RESUMO
Twenty-two potential renal donors were examined by both arterial digital and conventional aortography. The digital studies accurately identified all of the renal arteries. Digital subtraction angiography may be a suitable alternative to conventional aortographic evaluation of the renal arterial supply of potential renal donors.
Assuntos
Aortografia/métodos , Transplante de Rim , Artéria Renal/diagnóstico por imagem , Adulto , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Técnica de Subtração , Doadores de TecidosRESUMO
Three patients with giant aneurysms (2 internal carotid and 1 anterior communicating) were treated by internal carotid occlusion with a detachable balloon. 133Xe regional cerebral blood flow (rCBF) was performed on each patient on admission. Due to low CBF, one patient received a superficial temporal artery--middle cerebral artery (STA-MCA) bypass. The rCBF was repeated when the balloon was inflated in the internal carotid prior to detachment of the balloon. All three patients were discharged within one week with no neurologic deficit. The rCBF assessment appears useful to decide which patient will tolerate acute balloon occlusion of the internal carotid and to help select patients who will need an extra-cranial-intracranial (EC-IC) bypass to avoid ischemic complication.
Assuntos
Circulação Cerebrovascular , Embolização Terapêutica , Aneurisma Intracraniano/terapia , Idoso , Angiografia Cerebral , Revascularização Cerebral , Feminino , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/fisiopatologia , Masculino , Pessoa de Meia-Idade , Radioisótopos de XenônioAssuntos
Derivação Arteriovenosa Cirúrgica/efeitos adversos , Fibrinólise/efeitos dos fármacos , Oclusão de Enxerto Vascular/tratamento farmacológico , Estreptoquinase/uso terapêutico , Braço/irrigação sanguínea , Criança , Oclusão de Enxerto Vascular/etiologia , Humanos , Masculino , Diálise Renal , Tromboflebite/tratamento farmacológico , Tromboflebite/etiologiaRESUMO
UNLABELLED: We conducted a prospective, randomized study comparing transcatheter partial splenic embolization (PSE) with splenectomy (SX) in 53 renal transplant candidates. An additional 112 PSE procedures were performed for various indications in 101 patients. STUDY RESULTS: A mean +/- SD of 65% +/- 16% of splenic mass was ablated in the PSE group. The early postoperative morbidity rate was similar in the two study groups, as was the duration of hospital stay. Abscess or rupture of the spleen were not encountered. Severe pancreatitis occurred only in the SX group. Renal transplantation was carried out in equivalent numbers in both groups, with a similar long-term (2.5 to 4.0 years) graft survival (60% versus 66%). No difference in long-term patient mortality was noted. Splenic "regeneration" occurred frequently after PSE. PSE experience exclusive of study: Embolization attempts failed in nine patients. Repeat PSE was performed in 11 of the 101 patients. Where hypersplenism was the primary indication, PSE resulted in significant improvement in the hematologic parameters. The incidence of serious complications was acceptably low. There were two late procedure-related deaths. Our conclusion from the study and the total experience of 137 PSE procedures is that PSE offers an acceptably safe alternative to SX in selected high-risk patients in whom both the surgical intervention and the resulting asplenic state carry a prohibitive risk.
