesive dosage per case was calculated. Relevant data were analyzed with the Reviewer Manager 5.3.5. RESULTS: Four cohort studies with a total of 587 patients were included in this meta-analysis. In the treatment of GVB with liver cirrhosis, compared with the traditional sandwich method, the modified sandwich method was associated with a higher GV remission rate (RR: 1.24, 95% CI: 1.09-1.42; P = .001) according to the pooled results. There were no statistically significant differences between the 2 methods in the rate of hemostasis, re-bleeding, pain, fever, ulcer or erosion, ectopic embolism, and all-cause mortality (P ≧ .05). CONCLUSIONS: This meta-analysis indicated that the modified sandwich method with lauromacrogol is more effective than the traditional sandwich method without lauromacrogol. Due to the limited number of studies and samples, more RCT studies are needed to further validate the efficacy and safety of the modified sandwich method with lauromacrogol in the treatment of GVB with liver cirrhosis.


Assuntos
Varizes Esofágicas e Gástricas/terapia , Hemorragia/terapia , Cirrose Hepática/terapia , Escleroterapia , Varizes Esofágicas e Gástricas/complicações , Hemorragia/etiologia , Humanos , Cirrose Hepática/complicações , Polidocanol/uso terapêutico , Soluções Esclerosantes/uso terapêutico , Escleroterapia/métodos , Adesivos Teciduais/uso terapêutico
5.
Paraguay Oral Research ; 8(1): 47-54, julio 2019.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1021725

RESUMO

El hemangioma, según la Organización Mundial de la Salud (OMS), es una neoplasia vascular benigna, caracterizada por la proliferación anormal de vasos sanguíneos, se presenta como una lesión única, pudiéndose observar en cualquier parte del organismo, sin embargo es más incidente en el área de cabeza y cuello, con predominio en los labios, en la lengua y en la mucosa yugal. Técnicamente, su exrpación quirúrgica es dicil y desafiante, al estar cargada con complicaciones como hemorragia, escisión incompleta, desfiguración facial y recurrencia. Objevo: relatar el caso clínico de un paciente con hemangioma lingual tratado con Polidocanol al 0,5%. Se necesitaron de 4 sesiones de aplicación del agente esclerosaste para que retrocediera completamente la lesión donde en cada infiltración se ulizó 1ml y en la úlma sesión 0.7 ml, logrando en esta úlma obtener la desaparición de la lesión por lo que el pronósco fue bueno. Conclusión: De acuerdo a los resultados de este trabajo el uso del Polidocanol al 0.5% en tratamientos de hemangioma linguales resulta ser una técnica bastante efecva, ya que con su prácca nos da una disminución del volumen de dicha lesión


The hemangioma, according to theWorldHealthOrganizaon (WHO), is a benign vascular neoplasm, characterized by the abnormal proliferaon of blood vessels, it presents as a single lesion, it can be found anywhere in the body, however it is more incident in thearea of the head and neck, predominantlyonthelips, onthetongue and onthejugal mucosa. Technically, its surgical removal is difficult and challenging, incomplete disease, facial disfigurement and recurrence. Objecve: to report the clinical case of a paentwith lingual hemangioma treatedwith 0.5% Polidocanol. iook 4 sessions of applicaon of thesclerosingagent to completelyretrachelesionwhere 1 ml wasused in eachinfiltraon and 0.7 ml in thelastsession, obtainingthedisappear of thelesion in thelaer, so the prognosis wasgood. Conclusion: According to the results of this study, the use of Polidocanol at 0.5% in lingual hemangioma treatmentsis a very effecve technique, and with its pracce we have a decrease in the volume of this lesion


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Soluções Esclerosantes/uso terapêutico , Neoplasias da Língua/tratamento farmacológico , /uso terapêutico , Hemangioma/tratamento farmacológico , Soluções Esclerosantes/administração & dosagem , /administração & dosagem
6.
BMC Cancer ; 19(1): 614, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234819

