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Maynar M, Reyes R, Cabrera V, Pulido J, Yetano J, Castañeda F, Letourneau J, Castañeda-Zúñiga W. Percutaneous Atherectomy of Iliac Arteries. Semin Intervent Radiol 2008. [DOI: 10.1055/s-2008-1075963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Maynar M, Reyes R, Cabrera V, Castañeda F, Baldo C, Letourneau J, Castañeda-Zúñiga W. Simpler Technique for Introduction of Simpson Atherectomy Catheter Technical Note. Semin Intervent Radiol 2008. [DOI: 10.1055/s-2008-1075967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Maynar M, Reyes R, Cabrera V, Yetano J, Pulido J, Tobio R, Castañeda F, Letourneau J, Castañeda-Zúñiga W. Percutaneous Atherectomy with Simpson Atherectomy Device in the Management of Arterial Stenosis. Semin Intervent Radiol 2008. [DOI: 10.1055/s-2008-1075962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Maynar M, Cabrera V, Alamo R, Letourneau J, Castañeda-Zúñiga W. Arterial Dissection: A Complication of Percutaneous Atherectomy Case Report. Semin Intervent Radiol 2008. [DOI: 10.1055/s-2008-1075965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Maynar M, Reyes R, Pulido-Duque J, Casal G, Letourneau J, Castañeda-Zúñiga W. Use of Guidewire as Access Preservation Measure after Placement of Biliary Endoprosthesis: Technical Note. Semin Intervent Radiol 2008. [DOI: 10.1055/s-2008-1074620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Maynar M, Reyes R, Cabrera V, Perez-Gil J, Letourneau J, Castañeda-Zúñiga W. Use of Safety Wire in Atherectomy Procedures for Recanalization of Complete Arterial Obstructions Technical Note. Semin Intervent Radiol 2008. [DOI: 10.1055/s-2008-1075964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Maynar M, Martin M, Cabrera P, Fernandez J, Reyes R, Castañeda F, Gissel-Letourneau J. Percutaneous Introduction of Inferior Vena Cava Filters as Prophylaxis for Pulmonary Embolus. Semin Intervent Radiol 2008. [DOI: 10.1055/s-2008-1075949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Maynar M, Lopez L, Ramirez J, Reyes R, Pulido A, Castañeda W, Gissel-Letourneau J. Clinical Experience with Silicone Biliary Endoprosthesis. Semin Intervent Radiol 2008. [DOI: 10.1055/s-2008-1075948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Maynar M, Rodriguez J, Fernandez A, Palop L, Reyes R, Pulido A. Transluminal Angioplasty of Transplant Renal Artery Stenosis. Semin Intervent Radiol 2008. [DOI: 10.1055/s-2008-1075950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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De Gregorio M, Laborda A, Palmero J, Montes H, Felices J, Tobio R, Maynar M. Abstract No. 171: Endovascular Treatment of Stenotic and Occlusive Lesions of Iliac Artery by Self-Expandable Stent. Multicenter Study. J Vasc Interv Radiol 2008. [DOI: 10.1016/j.jvir.2007.12.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Rabellino M, Zander T, Baldi S, Zerolo I, Llorens R, Crisostomo V, Maynar M. Abstract No. 172: Endovascular Treatment of Femoropopliteal Segment TASC C and D Lesions. J Vasc Interv Radiol 2008. [DOI: 10.1016/j.jvir.2007.12.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Maynar M, Baldi S, Rostagno R, Zander T, Rabellino M, Llorens R, Alvarez J, Barajas F. Carotid stenting without use of balloon angioplasty and distal protection devices: preliminary experience in 100 cases. AJNR Am J Neuroradiol 2007; 28:1378-83. [PMID: 17698546 PMCID: PMC7977659 DOI: 10.3174/ajnr.a0543] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE A major concern during carotid artery stent placement is the potential for cerebral embolism. Diminishing the number of device manipulations across the lesion might reduce procedural stroke risk. For this purpose, we report our initial experience with carotid stent placement without the use of either balloon angioplasty or distal protection devices. MATERIALS AND METHODS Eighty-seven consecutive patients with 100 carotid stenoses compose this series. Ninety four of the 100 hundred stented carotid arteries were either symptomatic (58 [58%]) or had a greater than 70% stenosis (36 [36%]). Six percent of them were asymptomatic and had stenosis between 50% and 70%. Patients underwent neurologic evaluation before the procedure and during follow-up at 1, 3, 6, and 12 months and annually thereafter. Carotid sonography and plain films of the neck were performed immediately after the procedure and then at the same time intervals. RESULTS Primary stent placement was successful in 98 of 100 case subjects. In 2 case subjects, predilation was necessary before stent deployment. Neurologic periprocedural complications included 1 nondisabling and 1 disabling stroke and 5 transient ischemic attacks. The mean duration of follow-up was 23 months (range: 10-36 months). During the follow-up period, there were 5 deaths, all unrelated to the carotid disease, and no major stroke. The degree of stenosis decreased from a mean of 78.85% before the procedure to a mean of 21.23% immediately after. CONCLUSIONS In this series, carotid stent placement without the use of either balloon angioplasty or distal protection devices was safe and effective with a low incidence of periprocedural complications.
