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Title: Vesical Artery Embolization in Haemorrhagic Cystitis in Children

Abstract

Haemorrhagic cystitis is an uncommon and, in its severe form, potentially life-threatening complication of haematopoietic stem cell transplantation or cancer therapy in children. The severe form involves macroscopic haematuria with blood clots, urinary obstruction and/or renal impairment. There are many therapeutic options to treat acute haemorrhage, but only recombinant factor VII has a high level of clinical evidence in children. Supraselective vesical artery embolization (SVAE) is an increasingly used therapeutic procedure for controlling haemorrhage in adults, but is less commonly used in children. This might be due to several factors, such as the invasive nature of the procedure, lack of appropriate medical experience and possible long-term side effects. We present three cases of children successfully treated by means of effective SVAE.

Authors:
;  [1];  [2];  [1];  [2]; ;  [3];  [1]
  1. Hospital Clinic (Spain)
  2. Hospital de la Santa Creu y Sant Pau (Spain)
  3. Great Ormond Street Hospital for Children (United Kingdom)
Publication Date:
OSTI Identifier:
22642491
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 7; Other Information: Copyright (c) 2016 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ADULTS; ARTERIES; BLOOD; CHILDREN; HEMORRHAGE; KIDNEYS; NEOPLASMS; SIDE EFFECTS; STEM CELLS; THERAPY; VASCULAR DISEASES

