Background Fibromuscolar dysplasia (FMD) is an idiopathic, non-atherosclerotic and non-inflammatory stenotic lesion of renal arteries causing renovascular hypertension up-regulating renin-angiotensin-aldosterone system. Case report: A 18-year-old man was referred to our Hypertension Center (Clinica e Terapia Medica) for the recent onset of hypertension, poorly controlled on calcium channel blockers, already associated to electrocardiographic and echocardiography signs of left ventricular hypertrophy and significant albuminuria (728 mg/24 h). An increased plasma renin activity (PRA), aldosterone level and a mild hypokalemia raised the suspicion of renovascular hypertension.
View Article and Find Full Text PDFObjective: We describe the first case to our knowledge of Hypervascularised placental polyp (HPP) presenting with acute pelvic pain and hemoperitoneum.
Case Report: A 33 years-old woman with a history of medical abortion three months earlier came to our attention complaining acute pelvic pain and vaginal bleeding. Transvaginal (TV) and transabdominal (TA) ultrasound (US) demonstrated a highly vascular intrauterine lesion and intra-abdominal free fluid consistent with a diagnosis of haemoperitoneum.
Background: Percutaneous renal artery embolization is a valid non-invasive technique alternative to nephrectomy for patients with symptomatic non-functioning allograft (graft intolerance syndrome-GIS). The purpose of this article is to report the experience of our centre.
Methods: We analysed retrospectively 15 patients with symptomatic non-functioning renal allograft treated with percutaneous embolization from 2003 to 2017.
Hemobilia is an unusal cause of upper gastrointestinal bleeding and may be the result of the formation of an hepatic vessel pseudoaneurysm. This is a rare occurence after laparoscopic or open cholecistectomy. The most importants factor for pathogenesis are direct or indirect iatrogenic injuries during intervention and hepatic trauma.
View Article and Find Full Text PDFA 56-year man with multiple comorbidities and recent septic embolization presented claudication intermittens (Rutherford3) at right lower limb and complaint in right lower quadrant at abdominal palpation. Duplex and computed tomography angiogram (CTA) showed a 64mm-pseudo-aneurysm (PA) originating from right common iliac artery, occlusion of external iliac and patency of hypogastric artery. An urgent endovascular approach was preferred.
View Article and Find Full Text PDFObjectives: Blunt thoracic aortic injury can be treated with thoracic endovascular aortic repair (TEVAR) with excellent short and mid-term outcomes. However, few data are available about the long-term results. Our goal was to report our single-centre, 20-year experience using TEVAR to treat blunt thoracic aortic injury.
View Article and Find Full Text PDFTreatment of thoracic aortic rupture poses a substantial challenge for the aortic surgeon. The advent of thoracic endovascular aortic repair (TEVAR) revolutionized the treatment of this heterogeneous group of diseases. Some patients suitable for TEVAR, however, present severe peripheral vascular diseases that can prevent standard retrograde delivery of the stent graft through the femoral artery.
View Article and Find Full Text PDFBackground The endovascular approach became an alternative to open surgical treatment of popliteal artery aneurysm over the last few years. Heparin-bonded stent-grafts have been employed for endovascular popliteal artery aneurysm repair, showing good and stable results. Only few reports about the use of multilayer flow modulator are available in literature, providing small patient series and short follow-up.
View Article and Find Full Text PDFPurpose: Percutaneous renal artery embolisation has been introduced as an alternative to nephrectomy in patients with non-functioning allograft and Graft Intolerance Syndrome (GIS). The symptoms resulting from GIS include fever, local pain, hypertension and haematuria.
Materials And Methods: From April to October 2003, five patients were treated using this technique.
Upper gastrointestinal bleeding can be produced by varicose, inflammatory-ulcerative or neoplastic lesions of the eosophageal-gastric-duodenal anatomical district. The aim of this study was to define the role of arterial embolotherapy with an angiographic approach in the treatment of these conditions, starting from our personal experience and a review of the literature. The treatment of upper gastrointestinal bleeding is based on a multimodal approach in which arterial embolotherapy has its place alongside endoscopy and surgery.
View Article and Find Full Text PDFAims And Background: Taxanes are largely metabolized and almost exclusively excreted in the feces by the liver through the biliary pathway, thus providing a rationale for investigating the activity of their hepatic artery delivery in case of liver metastases.
Study Design: The aim of this study was to assess the feasibility of administering docetaxel via the hepatic artery in advanced breast cancer patients in whom the liver was the only or the predominant site of metastatic involvement. The dose was increased cycle by cycle in a prospective manner.
Objective: To evaluate the percentage of cases in which emboli can be detected in unenhanced scans and to identify the cases in which they appear hyperattenuating or hypoattenuating in comparison to the circulating blood.
Method: An angio-computed tomography (CT) scan was performed before and after contrast injection in 140 consecutive patients after clinical suspicion of pulmonary embolism. A radiologist analyzed the examination results thus obtained.
A case of severe hemorrhage after TURP leading to hypovolemic shock and its successful management by superselective unilateral arterial embolization is described. The authors conclude that arterial embolization is a safe and effective procedure for severe prostatic hemorrhage that may be performed in selected cases when conservative means or fulguration of the prostatic fossa have failed to achieve the control of the bleeding. Adequate selection of the patients, correction of any underlying coagulation defects and a proper resection technique are surely the most important issues in preventing any postoperative bleeding.
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