Background. Uterine myoma is the most common benign tumor of the pelvic organs in women. One of the effective therapies for myomas is uterine artery embolization (UAE), which can be associated with unintended ovarian embolization. However, there is no certainty about the effect of unintended ovarian embolization on fertility and ovarian function since no precise evidence-based ways of identifying unintended embolization have been described.
Aim. To develop a highly accurate method for identifying unintended ovarian embolization during UAE.
Materials and methods. A series of clinical cases of the utilization of combined embolization material based on the paramagnetic contrast agent gadoteridol and saturable HepaSphere microspheres are presented.
Results. On admission, patients underwent magnetic resonance imaging (MRI) of the pelvic organs with contrast enhancement. After UAE with this combined embolization material, another pelvic MRI without contrast enhancement was performed on the in-hospital day 2. In the first clinical case, no hyperintensive zones were detected in the ovarian stroma. However, in the second case, a previously undetected hyperintensive signal up to 6 mm in diameter was seen in the stroma of the left ovary by repeat MRI.
Conclusion. Using this combined material during UAE significantly increases the accuracy of possible unintended ovarian embolization detection as soon as in the early postoperative period.
Osteoarthritis is a common disease of the musculoskeletal system, the cause of pain, loss of joint function and, as a consequence, a factor in the disability of the population. The treatment strategy for patients with gonarthrosis is not fully defined, especially in patients with stage 1–2. One of the treatment options for such patients is transcatheter embolization of the hypervascular network of the popliteal arteries. The article presents a series of clinical cases of embolization of the popliteal artery branches. Retrograde percutaneous puncture and catheterization of the target femoral artery were performed under local anesthesia. Then, selective angiography of the popliteal artery was performed to identify the hypervascular vasculature of the knee joint. After revealing the target artery along the interventional guidewire, selective catheterization of the artery of the hypervascular vascular network was performed using a microcatheter. Transcatheter arterial embolization of the hypervascular vascular network in osteoarthritis of various origins and localization can be successfully applied as an alternative treatment if conservative therapy is ineffective and if there are contraindications to surgical treatment. It should be noted that further randomized multicenter studies and meta-analyzes are needed to introduce this treatment method into everyday clinical practice.
The paper describes a clinical case of successfully applying a transradial access during mechanical thrombus extraction in a patient in the acutest stage of ischemic stroke with a congenital anatomical feature (the left common carotid artery and brachiocephalic trunk with the common ostium from the aortic arch).X-ray endovascular interventions were performed in an operating room equipped with a digital angiographic unit including an Axiom Artis dTA flat detector (Siemens Medical System).Mechanical recanalization for acute occlusion of the M2 segment of the left middle cerebral artery (MCA) was carried out using a right radial access into and catheterization of the left internal carotid artery. A stent retriever was inserted into the occlusion area through a microcatheter and was opened. Double thrombus extraction from the left MCA was made using the stent retriever to restore TICI 2B blood flow. There were no signs of dissection, thrombosis, or distal thromboembolism.
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