RESUMEN
Eleven segmental and eight total renal artery occlusions were evaluated by sonography in transplanted kidneys of 19 adult mongrel dogs. The segmental occlusions were serially scanned daily or every other day for up to 35 days. The total occlusions were scanned daily for up to 10 days. Each occlusion was confirmed angiographically, and kidneys were examined pathologically. Acute segmental renal artery occlusion produces a sequence of sonographic changes, beginning with a focal hypoechoic mass at 24 hr, which stays unchanged for 5-7 days. At 7 days, internal echoes appear, and the infarct slowly consolidates to an echogenic, slightly depressed focus at 17 days. Total renal artery occlusion produced no appreciable change in cortical echogenicity and only slight increase in size. Acute segmental renal infarction can be detected early in its course and demonstrates a sequence of changes that may aid in dating the infarct. Total renal infarction may appear normal sonographically, and further studies are needed to confirm that diagnosis.
Asunto(s)
Obstrucción de la Arteria Renal/diagnóstico , Ultrasonografía , Animales , Perros , Embolización Terapéutica , Esponja de Gelatina Absorbible , Infarto , Riñón/irrigación sanguínea , Trasplante de Riñón , Ligadura , Obstrucción de la Arteria Renal/etiología , Factores de TiempoRESUMEN
Massive hemoptysis (600 ml in 48 hours) has an ominous prognosis with a mortality of 50 to 100% in medically treated patients and up to 35% in patients undergoing operation. Surgical resection has been the procedure of choice in patients with massive hemoptysis. Those with a contraindication to operation present a particularly frustrating problem. We have treated 7 such patients with massive hemoptysis by transcatheter bronchial artery embolization. In all 7, the bleeding was arrested. Two patients died of recurrent hemoptysis, 1 ten days and the other 2 months following embolization, and 5 are well 1 month to one year later. Transcatheter bronchial artery embolization is a valuable therapeutic modality in patients with massive hemoptysis. However, the procedure is palliative, and, therefore, elective resection must be considered as definitive treatment in those patients who have no contraindication to operation.