Transcatheter embolization: prevention of embolic reflux using balloon catheters

Aj, Greenfield; Athanasoulis, C A; Waltman, A C; LeMoure, ER

doi:10.2214/ajr.131.4.651

Cited by 37 publications

(13 citation statements)

References 12 publications

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“…The major stem of the artery does not have to be occluded and the method thus does minimize the danger of damaging the circulation of the limb. Embolization with gel foam failed in our case and complications have been reported, mainly peripheral unwanted ambolization (Greenfield et al 1978). Reconstructive surgery should be reserved for arterial lesions where an intact vessel is imperative for normal function.…”

Section: Discussionmentioning

confidence: 68%

Coil embolization of major bleeding after femoral fracture: A case report

Kristoffersson¹,

Friberg²,

Nordmark

1986

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 68%

Coil embolization of major bleeding after femoral fracture: A case report

Kristoffersson¹,

Friberg²,

Nordmark

1986

Acta Orthopaedica Scandinavica

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“…The occlu sion mechanism was mechanical blood stasis and thrombus forma tion. Gelfoam particles form the matrix for platelet aggregation [22,45,47], Histoacryl (Braun, Melsungen). N-butyl-cyanoacrylate is available in 0.5-ml vials stained with methylene blue.…”

Section: Embolization Mediamentioning

confidence: 99%

“…They should be biologically inert with no local toxicity or canceroge-(1 nicity, sterilizable to avoid infection, and any tendency to recanalization is unwanted [1,15,22,31,36,45], How ever, if capillary embolization is aimed for, technical requirements should include that only liquids with a suit able radiodensity, viscosity, and controllable occlusion mechanism are used [45], Ethibloc and Gelfoam are inert, whereas Histoacryl causes severe specific inflammatory reactions and for eign-body granulomas [19,25,31,45,49]. The latter is discussed as a possible source of tumor induction, but this has never been proven clinically [42].…”

Section: Embolization Mediamentioning

confidence: 99%

“…Both factors lead to hypoxia in the embolized area instead of anoxia thus supporting sus tained hypertension-active parenchyma [2,15,31,46,51,55], Several authors advocate a more peripheral prop agation of the embolization medium to achieve complete organ necrosis [1,2,13,32,41], However, up to now no medium that reaches the vascular periphery and avoids passage to the venous system as well has been found [3,22], Most of the embolic agents especially developed for angioinfarction, such as the GAW-coil [56], detachable balloons [28], bristle brush [22], etc., lead to occlusion of only the main renal artery. Particulate substances adapted for vaso-occlusion, i.e.…”

Section: Introductionmentioning

confidence: 99%

“…Particulate substances adapted for vaso-occlusion, i.e. Gelfoam [2,4,57], Tachotop [44], Ivalon [15,22], Fibrospum [10,15], are transported more peripherally, but early resorption and incomplete 'embolization pattern' lead to recanalization [47], Ethibloc is the first embolization medium especially developed for peripheral intravascular transport [10], Its properties for reducing the efficiency of collateral supply were studied and compared with the effect of renal artery ligation (central occlusion type), Gelfoam powder (pe ripheral occlusion type) and Histoacryl/Lipiodol (capil lary occlusion type). …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Experimental Basis of Angioinfarction for the Treatment of Renal Hypertension

Rassweiler¹,

Kauffmann

Richter

et al. 1986

Urol Int

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Collateral circulation and recanalization represent the main problems of organ-ablating renal embolization. Different animal models were used to study the influence of central, peripheral, and capillary occlusion on organ necrosis. The first laboratory experiments were performed to optimize transcatheteral application of the embolization media tested (Gelfoam powder, Histoacryl, Ethibloc). Experiments with the model of a normal rat kidney (n = 400) showed that only capillary embolization homogenously occluding the entire arterial system resulted in complete organ necrosis, while following central (renal artery ligation) or peripheral (Gelfoam powder) occlusion, areas of intact parenchyma remained. Ethibloc/glucose proved to be the embolization medium best suited for capillary embolization (radiopaque, inert, slow resorption). Studies with the model of unilateral renal hypertension of the rat (n = 146) demonstrated the equivalent therapeutic efficiency on blood pressure of Ethibloc embolization (57% cured, 21% improved) compared to surgical nephrectomy (50% cured, 29% improved), whereas renal artery ligation (85% failed) resulted in minor improvement only. In order to adapt capillary embolization with Ethibloc/glucose to clinical angiographic techniques, we performed angioinfarction of canine kidneys (n = 15): the use of a balloon catheter is mandatory. This guarantees blood stasis during the embolization procedure and avoids embolic reflux. Possible clinical indications of capillary embolization in renal hypertension as a less invasive method are, e.g.: malignant nephrosclerosis; renovascular or glomerulonephritic contracted kidneys, and renal dysplasia. Indications for super-selective vaso-occlusion are renal aneurysms, a-v malformations, and segmental hypoplasia.

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Therapeutic Embolization With Detachable Silicone Balloons

White

Kaufman

Barth³

et al. 1979

JAMA

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A recently developed percutaneous transcatheter technique for selectively occluding arteries with detachable silicone balloons was applied in four patients. Uncontrollable hemorrhage from carcinoma of the cervix was controlled by selective uterine artery occlusion in one patient. Life-threatening hemorrhage from cystic fibrosis in another patient was controlled by balloon occlusion of a bronchial artery. A patient with hypernephroma and another with right ischial fibrous histiocytoma each had preoperative occlusion of the arteries supplying the neoplasms to reduce operative blood loss and to obviate the need for surgical ligation of the internal iliac artery in the latter patient. Detachable balloon embolization techniques represent a nonoperative method for permanently occluding arteries without the risks of inadvertent embolization.

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Transcatheter embolization: prevention of embolic reflux using balloon catheters

Cited by 37 publications

References 12 publications

Coil embolization of major bleeding after femoral fracture: A case report

Coil embolization of major bleeding after femoral fracture: A case report

Experimental Basis of Angioinfarction for the Treatment of Renal Hypertension

Therapeutic Embolization With Detachable Silicone Balloons

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