Subject(s)
Humans , Female , Adult , Hemoptysis/etiology , Lung , Arteries , Aorta, Abdominal/abnormalitiesABSTRACT
Haemorrhagic cystitis is an uncommon and, in its severe form, potentially life-threatening complication of haematopoietic stem cell transplantation or cancer therapy in children. The severe form involves macroscopic haematuria with blood clots, urinary obstruction and/or renal impairment. There are many therapeutic options to treat acute haemorrhage, but only recombinant factor VII has a high level of clinical evidence in children. Supraselective vesical artery embolization (SVAE) is an increasingly used therapeutic procedure for controlling haemorrhage in adults, but is less commonly used in children. This might be due to several factors, such as the invasive nature of the procedure, lack of appropriate medical experience and possible long-term side effects. We present three cases of children successfully treated by means of effective SVAE.
Subject(s)
Cystitis/therapy , Embolization, Therapeutic/methods , Hematuria/therapy , Urinary Bladder/blood supply , Adolescent , Adult , Arteries , Child , Child, Preschool , Cystitis/etiology , Female , Hematuria/etiology , Humans , Infant , MaleABSTRACT
El abordaje de los miomas uterinos sintomáticos ha presentado una franca evolución en los últimos años gracias a la aparición de técnicas mínimamente invasivas que permiten la conservación uterina. La embolización selectiva de arterias uterinas (EAU) consiste en la oclusión completa de las 2 arterias uterinas con partículas embolizantes con el objetivo de producir una necrosis isquémica de los miomas sin afectar de forma permanente al tejido uterino normal. Esta técnica mejora significativamente la cantidad de sangrado y produce una reducción del volumen uterino a los 3 meses posprocedimiento, que se mantiene a lo largo del tiempo, permitiendo que un 70% de las pacientes evite la cirugía. Por otro lado, la EAU conlleva un menor tiempo quirúrgico, una reducción en la estancia hospitalaria y un menor número de días necesarios para la reincorporación a la vida laboral si lo comparamos con las técnicas quirúrgicas clásicas (histerectomía y miomectomía), sin presentar diferencias en las escalas de calidad de vida a 5 años. Por lo tanto creemos que debe incluirse la EAU en las opciones terapéuticas que ofrecer a las pacientes con útero miomatoso sintomático (AU)
The approach to symptomatic uterine fibroids has seen a marked evolution in recent years thanks to the emergence of minimally invasive techniques that allow for uterine preservation. Selective uterine artery embolization (UAE) consists of the complete occlusion of the 2 uterine arteries with embolic particles in order to produce ischemic necrosis of the fibroids without permanently affecting the normal uterine tissue. This technique significantly reduces the amount of bleeding and causes a reduction in uterine volume at 3 months postprocedure, which is maintained over time, allowing for 70% of patients to avoid surgery. Moreover, UAE entails shorter surgical times, reduced hospital stays and fewer days needed to return to work when compared with traditional surgical techniques (hysterectomy and fibroidectomy), without any differences in the quality-of-life scales at 5 years. UAE should therefore be included in the therapeutic options offered to patients with symptomatic fibroid uteri (AU)
