Clinical experience with Gelfoam embolization for arterial hemorrhage in 55 patients is described. This technique controlled hemorrhage in 51 patients (92.7%). Two patients (3.6%) died of complications related to embolization. Gelfoam can be a permanent occluding agent which does not require subselective catheter position for effectiveness and safety. The advantages of Gelfoam are its availability, low cost, the ease and speed with which it can be applied through conventional catheters, and its safety and effectiveness if properly applied. The data presented here, and those in the literature, indicate that transcatheter therapeutic embolization for arterial bleeding below the diaphragm is by far the safest and most effective method available.
The use of vasopressin infusion or arterial embolization in the treatment of 87 patients with gastrointestinal hemorrhage is reviewed. A bleeding point was identified angiographically in 46 patients (53%), with a higher success rate in those with upper gastrointestinal hemorrhage (63%) than in those with lower (39%) gastrointestinal hemorrhage. Vasopressin infusion in 33 patients completely stopped hemorrhage in 14 and slowed hemorrhage pending surgery in another 5. Gelfoam embolization was successful as definitive therapy in 12 of 15 patients. Mortality as a result of hemorrhage or its sequelae was 40% in patients with upper gastrointestinal hemorrhage and 21% in those with lower gastrointestinal hemorrhage.
Postinflammatory and posttraumatic urethral strictures present a significant clinical problem. Conventional dilatation techniques are usually associated with recurrence and aggravation of the strictures. This is attributed to the mucosal and periurethral trauma associated with conventional dilatation methods. The initial results in seven patients undergoing balloon dilatation for urethral strictures are presented. The method is relatively atraumatic and painless, and better long-term results are anticipated.
A case of hepatic myelolipoma is described, including the angiographic and computed tomographic appearance. Only three such cases have been reported previously.
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