Search NEL Online

Case Reports 2005; 26(4): 401-406 PubMed PMID: 16136001 Citation  Keywords:  Aged, Aged, 80 and over, Carcinoma:pathology, Embolization, Therapeutic:methods, Female, Humans, Male, Middle Aged, Palliative Care, Thyroid Gland:blood supply, Thyroid Neoplasms:pathology, Treatment Outcome,.   

OBJECTIVES: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive solid tumors in humans. Despite intense application of multimodality of treatment with surgery and/or external beam radiotherapy and chemotherapy, the survival rates remain low--generally the mean survival is about six (6) months after diagnosis. Rapid development--particularly over the last decade--of interventional radiology, provides methodology that allows examining thyroid arterial embolization as an alternative approach to ablating thyroid tissue. The aim of the present study was to evaluate selective embolization of the thyroid arteries (SETA) as a possible alternative for the palliative treatment of advanced, inoperable ATC.

PATIENTS AND METHODS: The study group comprised five (5) patients with advanced stage of inoperable ATC. All the patients underwent SETA of the superior and/or inferior thyroid arteries. SETA was performed using polyvinyl alcohol particles, ranging from 500-710 microm in diameter. After SETA, selective angiography of thyroid arteries was performed to ensure that the targeted arteries were completely occluded.

CONCLUSIONS: The results of the present study suggest that SETA is minimally invasive and save method of palliative treatment of ATC and, as such, may be recommended in cases of intractable hemorrhage and pain caused by ATC progression....

Read abstract  Full text PDF

Clinical Trial 2004; 25(4): 287-291 PubMed PMID: 15361819 Citation  Keywords:  Adolescent, Adult, Aged, Carotid Artery Diseases:diagnostic imaging, Carotid Artery, Internal:diagnostic imaging, Catheterization:methods, Cerebral Angiography, Embolization, Therapeutic:methods, Female, Humans, Intracranial Aneurysm:diagnostic imaging, M.   

OBJECTIVES: The incidence of giant aneurysms in the paraclinoid section of the internal carotid artery (ICA) is low. They manifest their occurrence by subarachnoid haemorrhage and neurological and hormonal symptoms, resulting from compression on either the nervous structures or on the pituitary. The treatment of these aneurysms is a challenge for the surgeon, due to a difficult access, high operational risk and when the size of operated malformations is large.

MATERIAL AND METHODS: Between the years 1994 and 2001, twenty (20) patients with giant paraclinoid aneurysms of the carotid artery were submitted to: endovascular treatment - 7 patients and to microsurgery - 13 patients. The treatment, following the access to the aneurysm and consisting in short-time (temporary) endovascular occlusion of ICA, was applied in some cases, while trapping was the method of choice in other cases.

RESULTS: Good results of the endovascular treatment were obtained in 6 patients and, in one (1) case, satisfactory result was observed. Regarding the whole study group, hormonal symptoms (amenorrhoea) occurred in one case only. Four aneurysms were totally embolized, 1 - almost totally and 2 - partially. Recanalisation was observed in one case after 2 years. In the surgical method, good and very good results were obtained in 10 patients and satisfactory results - in 3 patients.

CONCLUSION: Application of either the endovascular method or of the microsurgical method - or of both these methods - used individually in case of a given aneurysm, increases the chances for an effective occlusion with a lower operative risk....

Read abstract  Full text PDF