[Visceral arterial embolization (VAE). Note I. VAE in renal cancer. Experimental study and preliminary clinical results]

After a short history of the VAE, a new method in the intervention radiology, the authors present the technique and results of the experimental renal VAE performed on dogs, with autologous clot, Gelaspon and Isobutyl-2-cyanoacrylat. The favourable results of the experimental investigations permitted for the first time in our country the use of VAE in inoperable renal cancers. The paper presents the clinico-therapeutical results of VAE as well as the control angiographic and echotomographic aspects after embolization. The conclusions support the need of using VAE both preoperatively and in the inoperable cases of renal cancer, suggesting the possibility of extending the use of this method to other visceral cancers with selective arterial catheterizations approach.

[Transrenal ureteric embolisation. Experimental and clinical results (author's transl)]

Transrenal ureteric embolisation with the tissue adhesive butyl 2-cyano-acrylate mixed with lipiodol and tantalum powder produces rapid and effective occlusion of the ureter. This can be combined with the use of a Gianturco spiral. In an experimental series of eight dogs observed for 54 days, the adhesive disappeared partly in three animals and totally in a further three. Fibrotic ureteric stenosis was observed in three animals. Clinical results were rather better because of the presence of external urinary drainage. Twenty-one ureters in eighteen patients were occluded either unilaterally or bilaterally, and sometimes combined with percutaneous contralateral renal embolisation. After one to four months, the ureter was still occluded in three out of six cases; after five to 17 months, three out of five cases were no longer totally occluded, but in two cases they were still blocked. The procedure is new and suitable for the treatment of otherwise untreatable conditions, such as extensive urinary fistulae, bladder tenesmus and haematuria due to extensive tumours of the minor pelvis.

An outpatient approach to female sterilization with methylcyanoacrylate

MCA is a tissue adhesive which can be delivered transcervically to the Fallopian tubes by means of the FEMCEPT device. In the patients treated with this system, both prior to hysterectomy and on an ambulatory basis, there have been no significant complications or side effects. In the most recent series of ambulatory patients treated with the REMCEPT-MCA system, the bilateral tubal closure rate was 78%.

Intra-arterial tissue adhesives for medical splenectomy in dogs

Transcatheter intra-arterial tissue adhesives are effective agents for producing medical splenectomy in dogs. Because of the rapid polymerization of the tissue adhesive, localized occlusion of the splenic artery mimicking a surgical ligation can be achieved leaving the intrasplenic vessels patent. Splenic infarction without evidence of infection was accomplished.

Experimental catheter obstruction of the gastric coronary vein. Possible technique for percutaneous intravascular tamponade of the gastroesophageal varices

Experimental catheter obstruction of the left gastric (coronary) vein was explored in 10 dogs. Using a transjugular approach, the liver was punctured and the portal vein catheterized. Coaxially introduced catheters were then used to catheterize selectively and produce an intravascular obstruction (tamponade) of the gastric coronary vein. Ballon catheters were used for a temporary occlusion. Injection of a tissue adhesive, isobutyl 2-cyanoacrylate, was used for a definitive obliteration. The achieved results show the anatomical feasibility of this approach and give good perspective for development of a clinical method for percutaneous intravascular tamponade of the bleeding gastroesophageal varices in cirrhotics.