Citation Formats

García-Gámez, Andrés, E-mail: agargamez@gmail.com, Bermúdez Bencerrey, Patricia, E-mail: PBERMUDE@clinic.ub.es, Brio-Sanagustin, Sonia, E-mail: sbrio@santpau.cat, Guerrero Vara, Rubén, E-mail: rguerrerov@santpau.cat, Sisinni, Luisa, E-mail: lsisinni@santpau.cat, Stuart, Sam, E-mail: sam.stuart@gosh.nhs.uk, Roebuck, Derek, E-mail: Derek.Roebuck@gosh.nhs.uk, and Gómez Muñoz, Fernando, E-mail: FEGOMEZ@clinic.ub.es. Vesical Artery Embolization in Haemorrhagic Cystitis in Children. United States: N. p., 2016. Web. doi:10.1007/S00270-016-1300-Y.
García-Gámez, Andrés, E-mail: agargamez@gmail.com, Bermúdez Bencerrey, Patricia, E-mail: PBERMUDE@clinic.ub.es, Brio-Sanagustin, Sonia, E-mail: sbrio@santpau.cat, Guerrero Vara, Rubén, E-mail: rguerrerov@santpau.cat, Sisinni, Luisa, E-mail: lsisinni@santpau.cat, Stuart, Sam, E-mail: sam.stuart@gosh.nhs.uk, Roebuck, Derek, E-mail: Derek.Roebuck@gosh.nhs.uk, & Gómez Muñoz, Fernando, E-mail: FEGOMEZ@clinic.ub.es. Vesical Artery Embolization in Haemorrhagic Cystitis in Children. United States. doi:10.1007/S00270-016-1300-Y.
García-Gámez, Andrés, E-mail: agargamez@gmail.com, Bermúdez Bencerrey, Patricia, E-mail: PBERMUDE@clinic.ub.es, Brio-Sanagustin, Sonia, E-mail: sbrio@santpau.cat, Guerrero Vara, Rubén, E-mail: rguerrerov@santpau.cat, Sisinni, Luisa, E-mail: lsisinni@santpau.cat, Stuart, Sam, E-mail: sam.stuart@gosh.nhs.uk, Roebuck, Derek, E-mail: Derek.Roebuck@gosh.nhs.uk, and Gómez Muñoz, Fernando, E-mail: FEGOMEZ@clinic.ub.es. 2016. "Vesical Artery Embolization in Haemorrhagic Cystitis in Children". United States. doi:10.1007/S00270-016-1300-Y.
@article{osti_22642491,
title = {Vesical Artery Embolization in Haemorrhagic Cystitis in Children},
author = {García-Gámez, Andrés, E-mail: agargamez@gmail.com and Bermúdez Bencerrey, Patricia, E-mail: PBERMUDE@clinic.ub.es and Brio-Sanagustin, Sonia, E-mail: sbrio@santpau.cat and Guerrero Vara, Rubén, E-mail: rguerrerov@santpau.cat and Sisinni, Luisa, E-mail: lsisinni@santpau.cat and Stuart, Sam, E-mail: sam.stuart@gosh.nhs.uk and Roebuck, Derek, E-mail: Derek.Roebuck@gosh.nhs.uk and Gómez Muñoz, Fernando, E-mail: FEGOMEZ@clinic.ub.es},
abstractNote = {Haemorrhagic cystitis is an uncommon and, in its severe form, potentially life-threatening complication of haematopoietic stem cell transplantation or cancer therapy in children. The severe form involves macroscopic haematuria with blood clots, urinary obstruction and/or renal impairment. There are many therapeutic options to treat acute haemorrhage, but only recombinant factor VII has a high level of clinical evidence in children. Supraselective vesical artery embolization (SVAE) is an increasingly used therapeutic procedure for controlling haemorrhage in adults, but is less commonly used in children. This might be due to several factors, such as the invasive nature of the procedure, lack of appropriate medical experience and possible long-term side effects. We present three cases of children successfully treated by means of effective SVAE.},
doi = {10.1007/S00270-016-1300-Y},
journal = {Cardiovascular and Interventional Radiology},
number = 7,
volume = 39,
place = {United States},
year = 2016,
month = 7
}
  • BackgroundProstate artery embolization (PAE) is a new approach to improve lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia. PAE results in global reduction of prostate volume (PV). There are no data available on the efficacy of PAE in reducing intra-vesical prostatic protrusion (IPP), an anatomic feature that is clinically related with bladder outlet obstruction and LUTS.ObjectiveTo assess the results of PAE in patients with significant IPP due to median lobe hyperplasia and to compare the IPSS decrease and IPP change.Material and MethodsProspective analysis of 18 consecutive patients with significant IPP (>5 mm) related to median lobe hyperplasia undergoing PAEmore » using 30–500-μm-calibrated trisacryl microspheres. We measured IPP on sagittal T2-weighted images before and 3 months after PAE. IPSS and clinical results were also evaluated at 3 months.ResultsPAE resulted in significant IPP reduction (1.57 cm ± 0.55 before PAE and 1.30 cm ± 0.46 after PAE, p = 0.0005) (Fig. 1) with no complication. IPSS, quality of life (QoL), total prostate-specific antigen (PSA) level, and PV showed significant reduction after PAE, and maximum urinary flow rate (Q{sub max}) showed significant increase after PAE. No significant change of International Index of Erectile Function (IIEF) for clinical evaluation after PAE. A significant correlation was found between the IPP change and the IPSS change (r = 0.636, p = 0.0045).ConclusionPatients had significant IPP reduction as well as significant symptomatic improvement after PAE, and these improvements were positively correlated.« less
  • The objective of this paper is to present an alternative therapeutic approach for the treatment of patients with massive hemoptysis in whom bronchial and/or nonbronchial systemic arterial embolization is not possible. We describe a percutaneous procedure for pulmonary segmental artery embolization. Between May 2000 and July 2006, 27 adult patients with hemoptysis underwent percutaneous treatment at our department; 20 of 27 patients were embolized via bronchial and or nonbronchial systemic arteries and 7 patients were embolized via pulmonary artery. Femoral arterial access for systemic artery catheterization and femoral vein access for pulmonary arterial catheterization were used. Gelfoam particles and coilsmore » were used for embolization. In this study, we report on three cases of massive hemoptysis from a systemic arterial source in whom bronchial and/or nonbronchial arteries embolization was not possible. Percutaneous embolization via the pulmonary artery access was successful in all three patients. In conclusion, embolization via pulmonary artery is presented as an alternative approach for the management of hemoptysis in patients in whom bronchial arterial embolization is not possible.« less
  • No abstract prepared.
  • Purpose: To describe the angiographic appearance of the ovarian artery and its main variations that may be relevant to uterine fibroid embolization. Methods: The flush aortograms of 294 women who had been treated by uterine artery embolization for fibroids were reviewed. Significant arterial supply to the fibroid, and the origin and diameter of identified ovarian arteries were recorded. In patients with additional embolization of the ovarian artery, the follow-up evaluation also included hormonal levels and Doppler imaging of the ovaries. Results: A total of 75 ovarian arteries were identified in 59 women (bilaterally in 16 women and unilaterally in 43more » women). All ovarian arteries originated from the aorta below the level of the renal arteries with a characteristic tortuous course. Fifteen women had at least one enlarged ovarian artery supplying the fibroids. Fourteen women (14/15, 93%) presented at least one of the following factors: prior pelvic surgery, tubo-ovarian pathology or large fundal fibroids. Conclusion: We advocate the use of flush aortography in women with prior tubo-ovarian pathology or surgery or in cases of large fundal fibroids. In the case of an ovarian artery supply to the fibroids, superselective catheterization and embolization of the ovarian artery should be considered.« less
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