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Effect of Preoperative Embolization on the Intraoperative Bleeding during Posterior Stabilization in Thoracolumbal Fracture Cases at Prof. Dr. R. D Kandou Hospital Manado Nathaniel Pali; Tommy Suharso; Richard Sumangkut; Billy Karundeng; Djony E. Tjandra; Yuansun Khosama; Windy M. V. Wariki
e-CliniC Vol. 11 No. 2 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i2.44759

Abstract

Abstract: Embolization is a technique to stop or prevent bleeding by inserting an object, such as an air-filled membrane (balloon), or an embolic material such as foam into a blood vessel to block the blood flow. This study aimed to prove that preoperative embolization might affect and reduce the amount of intraoperative bleeding during the posterior stabilization procedure for thoracolumbal vertebrae fracture. A quasi-experimental method was chosen for this study, and samples were not taken at random. Samples were patients with thoracolumbal vertebrae fracture who underwent the posterior stabilization procedure. Samples were divided into two groups, treated with and without preoperative embolization groups. The treatment was given 24-48 hours before posterior stabilization procedure. The intraoperative bleeding was measured in milliliters. The resulys showed that the average intraoperative blood loss was 283.3 mL, meanwhile of the untreated group was 583.3 mL. The one-way t-test resulted in a p-value of 0.004 at 5% of significance. In conclusion, preoperative embolization could reduce the amount of blood loss during intra-operative posterior stabilization in patients with thoracolumbar vertebral fractures. Further research on preoperative embolization in patient who will undergo posterior stabilization surgery of the thoracolumbal region due to fracture, either mechanically or generatively, is needed. Keywords: preoperative embolization; intraoperative blood loss
Amplatzer Vascular Plug in Renal Artery Embolization: Case Serial and Review of the Literature Billy Karundeng; Richard Sumangkut; Yuansun Khosama; Djonny E. Tjandra; Michael D. Winarto
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.48476

Abstract

Abstract: Embolization constitutes a safe and effective therapeutic possibility in the treatment of numerous renal pathologies whether election or urgency. The use of Amplatzer vascular plug (AVP) constitutes a more recent and less widespread therapeutic choice, and its use in the renal district is not yet widespread although potentially very valid. Perioperative renal artery embolization has been introduced to reduce the risk of oncological spread and intraoperative bleeding, in order to facilitate surgery, thus decreasing perioperative morbidity. Nevertheless, in recent literature the real usefulness of perioperative renal artery embolization is still debated. Some authors agree that the advantages of perioperative renal artery embolization are to decrease intraoperative bleeding with a lower transfusion rate and to reduce operative time. Therefore, we presented five cases of renal arterial embolizations (RAEs) performed with AVP from July to August 2022 at Prof. Dr. R. D. Kandou Hospital, Manado. In all cases, a single plug was used which perfectly adapted to the target artery resulting in complete occlusion of the vessel within a short period of time. Renal artery embolization was generally performed the day before surgery under local anesthesia. After confirmation of the tumor vascularization with a contrast study, the selective renal artery embolization was performed. In our experience, the use of AVP for the treatment of renal arteriovenous fistula and neoplastic masses had given excellent results without any complications during and after the treatment. In conclusion, RAE performed with AVP has growing potential and numerous advantages in terms of the time of the procedure, speed of embolization, and precision of occlusion, but with a relative increase in costs. Keywords: amplatzer vascular plugs; vascular surgery; endovascular surgery; renal artery embolization