Abstract:

A 57-year-old woman was on the waiting list of Orthotopic Liver Transplantation (OLT) due to cirrhosis of viral etiology MSCT with contrast enhancement showed two aneurysms of the splenic artery, stenosis of the celiac trunk with aneurysm of the pancreaticoduodenal artery Taking into account asymptomatic course, we decided to eradicate vascular changes during the forthcoming OLT OLT performed 6 month later, was technically difficult and complicated by massive blood loss and episodes of unstable hemodynamics, so surgical correction of aneurysms was not performed because of high risk. The patient was well and asymptomatic for 2 years after the OLT, but then she developed abdominal pain. MSCT showed progression of vascular changes. Successful endovascular treatment included celiac trunk stenting and embolization of aneurysms. 

References

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Abstract:

Between May 2005 and March 2007, catheter-port systems were placed in 20 pts for continuous hepatic artery infusion chemotherapy in the treatment of unresectable colorectal liver metastases. Carboplatin (or oxaliplatin) plus 5-fluorouracil and systemic leucovorin were administered. No complications occurred during the implantation procedures. The mean number of intrahepatic chemotherapy cycles per patient was 10 (4-25). The mean follow-up period was 412 (100-853) days. During the follow-up period, complications occurred in 9 patients (45%), but surgical or interventional radiological correction was successful in all but one case. At present, 14 patients are alive within 4 and 41 months and continue to receive intraarterial chemotherapy, while 6 patients died in 5 to 21 months from tumor progression. The common 1 -year survival is 90% (18 patients). Percutaneous implantation is potentially effective treatment for patients with CLM.

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Abstract:

To show possibilities to diagnose and treat toxic complications of continuous hepatic artery chemoinfusion using percutaneous implanted catheter-port system.

Materials and methods: Between May 2005 and March 2007, 20 patients (pts) underwent percutaneous transfemoral implantation of the catheter-port system for treatment of unresectable colorectal liver metastases. Toxic complications (gastritis, pancreatits or stomach ulcer) occurred in three pts (each in one). Endoscopy (after arterial injection of methylene blue) and scintigraphy (after arterial injection of technetium-99m macroaggregated albumin) showed abnormal liver perfusion. Visceral angiography was performed for verification and embolization of non-targeted vessels. Angiography with embolization of collateral arteries resulted in normalization of liver perfusion and resolution of complications. At present, all pts continue to receive intraarterial chemotherapy. Transcatheter coil embolization of non-targeted arteries is effective for the management of the catheter-port system misperfusion.

Reference 

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Article exists only in Russian.

Abstract:

Intraoperative vascular injury is infrequent complication (0.02-0.06%) during surgical operations on lumbar discs. We report a case of a 44-year-old man with oedema and varicose veins of the right lower limb. Despite an 4-year history of oedema and varicose veins, he appeared to be asymptomatic and could recollect no traumatic injury or surgery that might have caused it. Near the vertebral column, we found a small scar, the result of spinal disk surgery six years before. CT scan showed pseudoaneurysm of the right iliac artery with a 54 mm diameter. Thereafter, we located the suspected arteriovenous fistula by selective angiography of the aorta and its branches: a communication of the right iliac artery with the right iliac vein had resulted in a large shunt. This lesion was repaired by transluminal placement of stent-grafts Aorfix (Lombard Medical, UK). We had to use three stent-grafts due to the large difference in diameter between the common and external right iliac arteries. Hemodynamic improvement was immediate, and the postoperative course was uneventful. At the present time, almost six months postoperatively, the patient is asymptomatic. Sealing of pseudoaneurysm and arteriovenous fistula as a complication of lumbar-disc surgery with a stent graft is simple and is suggested as an excellent alternative to open surgery for iatrogenic vessel injuries. 

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