Dena EEJ, Rodríguez NP, Hernández GM, Méndez PLR, Olvera NR, Rojero VJ, Campos GRC, Cervantes SC, Jiménez GJ, Ramos SO, Hernández GA

Idioma: Español
Referencias bibliográficas: 59
Paginas: 171-183
Archivo PDF: 237.24 Kb.

RESUMEN

Objetivo: Determinar, en 28 perros mestizos, qué material o materiales de bajo costo son mejores para realizar la embolización de la región hepatorrenal en un mismo tiempo y comparar si es mejor el uso de un agente embolizante comparado con la utilización de dos, en vasos de mediano y pequeño calibre de un segmento renal y hepático, para probar su eficacia y efectividad y posteriormente ser utilizados en humanos. Lo anterior por el alto costo de los agentes embolígenos que tienen a disposición las casas comerciales.
Material y método: Todos los procedimientos fueron realizados de acuerdo con el Comité de Ética del Hospital General de México, de la Secretaría de Salud y de experimentación en animales de la Ley de Protección Animal y Normas internacionales de cuidados a los animales. Protocolo de Investigación experimental, en donde se realizó de acuerdo con los criterios de selección: Tomografía Computarizada (TC) preembolización, angiografía y embolización y TC de control dos semanas después, angiografía de control y revisión por patología, de los órganos embolizados. Los animales sometidos a la embolización se dividieron en dos grupos: Grupo “A” con un solo agente embolizante y Grupo “B”con dos agentes. Se realizó análisis comparativo mediante las pruebas de Mann-Withney y prueba exacta de Fisher.
Resultados: El Grupo “A”, de un solo agente embolizante, presentó una sobrevida global de 47.3% (9/19), mientras que en el Grupo “B”, de dos agentes, fue de 89% (8/9), diferencia que fue estadísticamente significativa (p = 0.049).
Conclusiones: La sobrevida global para los dos grupos fue de 60.7% y la mortalidad de 39.3%. Se observa una mayor sobrevida con el uso tan sólo de dextrán (Grupo “A”) y tapioca + etanol, gelfoam + farmaflebón y tapioca + farmaflebón (Grupo “B”).

REFERENCIAS (EN ESTE ARTÍCULO)

1. Brooks B. The treatment of traumatic arteriovenous fistula. South Med J 1930; 23: 100.

2. Luesenhof AJ, Spence WT. Artificial embolization of cerebral arteries: Report of use in a case of arteriovenous malformation. JAMA 1960; 172: 1153.

3. Djindjian R, Cophignon J, Rey A. Theron J, Merlan JJ, Houdart R. Superselective arteriography embolization by the femoral route in neurorradiology: Study of 60 cases. Neurorradiology 1973; 6: 132.

4. Gianturco C, Anderson JH, Wallace S. Mechanical devices for arterial oclusion. AJR 1975; 124: 428.

5. Debrun G, Lacour P, Caron JP, Hurt M, Comoy J, Keravel Y. Detachable balloon and calibrated-leak balloon techniques in the treatment of cerebral vascular lesions. J Neurosurg 1978; 49: 635.

6. Castañeda ZWR, Sanchez R, Amplatz K. Experimental observations on short and long-term effects of arterial occlusion with ivalon. Radiology 1978; 126: 783.

7. Becker GJ, Holden RW, Klatte EC. Therapeutic embolization with absolute ethanol. Semin Intervent Radiol 1984; 1: 118.

8. Wojtowyez M. Embolotherapy. Interventional Radiology and Angiography. In: Year Book Medical. Publish hers, Inc; 1990, pp. 203-25.

9. Soyer PH, Derhys S, Brett Mayer F. Embolization d’hémostase. In: Radiologie Interventionelle. Masson Edit 1992; pp. 136-60.

10. Novak D. Embolization Materials. Dondelinger RF, Rossi P, Kurdziel JC, Wallace S (Ed.). In: Interventional Radiology. Georg Thieme Verlag 1990; pp. 295-313.

11. Guedes Cabral de Campos JRG. Sistemas de cateterismo arterial e materiais embólicos.Terapeutica endovascular en neurorradiologia. Lisboa: Schering Ed.; 1993, p. 18-26.

12. Lasjaunias P, Berenstein A. Technical aspects of surgical neuroangiography. Embolic agents. In: Surgical neuroangiography. 2 Endovascular treatment of craniofacial lesions. Springer-Verlag 1987; p. 19-45.

13. Kishimoto W, Nakada A, Takagi H, Hayakawa T. Acute pancreatitis after transcatheter arterial embolization (TAE) for hepatocelular carcinoma. AMJ Gastroenterol 1988; 84: 1396-9.

