Intra-Arterial Therapy with 90Y for Hepatic Tumour Lesions: A Review | Chapter 5 | Medical Science: Recent Advances and Applications Vol. 12

 

Aim: The objective of this integrative review study was to identify existing studies in the literature that provide information on the advances associated with the therapeutic technique of radioembolization with 90Y-labelled microspheres and its relationship within radiology, from the perspective of expanding the culture of radiological protection.

 

Methodology: Through an integrative literature review, the advances associated with the therapeutic technique of radioembolization with yttrium-90 (90Y) microspheres were analysed, highlighting the reduction of radiation dose in medical and occupational exposures, as well as evaluating the role of intra-arterial radionuclides in terms of survival benefit, progression-free survival, and quality of life.

 

Results: The results showed that therapeutic association with radioembolization using 90Y microspheres was effective in the treatment of liver tumours, but further studies are still required to determine ideal administration protocols and combination with radionuclide therapy.

 

Conclusion: Moreover, additional research is needed to establish the absorbed dose delivered to the tumour, taking into account its specific radiosensitivity and the desired final mass of the treated lesion.

 

 

Author(s) Details

Adrine Silveira da Silva
Universidade Franciscana - UFN, 97010-032, Santa Maria, RS, Brazil.

 

Luísa Vargas Cassol
Universidade Franciscana - UFN, 97010-032, Santa Maria, RS, Brazil.

 

Cássio Mori da Silva
Universidade Franciscana - UFN, 97010-032, Santa Maria, RS, Brazil.

 

Jéssica Fetzer da Costa Rosa
Universidade Franciscana - UFN, 97010-032, Santa Maria, RS, Brazil.

 

Vagner Bolzan
Instituto Federal de Santa Catarina - IFSC, 88075010, Florianópolis, SC, Brazil.

 

Silvio Atilio Michelin Bertagnolli
Universidade Federal de Santa Maria - UFSM / Hospital Universitário de Santa Maria - HUSM, 97105-900, Santa Maria, RS, Brazil.

 

Thiago Victorino Claus
Universidade Franciscana - UFN/Hospital Universitário de Santa Maria - HUSM, 97105-900, Santa Maria, RS, Brazil.

 

Please see the book here :- https://doi.org/10.9734/bpi/msraa/v12/6367

A Case Report on Multiple Renal Infarctions in Spontaneous | Chapter 13 | Medical Science: Recent Advances and Applications Vol. 2

Aim: This study reports a rare clinical case of spontaneous renal artery dissection (SRAD) presenting with multiple renal infarctions.

Background: As spontaneous renal artery dissection (SRAD) is a rare cause of abdominal pain, bilateral dissection is an extremely rare event. It can be defined as a dissection of the renal artery with no underlying vascular disease, renal artery intervention, or trauma. Only approximately two hundred cases of SRAD have been reported in the literature. The diagnosis is often delayed due to the rarity of the disease and non-specific clinical presentations such as flank pain, hypertension, fever, nausea, vomiting, and hematuria, which can be often misdiagnosed as a genito-urinary infection or gastrointestinal or bowel disease. Before 1980, the diagnosis of SRAD was mostly confirmed via autopsy or, rarely, via angiography. At present, the diagnosis is made using advanced imaging approaches, including computed tomography angiography (CTA) and magnetic resonance angiography (MRA), with a higher number of incidentally diagnosed SRADs.

Methods: The case of a 49-year-old man who was referred to our Emergency Room with acute abdominal flank lower back pain, uncontrolled hypertension, headache, and malaise has been reported. Laboratory tests and radiological examinations (computed abdominal tomography and multiplanar reconstruction) have been performed that revealed multiple infarctions and ischemic areas with hypoperfusion in the upper middle third of the left kidney and in a large part of middle and lower areas of the right kidney; the left renal artery exhibited increased intimal thickening and arteritis.

Results: The multiplanar reconstruction revealed bilateral renal artery dissection and multiple arterial infarctions disseminated throughout both kidneys. After a clinical follow-up and hypertension retargeting, the patient was discharged with dual antiplatelet therapy and ACE inhibitor drugs. No lipid-lowering therapy was needed.

Conclusions: SRAD remains a diagnostic challenge as it could be misdiagnosed or receive a delayed diagnosis due to its relative rarity and non-specific presentation. The gold standard is enhanced computed tomography (CT) scans, and if the diagnosis is positive, vascular multiplanar reconstruction is generally suggested, as it can display lesions more clearly. However, to date, a consensus has not been reached on the most appropriate treatment. Conservative therapy, open surgery, and intravascular intervention have been reported as treatments for SRAD. Additionally, stabilizing blood pressure must be the primary objective not only during hospitalization but also at discharge when planning clinical and radiological follow-ups for cases that do not require urgent endovascular or open surgery treatment but could worsen or relapse.

 

Author (s) Details

 Jirotiya V
Department of Ophthalmology, Railway Hospital Ajmer, India.

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v2/5181