Müller J H, Engel D, Waigand J, Mebel M
Z Urol Nephrol. 1978 Jul;71(7):481-93.
During 18 months in 15 patients with inoperable renal tumours palliative therapeutic vascular embolisations were carried out with the help of an own catheter technique. In contrast to preoperative embolisation (16 patients) in the inoperable cases a non-absorpable polyvinyl alcohol foam substance ("Ivalon") was used, which leads to a secure permanent vascular occlusion. The haematuria occurring in all patients which many times threateningly increased was removed in all cases. There did not appear any essential complications. However, on account of the formation of a symptomatology of renal infarction a clinical after-treatment is necessary. In 12 patients regulary clinical and paraclinical control examinations during an observation period of on an average 11 months were carried out (minimum 6 months, maximum 18 months). 11 of these patients were still alive at the end of the report and had a tolerable or even improved general condition. In angiographical after-controls of 4 patients, and in one case by autopsy, permanent vascular occlusions with formation of necroses of a large area and partly considerable restriction of the tumour kidneys were found. In these cases the therapeutic embolisation led to a provable damage of the tumorous process. An influence of metastases distant from the primary tumour was not observed.
在18个月期间,对15例无法手术切除的肾肿瘤患者采用自行研发的导管技术进行了姑息性治疗性血管栓塞。与术前栓塞(16例患者)不同,在无法手术的病例中使用了不可吸收的聚乙烯醇泡沫物质(“Ivalon”),这可实现可靠的永久性血管闭塞。所有患者均出现血尿,且多次严重加重,所有病例的血尿均已消除。未出现任何严重并发症。然而,由于出现了肾梗死症状,需要进行临床后续治疗。12例患者在平均11个月(最短6个月,最长18个月)的观察期内定期进行临床和辅助临床检查。报告结束时,其中11例患者仍存活,总体状况尚可甚至有所改善。在4例患者的血管造影复查中,以及在1例尸检中,发现有永久性血管闭塞,伴有大面积坏死形成,部分肿瘤肾有明显缩小。在这些病例中,治疗性栓塞导致肿瘤进程出现可证实的损害。未观察到对原发肿瘤远处转移的影响。