RESUMO

BACKGROUND: Malignant pleural effusion (MPE) is a devastating sequela associated with cancer. Talc pleurodesis is a common treatment strategy for MPE but has been estimated to be unsuccessful in up to 20-50% of patients. Clinical failure of talc pleurodesis is thought to be due to poor dispersion. This monograph reports the development of a foam delivery system designed to more effectively coat the pleural cavity. METHODS: C57BL/6 mice were injected with Lewis lung carcinoma (LL/2) cells intrapleurally to induce MPE. The mice then received either normal saline (NS) control, foam control (F), talc slurry (TS, 2 mg/g) or talc foam (TF, 2 mg/g). Airspace volume was evaluated by CT, lungs/pleura were collected, and percent fibrosis was determined. RESULTS: The TF group had significantly better survival than the TS group (21 vs 13.5 days, p < 0.0001). The average effusion volume was less in the talc groups compared to the control group (140 vs 628 µL, p < 0.001). TF induced significant lung fibrosis (p < 0.01), similar to TS. On CT, TF significantly (p < 0.05) reduced loss of right lung volume (by 30-40%) compared to the control group. This was not seen with TS (p > 0.05). CONCLUSIONS: This report describes using a novel talc foam delivery system for the treatment of MPE. In the LL/2 model, mice treated with the TF had better survival outcomes and less reduction of lung volume than mice treated with the standard of care TS. These data provide support for translational efforts to move talc foam from animal models into clinical trials.


Assuntos
Sistemas de Liberação de Medicamentos/métodos , Derrame Pleural Maligno/terapia , Pleurodese/métodos , Soluções Esclerosantes/uso terapêutico , Talco/uso terapêutico , Animais , Carcinoma Pulmonar de Lewis/complicações , Modelos Animais de Doenças , Feminino , Fibrose/diagnóstico , Hidrogel de Polietilenoglicol-Dimetacrilato/química , Pulmão/patologia , Medidas de Volume Pulmonar , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Pleura/patologia , Derrame Pleural Maligno/etiologia , Soluções Esclerosantes/administração & dosagem , Talco/administração & dosagem , Temperatura de Transição , Resultado do Tratamento
7.
Curr Opin Ophthalmol ; 30(5): 380-385, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31232717

RESUMO

PURPOSE OF REVIEW: Currently, there is no ideal management for orbital lymphatic malformations. Significant advances have been made since the discovery of new agents in the treatment. The purpose of this manuscript is to review the recent evidence on new sclerotherapy agents and systemic medications. RECENT FINDINGS: Traditional sclerosants are OK-432, sodium tetradecyl sulphate and ethanol. More recent developments are the use of doxycycline, bleomycin, and pingyangmycin. Sirolimus as a systemic medication has revolutionized the medical management of lymphatic malformations. Other oral drugs such as propranolol and sildenafil are controversial. Future treatment involves targeting lymphangiogenic pathways including inhibition of vascular endothelial growth factors and the phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit. SUMMARY: The development of new agents allows multimodal management either as monotherapy or combined therapy to achieve better outcomes in this difficult to manage disease.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Antineoplásicos/uso terapêutico , Linfangioma/terapia , Neoplasias Orbitárias/terapia , Soluções Esclerosantes/uso terapêutico , Escleroterapia/métodos , Sirolimo/uso terapêutico , Bevacizumab/uso terapêutico , Bleomicina/uso terapêutico , Doxiciclina/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Picibanil/uso terapêutico
8.
BMJ Case Rep ; 12(6)2019 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-31177193

RESUMO

We hereby report a case of a 55-year-old woman, with complaints of sudden onset outward protrusion of left eye progressing over 2 months, along with pain and loss of vision. Visual acuity in the affected eye was light perception only. On imaging, a well-defined solitary cystic lesion was noted in the retrobulbar space, which showed no enhancement on contrast-enhanced MRI. We performed fluid aspiration from the cyst under negative pressure and injected bleomycin as a sclerosant, without attempting a surgical excision. The proptosis reduced visibly, and after a week, visual acuity improved to finger counting at 1 m. At the 6 months follow-up, the patient did not show any recurrence of proptosis. This report highlights the importance of sclerosant therapy without the need for surgical excision in managing macrocystic lymphangiomas in adult age group.