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Pulido-Duque JM, Carreira JM, Qian Z, Maynar M. Treatment of innominate arterial stenosis with self-expanding stent: long-term follow-up. MINIM INVASIV THER 2006; 14:19-22. [PMID: 16754149 DOI: 10.1080/13645700510010791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We report our experience with the use of a self-expanding stent in the treatment of a severe innominate artery stenosis resulting in right upper limb ischemia. A 45-year-old woman was admitted for right upper limb ischemia, asymmetry of the carotid pulse and the lack of pulse in the right upper extremity. The patient had a history of chain smoking, hypertension, hypercholesterolemia, and acute myocardial infarction one year ago. She was diagnosed of the innominate artery stenosis by angiography one year ago at another hospital. At the time of admission her blood pressure was normal in the left arm and absent in the right upper limb. Arteriography showed a severe stenosis subocclusion of the innominate artery with an inverse flow of the ipsilateral vertebral artery. As the patient was not considered to be a surgical candidate due to instable angina, stent placement was indicated. After placement through an axillary approach an angiogram showed a patent right subclavian artery without residual stenosis. Angiographic follow-up showed a patent innominate arterial lumen two years after the procedure. The patient continued to be asymptomatic during six years follow-up. Blood pressure remained normal in both upper extremities, without any ischemic signs. Our experience indicates that placement of an endovascular stent is an effective therapeutic option in selected patients with symptomatic stenosis in the innominate artery when a surgical treatment is contraindicated.
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Zander T, Llorens R, Rostagno R, Zerolo I, Baldi S, Sanabria E, Maynar M. Endovaskuläre Behandlung von thorakalen Aortenaneurysmen und Dissektionen nach Transposition der supraaortalen Gefäße. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zander T, Llorens R, Rostagno R, Zerolo I, Rabellino M, Baldi S, Maynar M. Langzeit-Follow up von Hemobahnendograft-Implantationen in der Behandlung von langen AFS-Läsionen. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zander TZ, Llorens R, Alvarez JA, Barajas F, Rostagno R, Valencia F, Qian Z, Maynar M. Carotis-Stent ohne PTA: Eine neue Technik. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zander TZ, Zerolo I, Rostagno R, Llorens R, Prieto V, Qian Z, Maynar M. Bilaterale Okklusion der Arteria iliaca interna während der Implantation eines endovaskulären AAA Stent-Grafts. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zander TZ, Zerolo I, Rostagno R, Llorens R, Valencia F, Qian Z, Maynar M. Endovaskuläre Behandlung von Spätkomplikationen nach Aortenchirurgie. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zander TZ, Llorens R, Rostagno R, Zerolo I, Valencia F, Qian Z, Schonholz C, Maynar M. Extrakranielle ACI-Aneurysmata: endovaskuläre Therapie mittels Endoprothese. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Maynar M, Mahedero G, Maynar I, Maynar JI, Tuya IR, Caballero MJ. Menopause-induced changes in lipid fractions and total fatty acids in plasma. Endocr Res 2001; 27:357-65. [PMID: 11678583 DOI: 10.1081/erc-100106013] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
UNLABELLED The purpose of the present work was to evaluate the changes induced by the menopause in plasma lipids and total fatty acids. METHODS 35 post-menopausal and 25 non-postmenopausal women were included in the study. Plasma triglycerides (TG), total cholesterol (TC) and HDL-C concentrations were detemined enzymatically. Plasma fatty acids were determined by capillary gas chromatography. RESULTS Total cholesterol was higher (p < 0.05) in the postmenopausal women (6.18 +/- 0.77 mmol/l vs. 5.21 +/- 0.85 mmol/l). No significant changes were observed, however, in TG, HDL-C or LDL-C. The study of plasma fatty acids showed the post-menopausal women to have raised levels (p < 0.05) of stearic acid (C18:0), oleic acid (C18:1), and decrease of arachidonic acid (C20:4). Also noteworthy was the significant decrease (p < 0.001) of the desaturation index D5 (3.82 +/- 1.75) in the post-menopausal women. The SHBG level was lower (p <0.001) in the post-menopausal women (55.98 +/- 20nmol/l) than in the non-menopausal women (68.36 +/- 30 nmol/l). Multivariate analysis revealed correlation between menopause and SHBG (r = -0.3904, p < 0.05), D5 (r = -0.500, p < 0.001), TC (r = 0.3137, p <0.05), stearic acid (r = 03564, p < 0.05) and oleic acid (r = 0.2954, p < 0.05). CONCLUSION In post-menopausal women, as well as higher total cholesterol, the alterations in plasma fatty acids may constitute an important risk factor for cardiovascular diseases.
