Role of prostatic artery embolization in management of symptomatic benign prostatic hyperplasia

AbstractObjectivesTo assess the feasibility and efficacy of prostatic artery embolization in relieving symptoms of benign prostatic hyperplasia.Materials and methodsIn a prospective study 28 patients with symptomatic benign prostatic hyperplasia were presented for prostatic artery embolization between June 2012 and June 2014. Patients age was 48–85years with mean age 68.5years±10.6SD. International Prostate Symptoms Score (IPSS) before intervention measured 20–35 with mean score 26.3±6.8SD. Prostatic volume before intervention ranged between 48 and 166cc3 with mean of 82.6±11.2SD.ResultsTechnical success was achieved in all cases (100%). All patients were followed for 6months after the procedure. IPSS improved at 6months in all patients with post embolization mean of 12.2±3.4SD with significant P value of 0.0006. Mean post-procedure prostatic volume at 6months was 49.8cc3±16.9SD with 39.7% mean volume reduction. No major complications were recorded. We achieved clinical success in 27 patients (96.4%) with only one non responding patient (3.6%).ConclusionProstatic artery embolization is a feasible technique and preliminary short-term results show promising high technical and clinical success rates in symptomatic patients with benign prostatic hyperplasia

Portal Vein Hemodialysis-Tunneled Catheter: A Case Report in a Pediatric Patient with Extensive Systemic Venous Thrombosis

We report a case of an 11-year-old child with end-stage renal disease and extensive systemic venous thrombosis including the inferior and superior vena cava. Transhepatic portal vein hemodialysis tunneled catheter was inserted after exhausting all other possible venous access through internal jugular, subclavian, femoral, and hepatic veins

Percutaneous Endoscopic Gastrostomy Large-Bore Tube Application without the Use of Endoscope: Single-Center Experience on 86 Neurologically Compromised Patients

Context: Percutaneous placement of gastrostomy tube has replaced surgical placement as the most accepted method of gastrostomy tube insertion. It can be done by an alternative nonendoscopic fluoroscopy-guided technique that combines the advantages of fluoroscopic guidance and the pull technique. Aims: This study aimed to describe a percutaneous fluoroscopy-guided technique for applying mushroom-retained large-bore gastrostomy advanced through the nose without endoscopy. Settings and Design: This retrospective study was conducted at the Interventional Radiology Unit, Ain Shams University Hospitals, Cairo, Egypt. Subjects and Methods: Between January 2015 and November 2017, 86 neurologically compromised patients underwent placement of 24F mushroom gastrostomy tubes. There were 55 males and 31 females, with the mean age of 61 years (58–87 years). Technical success and procedural complications were assessed. Follow-up data were collected retrospectively by reviewing the medical records at the neurology clinic to evaluate tube function and monitor complications. Results: Technical success rate was 100%. Procedure time varied between 10 and 13 min. No major procedure-related complications occurred. Twenty-two patients (25.5%) died during the study period with no procedure-related deaths. Nearly 34.8% of the patients (30/86 patients) could not be followed up due to loss of contact. Follow-up time ranged between 200 and 230 days in the remaining 34 patients with no evidence of tube dysfunction. Conclusions: Fluoroscopy-guided percutaneous placement of large-bore pull gastrostomy tubes inserted via nasal route showed a high rate of technical success and long-term patency with low risk of complications