Preoperative embolisation of head and neck paragangliomas - a single-centre experience.

INTRODUCTION: Paragangliomas are neuroendocrine tumours commonly located in the abdomen, thorax, head and neck. The definitive treatment for these tumours is surgical resection, which in some cases can be very challenging due to the involvement of critical neurovascular structures and their high vascularity. Therefore, pre-operative embolisation may be performed to reduce the risk of complications. This study aimed to present our experience with endovascular embolisation of head and neck paragangliomas (HNP). MATERIAL AND METHODS: In this single-centre study, we reviewed data from consecutive patients with HNP who underwent pre-operative embolisation from 2017 to 2023. The efficacy of embolisation, the method of embolisation, as well as the rate of complications, were noted. RESULTS: A total of 27 patients (15 females) with an average age of 47 years underwent selective embolisation of HNP. Satisfactory embolisation, defined as occlusion of > 75% of the blood supply, was achieved in 22/27 cases (81.5%). The most commonly used embolic agents included coils and microspheres. With the exception of minor vessel dissections in two patients and embolic agent migration in two patients causing reversible occlusion of the intracranial vessels, there were no other complications associated with embolisation. No neurological deficits occurred in relation to the endovascular procedure. CONCLUSIONS: The results of our study indicate that endovascular embolisation of HNP prior to surgical resection is a safe and efficacious procedure, with a relatively low complication rate and associated morbidity.

[Morbidity of lower limbs obliterating atherosclerosis in the population of Opole Region]. / Zachorowalnosc na miazdzyce zarostowa tetnic konczyn dolnych w populacji Opolszczyzny.

UNLABELLED: The objective of this study was to evaluate morbidity of lower limbs obliterating atherosclerosis in the population of Opole Region. The subject of the study was the population of patients admitted and treated in the Voivodship Medical Center in Opole between 1992-1994 (1st period) and 2000-2002 (2nd period). MATERIAL AND METHODS: Material includes detailed data about 1114 patients: 387 treated between 1992-1994 and 727 treated in period 2000-2002. The analysis was made on base of documentation of the Department of General and Vascular Surgery in the Voivodeship Medical Center in Opole. Patients filled special prepared questionnaires. The completed data were intoducted to the computer database and submitted to mathematical and statistical comparative analysis with regard to both examined periods. RESULTS: The study confirmed that the major cause of chronic lower limbs ischaemia is obliterating atherosclerosis. It was found in 91% of cases in both periods. Significant increase in atherosclerosis of the lower limbs morbidity was confirmed. The most voluminous group in this study ware patients more than 65 years of age, wih elementary or elementary professional education. Significant increase in incidence was also noted in patients inhabiting rural areas and in population of women. In between 2000-2002 the percentage of patients admitted with early phase of the disease increased significantly where compared to the first period. CONCLUSIONS: Significant increase of morbidity on atherosclerosis of the lower limbs needs planning of responsible local governors in Opole Region suitable financial expend to prevent and treat this disease.

Use of dacron vascular prosthesis impregnated with salts of silver, in treatment of extraanatomical axilla-femoral by-pass's infection. Infections in vascular surgery.

We presented a case of use a dacron prosthesis, bonded with collagen and impregnated with salts of silver in the treatment of extraanatomical axilla-femoral by-pass infection, by-pass was made at 78-years-old patient cause of an acute ischaemia of the lower extremity caused by an inoperative inflammatory aneurysm of abdominal aorta and iliac arteries. Firstly intentional antibiotics were administered. The patient was again admitted to hospital and operated on after an ineffective preventive treatment. The infected prosthesis was replaced by a new, salts of silver impregnated dacron one with increased infection resistance. The clinical effect was successful.