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Cabrera J, Falcón L, Gorriz E, Pardo MD, Granados R, Quinones A, Maynar M. Abdominal decompression plays a major role in early postparacentesis haemodynamic changes in cirrhotic patients with tense ascites. Gut 2001; 48:384-9. [PMID: 11171830 PMCID: PMC1760128 DOI: 10.1136/gut.48.3.384] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Some cirrhotic patients with tense ascites who undergo paracentesis develop a circulatory dysfunction syndrome, manifested by an increase in plasma renin activity. Recently, a significant inverse correlation between postparacentesis changes in plasma renin activity and systemic vascular resistance has been demonstrated in these patients, suggesting that peripheral arterial vasodilatation could be responsible for this circulatory dysfunction, but the mechanisms by which tense ascites removal induces such changes are unknown AIM To investigate the role of a decrease in intra-abdominal pressure (IAP) in the development of early postparacentesis haemodynamic changes METHODS Eleven cirrhotic patients with tense ascites received a large volume paracentesis. A specially designed pneumatic girdle was used to compress the abdomen to avoid a decrease in IAP during ascites removal. Haemodynamic studies were performed before paracentesis, one hour after ascites flow stopped, and 30 minutes after pneumatic girdle deflation RESULTS When IAP was maintained at its original level, no haemodynamic changes were observed, despite large volume paracentesis. However, a significant decrease in systemic vascular resistance was seen immediately after pneumatic girdle deflation CONCLUSIONS Early haemodynamic changes after paracentesis are avoided if IAP is maintained at its original level. The abrupt decrease in IAP could be the trigger for the development of the initial haemodynamic changes that eventually produce postparacentesis circulatory dysfunction.
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Abad C, Maynar M, De Blas M, Ponce G, Plaza C. Endovascular repair of abdominal aortic aneurysm in a renal transplant patient. THE JOURNAL OF CARDIOVASCULAR SURGERY 2000; 41:915-7. [PMID: 11232976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
A 65-year-old man presented with an asymptomatic infrarenal abdominal aortic aneurysm of 6 cm in transverse diameter. Five years before he received a cadaveric renal transplant. The patient also had the following risk factors and associated diseases: arterial hypertension, coronary artery disease, previous myocardial infarction, coronary angioplasty and stent, ileal resection secondary to Chron disease, hepatopathy, hyperlipidemia and hepato-renal cystic disease. The ASA classification was III, IV. Considering previous abdominal operations and risk factors, we decided to repair the aneurysm with a minimal aggression. The aneurysm was successfully approached by an endovascular route implanting a 22x10 bifurcated aorto-iliac endovascular prosthesis. The patient died 13 months later after being diagnosed of enterocolitis by cytomegalovirus complicated with sepsis and lung infection. We consider this less invasive modality of treatment a valid and useful alternative in this high-risk group of patients.
