Efficacy Of Superselective Arterial Embolization Research Articles

A new management strategy for renal angiomyolipomas: superselective arterial embolization in combination with radiofrequency ablation.

The present study analyzed the safety and efficacy of superselective arterial embolization (SAE) combined with radiofrequency ablation (RFA) to treat renal angiomyolipoma (RAML). This retrospective study included the clinical data of 6 patients with RAML treated between March 2016 and October 2017. All patients underwent RFA treatment immediately after SAE guided by angio-computed tomography (angio-CT). The tumor size, renal function and complications, and time to recurrence were compared before and after treatment. The success rate of the SAE + RFA technique was 100%, and no serious complications were found during or after surgery. After treatment, the patients' symptoms, including low back pain and hematuria, were relieved. The pre-treatment creatinine level (55.6±11.0 µmol/L) did not differ significantly from the post-treatment creatinine level (68.2±13.7 µmol/L), which was measured 1 day after surgery (t=1.75, P=0.109). The mean follow-up time was 29.5±6.1 months. By the end of the follow-up period, the maximum diameter of the tumor was 3.1±0.6 cm, which was significantly smaller than the pre-treatment diameter of 5.9±1.01 cm (t=5.83, P<0.001). At 3 months after surgery, the maximum diameter of the tumor was reduced by 22-38% in all 6 patients. At the last follow-up examination, the maximum diameter of the tumor was reduced by 36-61%. Contrast-enhanced CT or magnetic resonance imaging scans showed that the enhanced part of the original lesion had disappeared, the renal parenchyma was full of even fat signals, and only one patient had new enhanced lesions at the site of the original lesions. SAE combined with RFA is a safe and effective treatment for RAML, and its strengths qualify it to become a new treatment strategy for RAML.

A comparison of the therapeutic efficacy of superselective arterial embolization and watchful waiting in high-flow priapism

Objective Compare the efficacy of superselective arterial embolization with observation in the treatment of HFP caused by trauma. Methods From Jan, 2013 to Dec, 2017, 6 traumatic HFP patients were involved into the study, the age range from 18 to 44 years old, with an average age of 26.2 years. The fistula was measured by doppler ultrasonography before the treatment with its longest diameter, and which ranges from 0.8 to 1.4 cm, the average diameter is 1.14 cm. All patients are divided into two groups according to their treatment. Operation group: 4 patients underwent the pudendal artery superselective gelatin sponge vascular embolization. Control group: 2 cases were treated with local cold compressing under watchful waiting. In control group, patients are treated by local cold compress with ice bag for 3 weeks: 15 mins×10 times every day. The erectile hardness of the patients was observed and the fistula was evaluated by doppler ultrasonography 3 weeks later, and all the patients were reexamined by doppler ultrasonography 1 year later. The erectile hardness was divided into four grades according to the patient's subjective feelings: grade Ⅰ, the penis was enlarged but not rigid; grade Ⅱ, the penis had hardness, but not enough to insert into the vagina; grade Ⅲ, the penis could be inserted into the vagina, but not to achieve complete erection; grade Ⅳ, the penis fully erect and firm. The erectile function was evaluated with the International Index of Erectile Function-5(IIEF-5) after 1-year′s follow-up. Results 4 patients in the operation group were operated successfully without obvious complications after operation. Median follow-up time of all the patients was 21 months (5-50). In group operation, 4 cases of surgical patients did not have the recurrence of priapism. There was no obvious abnormality in the color doppler ultrasound of penis. The score of IIEF-5 was 25, 24, 24 and 23, respectively. Postoperative erectile function made a complete recovery. In group observation, 2 patients under watchful waiting still have gradeⅡ-Ⅲ sustained priapism, IIEF-5 score is 21 and 19 respectively, the penis color doppler ultrasound scan still showed the change of arteriovenous fistula. Conclusion Superselective arterial embolization is effective in the treatment of HFP, and the recovery of sexual function is better after operation compared with watchful waiting. Key words: Priapism; Artery embolization; Watchful waiting; Sexual function; Follow-up

W1062 Therapeutic Efficacy of Superselective Arterial Embolization in Patients with Gastrointestinal Hemorrhage

W1062 Therapeutic Efficacy of Superselective Arterial Embolization in Patients with Gastrointestinal Hemorrhage