Ruge Abhinandan, Kumar Nidhi, Menezes Clyde
Department of Radio Diagnosis, St. John's Medical College Hospital, Bengaluru, Karnataka, India.
J Clin Imaging Sci. 2021 Feb 25;11:10. doi: 10.25259/JCIS_160_2020. eCollection 2021.
The objective of this study was to evaluate the role of Gelfoam as an effective embolizing agent in patients with hemoptysis presenting to a tertiary care center in developing nations.
A retrospective analysis of data from 30 patients treated by Interventional radiologist at St. John's Medical College, Bangalore, India, was performed. The study included 22 males (73.3%) and 8 (26.65%) female patients. Gelfoam was used as the sole embolizing agent and arteries with features of abnormal blush and hypertrophy were targeted. Analysis of the etiology, immediate, and short-term outcome and complications, when present, was performed. The median follow-up period was 45 days following an embolization procedure at this center.
A high short-term efficacy was noted following embolization procedures with Gelfoam as the sole agent. Twenty-eight out of 30 procedures were deemed successful, and post-tubercular changes were noted to be the cause for hemoptysis in 23 patients. The high short-term efficacy (93.3%), evidenced by a complete stoppage of hemoptysis, along with a relatively low rate of complications (spinal cord ischemia in only 2.3%), strengthens the position of Gelfoam as the sole embolizing agent in a resource-limited setting.
In an economically constrained setting, Gelfoam proves to be a useful first choice single embolization agent, while polyvinyl alcohol particles coupled with microcatheter systems remain within reach of only those who can afford them.
本研究的目的是评估明胶海绵作为一种有效栓塞剂在发展中国家三级医疗中心咯血患者中的作用。
对印度班加罗尔圣约翰医学院介入放射科治疗的30例患者的数据进行回顾性分析。该研究包括22例男性患者(73.3%)和8例女性患者(26.65%)。明胶海绵用作唯一的栓塞剂,目标是具有异常造影剂外渗和增粗特征的动脉。对病因、即时和短期结果以及并发症(如有)进行分析。在该中心进行栓塞手术后的中位随访期为45天。
以明胶海绵作为唯一栓塞剂进行栓塞手术后,观察到较高的短期疗效。30例手术中有28例被认为成功,23例患者的咯血原因被认为是结核后改变。咯血完全停止证明了较高的短期疗效(93.3%),同时并发症发生率相对较低(仅2.3%发生脊髓缺血),这巩固了明胶海绵在资源有限环境中作为唯一栓塞剂的地位。
在经济受限的环境中,明胶海绵被证明是一种有用的首选单一栓塞剂,而聚乙烯醇颗粒与微导管系统仅为那些有能力购买的人所能使用。