Transvenous sclerotherapy of the gonadal veins for treatment of varicocele: long-term results.

Percutaneous occlusion of the spermatic vein has been performed on 136 consecutive patients with varicocele scroti during the last six years. The authors report their long-term results on the first 119 cases to have a follow-up of at least six months. Occlusion of the insufficient gonadal vein is induced by the selective transcatheter injection of sclerosing agent with local anesthesia. Their patients are always evaluated before and after the procedure by Doppler examination. A spermiogram is done before the procedure and after six months. In this series they registered only 4 recurrences with no major complications.

[Embolization of the splenic artery in cirrhotic patients with portal hypertension. Ultrasound results and follow-up]. / L'embolizzazione dell'arteria splenica nei pazienti cirrotici con ipertensione portale. Risultati e controlli ecografici.

Over the last four years the authors performed transcatheter embolization of the splenic artery by Gianturco coils in 32 consecutive cirrhotic patients with portal hypertension, splenomegaly, cytopenia and gastro-esophageal varices endoscopically proved. This procedure was especially useful for treatment of splenomegaly and cytopenia because a constant reduction of spleen dimensions and increase in platelet count were registered. The effectiveness of transcatheter embolization and follow-up are based on clinic, hematologic and sonographic findings. We believe sonographic monitoring to be very useful both to evaluate splenomegaly and signs of portal hypertension and to reveal splenic complications (abscesses). We never registered severe complications.

Therapeutic embolization of renal artery to control severe hypertension due to renal trauma.

In a young patient with a post-traumatic renal hematoma, severe systemic hypertension, secondary to the activation of the renin-angiotensin axis, developed. Because of persistent hypertension, after 3 months of drug therapy, selective percutaneous embolization of the damaged vessels was performed. One year after procedure, the patient is normotensive without drugs.

[Percutaneous treatment of varicocele]. / Trattamento percutaneo del varicocele.

Percutaneous occlusion of the spermatic vein has been performed in 104 patients with varicocele in the last five years. We report our long-term results on the first 87 cases with a follow-up of at least six months. The occlusion of the gonadal vein is generally induced by selective transcatheter injection of sclerosing agent. Our patients are always evaluated before and after sclerotherapy by telethermography and/or doppler examination. Furthermore spermiogram is obtained before and six months after therapy. We registered only four recurrences with no major complications.

[Pharmacological test with cerulein during manometric cholangiography via external biliary drainage]. / La prova farmacologica con ceruleina durante colangiografia manometrica attraverso drenaggio biliare esterno.

The manometric post-operative cholangiography through external drainage is now a method of everyday use. However in some cases the substenotic appearance of the terminal bile tract and of the Oddi's sphincter gives rise to doubts as to the real cause of this alteration. Caerulein solves the functional hypertone. It also starts a good peristalsis of the terminal bile tract, reducing the intrabiliary pressure and causing an evident transpapillary passage. Thus, the use of this substance allows a differential diagnosis between organic or functional stenosis.