Abstract:

The article presents analysis of 1500 cases of varicocele endovascular occlusion (EO) in children and adolescents, giving the exhaustive account of varicocele diagnostics and treatment. Standardization of the endovascular procedure was performed, and algorithm proposed for choosing the occlusion technique and embolization agent depending on the lesion anatomy.

The authors specify 5 anatomical varieties of left testicular vein (LTV), each having some particularities in occlusion procedure. For the first time in pediatric practice the Foam-form was used for LTV occlusion against the background of prominent veno-venous reflux, which considered to be one EO contraindications. The causes were specified for false and true varicocele recurrence: the former is shown to occur due to technical imperfections, and the causes of the latter can be LTV lumen recanalization or formation of the bridging collaterals.

EO of LTV is proved to be the effective for recurrent varicocele after conventional surgery in children and adolescents.   

Reference 

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Abstract:

Pulmonary arteriovenosus aneurisms are rare congenital disorders. There are few scientific data about endovascular corrections. The aim of our study was to estimate possibilities and efficiency of endovascular occlusion with AZUR Peripheral Hydrocoil (TERUMO). Article describes methodics and results of endovascular correction on the base of case report.

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Abstract:

Purpose: to prove the safety and efficiency of minimally invasive endovascular and puncture techniques in management of splen diseases in children.

Aims: to develop standard procedures and justify the necessity of splenic artery embolization (SAE) in hemangiomas, extrahepatic portal hypertension, and idiopathic thrombocytopenic purpura (ITP). Develop standard procedures for splenic cysts treatment in pediatric practice.

Materials and methods: there were 129 children aged 3-16 years treated in Endovascular Surgery Department of Russian State Pediatric Hospital (Moscow) with the following diagnoses: hemangiomas (4 patients), hereditary hemolytic globular-cell anemia - HHGCA (41 cases), extrahepatic portal hypertension - EHPG (25 cases), ITP (24 cases), and nonparasitic cysts (35 patients).

Results: SAE is shown to be effective in treatment the diseases where splenic hyperfunctioning is seen. In HHGCA and ITP no hemolytic crises were seen, and there was no need of substitution therapy after performing the SAE procedure. In cases of EHPG splenic artery embolization is proved to reduce the esophageal varices and decrease hypersplenia symptoms. Among the advantages of endovascular approach can be named minimal operation trauma and splenic tissue preservation. The authors present an algorithm for splenic cysts treatment in pediatric practice. It was shown that laparoscopy is effective in big (over 70-80 mm) subcapsular cysts, whereas intraparenchymatous cysts fewer than 70 mm in diameter are more suitable for puncture techniques.

Conclusions: the minimally invasive techniques are shown to be safe and effective in management of splen diseases in pediatric practice. It was shown that their effectiveness is comparable to the conventional methods, meanwhile they cause much less operation trauma, reduce the hospital stay and terms of rehabilitation.

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