Assuntos
Bleomicina/administração & dosagem , Exoftalmia/etiologia , Linfangioma/tratamento farmacológico , Neoplasias Orbitárias/patologia , Antibióticos Antineoplásicos/administração & dosagem , Bleomicina/uso terapêutico , Cistos/diagnóstico por imagem , Cistos/patologia , Feminino , Humanos , Injeções Intralesionais , Linfangioma/patologia , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Órbita/patologia , Paracentese , Soluções Esclerosantes/uso terapêutico , Resultado do Tratamento , Acuidade Visual
9.
Artigo em Chinês | MEDLINE | ID: mdl-30704167

RESUMO

Objective: To investigate the efficacy and safety of percutaneous lauromacrogol injection (PLI) in treatment of cystic or predominantly cystic thyroid nodules. Methods: A total of 114 cystic thyroid nodules and 61 predominantly cystic thyroid nodules with pain or uncomfort or aesthetic complaints were offered PLI. Therapeutic success rates and side effects were evaluated. From October 2012 to December 2015,114 patients with cystic thyroid nodules and 61 with predominantly cystic thyroid nodules with pain or uncomfortable or aesthetic complaints at the outpatient clinic of the First Affiliated Hospital of Wenzhou Medical University were offered percutaneous lauromacrogol sclerotherapy. Cytological results were benign. This study was a prospective trial. Ultrasonography sound examination was performed in all patients before treatment. The baseline data of all the patients and the data of the patients examined at the follow-up of 1, 3, 6 and 12 months were analyzed. Therapeutic success rate (nodule volume reduction >50%) and safety were observed. The data of nodule volume reduction ratio and the function of thyroid were normal distribution and analyzed by Mann-Whitney test and t test. The data of nodule volume, symptoms score and cosmetic score were skewed distribution, which were indicated with median and analyzed by nonparamentic test. Results: The mean volume of the cystic thyroid nodules was reduced from 12.5 cm(3) before PLI to 0.2 cm(3) at 12 months after PLI (χ(2)=266.175, P<0.001), with a therapeutic success rate of 100%, and the mean volume of the predominantly cystic thyroid nodules was reduced from 10.5 cm(3) before PLI to 2.0 cm(3) at 12 months after PLI (χ(2)=203.122, P<0.001) with a therapeutic success rate of 93.4%(57/61). Pressure symptom score and cosmetic grade were significantly improved at 12 months after PLI in patients with cystic or predominantly cystic thyroid nodules. Pressure symptom score and cosmetic grade in patients with cystic thyroid nodules were Z=-6.126 and Z=-13.735, respectively; pressure symptom score and cosmetic grade in patients with predominantly cystic thyroid nodules were Z=-3.126 and Z=-7.212, respectively (all P<0.001) . There no significant difference in the thyroid functions before and after PLI in two groups of patients (all P>0.05) . The side effects of PLI were mild. Conclusion: PLI is a safe and effective alternative to treat benign cystic or predominantly cystic thyroid nodules.


Assuntos
Cistos/terapia , Polidocanol/uso terapêutico , Soluções Esclerosantes/uso terapêutico , Escleroterapia/métodos , Doenças da Glândula Tireoide/terapia , Nódulo da Glândula Tireoide/terapia , Ultrassonografia de Intervenção , Humanos , Polidocanol/efeitos adversos , Estudos Prospectivos , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Resultado do Tratamento
10.
Dermatol Surg ; 45(7): 950-953, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30741789