14. Teshima Y, Iwasaki N. Efficacy of CO2-DSA in embolization. Cancer Chemoter Pharmacol 1994; 33: 5109-10.

15. Poulin E, Thibault C, Mamazza J, Girotti M, Cote G, Remaud A. Laparoscopic splenectomy; Clinical experience and the role of preoperative splenic artery embolization. Surg Laparoscop Endosc 1993; 3: 445-50.

16. Lang EV, Picus D, Marx V, Hiks ME. Massive arterial hemorrage from the stomach and lower esophagus: Impact of embolotherapy on survival. Radiology 1990; 177: 249-52.

17. Sharma VS, Valji K, Bookstein JJ. Gastrointestinal hemorrhage in AIDS: Arteriograpic diagnosis and transcatheter treatment. Radiology 1992; 185: 447-51.

18. Lampmann LE, Tjan TG. Embolization theraphy in haemoptysis. Eur Radiol 1994; 8: 15-19.

19. Oulton C, Castellari M, Machado M, Maldonado D, Marchegiani S. The endovascular treatment of the hemoptysis. Medicina B Aires 1992; 52: 534-8.

20. Miyazono N, Inove H, Hori A, Kanetsuki Y, Shimrada J, Nakajo M. Visualization of left bronchial to coronary artery communication after distal bronchial artery embolization for bronchiectasis. Cardiovasc Intervent Radiol 1994; 17: 36-7.

21. Kawfman GW, et al. Capillary embolization with ethibloc; New embolization concept tested in dog kideneys. AJR 1981; 137: 1163-8.

22. Dion JE, et al. Dextran microsphere embolization; experimental and clinical experience with Radiology-Pathology correlation. Radiology 1986; 160: 717-21.

23. Wang J, Li LS, Feng YL, Yao HM, Wang XH. Permanent hepatic artery embolization with dextran microspheres in 131 patients with unresectable hepatocellular carcinoma. Chin Med Engl 1993; 106: 441-5.

24. Wright KC, et al. Partial splenic embolization using polyvinil alcohol, dextran, polystyrene, or silicone (an experimental study in dogs). Radiology 1982; 142: 351-4.

25. Castañeda ZWR, Sanchez R, Amplatz K. Experimental observations on short and long-term effects of arterial occlusion with ivalon. Radiology 1978; 126: 783-5.

26. Widlus DM, et al. Congenital arteriovenous malformations: Tailored embolotherapy. Radiology 1988; 169: 511-16.

27. Berenstein A. Flow-Controled silicone fluid embolization. AJR 1980; 134: 1213-18.

28. Mineaw DE, et al. Experimental transcatheter esplenectomy using absolute ethanol. Radiology 1982; 142: 355-9.

29. Earthman WJ, Nazer MJ, Winfield C. Angiomyolipomas in tuberous sclerosis. Subselective embolotherapy with alcohol, with long-term folllow up study. Radiology 1986; 160: 437-41.

30. Ellman BA, et al. Ablation of renal tumors with absolute ethanol: a new technique. Radiology 1981; 141: 619-26.

31. Lencioni R, Vignali C, Caramella D, Cioni R, Mazzeo S, Bartolozzi C. Transcatheter arterial embolization followed by percutaneus ethanol injection in the treatment of hepatocellular carcinoma. Cardiovasc Intervent Radiol 1994; 17: 70-5.

32. Koda M, Okamoto K, Miyoshi Y, Kato S, Murawaki Y, Horie Y, Suou T, Kawasaki H. Combination therapy with transcatheter arterial embolization and percutaneus ethanol injection for advanced hepatocellular carcinoma. Hepatogastroenterology 1994; 41: 25-9.

33. Tateshi H, Kinuta M, Furukawa J, Takata N, Muruyama H, Oi H, Yayoi E, Okamura J. Follow up study combination treatment (TAE and PEIT) for unresectable hepatocellular carcinoma. Cancer Chemoter Pharmacol 1994; 33: S119-S123.

34. Bolan GW, Lee MJ, Dawson SL, Mueller PR. Percutaneus injection of ethanol in a patient with a solitary hepacellular carcinoma. AJR 1993; 161: 1071-7.

35. Livraghi T, Lazzaroni S, Pellicano S, Ravasi S, Torzilli G, Vettori C. Percutaneus ethanol injection of hepatic tumors: Single-Session therapy with general anesthesia. AJR 1993; 161: 1065-9.

36. Amin Z, Lees WR, Bown SG. Hepatocellular carcinoma: CT appearence after percutaneus ethanol ablation therapy. Radiology 1993; 188: 882-3.

37. Livraghi T, Giorgio A, Marin G, Salmi A, de Sio Y, Bolondi L, Pompili M, Brunello F, Lazzaroni S, Torzilli G, Zucchi A. Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneus ethanol injection. Radiology 1995; 197: 101-8.

38. Deruty R, Pelissou Guyotat I, Mottolese C, Bascoulergue Y, Amat D. The combined management of cerebral arteriovenous malformations. Experience with 100 cases and review of the literatura. Acta Neurichir Wien 1993; 123: 101-12.

