RESUMEN
OBJECTIVE: To evaluate the feasibility of percutaneous access via the recanalized paraumbilical vein for varix embolization. MATERIALS AND METHODS: Between July 2008 and Jan 2014, percutaneous access via the recanalized paraumbilical vein for varix embolization was attempted in seven patients with variceal bleeding. Paraumbilical vein puncture was performed under ultrasonographic guidance, followed by introduction of a 5-Fr sheath. We retrospectively evaluated the technical feasibility, procedure-related complications, and clinical outcomes of each patient. RESULTS: Recanalized paraumbilical vein catheterization was performed successfully in all patients. Gastroesophageal varix embolization was performed in six patients, and umbilical varix embolization was performed in one patient. Embolic materials used are N-butyl cyanoacrylate (n = 6) and coil with N-butyl cyanoacrylate (n = 1). There were no procedure-related complications. One patient underwent repeated variceal embolization 6 hours after initial procedure via recanalized paraumbilical vein, due to rebleeding from gastric varix. CONCLUSION: Percutaneous access via the paraumbilical vein for varix embolization is a simple alternative in patients with portal hypertension.
Asunto(s)
Adulto , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Embolización Terapéutica , Enbucrilato/uso terapéutico , Várices Esofágicas y Gástricas/diagnóstico por imagen , Hemorragias Intracraneales/etiología , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Venas Umbilicales/cirugíaAsunto(s)
Humanos , Perros , Animales , Masculino , Femenino , Técnicas In Vitro , Venas Umbilicales/cirugía , Venas Umbilicales/trasplanteRESUMEN
Trinta e dois portadores de cardiopatias congênitas cianóticas com hipofluxo pulmonar, sofreram operaçöes paliativas com interposiçäo de um segmento de veia umbilical homólogo de 4 e 5 mm de diâmetro interno entre a artéria subclávia e a artéria pulmonar do mesmo lado. Dezessete pacientes eram do sexo masculino e 15 do sexo feminino, com idades variando de 2 dias a 14 anos. Destacam as vantagens técnicas do procedimento: dispensar a dissecçäo distal da artéria subclávia, permitir um comprimento adequado do enxerto, impedir acotovelamento do mesmo, limitar o fluxo através do calibre da própria artéria subclávia. Os resultados foram satisfatórios com imediata paliaçäo dos sintomas e sinais e permeabilidade de 100% dos enxertos utilizados. A mortalidade foi de 12,5% até os 6 meses e depois 7,1%