RESUMO

BACKGROUND: Sclerotherapy is used to treat varicosities and telangiectases. Glycerin is a sclerosing agent that has been used off-label for years with a favorable adverse effect profile. However, the treatment of facial telangiectases with sclerotherapy is controversial given the potential for necrosis and embolization in relation to the complex vascular anatomy of the face. OBJECTIVE: To determine the safety and efficacy of glycerin sclerotherapy for the treatment of facial telangiectases. MATERIALS AND METHODS: The authors report a series of 8 patients with facial telangiectases treated with glycerin sclerotherapy. Glycerin mixed with lidocaine and epinephrine was used. The telangiectases were measured and identified as targets for treatment. RESULTS: The patients ranged in age from 45 to 88 years. Between 0.5 and 1 mL was used to treat telangiectases of the nose and malar cheek area per session. Five of the patients achieved satisfactory results after 1 treatment, whereas patients with more extensive telangiectases required up to 3 sessions with 4-week intervals between each session. Injection site pain was the only reported adverse effect, and no evidence of necrosis or blindness was observed. CONCLUSION: Glycerin sclerotherapy seems to be a safe and effective modality for the treatment of facial telangiectases.


Assuntos
Dermatoses Faciais/terapia , Glicerol/uso terapêutico , Soluções Esclerosantes/uso terapêutico , Escleroterapia , Telangiectasia/terapia , Idoso , Idoso de 80 Anos ou mais , Anestésicos Locais/uso terapêutico , Estudos de Coortes , Feminino , Humanos , Lidocaína/uso terapêutico , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
11.
Lasers Med Sci ; 34(7): 1325-1332, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30707327

RESUMO

Sclerotherapy continues to be the treatment of choice for varicose veins in the legs. However, isolated treatment using microfoam or lasers requires a high number of sessions to eliminate them. In 2013, we published results about the efficacy and safety 3 years after the combined treatment with microfoam injections and subsequent application of Nd:YAG laser. The aim of this paper is to clinically evaluate the treatment of varices in a control visit after 5 years, when polidocanol microfoam is used and is immediately irradiated in the tissue with 1064-nm Nd:YAG laser beam. The outcome persistence after 5 years was studied in the legs that had received combined treatment and had been studied 3 years after treatment. Patients were contacted by phone, interviewed, and examined with echo-Doppler. Out of the 259 patients who were contacted, 221 agreed to make the appointment, although in the end, only 202 came, which meant analysing 404 legs. At 5 years, the clearance rates were very high: patients were included in class CEAP C1 showing vessels of from 0.5 to 3 mm diameter. The patients showed a high level of satisfaction. Regarding adverse effects, only 4 cases of hypopigmentation described in the previous publication persisted. Although the action mechanisms between the microfoam and the Nd:YAG laser must still be elucidated, it is notable that combining microfoam with laser exposure obtained a complete, effective treatment of legs in only 2 sessions, with high clearance rates and high level of satisfaction among patients.


Assuntos
Lasers de Estado Sólido , Perna (Membro)/patologia , Polidocanol/administração & dosagem , Polidocanol/uso terapêutico , Varizes/tratamento farmacológico , Varizes/cirurgia , Terapia Combinada , Feminino , Humanos , Lasers de Estado Sólido/efeitos adversos , Pessoa de Meia-Idade , Satisfação do Paciente , Polidocanol/efeitos adversos , Soluções Esclerosantes/uso terapêutico , Escleroterapia/efeitos adversos , Resultado do Tratamento
13.
Int J Pediatr Otorhinolaryngol ; 118: 143-146, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30634101

RESUMO

OBJECTIVES: To review simultaneous intra-operative sclerotherapy (IOS) with immediate surgical resection for the treatment of cervicofacial venous malformations (VMs) at a single institution. While pre-operative sclerotherapy (POS) has been reported in the literature, simultaneous intra-operative sclerotherapy and surgery in the operating room has not. METHODS: The database from the Hemangioma and Vascular Birthmarks Clinic was reviewed. All patients in both groups had biopsy-proven VMs. RESULTS: IOS was used in 11 surgical patients with average age 17 years. Sclerotherapy was performed with sodium tetradecyl sulfate 3%, absolute alcohol or bleomycin. Immediately after IOS, and under the same anesthetic, all patients had either complete resection or debulking of the VMs. Eight patients had complete resolution of their VM and 3 had improvement. Average duration of the combined procedures done under a single anesthetic was 121 min. The POS approach was used for 6 surgical patients with average age 7 years. Sclerotherapy agents used were absolute alcohol or sodium tetradecyl sulfate 3%. All patients underwent complete resection of the VM 24-72 h after sclerotherapy under a separate surgical session. Five patients experienced complete resolution of their VM and one has had further sclerotherapy for recurrent disease. Interventional Radiology suite sclerotherapy times were on average 70 min. Surgical times were on average 142 min. Total combined anesthesia times for the two procedures added together were 212 min. Treatment time was significantly shorter in the IOS group (p = 0.0015). CONCLUSIONS: Simultaneous IOS at the time of surgical resection has been successful in our hands. IOS has the advantage of a single procedure and decreased cost to the patient. In the era of reducing pediatric exposure to anesthesia, this approach is especially attractive in the pediatric population. As well, at approximately $100/minute cost to the patient to be in either the Interventional Radiology Suite or in the operating room, the reduced length of the procedures seen in the IOS approach results in lower overall cost to the patient.


