Abstract: We present case report of patient, with recurrent pulmonary bleeding of malignant genesis and ineffective previous endoscopic hemostasis. During embolization of bronchial artery, to stop massive life-threatening pulmonary bleeding, transradial approach was used for the first time. Full bleeding control was reached after embolization of right bronchial artery with use of microspheres through microcatheter 2,8 Fr. During hospital stage, recurrence of bleeding was not notices; patient discharged on the 7th day in satisfactory condition. Duration of procedure and radiation exposure at this patient were comparable with same parameters in case of transfemoral approach. Main advantages of this vascular access are increased comfort of the patient after the procedure and the possibility of early activization. Besides, use of transradial vascular approach provides decreased frequency of complications, that is very important among patients with signs of respiratory insufficiency, because of the inability of these patients to stay in bed within a day. References 1. Cowling M.G., Belli A.M. A potential pitfall in bronchial artery embolization. Clin. Radiol. 1995; 50: 105-107. 2. Haponik E.F., Fein A., Chin R. Managing life-threatening hemoptysis: has anything really changed? Chest. 2000; 118: 1431-1435. 3. Hirshberg B., Biran I., Glazer M. et al. Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital. Chest. 1997; 112: 440-444. 4. Saluja S., Henderson K.J., White R.I. Embolotherapy in the bronchial and pulmonary circulations. Radiol. Clin. North Am. 2000; 38: 425-448. 5. Chandrasekar B., Doucet S., Bilodeau L. et al. Complications of cardiac catheterization in the current era: a single-center experience. Catheter Cardiovasc. Interv. 2001; 52(3): 289-295. 6. Sherev D.A., Shaw R.E., Brent B.N. Angiographic predictors of femoral access site complications: implication for planned percutaneous coronary intervention. Catheter Cardiovasc. Interv. 2005; 65(2): 196-202. 7. Tavris D.R., Gallauresi B.A., Lin B. et al. Risk of local adverse events following cardiac catheterisation by hemostasis device use and gender. J. Invasive Cardiol. 2004; 16(9): 459-464. 8. Mc. Ivor J., Rhymer J.C. 245 transaxillary arteriograms in arteriopathic patients: success rate and complications. Gin. Radiol. 1992; 45: 390-394. 9. Jolly S.S., Yusuf S., Cairns J. et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet. 2011; 377(9775): 1409-1420. 10. Kanei Y, Kwan T., Nakra N.C. et al. Transradial cardiac catheterization: A review of access site complications. Catheter Cardiovasc. Interv. 2011. 11. Caputo R.P., Tremmel J.A., Rao S. et al. Transradial arterial access for coronary and peripheral procedures: Executive summary by the transradial committee of the SCAI. Catheter Cardiovasc. Interv. 2011.
Abstract: Despite the comparatively low morbidity rate, skin melanoma is known for its high mortality rate. High metastatic potential of the tumor, urges the necessity of improving methods of diagnostics, which can identify metastasis and assess the degree of dissemination at the early stage of disease. We have analyzed results of ultrasound imaging of one of the earliest and frequent types of progression of melanoma - metastasis in regional lymphatic nodes. The article presents results of examination of 182 patients with skin melanoma with early metastasis in lymphatic nodes, also - characteristics of the image of tumor changes are described. The high informativeness of ultrasound research for timely identification of metastatic changes and, respectively, the increase of the rate of survival of patients with skin melanoma are demonstrated. References 1. American Cancer Society.: Cancer Facts and Figures 2012. [Электронный ресурс]//Atlanta, Ga: American Cancer Society, 2012. URL: http://www.cancer.org/Research/ CancerFactsFigures/CancerFactsFigures/cancer-facts-figures-2012 (дата обращения: 21.12.2012) 2. Balch C.M., Gershenwald J.E., Soong S.J., Thompson J.F., Atkins M.B., Byrd D.R., et al. Final version of 2009 AJCC melanoma staging and classification. J. Clin. Oncol. 2009; 27(36): 6199-6206. 3. College of American Pathologists (CAP). Protocol for the Examination of Specimens from Patients with Melanoma of the Skin [Электронный ресурс]//Version 3.2.0.0. June 2011. URL: http://www.cap.org/apps/ docs/committees/cancer/cancer_protocols/2012/ SkinMelanoma_12protocol.pdf (дата обращения: 2012.12.21) 4. Thompson J.F, Shaw H.M. Sentinel node mapping for melanoma: results of trials and current applications. Surg. Oncol Clin. N. Am. 2007;16(1): 35-54. 