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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Renal arterial embolization and subsequent nephrectomy or nephrectomy alone were performed in 34 patients with renal cell carcinoma. Renal arterial embolization caused a blood pressure elevation concomitant with an increase in plasma renin activity (PRA), urinary aldosterone excretion or urinary prostaglandin (PGE2) excretion. Subsequent nephrectomy normalized hypertension and reduced the levels of these vasoactive substances. There were significant relationships between the increase in mean blood pressure and the increase in PRA, the increment in mean blood pressure and the increment in urinary aldosterone excretion, and the increase in PRA and increase in log urinary PGE2 excretion following embolization. These evidences suggest that enhancement of the renin-angiotensin-aldosterone system participates in the development of hypertension following embolization, and increased PRA may play an important role in the release of urinary PGE2.
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PMID:Changes of vasoactive substances following embolization for renal cell carcinoma. 322 30

We examined and managed two patients with posterior fossa dural arteriovenous malformations (DAVMs) and papilledema. Both DAVMs had venous drainage into the transverse, straight, and sigmoid dural venous sinuses. The mechanism of papilledema in the first case was presumed venous hypertension resulting in impaired cerebrospinal fluid absorption, as the malformation drained into the single transverse sinus. This was cured by selective arterial embolization of the causative DAVM. The second patient had venous sinus thrombosis that impaired venous drainage despite embolization. A lumboperitoneal shunt was necessary to treat the elevated intracranial pressure.
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PMID:Dural arteriovenous malformations and papilledema. 341 72

Transarterial renal embolization has been used in the management of renal cancer. We report on 9 patients who underwent selective and superselective renal arterial embolization for nonmalignant renal lesions. Embolization was done in 5 patients for hemorrhage owing to renal angiomas, renal artery, pseudoaneurysm, percutaneous renal biopsy and adult polycystic kidney disease, and in 2 patients with end stage renal disease because of massive proteinuria. Another chronic renal failure patient with severe hypertension was treated successfully with bilateral renal embolization. A postoperative renal arteriovenous fistula was treated successfully by catheter vaso-occlusion. Renal embolization may be a suitable alternative to surgery in poor operative risk patients and for technically difficult benign lesions. Renal infection is a contraindication to embolization.
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PMID:Percutaneous vaso-occlusion for nonmalignant renal lesions. 684 8

Adrenal arterial embolization with absolute ethanol was performed for the treatment of Cushing's syndrome. A 55-year-old woman was admitted to our hospital with complaints of obesity, hypertension, and back pain caused by left adrenal hyperplasia after surgical resection of the right adrenal gland. Therapeutic adrenal arterial embolization was performed by the coaxial technique using absolute ethanol (AE) as an embolic material. No severe complications were encountered during the procedure, and the patient was discharged without symptoms or abnormalities on laboratory tests.
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PMID:A case with Cushing's syndrome treated with arterial ablation of adrenal gland by absolute ethanol. 815 65

Renal ablation by transcatheter renal arterial embolization (TAE) was performed in 10 patients with benign renal disease (hydronephrosis n = 6; renovascular hypertension n = 3; nephrotic syndrome n = 1). Each affected kidney had little or no renal function. Six patients with hydronephrosis were treated with TAE using absolute ethanol alone in three patients and the combination of absolute ethanol and gelatin sponge in the other three. Each patient was followed by sclerotherapy of the pelvocalyceal system via nephrostomy using absolute ethanol. In four of the six patients, the embolized kidney had no urine, and there was very little urine in the remaining two. The size of the embolized kidney was markedly decreased on CT. The three patients with renovascular hypertension were pre-studied by selective and renal vein sampling for PRA, and the kidney excreting higher renin was embolized by TAE with absolute ethanol. Blood pressure has become manageable without antihypertensive drug in two patients and with a reduced amount of drug in one. The patient with nephrotic syndrome had end stage renal failure and showed significant protein excretion. To prevent further protein loss, both kidneys were embolized with stainless steel coils. Urine output was significantly decreased, and consequently, hypoalbuminemia improved. All patients tolerated the procedure well, and there were no significant complications. Renal ablation by TAE may be an alternative to surgical treatment in selected patients with benign renal disease, particularly in patients with contraindications to surgery and in the elderly. Absolute ethanol and gelatin sponge seem safe and effective for TAE in patients with hydronephrosis and renovascular hypertension. For hydronephrosis, we recommend combining TAE with sclerotherapy of the pelvocalyceal system via nephrostomy using absolute ethanol. Though we successfully applied steel coil for the patient with nephrotic syndrome, absolute ethanol may be equally effective.
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PMID:[Renal ablation by transcatheter renal arterial embolization in the treatment of benign renal disease]. 926 Nov 90