Assuntos
Soluções Esclerosantes/uso terapêutico , Escleroterapia , Malformações Vasculares/terapia , Adolescente , Adulto , Bleomicina/uso terapêutico , Criança , Pré-Escolar , Etanol/uso terapêutico , Face , Feminino , Humanos , Masculino , Pescoço , Salas Cirúrgicas , Duração da Cirurgia , Radiologia Intervencionista , Estudos Retrospectivos , Tetradecilsulfato de Sódio/uso terapêutico , Resultado do Tratamento , Malformações Vasculares/cirurgia , Veias/cirurgia
14.
Ann R Coll Surg Engl ; 101(4): 285-289, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30602297

RESUMO

INTRODUCTION: This prospective study of foam sclerotherapy for varicose veins aimed to determine the outcomes of treatment including ulcer healing and complication rates in our unit. Data were collected prospectively over a 10-year period and maintained on a database by our vascular sciences unit, which performed the planning and post-treatment venous duplex scans. Patients undergoing treatment due to venous ulceration were identified from this database. An initial cohort of patients underwent a follow-up scan and assessment at one year. MATERIALS AND METHODS: Patients were treated with foam sclerotherapy, in multiple sessions if required, to occlude all incompetent superficial veins greater than 3 mm in size. We used 3% sodium tetradecyl sulphate as our sclerosing agent, according to our departmental protocol, followed by a period of compression therapy. Patients underwent pre- and post-treatment scans to assess venous competence, the effects of treatment and any complications that arose. RESULTS: We identified 336 patients treated for clinical, aetiological, anatomical and pathophysiological stage 5/6 venous ulceration. At six weeks post-treatment, 21% had fully healed ulcers and a further 46.1% were clinically improving with no further venous incompetence. The remainder continued treatment. An initial cohort of 162 patients was assessed at one year and 77.1% ulcers remained healed. The remainder demonstrated some venous incompetence and ultimately 12.5% required further treatment. Our complication rates were similar to those quoted in published meta-analyses including a deep vein thrombosis rate of 1.16%. CONCLUSIONS: Foam sclerotherapy remains a useful treatment option for venous ulceration with a low morbidity rate.


Assuntos
Escleroterapia , Úlcera Varicosa/terapia , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Soluções Esclerosantes/efeitos adversos , Soluções Esclerosantes/uso terapêutico , Escleroterapia/efeitos adversos , Escleroterapia/métodos , Cicatrização/efeitos dos fármacos
15.
Acta Radiol ; 60(5): 593-601, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30111191

