56 research outputs found
Nutcracker syndrome due to left renal vein compression by an aberrant right renal artery
No full textClassic nutcracker syndrome is caused by left renal vein compression between the superior mesenteric artery and aorta, leading to retrograde venous hypertension associated with such urinary abnormalities as hematuria or proteinuria. We describe a case of symptomatic nutcracker syndrome treated by means of stent placement in which hypertension in the left renal vein was caused by stenosis of this vein compressed by an aberrant right renal artery at a point closer to the inferior vena cava
Intrasomatic injection of corticosteroid followed by vertebroplasty increases early pain relief rather than vertebroplasty alone in vertebral bone neoplasms: preliminary experience
No full textIn this prospective multicenter study, we evaluate the effectiveness of corticosteroid plus vertebroplasty rather than vertebroplasty alone in the analgesic treatment of single-level vertebral neoplasms or pathological fractures
Induction intra-arterial chemotherapy (IAC) with epirubicin and mitoxantrone in locally advanced breast cancer
No full textCurrent role of microwave ablation in the treatment of small hepatocellular carcinomas
No full textPercutaneous radiofrequency ablation (RFA) can be as effective as surgical resection in terms of overall survival and recurrence-free survival rates in patients with small hepatocellular carcinoma (HCC). Effectiveness of RFA is adversely influenced by heat-sink effect. Other ablative therapies could be considered for larger tumors or for tumors located near the vessels. In this regard, recent improvements in microwave energy delivery systems seem to open interesting perspectives to percutaneous ablation, which could become the ablation technique of choice in the near future. Microwave ablation (MWA) has the advantages of possessing a higher thermal efficiency. It has high efficacy in coagulating blood vessels and is a relatively fast procedure. The time required for ablation is short and the shape of necrosis is elliptical with the older systems and spherical with the new one. There is no heat-sink effect and it can be used to ablate tumors adjacent to major vessels. These factors yield a large ablation volume, and result in good local control and fewer complications. This review highlights the most relevant updates on MWA in the treatment of small (<3 cm) HCC. Furthermore, we discuss the possibility of MWA as the first ablative choice, at least in selected cases
Ultra-low profile polymer-filled stent graft for abdominal aortic aneurysm treatment : a two-year follow-up
No full textPURPOSE:
This study evaluated 2 years of follow-up of the Ovation Abdominal Stent Graft System (TriVascular Inc., Santa Rosa, CA, USA) for endovascular repair (EVAR) of abdominal aortic aneurysms (AAAs).
MATERIALS AND METHODS:
This retrospective multicentre study included 36 patients (median age, 73.6 year) with AAAs (mean diameter, 5.65 cm) treated with the Ovation stent graft and followed up for at least 2 years. Safety and effectiveness of the Ovation stent graft were evaluated. Indications for EVAR were the following: AAA ≥5 cm, neck length ≥7 mm, angulation ≤60° and diameter <30 mm; the presence of neck calcification and thrombosis was not considered a contraindication; distal iliac landing zone length of 10 mm, and diameter between 5 and 20 mm. Patients were treated under a common protocol, including clinical and imaging follow-up at discharge, 30 days, 6 months, and annually for 5 years. Adverse events, clinical and imaging data and possible re-intervention were recorded.
RESULTS:
The Ovation stent graft was implanted successfully in 36 patients (100 %). None of the patients required conversion to open surgery, and none presented with an aneurysm rupture. Endograft stent fracture or migration was not observed in any case. No type I, III or IV endoleaks were observed; in 12 patients (33.3 %), a type II endoleak was noted, in one case with sac enlargement but not treated due to concomitant comorbidities and the patient's decision.
CONCLUSIONS:
The 2-year results of the Ovation Abdominal Stent Graft System demonstrate excellent safety and effectiveness in the treatment of patients with AAAs, particularly in those with challenging anatomical characteristics
Intrasomatic injection of corticosteroid followed by vertebroplasty increases early pain relief rather than verteroblasy alone in vertebral bone neoplasms: preliminary experience
No full textTreatment of abdominal aortic aneurysm with a new type of polymer-filled low profile device.