We report a case of aneurysmal rupture of the pancreaticoduodenal artery successfully treated by transcatheter arterial embolization. A 61-year-old man with a history of hypertension underwent surgery at our hospital in November 1995 for local peritonitis caused by perforation of the sigmoid colon secondary to cancer. On the 9th postoperative day, he developed shock, with complaints of epigastric and back pain. Abdominal computed tomography showed an enhanced mass, thought to be a peripancreatic aneurysm. Emergency angiography demonstrated an aneurysm arising from the arcade of the anterior pancreaticoduodenal artery. After diagnostic angiography, transcatheter arterial embolization was performed. With steel coils, the anterior superior pancreaticoduodenal artery and anterior inferior pancreaticoduodenal artery were embolized near the origin of the aneurysm. Angiography 7 weeks later revealed no recanalization of the aneurysm and the absence of anomalous collateral vessels. The patient has been well for 19 months without re-bleeding or recurrence of sigmoid colon cancer. Transcatheter arterial embolization is an effective therapeutic approach for aneurysm of the pancreaticoduodenal artery and is the preferred initial treatment.
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PMID:Aneurysmal rupture of the pancreaticoduodenal artery successfully treated by transcatheter arterial embolization. 968 62

Transcatheter arterial embolization (TAE) was performed in 2 patients with Cushing's syndrome caused by adrenal adenoma by using a mixture of absolute ethanol and iohexol. In 1 patient successful suppression of the hypersecretion of cortisol has continued for 9 months after TAE without complications. However, in the other patient, TAE was discontinued due to marked hypertension and tachycardia induced by a massive release of catecholamines from the embolized "normal" part of the tumor-bearing adrenal gland during the procedure. These results suggest that it is important to perform TAE of only the arterial branches feeding the tumor.
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PMID:Transcatheter adrenal arterial embolization of cortisol-producing tumors. Two cases of Cushing's syndrome. 997 12

This article is a critical review of the obstetric literature concerning preeclampsia-associated hepatic hemorrhage to develop guidelines conducive to optimal maternal and perinatal outcomes. An English literature search was performed for reports of hepatic hemorrhage or hepatic rupture in pregnancy during 1960 to 1997. Data were analyzed by Statmost packages using ANOVA, Chi-square, and Fisher's exact tests. One hundred forty-one patients with hepatic rupture/hemorrhage were reported. The three most common presenting findings were epigastric pain, hypertension, and shock. With rare exception, patients had evidence of preeclampsia. Diagnosis was elusive and most frequently accomplished at laparotomy. When utilized, ultrasound and computed tomography (CT) were helpful diagnostic modalities. Maternal survival was highest in the arterial embolization treatment group. Maternal and perinatal survival improved considerably during the study interval. Route of delivery did not seem to impact survival rates. It was concluded that the application of ultrasound and CT for diagnosis and the use of hepatic artery embolization for treatment of hepatic hemorrhage/rupture seem to be beneficial management options for this rare event.
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PMID:Preeclampsia-associated hepatic hemorrhage and rupture: mode of management related to maternal and perinatal outcome. 1007 39

A 62-year-old Japanese male developed multiple hepatic metastases two years after resection of pheochromocytoma of the right adrenal gland. Transcatheter arterial embolization (TAE) was performed for the purpose of the treatment of hepatic metastases resistant to 27 cycles of combined chemotherapy consisting of cyclophosphamide, vincristine, and dacarbazine. After TAE, the hepatic metastatic lesions decreased in size and hypertension passed its crisis. The present case suggests the utility of TAE for multiple hepatic metastases under careful blood pressure monitoring.
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PMID:Malignant pheochromocytoma with multiple hepatic metastases treated by chemotherapy and transcatheter arterial embolization. 1036 8

Monitored anesthesia care (MAC) is being increasingly used in the 1990s for a wide variety of diagnostic and therapeutic procedures. The primary objective in providing MAC is to ensure patients' comfort and safety, whether in the operating room or in other places. We experienced MAC for a patient with pheochromocytoma. A 63-year-old man with hepatic metastasis of malignant pheochromocytoma, received transcatheter arterial embolization (TAE) in the angiographic room. Hypertension and ventricular arrhythmia occurred during the hepatic arterial embolization. However, we successfully controlled the hemodynamic changes using phentolamine and propranolol under the close monitoring. He showed an uneventful recovery during postoperative period except for mild hypotension on the third day which needed temporary norepinephrine infusion.
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PMID:[Monitored anesthesia care for a patient with malignant pheochromocytoma]. 1040 16


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