[Use of x-ray endovascular occlusion in combined treatment of juvenile angiofibroma of the skull base in children]. / Primenenie rentgenoéndovaskuliarnoi okkliuzii v kombinirovannom lechenii iunosheskikh angiofibrom osnovaniia cherepa u detei.

Of a total of 103 patients with juvenile angiofibroma of the base of the skull surgical treatment was given to 98 children. 10 operations were performed after preoperative roentgeno-endovascular occlusion (REO) of the tumor afferent vessels. Such occlusion in the region of a maxillaris was a sufficient measure to warrant a 2-fold reduction in the intraoperative blood loss and was achieved with hydrogel spheres and cylinders 0.4-0.6 mm in diameter. 4 days are an optimal time for operative intervention after the REO. The nasomaxillary approach was used in most cases preceded by diagnostic carotid angiography in the frontal and lateral views. No complications arose due either to the angiography or REO. The latter was found beneficial when performed prior to surgical intervention for juvenile angiofibroma of the base of the skull.

[Attempt to use partial occlusion of the spleen in extrahepatic portal hypertension in children]. / Opyt primeneniia chastichnoi okkliuzii seleznki pri vnepechenochnoi forme portal'noi gipertenzii u detei.

Hemodynamics in the portal system was assessed at digital subtraction angiography in 57 children aged 9 months-15 years suffering from extrahepatic portal hypertension. Natural splenorenal anastomoses were found in 31 patients. 13 patients developed arteriovenous shunting into gastroesophageal plexus through the conglomerate of pathological vessels in the upper splenic pole. Partial occlusion of the spleen was performed in 12 patients aged 3-12 to block arteriovenous anastomoses and to reduce the blood flow from the spleen to the portal system. In various postocclusion periods blood effusion into gastric veins through arteriovenous shunts and retrograde flow via splenic vein and natural splenorenal anastomoses to the lower vena cava inferior were absent or drastically diminished. Septic complications were absent. Partial splenic occlusion in children with extrahepatic portal hypertension is considered valid.