39. Nicola N, Lins E. Vertebral hemangioma late results of retrograde embolization stabilization with methyl methacrylate in two cases. Surg Neurol 1993; 40: 491-4.

40. White RI, Stranberg JV, Gross GS, Barth KH. Terapeutic embolization with long-term occluding agents and their effects on embolized tissues. Radiology 1977; 125: 677-87.

41. Freeny PC, Bush Jr WH, Kidd R. Transcatheter occlusive therapy of genitourinary abnormalities using isobutyl 2-cyanoacrylate (bucrylate). AJR 1979; 133: 647-56.

42. Alvarez González E, Pamplona M, Rodriguez A, Garcia Hidalgo E, Nuñez V, Leiva O. High flow priapism after blunt perineal trauma: resolution with bucrylate embolization. J Urol 1994; 151: 426-8.

43. Nakao N, Uchida H, Kamino K, Nishimura Y, Ohishi H, Takayasu Y, Miura K. Determination of the optimum dose level of Lipidol in transcatheter arterial embolization of primary hepatocellular carcinoma based on restrospective multivariate analysis. Cardiovasc Intervent Radiol 1994; 17: 76-80.

44. Bronowicki JP, Vetter D, Dumas F, Boudjema K, Bader R, Weiss AM, et al. Transcatheter oily chemoembolization for hepatocellular carcinoma. A 4 year study of 127 French patients. Cancer 1994; 74: 16-24.

45. Tarazov PG. Iodized oil in the portal vein after arterial chemoembolization of liver metastases a caution regarding hepatic necrosis. Acta Radiol 1994; 35: 143-6.

46. Castañeda-Zuñiga WR, Tadavarthy SM, Galliani CA, Laerum F, Schwarten DE, Amplatz K. Experimental venous occlusion with stainless-steel spiders. Radiology 1981; 141: 238-42.

47. Khan AB, Reid AW. Management of renal stab wounds by arteriographic embolization. Scand J Urol Nephrol 1994; 28: 109-10.

48. Huppert PE, Duda SH, Erley OM, Roth M, Lauchart W, Dietz K, Clausen OD. Embolization of renal vascular lesions; clinical experience with microcoils and tracker catheters. Cardiovasc Intervent Radiol 1993; 16: 361-7.

49. Sharma S, Kothar SS, Rajani M, Venougopal P. Life threatening arterial haemorrhage: results of treatment by transcatheter embolization using home made steel coils. Clin Radiol 1994; 49: 252-5.

50. 50.- Chung JW, Park JH, Han JK, Han MC. Perforation of the gastroduodenal artery induced by steereable guidewires in two cases: treatment of hemorrhage by embolization. Cardiovasc Intervent Radiol 1994; 17: 41-3.

51. Deveikis JP, Manz HJ, Luessenhop AJ, Caputy AJ, Kobrine AI, Schellinger D, Patronas N. AJNR Am J Neuroradiol 1994; 15: 263271.

52. Yamauchi T, Furui S, Irie T, Kusano S. Partial splenic embolization with Y-shaped silicone particles. Acta Radiol 1994; 35: 335-9.

53. Yang J, Chen X, Zou ZJ, Wu QG, Wei SL. Percutaneus internal maxillary arterial embolization with ethylcellulose microspheres. Invest Radiol 1995; 30: 354-8.

54. Link DP, Mourtada FA, Jackson J, Blashka K, Samphilipo MA. Hydrogel embolic agents. Invest Radiol 1994; 29: 746-51.

55. Raoul JL, Bourguet P, Bretagne JF, Duvauferrier R, Coornaert S, Darnault P, Rameé A, Herry JY, Gastard J. Hepatic artery injection of I-131 labeled Lipidol. Part I. Biodistribution study results in patients with hepatocellular carcinoma and liver metastases. Radiology 1988; 168: 541-5.

56. Bretagne JF, Raoul JL, Bourget P, Duvauferrier R, Deugnier Y, Faroux R, Rameé A, Herry JY, Gastard J. Hepatic artery injection of I-131 labeled Lipidol. Part II. Preliminary results of therapeutic use in patients with hepatocellular carcinoma and liver metasteses. Radiology 1988; 168: 547-50.

57. Maataoui A, et al. Liver metastases in rats: Chemoembolization combined with interstitial lasser ablation for treatment. Radiology 2005; 237: 479-84.

58. Kan Z, Kobayashi S, Phongkitkarun S, Charnsangavej. Functional quantification of tumor perfusion after transhepatic arterial embolization in a rat model. Radiology 2005; 237: 479-84.

59. Pelage JP, et al. Uterine artery embolization in sheeep: Comparison of acute effects with polyvinyl alcohol particles and calibrated microespheres. Radiology 2002; 224: 436-45.