ABSTRACT
The Peripheral Cutting Balloon device was originally described to treat in-stent coronary artery stenosis. We aim to evaluate the use of this device in the management of ureteric anastomotic strictures. Four patients with radiologically proven ureteric anastomotic strictures were treated with the Peripheral Cutting Balloon Device using an antegrade approach. Follow up ranged between 2 and 12 months. All patients' initial procedure was successful, and all patients had improvement of symptoms. No patient showed evidence of biochemical deterioration of renal function, and no periprocedural complications occurred. One patient had restenosis as a result of invasive bladder cancer and required subsequent cystectomy. The Peripheral Cutting Balloon device is a novel instrument for the treatment of ureteric anastomotic strictures. Our experience shows promising short-term results but more follow up is required.
Subject(s)
Catheterization/methods , Ureteral Obstruction/surgery , Adult , Aged , Anastomosis, Surgical/adverse effects , Constriction, Pathologic , Female , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
OBJECTIVES: To evaluate the role of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in the assessment of germ cell tumors after chemotherapy. METHODS: We reviewed patients' records for the histologic findings and clinical outcome. 18F-FDG PET results were correlated with tissue histologic features where available; and if not available, the correlation was with the clinical outcome. RESULTS: A total of 45 PET studies were performed on 38 patients (age range 19 to 64 years, median 31). All patients had received chemotherapy. In the nonseminomatous germ cell tumor (NSGCT) group, of the 31 patients with one scan, 18 PET scans were reported as positive, with only 2 not having active disease. Of the 12 negative scans, 6 showed teratoma, 1 tumor, and 5 did not show active disease. The equivocal scan revealed thyroid adenoma. In the seminoma group, the PET scans correlated well with the clinical and histologic outcomes. Four patients underwent salvage chemotherapy, and in this subgroup, the PET findings also correlated with the outcome. CONCLUSIONS: (18)F-FDG PET is a promising tool as an adjunct to current imaging techniques in detecting residual viable germ cell tumor after chemotherapy. In NSGCT, a positive PET scan was accurate in 16 of 18 patients, although negative PET studies did not exclude the presence of disease, mainly because of the presence of teratoma. In seminoma, a negative 18F-FDG PET study correlated with a favorable clinical outcome. PET was also predictive of the response to salvage chemotherapy and was highly specific for active tumor in both NSGCT and seminoma.