No full textPURPOSE OF THE STUDY:
To evaluate the mid-term safety and effectiveness of a novel stent graft for treatment of abdominal aortic aneurysm (AAA).
METHODS:
Thirty-three patients with AAA (20 males and 13 females; mean age: 71.3 y) were treated with the OvationTM Abdominal Stent Graft System (TriVascular, Inc., Santa Rosa, CA, USA). Indications for endovascular aneurysm repair: AAA ≥ 5.5 cm, neck ≥ 7 mm, angulation ≤ 60° and with an inner wall diameter of no less than 16 mm and no greater than 30 mm; the presence of neck calcification and thrombosis is not much of a problem in this device because aortic seal is achieved with 2 polymer-filled sealing rings and the fixation by means of a suprarenal stent with 8 pairs of anchors. Patients were followed through discharge and returned for follow-up visits. The follow-up protocol included a CT-A exam at 1 and 12 months after the intervention; the mid-term follow up was performed at 3 and 6 months with contrast-enhanced ultrasound (CEUS). Mean follow-up duration was 18.6 months (range: 3-25 months).
MAIN FINDINGS:
Technical success was 100%. Mean implantation procedure time was 31.1 minutes, and median hospital stay was 4.6 days. None of the patients required conversion to open surgery, and no aneurysm enlargement, rupture, fracture, or migration were observed. No type I, III or IV endoleaks were observed. Hospitalization death rate was 0%. Death rate at 30 days was 0%. No major complications were observed.
CONCLUSIONS:
The first results from this 3-center study with the Ovation stent graft are promising with high technical success and excellent safety and effectivene
Carotid artery stenting: influence of experience and cerebrovascular risk factors on outcome
No full textAim: To evaluate technical success, complications and the influence of the learning curve on outcome in carotid artery stenting (CAS) performed in patients not suitable for surgery. Patients and methods: One hundred and nine procedures of protected carotid stenting in 103 high risk patients were performed. All patients presented at least one factor that potentially increased the surgical risk of carotid endoarterectomy (CEA), according to SAPPHIRE criteria. Neurologic complications were quantified by the National Institutes of Health Stroke Scale (NIHSS) and were evaluated by median Rankin Scale (mRS). To evaluate the influence of experience of the operator to perform CAS, we retrospectively analyzed periprocedural and neurological complications of the first 50 procedures compared with that of the following 59 interventions. Results: Technical success rate was 98%. Neurological periprocedural complications were revealed in 4.5% of patients. In-hospital and 30-days neurological complications rate was 7.6 and 2.6% respectively. Periprocedural neurological complications rate was lower in the last procedures performed, according to a higher confidence of the operators. Conclusions: CAS may be performed as an alternative of CEA for the treatment of severe carotid obstructive disease in patients not suitable for surgery. The learning curve positively influence complications rat
Polypoid hamartoma of Brunner's gland of the duodenum
No full textBackground/Aims: Brunner’s gland adenoma is an extremely rare but important entity. Controversy exists over its etiology and pathogenesis, but the present view is that it is a duodenal hamartoma with a predominance of Brunner’s gland elements. Methods: A case of a 76-year-old woman with a reddish pedunculated polyp prolapsing between the bulb and the second part of the duodenum seen at endoscopy and removed surgically through a longitudinal duodenotomy is presented. Results: The cut surface of the tumor had a grayish color, revealing multiple cystic spaces which on microscopic examination proved to be enlarged Brunner’s glands. The hyperplastic glands formed lobules which were surrounded by bundles of fibromuscular and connective tissue. In the adjacent duodenum, large numbers of lobules of well-differentiated Brunner’s glands with mucus-secreting epithelial cells were seen. Conclusion: The reported case supports the theory that Brunner’s gland adenomas are duodenal hamartomas with a predominance of Brunner’s gland elements and further shows that a continuity exists in Brunner’s glands of the tumor and those of the adjacent duodenum. Copyright (C) 1999 S. Karger AG, Basel
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