15 research outputs found
Management and prevention of acute bleedings in the head and neck area with interventional radiology
Duplex-guided foam sclerotherapy for the treatment of the symptomatic venous malformations of the face.
BACKGROUND:New sclerosing foam is considered to have the advantage of causing more damage on the intima than liquid form. Therefore we recently applied duplex-guided foam sclerotherapy in a patient with venous malformations of the face.METHODS:A 20-year-old man was referred to our institute for the evaluation and treatment of vascular malformations of the face. Preoperative duplex scanning and magnetic resonance imaging (MRI) revealed subcutaneous and intramuscular venous malformations. The sclerosing foam was produced by Tessari's method using 1% polidocanol, and the duplex-guided foam sclerotherapy was performed under general anesthesia. A 20-gauge plastic needle was inserted into the venous space using ultrasound guidance and a total of 5 ml of sclerosing foam was infused followed by immediate tie-over dressing.RESULTS:The venous malformations were successfully reduced in size and postoperative MRI showed significant reduction of the venous malformations.CONCLUSION:Although further collective study is necessary to ensure the validity of this treatment, duplex-guided foam sclerotherapy could have great promise in the treatment of symptomatic venous malformations.61962
Tratamento cirúrgico de nasoangiofibroma sem embolização Surgical Treatment of Non-embolized Patients with Nasoangiofibroma
Nasoangiofibroma juvenil (NAFJ) é um tumor incomum que se localiza na região do forame esfenopalatino. A cirurgia combinada à embolização pré-operatória tem sido a opção terapêutica mais empregada nos pacientes com NAFJ sem invasão intracraniana. O objetivo desse estudo é avaliar a viabilidade do tratamento cirúrgico do nasoangiofibroma em pacientes estágios I- III de Fisch, sem uso de embolização pré- operatória. MATERIAL E MÉTODO: Estudo descritivo, retrospectivo, utilizando-se dados de revisão de prontuário de quinze pacientes com NAFJ estágio I a III de Fisch submetidos à cirurgia sem embolização pré-operatória, entre os anos de 2000 e 2005. RESULTADOS: Dos quinze pacientes, sete pacientes foram submetidos à cirurgia endoscópica, quatro via transmaxilar, três via endoscópica e transmaxilar e um via transmaxilar e transpalatina. Seis pacientes necessitaram de hemotransfusão no intra-operatório, com média geral de 1.3 bolsa/paciente. Nenhum caso de mortalidade ou morbidade significativa foi registrado. Onze dos quinze pacientes foram acompanhados por tempo médio de doze meses com taxa de recidiva de 27%. Quatro pacientes perderam seguimento. CONLUSÃO: A ressecção de NAFJ classes I- III foi realizada com segurança em pacientes não-embolizados, com taxa de sangramento intraoperatório, ocorrência de complicações e taxa de recorrência próximas dos valores pesquisados na literatura para pacientes embolizados.<br>Juvenile nasopharyngeal angiofibroma (JNA) is an uncommon tumor of the sphenopalatine foramen. Surgery combined with preoperative embolization has been the treatment of choice for JNA patients without intracranial invasion. This study aims to assess the viability of surgically treating non-embolized patients with JNA (types I-III according to Fisch). MATERIAL AND METHOD: This is a retrospective, descriptive study based on the medical records of 15 patients with histologically confirmed JNA (Fisch’s types I- III), who underwent surgical treatment without pre-op embolization in our institution between 2000 and 2005. RESULTS: Seven of the fifteen patients were approached endoscopically, four through the transantral approach, three were treated with the combined transmaxillary and endoscopic approach, and one with the combined transmaxillary and transpalatal approach. Six patients required intraoperatory blood transfusion, averaging volumes of 1.3 unit/patient. There were no cases of death or significant morbidity. Eleven of the fifteen patients were followed for an average of twelve months and 27% of them relapsed. Four patients did not comply with the follow-up scheme. CONCLUSION: Resection of JNF types I-III was safely completed in non-embolized patients. The observed levels of intraoperative bleeding, occurrence of complications, and rates of recurrence were close to those seen in embolized patients as found in the literature