40 research outputs found
Therapeutic embolisation for postoperative haemorrhage after total arthroplasty of the hip and knee
We describe three cases of postoperative haemorrhage, two after total hip and one
after total knee replacement, treated by percutaneous embolisation. After
diagnostic angiography, this is the preferred method for the treatment of
postoperative haemorrhage due to the formation of a false aneurysm, after hip or
knee arthroplasty. This procedure, carried out under local anaesthesia, has a low
rate of complications and avoids the uncertainty of further surgical exploratio
Selective internal radiation therapy: an effective treatment for hormonal syndromes in pancreatic neuroendocrine tumors
The hormone secretion in pancreatic neuroendocrine tumors (pNET) causes an important interference in patients' quality of life. We present two cases of pNET metastatic to the liver (a pancreatic endocrine carcinoma with a severe hormonal syndrome and an insulinoma with severe crisis of hypoglycemia and coma) refractory to conventional treatments, which were finally solved with selective internal radiation therapy (SIRT), a nonstandard level 1 therapy. We show two examples of an excellent control of symptoms together with a long survival after treatment with SIRT. The evidence supporting the use of this therapy is level 2. Our case reports strongly support the use of SIRT for the severe clinical syndrome in pNET metastatic to the liver and refractory to somatostatin analogs
Técnicas terapéuticas endovasculares
Percutaneous and endovascular techniques have
shown their efficacy in the treatment of a great variety
of pathologies. The advances in diagnostic imaging as
well as the development of new materials have made it
possible to carry out new procedures that were
unthinkable not many years ago. The irruption of this
new form of treating patients has had, is having, and
will have a clear impact on the multidisciplinary
approach to numerous diseases
Osteosarcoma: correlation between radiological and histological changes after intra-arterial chemotherapy
The statistical correlation between three different radiological methods (conventional radiography, computed tomography and angiography) and tumor necrosis (TN) of the resected specimen have been studied in a series of 31 patients diagnosed with osteosarcoma (OS). They were treated with a multidisciplinary approach including intraarterial and intravenous chemotherapy followed by limb salvage procedures, plus intraoperative radiotherapy and adjuvant chemotherapy. A clear statistical correlation has been obtained between TN and angiography (p = 0.02) and between TN and two specific radiological signs: 'tumoral stain and neovascularity' (p = 0.02) and 'peritumoral fat planes' (p = 0.05). Conventional radiography, computed tomography and other radiological signs studied (nutrient vessel, soft tissue mass and central peripheral calcifications) did not show any significant correlation with TN. These results seem to suggest that angiography is a method to evaluate TN preoperatively and also to define the efficacy of neoadjuvant chemotherapy in OS
Gastroduodenal injury after radioembolization of hepatic tumors
Radioembolization is a new tool for the treatment of hepatic tumors
that consists in the injection of biocompatible microspheres carrying
radioisotopes into the hepatic artery or its branches. METHODS: We have performed
radioembolization in 78 patients with hepatic tumors using resin-based
microspheres loaded with yttrium-90. All patients were previously evaluated to
minimize the risk of hazardous irradiation to nontarget organs and to obtain the
data needed for dose calculation. RESULTS: We report a complication found in
three cases (3.8%) that consists of abdominal pain resulting from gastroduodenal
lesions and that had a chronic, insidious course. Microscopically, microspheres
were detected in the specimens obtained from all affected gastric areas. Since
these gastroduodenal lesions do not appear when nonradiating microspheres are
injected in animals, lesions are likely to be due to radiation and not to an
ischemic effect of vascular occlusion by spheres. CONCLUSIONS: We believe that a
pretreatment evaluation that includes a more thorough scrutiny of the hepatic
vascularization in search of small collaterals connecting to the gastroduodenal
tract can help prevent this awkward complicatio
Ionizing radiation received by patients with osteosarcoma during intra-arterial chemotherapy treatment
Fundamento. Los pacientes afectos de osteosarcoma reciben tratamiento con quimioterapia administrada por vÃa intraarterial (QTia)3 directamente al tumor y son expuestos a radiación ionizante durante el mismo. Los pacientes pediátricos son especialmente vulnerables a esta exposición.
Material y métodos. Se registró la cantidad de radiación ionizante recibida por 16 pacientes pediátricos
afectos de osteosarcoma durante la administración de QTia en la ClÃnica Universidad de Navarra.
Resultados. La mediana de radiación total recibida fue de 33,4 Gy·cm2 (IQR 43,33 Gy·cm2) y la mediana de número de pruebas por paciente de 10 (IQR: 6,5).
Conclusión. El estudio resalta la importancia de cuantificar la radiación recibida por un grupo de niños
y adolescentes afectos de osteosarcoma durante el tratamiento con QTia ya que no conviene olvidar los potenciales efectos adversos a largo plazo de esta exposición. Actualmente, no existen estudios previos que aporten datos acerca de la cantidad de radiación ionizante recibida a través de este procedimiento.Background. Osteosarcoma paediatric patients are usually treated with intra-arterial chemotherapy (QTia) which is administered directly to the tumour. This procedure exposes patients to ionizing radiation. Paediatric patients are especially sensitive to this exposure.
Methods. The total amount of ionizing radiation received from QTia administration was quantified in a group
of 16 osteosarcoma paediatric patients from the ClÃnica Universidad de Navarra.
Results. The median of the total radiation received per patient was 33.4 Gy·cm2 (IQR: 43.33 Gy·cm2), and the median number of procedures performed per subject was 10 (IQR: 6.5).
Conclusions. The study highlights the importance of quantifying the radiation received by a group of children and adolescents affected by osteosarcoma during treatment with QTia. Long-term side effects of this radiation should be considered in paediatric patients. Currently, there are no previous studies that provide data of the amount of ionizing radiation received through
this procedure
Follow-up after radiological intervention in oncology: ECIO-ESOI evidence and consensus-based recommendations for clinical practice
Interventional radiology plays an important and increasing role in cancer treatment. Follow-up is important to be able
to assess treatment success and detect locoregional and distant recurrence and recommendations for follow-up are
needed. At ECIO 2018, a joint ECIO-ESOI session was organized to establish follow-up recommendations for oncologic
intervention in liver, renal, and lung cancer. Treatments included thermal ablation, TACE, and TARE. In total five topics
were evaluated: ablation in colorectal liver metastases (CRLM), TARE in CRLM, TACE and TARE in HCC, ablation in renal
cancer, and ablation in lung cancer. Evaluated modalities were FDG-PET-CT, CT, MRI, and (contrast-enhanced)
ultrasound. Prior to the session, five experts were selected and performed a systematic review and presented
statements, which were voted on in a telephone conference prior to the meeting by all panelists. These statements
were presented and discussed at the ECIO-ESOI session at ECIO 2018. This paper presents the recommendations that
followed from these initiatives. Based on expert opinions and the available evidence, follow-up schedules were
proposed for liver cancer, renal cancer, and lung cancer. FDG-PET-CT, CT, and MRI are the recommended modalities,
but one should beware of false-positive signs of residual tumor or recurrence due to inflammation early after the
intervention. There is a need for prospective preferably multicenter studies to validate new techniques and new
response criteria. This paper presents recommendations that can be used in clinical practice to perform the follow-up
of patients with liver, lung, and renal cancer who were treated with interventional locoregional therapies