5. Ferrone C.R., Panageas K.S., Busam K. et al. Multivariate prognostic model for patients with thick cutaneous melanoma: importance of sentinel lymph node status. Ann. Surg. Oncol. 2002; 9(7): 637-645. 6. Gershenwald J.E., Mansfield P.F., Lee J.E. et al. Role for lymphatic mapping and sentinel lymph node biopsy in patients with thick (> or = 7. O’Brien CJ., Uren R.F, Thompson J.F. et al. Prediction of potential metastatic sites in cutaneous head and neck melanoma using lymphoscintigraphy. Am. J. Surg. 1995; 170(5): 461-466. 8. Uren R.F. Lymphatic drainage of the skin. Ann. Surg. Oncol. 2004; 11(3 Suppl): 179-185. 9. Blum A., Schlagenhauff B., Stroebel W. et al. Ultrasound examination of regional lymph nodes significantly improves early detection of locoregional metastases during the follow-up of patients with cutaneous melanoma. Cancer. 2000; 88 (11): 2534-2539. 10. Voit C.A., Van Akkooi A.C.J., Sc^fer-Hesterberg G. et al. Ultrasound Morphology Criteria Predict Metastatic Disease of the Sentinel Nodes in Patients With Melanoma. J. Clin. Oncology. 2010; 28 (5): 847-852. 11. Voit C.A., van Akkooi A.C.J., Schaefer-Hesterberg G. et al. Rotterdam criteria for sentinel node (SN) tumor burden and the accuracy of ultrasound (US)-guided fine-needle aspiration (FNAC) cytology: Can US-guided FNAC replace SN staging in patients with melanoma? J. Clin. Oncol. 2009; 27: 4994-5000. 12. Струков А.И., Серов В.В. Патологическая анатомия. 4-е изд. М.: Медицина, 1995. 688.
|
keywords:
|
Abstract: We present case reports of patients with multiple metastatic lesions and multiple myeloma in vertebral column with pathological fractures of vertebral bodies and intense pain. Authors recommend to perform multilevel vertebroplasty because this approach allows to reduce pain severity, and to prevent pathological vertebral fracture and provides early rehabilitation of patient. References 1. Biermann W.A., Cantor R.I., Fellin F.M. et al., An evaluation of the potential cost reductions resulting from the use of clodronate in the treatment of metastatic carcinoma of the breast. Bone. 1991; 12: 37-42. 2. Galasko C.S. Incidence and distribution of bone metastases. Clin. Orthop. 1986; 210: 14-21. 3. Chiras J., Cormier E., Baragan H., Jean B., Rose M. Interventional radiology in bone metastases. Journal de radiologie 2007; 94(2):161-9. 4. Fadilah S.A. Fundamentals in the management of multiple myeloma. Med. J. Malaysia. 2010; 65(3):231-9. 5. Kasperk C., Grafe I. Osteoplastic procedures for the treatment of vertebral complications in multiple myeloma patients. Review. Recent Results Cancer Res. 2011; 183:293-306. 6. Kose K.C., Cebesoy O., Akan B., Altinel L., Dincer D., Yazar T. Functional results of vertebral augmentation techniques in pathological vertebral fractures of myelomatous patients. J. Neuroradiol. 2006; 98(10):1654-8. 7. Kalyani A., Rohaizak M., Cheong S.K., Nor Aini U., Balasundaram V., Norlia A. Recurrent multiple myeloma presenting as a breast plasmacytoma. Med. J. Malaysia. 2010;65(3):227-8. 8. Basile A., Cavalli M., Fiumara P, Di Raimondo F., Mundo E., Caltabiano G., Arcerito F., Patti M.T., Granata A., Tsetis D. Vertebroplasty in multiple myeloma with osteolysis or fracture of the posterior vertebral wall. Usefulness of a delayed cement injection. Skeletal Radiol. 2011 Jul; 40(7):913-9. Epub 2011 Feb 28. 9. Anselmetti G.C., Manca A., Montemurro F., Hirsch J., Chiara G., Grignani G., Carnevale Schianca F., Capaldi A., Rota Scalabrini D., Sardo E., Debernardi F., lussich G., Regge D. Percutaneous Vertebroplasty in Multiple Myeloma: Prospective Long-Term Follow-Up in 106 Consecutive Patients. Cardiovasc .Intervent. Radiol. 2011 Feb 9. [Epub ahead of print]. 10. Cortet B., Boutry., N., et al. Percutaneous Vertebroplasty in patients with osteolytic metastases or multiple myeloma [see comments]. Rev. Rheum. Engl. Ed. 1997; 64(3):177-183. 11. Hrabalek L., Bacovsky J., Scudla V., Wanek T., Kalita O. Multiple spinal myeloma and its surgical management. Rozhl. Chir. 2011; 90(5):270-6 [In Czech]. 12. Tepljakov V.V., Karpenko V.Ju., Buharov A.V. Intervencionnye metody lechenija pri opuholevom porazhenii kostej. Sarkomy kostej, mjagkih tkanej i opuholi kozhi [Interventional treatment methods of bone tumoral lesions] M., Izd-vo «Farmarus Print Media». 2010; 1: 21-25 [In Russ].