RESUMO

BACKGROUND: Percutaneous therapy with various sclerosants is an established treatment of venous malformations in general. We investigated the safety and effectiveness of polidocanol in the craniofacial region. PURPOSE: To present and evaluate our subjective and objective mid- and long-term results of patients with craniofacial venous malformations (CFVM) after percutaneous sclerotherapy using polidocanol. MATERIAL AND METHODS: Twenty patients with CFVM treated by percutaneous sclerotherapy were followed up and asked to fill in a questionnaire comparing levels of the following CFVM-related symptoms before and after treatment: pain; functional impairment; cosmetic deformities; and impairment in daily life. Additionally, both size reduction as well as procedural-related complication rates were analyzed. RESULTS: Evaluation of the questionnaire revealed an improvement or complete relief of CFVM-related symptoms with significant reduced impairment in daily life after percutaneous sclerotherapy. Eighteen (90%) patients noticed a post-sclerotherapy improvement of at least one of their corresponding symptoms and expressed satisfaction with regard to their treatment. For 13 patients, a > 50% size reduction of the CFVM could be observed, while seven exhibited a < 50% size reduction. One minor complication was encountered in 56 treatment sessions (1.8%). CONCLUSION: Percutaneous sclerotherapy using polidocanol is a well-tolerated treatment for CFVM with a low complication rate. Size reduction and positive results with improvement of different clinical symptoms can be achieved.


Assuntos
Polidocanol/uso terapêutico , Soluções Esclerosantes/uso terapêutico , Escleroterapia/métodos , Malformações Vasculares/terapia , Face , Humanos , Pescoço , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento
16.
BJU Int ; 123(5A): E63-E68, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30253006

RESUMO

OBJECTIVE: To investigate the modulation of the inflammatory response after sclerotherapy for hydrocoele/spermatocoele. PATIENTS AND METHODS: All patients with hydrocoele or spermatocoele presenting at the Department of Urology, University Hospital, Linköping, Sweden, from 2006 to 2012, were included in this prospective observational study of sclerotherapy for hydrocoele/spermatocoele using polidocanol as a sclerosing agent and adjuvant antibiotic and anti-inflammatory medication (AAAM) for modulation of the inflammatory response. Patients were clinically evaluated within 24-48 h after a complication or adverse event possibly related to sclerotherapy. Evaluation of cure was scheduled after 3 months and re-treatment, if necessary was carried out in the same manner as the first treatment. Groups of patients were compared using the chi-squared test and logistic regression analysis. RESULTS: From a total of 191 patients, AAAM was given to 126, of whom 5% had subclinical epididymitis/swelling (SES) compared to 26% of the patients without AAAM (P < 0.001). No other complication was observed. The rate of cure for the whole group of patients was 93% after one or two treatments and significantly higher in the group with AAAM than in the group without AAAM (96% vs 88%, P = 0.03). CONCLUSIONS: Modulation of the inflammatory response after sclerotherapy resulted in a lower incidence of SES and an increased cure rate.


Assuntos
Anti-Inflamatórios/uso terapêutico , Epididimite/prevenção & controle , Escleroterapia/efeitos adversos , Espermatocele/terapia , Hidrocele Testicular/terapia , Idoso , Epididimite/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polidocanol/uso terapêutico , Estudos Prospectivos , Soluções Esclerosantes/uso terapêutico , Suécia , Resultado do Tratamento
17.
J Neurointerv Surg ; 11(1): 57-61, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29674482

RESUMO

PURPOSE: To evaluate the clinical outcome of patients with venous malformation (VM) involving the eyelid treated with bleomycin sclerotherapy. METHODS: A retrospective review was performed of 18 consecutive patients with VM involving the eyelid who underwent bleomycin sclerotherapy. Patients' clinical presentation, details of sclerotherapy, and post-sclerotherapy resolution of the lesion as well as any procedure-related complications were evaluated. RESULTS: Twelve women and six men of mean age 34.3±20.4 years underwent sclerotherapy with bleomycin. Chief complaints were cosmetic disfigurations with or without hemifacial deformity (n=2), pain in engorgement area (n=2), pain and swelling from venous thrombosis (n=2), swelling or engorgement obstructing their eyesight (n=2), or eyelid dysfunction (n=1). The lesions were only in the eyelid in three patients; otherwise they were extended out of the eyelid either superiorly (n=3), laterally (n=8), inferiorly (n=8), and/or posteriorly to the orbit (n=8) to various extents. Conjunctival involvement was present in 13 patients. 14 patients had received prior treatments including surgery, laser therapy, or non-bleomycin sclerotherapy. With an average three sessions of bleomycin sclerotherapy (average total dose 34.5 mg), more than 80% shrinkage was observed in seven patients (38.9%), 50-80% shrinkage in eight patients (44.4%), and 30-50% shrinkage in two patients (11.1%). One patient had recurrence, which was successfully treated again with bleomycin. No procedure-related complications were noted. CONCLUSIONS: The use of bleomycin appears to be a simple, safe, and effective treatment for venous malformations involving the eyelid, avoiding more elaborate and challenging surgical or laser interventions, and is even effective in full thickness lesions.


