Prostatic Artery Embolization as a Primary Treatment for Benign Prostatic Hyperplasia: Preliminary Results in Two Patients

Symptomatic benign prostatic hyperplasia (BPH) typically occurs in the sixth and seventh decades, and the most frequent obstructive urinary symptoms are hesitancy, decreased urinary stream, sensation of incomplete emptying, nocturia, frequency, and urgency. Various medications, specifically 5-α-reductase inhibitors and selective α-blockers, can decrease the severity of the symptoms secondary to BPH, but prostatectomy is still considered to be the traditional method of management. We report the preliminary results for two patients with acute urinary retention due to BPH, successfully treated by prostate artery embolization (PAE). The patients were investigated using the International Prostate Symptom Score, by digital rectal examination, urodynamic testing, prostate biopsy, transrectal ultrasound (US), and magnetic resonance imaging (MRI). Uroflowmetry and postvoid residual urine volume complemented the investigation at 30, 90, and 180 days after PAE. The procedure was performed under local anesthesia; embolization of the prostate arteries was performed with a microcatheter and 300- to 500-μm microspheres using complete stasis as the end point. One patient was subjected to bilateral PAE and the other to unilateral PAE; they urinated spontaneously after removal of the urethral catheter, 15 and 10 days after the procedure, respectively. At 6-month follow-up, US and MRI revealed a prostate reduction of 39.7% and 47.8%, respectively, for the bilateral PAE and 25.5 and 27.8%, respectively, for the patient submitted to unilateral PAE. The early results, at 6-month follow-up, for the two patients with BPH show a promising potential alternative for treatment with PAE

Séquence d’estimation de l’âge osseux à l’aide de l’association de méthodes manuelle et automatisée : application en médecine légale

International audienc

High-flow priapism: Highly selective embolization of a traumatic arterio-cavernosal fistula

International audienc

Imagerie tomodensitométrique post-mortem du suicide

Le suicide est la huitième cause de mortalité en France et la première cause chez les 25–34 ans. La pendaison, l’intoxication médicamenteuse et l’usage d’une arme à feu sont les principaux modes suicidaires. Le scanner post-mortem est une aide à l’autopsie pour confirmer le suicide et éliminer une autre cause de décès. En cas de pendaison, les lésions de l’os hyoïde et/ou du cartilage thyroïdien sont retrouvées dans un peu plus d’un cas sur deux à l’autopsie. Les lésions des vertèbres cervicales sont rares, survenant en cas de chute d’une hauteur importante. Les reconstructions 3D permettent de visualiser le sillon laissé par le lien sur le cou. Dans les suicides par arme à feu, le scanner permet de déterminer l’orifice d’entrée et l’éventuel orifice de sortie, de visualiser les lésions parenchymateuses le long du trajet du projectile, et de localiser le projectile en cas de traumatisme pénétrant. Le trajet du projectile est plus difficile à déterminer au niveau thoraco-abdominal. Le scanner montre également des anomalies évocatrices en cas de suicide par noyade ou par arme blanche, mais son apport est plus limité en cas d’intoxication. Les phénomènes de décomposition et la modification de la position du corps vont limiter l’analyse des lésions tomodensitométriques

Postmortem computed tomography findings in suicide victims.

Suicide is the eighth cause of mortality in France and the leading cause in people aged between 25 and 34 years. The most common methods of suicide are hanging, self-poisoning with medicines and firearms. Postmortem computed tomography (CT) is a useful adjunct to autopsy to confirm suicide and exclude other causes of death. At autopsy, fractures of the hyoid bone or thyroid cartilage, or both, are found in more than 50% of suicidal hangings. Cervical vertebra fractures are rare and only seen in suicide victims jumping from a great height. Three-dimensional reconstructions from CT data are useful to visualize the ligature mark on the neck. In suicides by firearm, postmortem CT shows entry and exit wounds, parenchymal lesions along the bullet path, as well as projectiles in case of penetrating trauma. However, in the chest and abdomen it is more difficult to identify the path of the projectile. Postmortem CT also shows specific features of suicide by drowning or stabbing, but its use is limited in cases of self-poisoning. The use of postmortem CT is also limited by decomposition and change of body position. This article presents the imaging features seen on postmortem CT according to the method of suicide

Hypersplenism due to portal hypertension: Retrospective evaluation of 17 patients treated by splenic embolization

International audienc

Treatment of atheromatous renal artery in-stent restenosis in 51 patients

International audienc