ABSTRACT
OBJECTIVE: Iliac vein compression syndrome is a well-recognized anatomic variant that is associated with the development of symptomatic deep venous thrombosis (DVT) of the left iliac vein. However, its relation with DVT in spinal cord injury has not been established. The purpose of this study was to determine the relation between iliac vein compression syndrome and DVT in spinal cord injured patients. METHOD: Thirteen spinal cord injured patients diagnosed with DVT from January 2002 to December 2003 were evaluated. After ascending venography, the catheter-directed thrombolytic therapy and balloon angioplasty with stent insertion after 24 hours of thrombolytic therapy were done. RESULTS: Twelve of 13 patients showed that the left iliac vein was compressed by the right iliac artery, with thrombosis shown in the distal venous segment of the crossover point and had a collateral formation. All 12 patients had residual stenosis of left iliac vein in spite of the thrombolytic therapy. The unimpeded venous flow of iliofemoral veins was revealed after the balloon angioplasty with stent insertion. CONCLUSION: We suggested that the proper evaluation and management about iliac vein compression syndrome be considered when residual stenosis was persistent through the chemical dissolution in spinal cord injured patient with left iliac vein thrombosis.
Subject(s)
Humans , Angioplasty, Balloon , Constriction, Pathologic , Iliac Artery , Iliac Vein , May-Thurner Syndrome , Phlebography , Spinal Cord Injuries , Spinal Cord , Stents , Thrombolytic Therapy , Thrombosis , Veins , Venous ThrombosisABSTRACT
PURPOSE: To determine the efficacy and clinical outcome of uterine arterial embolization as a new approach to the management of uterine leiomyomas MATERIALS AND METHODS: Uterine arterial embolization was performed in 21 patients aged 26-62(mean, 42) years. Twenty of these had menorrhagia, dysmenorrhea, and mass-related symptoms (low abdorminal discomfort, backache, urinary frequency, etc.) and one was diagnesed incidentally. Bilateral uterine arteries were selected individually and polyvinyl alcohol and/or gelfoam was used as an embolic material. RESULTS: Nineteen patients were followed up after embolization. Seventeen (89.5 %) reported satisfactory myoma volume. In 17 patients (89.5 %), the menstrual cycle returned to normal. All patients experienced pain after the procedure and other complications were vaginal bleeding (26.3%) and fever (23.8%). CONCLUSION: Uterine arterial embolization represents a new approach to the management of uterine leiomyoma-related symptoms. Further investigations and long-term follow-up are, however, equired.
Subject(s)
Female , Humans , Back Pain , Dysmenorrhea , Fever , Follow-Up Studies , Gelatin Sponge, Absorbable , Leiomyoma , Menorrhagia , Menstrual Cycle , Myoma , Polyvinyl Alcohol , Uterine Artery , Uterine HemorrhageABSTRACT
PURPOSE: To evaluate the effectiveness and safety of endoluminal bifurcated stent graft for the treatment of AAA. MATERIALS AND METHODS: Between August 1997 and August 1998, 20 patients with AAA underwent treatment involving the use of a bifurcated stent graft. Fourteen in whom the aneurysm involved only bifurcation and six patients in whom the common iliac arteries were involved. For one patient, a stent with a short proximal neck measuring 12 mm was used. The stent graft was inserted by means of a unilateral surgical femoral arteriotomy. After the procedure, follow up involving CT and aortography was performed between month 3 and month 12. RESULTS: The primary success rate with the first trial was 79 percent (15 of 19 patients), and the overall success rate was 84 percent; one perigraft leak was successfully corrected. In one case, technical failure occurred due to a tortuous iliac vessel and spasm. Procedure-related complications occurred in 16% of patients (3 of 19), one of whom died due to acute renal failure following a contrast overdose. CONCLUSION: Endovascular treatment of infrarenal AAA by means of a bifurcated stent graft was effective and safe. In particular, if the proximal neck measured more than 1cm, any AAA could be treated using bifurcated stent graft. Further investigation of the outcome and complications arising during long-term follow-up are needed, however.
Subject(s)
Humans , Acute Kidney Injury , Aneurysm , Aortic Aneurysm , Aortic Aneurysm, Abdominal , Aortography , Blood Vessel Prosthesis , Endoleak , Follow-Up Studies , Iliac Artery , Neck , Spasm , StentsABSTRACT
PURPOSE: To evaluate the therapeutic efficacy of intra-arterial infusion of Cis-Diamminedichloroplatinum (C-DDP) for the treatment of hepatocellular carcinomas with widespread involvement. MATERIALS AND METHODS: We retrospectively analyzed 22 patients who between July 1994 and June 1996 had undergone intra-arterial c-DDP infusion therapy for the treatment of hepatocellular carcinomas with widespread involvement. The hepatomas involved both lobes in ten, portal venous obstructions in fourteen, arterio-portal shunts in nine, and arterio-venous shunts in two. Proper hepatic artery was selected for infusion of 100mg/BSA of C-DDP. The same procedure was repeated every 3 to 4 weeks, and the total number of infusions was 65. On the basis of WHO criteria, response was classified as complete remission, partial remission, stable, or progression of the disease. Six-month and one-year survival rates were estimated, and adverse reactions were evaluated. RESULTS: Complete remission was noted in one patient (4.5%) and partial remission in three (13.6%), while 18 showed no response or progression after treatment. The six month survival rate was 59.1%, and the one-year survival rate was 32.1%. Adverse reactions included nausea/vomiting (59.8%), abdominal pain (9.2%), fever (8.0%), acute renal failure (2.3%) and hepatic encephalopathy (1.1%). These adverse reactions were, however, transient and reversible. CONCLUSION: Although the response rate is not high, intra-arterial C-DDP infusion therapy can be used as an alternative treatment for hepatocellular carcinomas with widespread involvement; adverse reactions are tolerable.