Assuntos
Bleomicina/uso terapêutico , Pálpebras/diagnóstico por imagem , Terapia a Laser , Soluções Esclerosantes/uso terapêutico , Escleroterapia/métodos , Malformações Vasculares/terapia , Adulto , Antibióticos Antineoplásicos/uso terapêutico , Criança , Pálpebras/irrigação sanguínea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Veias/anormalidades , Veias/diagnóstico por imagem
18.
J Hand Surg Am ; 44(3): 236-239, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29945842

RESUMO

Prolotherapy is a method of treatment of painful musculoskeletal conditions whereby a sclerosing agent is injected into an area of tendinosis or osteoarthritis to strengthen and repair painful connective tissue. It is a safe, effective, and relatively inexpensive nonsurgical treatment modality. This article provides a history of prolotherapy, discusses its proposed mechanisms of action, and provides a review of the existing literature on prolotherapy as a treatment for upper extremity pathologies, specifically, hand osteoarthritis, lateral epicondylitis, and rotator cuff disease.


Assuntos
Osteoartrite/terapia , Proloterapia , Manguito Rotador/fisiopatologia , Soluções Esclerosantes/uso terapêutico , Tendinopatia/terapia , Cotovelo de Tenista/terapia , Extremidade Superior/fisiopatologia , Humanos , Osteoartrite/fisiopatologia , Tendinopatia/fisiopatologia , Cotovelo de Tenista/fisiopatologia
19.
J Gastroenterol Hepatol ; 34(3): 495-500, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30170340

RESUMO

Gastric varices (GVs) are a major complication of portal hypertension in patients with liver cirrhosis. The mortality rate associated with the bleeding from GVs is not low. Balloon-occluded retrograde transvenous obliteration (BRTO) was first introduced by Kanagawa et al. as a treatment for isolated GVs in 1994. It has been performed most frequently in Asia, especially in Japan. Ethanolamine oleate was the original sclerosant used in the therapy. Since the late 2000s, BRTO using sodium tetradecyl sulfate foam or polidocanol foam as a sclerosant has been performed in many countries other than Japan. Then, early in the 2010s, modified BRTO techniques including vascular plug-assisted retrograde transvenous obliteration and coil-assisted retrograde transvenous obliteration were developed as an alternative treatment for GVs. This article provides a historical overview of BRTO using various sclerosants and modified BRTO techniques, such as plug-assisted retrograde transvenous obliteration and coil-assisted retrograde transvenous obliteration.


Assuntos
Oclusão com Balão/métodos , Varizes Esofágicas e Gástricas/terapia , Oclusão com Balão/tendências , Varizes Esofágicas e Gástricas/etiologia , Humanos , Hipertensão Portal/complicações , Cirrose Hepática/complicações , Ácidos Oleicos/uso terapêutico , Polidocanol/uso terapêutico , Soluções Esclerosantes/uso terapêutico , Tetradecilsulfato de Sódio/uso terapêutico
20.
Phlebology ; 34(5): 303-310, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30336757

RESUMO

INTRODUCTION: Sclerotherapy in all its current forms is based on experience going back to the 1850s. METHODS: To trace the evolution of sclerotherapy over the past 250 years, using the internet for past documentation and the literature. CONCLUSION: Sclerotherapy principles were established long ago, although current modifications have been made possible by the introduction of detergent sclerosants and ultrasound guidance.


Assuntos
Soluções Esclerosantes , Escleroterapia/história , Varizes , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Soluções Esclerosantes/história , Soluções Esclerosantes/uso terapêutico , Varizes/história , Varizes/terapia
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