Percutaneous infarction of renal tumors: comparison between gelatin sponge embolization and cyanoacrylate occlusion

Absolute ethanol renal angioinfarction for control of hypertension

Six patients (11 renal units) underwent ethanol renal angioinfarction for medically uncontrollable hypertension. The mean preablation blood pressure was 175/112 mm Hg despite antihypertensive medications. Five of the patients demonstrated elevated renal vein renin levels prior to angioinfarction. Hypertension was improved in all 6 patients, during a mean follow-up period of fifty-one months. Systemic hypertension was completely eliminated in 4 patients. Two patients continue to require antihypertensive medication to control their hypertension. There were no major complications directly related to intra-arterial injection of ethanol. Transcatheter renal ablation employing intra-arterial injection of absolute ethanol for control of severe hypertension appears to be a safe and efficacious procedure. It should be considered an alternative to nephrectomy in selected high-risk patients.

Preoperative arterial occlusion in renal tumors: 3 years experience

The authors describe their experience in preoperative embolization of 42 renal neoplasms. In all cases but one Gelfoam has been used for arterial occlusion with just a few and transient complications. Good hemostatic effect and décollement have been obtained irrespective of the diameter and vascularization of the tumor. To avoid late décollement difficulties and reduce the duration of clinical sequels the authors prefer, at present, to resort to surgery within 24 hours of embolization.

Transcatheter arterial chemoembolization of renal cell carcinoma with microencapsulated mitomycin C

Ethylcellulose microcapsules of mitomycin C were prepared for intra-arterial use in an attempt to enhance the antineoplastic effects of mechanical arterial embolization. The potential therapeutic effects of intra-arterial mitomycin C microcapsules were considered to be a function of microembolization and prolonged drug action, that is chemoembolization. A total of 33 patients with renal cell carcinoma was subjected to transcatheter arterial chemoembolization with mitomycin C microcapsules supplemented with gelatin sponge, and 10 patients were subjected to chemoembolization with non-encapsulated mitomycin C and gelatin sponge. Comparative studies on objective tumor decrease, angiographical findings and histological effects between the 2 treated groups indicated that mitomycin C microcapsules definitely enhanced the therapeutic responses to gelatin sponge embolization. Bioassay of the peripheral blood revealed that intra-arterial mitomycin C microcapsules reduced markedly mitomycin C levels in the blood compared to non-encapsulated mitomycin C, leading to a decrease in hematological toxicity. The results may prove that chemoembolization with mitomycin C microcapsules is effective as a preoperative and palliative measure in the treatment of renal cell carcinoma.

Per catheter control of haemorrhage from the superior and inferior mesenteric arteries

The relevant findings in 11 cases of per catheter control of haemorrhage from different sites in the large and small bowel are presented together with a description of the techniques and some of the possible complications of vasopressin infusion and gelfoam embolisation. In six of these cases vasopressin infusion was sus achieved by embolisation, three following the failure of vasopressin therapy. In one case embolisation of the ileo-colic artery produced a caecal infarct. Important differences in the vascular supply to the large and small bowel and their practical significance in embolisation are discussed.