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Abad C, Maynar M, Ponce G, Chau O, Cárdenes MA, Jiménez P, Betancor P. Implantation of a composite bifurcated cryopreserved aorto-iliac-femoral homograft in a patient with Candida albicans endocarditis. THE JOURNAL OF CARDIOVASCULAR SURGERY 2000; 41:317-9. [PMID: 10901544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
A 35 year old woman, cocaine addict, suffered Candida albicans aortic valve endocarditis complicated with embolisation of infected vegetations in the distal abdominal aorta. She underwent successful staged aortic valve replacement followed by transaortic and transfemoral thrombectomy. One month later an arteriogram disclosed partial occlusion of the left iliac artery, bilateral aneurysmal degeneration of both iliac arteries and right iliac artery-right iliac vein fistula. She was operated again, performing re-laparotomy and re-exploration. A composite bifurcated cryopreserved homograft was implanted end-to-side between the infrarenal abdominal aorta, right external iliac artery and left common femoral artery. The right iliac artery-iliac vein fistula was obliterated with suture. The patient had an uneventful recovery but a relapsing arterio-venous fistula was diagnosed by arteriography. Three months later she underwent percutaneous transluminal closure of the reopened fistula. At present, 17 months after the implantation of the homograft, the patient is symptom-free, on antifungal agents and with arteriographic and clinical evidence of a well-functioning arterial homograft.
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Qian Z, Wholey M, Ferral H, Maynar M, Postoak D, Hamide J, Newman WP, Moncada R, Gonzalez-Roman A, Gimenez C, Castañeda WR. Recanalization of thrombosed superficial femoral arteries with a hydraulic thrombectomy catheter in a canine model. AJR Am J Roentgenol 1999; 173:1557-63. [PMID: 10584801 DOI: 10.2214/ajr.173.6.10584801] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This experiment was conducted to evaluate efficacy and safety of the Oasis thrombectomy catheter on arterial thrombosis in dogs. MATERIALS AND METHODS Thrombosis was induced in 18 femoral arteries of nine mongrel dogs. Recanalization of the thrombosed femoral artery was performed using a thrombectomy catheter 7-10 days after thrombus induction. Pre- and postprocedural arterial status was documented by angiography. After mechanical thrombectomy, the animals were sacrificed and the femoral arteries were harvested and examined macro- and microscopically. Additionally, in vitro fragmentation was carried out to determine particle size and distribution from the recovered effluent. RESULTS Subacute thrombosis was successfully created in 15 femoral arteries. Full recanalization was achieved in 80% (12/15) of the thrombosed femoral arteries without any residual thrombus. No significant downstream embolization was documented angiographically. Endothelial denudation was observed in all the treated arteries along with occasional disruption of the internal elastic lamina. No medial injury was seen. Ninety-eight percent of thrombus was liquefied, defined as particles smaller than 15 microm, by the catheter. Particles larger than 400 microm represented 0.27% of the original clot weight. CONCLUSION Occluded femoral arteries with 7- to 10-day-old thrombus can be efficiently recanalized with the Oasis catheter in dogs without any significant complication. This thrombectomy catheter appears to be highly effective and safe and requires no sophisticated equipment. Blood loss was our major concern regarding use of this catheter but can be minimized by strictly controlling activation time and restricting the inflow into the vascular segment being treated.
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Carreira JM, Reyes R, Pulido-Duque JM, Travieso MM, Górriz E, Pardo MD, Maynar M. Diagnosis and percutaneous treatment of gastrointestinal hemorrhage. Long-term experience. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS : ORGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE PATOLOGIA DIGESTIVA 1999; 91:684-92. [PMID: 10601757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
OBJECTIVE to report our experience in the diagnosis and treatment of gastrointestinal hemorrhage. METHOD from April 1987 to April 1997, 196 patients with gastrointestinal hemorrhage (134 men and 62 women) were studied. 165 (84%) were diagnosed as presenting upper gastrointestinal hemorrhage, and 31 (16%) presented lower gastrointestinal hemorrhage. The patients were studied with endoscopy and arteriography, and embolization was prescribed in 131 (67%). Patients with bleeding from esophageal varices were excluded from this study. RESULTS a bleeding point was identified angiographically in 33% (n = 65) patients. 131 (67%) patients were treated with therapeutic embolization, which was successful in 89% (n = 116) patients. The bleeding was resolved in 80% (n = 93) of the patients. Complications included arterial spasm (n = 12), pain (n = 24), coil migration (n = 8), allergic reaction (n = 2) and celiac trunk dissection (n = 2). During follow-up 16 patients presented rebleeding that stopped after reembolization in 9 cases, whereas in 7 cases surgery was needed. CONCLUSIONS in our experience, diagnostic angiography and percutaneous therapeutic embolization are effective, less aggressive methods that lead to few complications. Both methods have become indispensable tools in managing patients with gastrointestinal hemorrhage that does not respond to conservative therapy. Even in patients with no evidence of angiographic bleeding, embolization in selected patients is successful.
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