ABSTRACT
El varicocele es la dilatación varicosa de la vena espermática y del plexo pampiniforme. Se origina más frecuentemente en el lado izquierdo(10:1) como consecuencia de un mal funcionamiento o ausencia delas válvulas de la vena espermática izquierda. Entre marzo del 1999 y diciembre del 2009 se han recogido un total de 37 casos (17,9%) de los diagnosticados de varicocele en la población pediátrica de nuestro centro, que requirieron tratamiento. Mediante anestesia local se crea un acceso femoral empleando un catéter Simmons tipo I. Posicionamos la punta del catéter más allá de lostium de la vena espermática para realizar el venograma de la venarenal izquierda mediante la administración de contraste yodado, que fluirá de forma retrógrada hasta testes. La embolización se realizará através de la introducción de coils metálicos (aproximadamente de 6 a8) de 0.038 empleando un catéter hidrofílico de 4 o 5F.Del total de los 37 casos tratados, se consiguieron embolizar correctamente33 pacientes (89,2%), siendo necesario una reembolización entres casos (10,8%) de los que uno acabó en cirugía. Tan sólo en un caso(2,7%) se practicó cirugía por embolización incompleta (AU)
Varicocele consists of the varicose expansion of the spermatic vein. Its more frequently in the left side (10:1) as consequence of an evilfunctioning or absence of the valves of the spermatic left vein. Between March 1999 and December 2009 there have been gathered a total of 37cases diagnosed of varicocele in the pediatric population of our center. After a local anesthetic we created a femoral aproach. We advanceinto the left renal vein using a catheter Simmons type I and then we position the top of the catheter beyond the ostium of the spermatic veinto fulfil the renal left vein by means of the administration of contrastiodized and gonadal vein could be visualized using retrograde phlebography .Transcatheter embolization will carry out across the introduction of coils (approximately from 6 to 8) of 0.038 using a hidrofiliccatheter of 4 or 5F.Of the total of the 37 cases, we obtained correctly embolization in33 patients (89.2%), being necessary a reembolization in three cases(10.8%) of which one finished in surgery. Only in a case (2.7%) surgerywas practised for embolization incomplete (AU)
Subject(s)
Humans , Male , Child , Embolization, Therapeutic/methods , Varicocele/surgery , Blood Vessel Prosthesis , Anesthesia, Local , Retrospective StudiesABSTRACT
Varicocele consists of the varicose expansion of the spermatic vein. It's more frequently in the left side (10:1) as consequence of an evil functioning or absence of the valves of the spermatic left vein. Between March 1999 and December 2009 there have been gathered a total of 37 cases diagnosed of varicocele in the pediatric population of our center. After a local anesthetic we created a femoral aproach. We advance into the left renal vein using a catheter Simmons type I and then we position the top of the catheter beyond the ostium of the spermatic vein to fulfil the renal left vein by means of the administration of contrast iodized and gonadal vein could be visualized using retrograde phlebography. Transcatheter embolization will carry out across the introduction of coils (approximately from 6 to 8) of 0.038 using a hidrofilic catheter of 4 or 5F. Of the total of the 37 cases, we obtained correctly embolization in 33 patients (89.2%), being necessary a reembolization in three cases (10.8%) of which one finished in surgery. Only in a case (2.7%) surgery was practised for embolization incomplete.
Subject(s)
Embolization, Therapeutic/methods , Varicocele/therapy , Adolescent , Child , Embolization, Therapeutic/instrumentation , Equipment Design , Humans , MaleABSTRACT
Central venous access devices are often essential for the administration of chemotherapy to patients with malignancy, but its use has been associated with a number of complications, mainly thrombosis. The true incidence of upper extremity deep vein thrombosis (DVT) in this setting is difficult to estimate since there are very few studies in which DVT diagnosis was based on objective tests, but its sequelae include septic thrombophlebitis, loss of central venous access and pulmonary embolism. We performed an open, prospective study in which all cancer patients who underwent placement of a long-term Port-a-Cath (Pharmacia Deltec Inc) subclavian venous catheter were randomized to receive or not 2500 IU sc of Fragmin once daily 90 days. Venography was routinely performed 90 days after catheter insertion, or sooner if DVT symptoms had appeared. Our aims were: 1) to investigate the effectiveness of low doses of Fragmin in preventing catheter-related DVT; and 2) to try to confirm if patients with high platelet counts are at a higher risk to develop subclavian DVT, as previously suggested. On the recommendation of the Ethics Committee, patient recruitment was terminated earlier than planned: DVT developed in 1/16 patients (6%) taking Fragmin and 8/13 patients (62%) without prophylaxis (Relative Risk 6.75; 95% CI: 1.05-43.58; p = 0.002, Fisher exact test). No bleeding complications had developed. As for prediction of DVT, there was a tendency towards a higher platelet count in those patients who subsequently developed DVT, but differences failed to reach any statistical significance (286 +/- 145 vs 207 +/- 81 x 10(9)/1; p = 0.067). According to our experience, Fragmin at the dosage used proved to be both effective and safe in these patients.
