The development of endovascular intervention in MC Erebouni. For the last two months the number of endovascular interventions on different organs have been carried out in MC Erebouni. The Cardiology & Cardiac Surgery Clinic is one of the most advanced in the field of carrying out such kind of surgeries, and it is necessary to note, that the uterine artery embolization, hemangiomas, prostate has become an integral part of the practice of endovascular surgeons, in particular Dr. A. Tsaturyan.
In 2014 for the first time in MC Erebouni the patient G.O. was performed uterine artery embolization for uterine fibroids (the patient was diagnosed with the large submucosal fibroids, accompanying bleeding and giant liver hemangioma). During the long-term postoperative period, at a recent CT examination, the patient wasn`t detected fibroids. It can be considered as a big breakthrough and success both for doctors and the used method of treatment.
Two years later the patient has consulted for endovascular treatment of giant hepatic hemangioma.
In 13.11.16 the patient G.O., 1961y/b, was performed embolization of all arteries feeding hemangioma. The endovascular intervention was successfully completed. The patient was discharged on the 3rd day.
Two more patients V.A., 1957y/b., and S.G. 1967 y/b., were admitted to MC Erebouni to perform embolization of arteries feeding hemangioma. As in the first case the endovascular intervention were successful and effective.
The patient A.G., 49-years-old was performed embolization of hemangioma. The initial size of this hemangioma was 21.2 × 17.1 × 9.7.cm.
After 6 months the sizes decreased by almost 50%: 10× 9 × 6 cm.
It is important to note, that reduction in tumor size is seen only a few months later!
Giant hepatic hemangiomas are dangerous, because they can be ruptured spontaneously or due to injury, which usually leads to a massive internal bleeding. In case of embolization the risk is leveled completely or the sizes of hemangioma are significantly reduced, that doesn`t interfere with the patient`s vital functions.
Patients B.A., 1977 y/b., and 1983 y/b., admitted to MC Erebouni for uterine fibroids with the purpose of embolization of uterine arteries.
Uterine arteries embolization is a radical, minimally-invasive endovascular method of the uterine fibroids treatment, which allows to get rid of the problems, preserving the organ. Such kind of intervention have become routine in practice and rather effective.
In MC Erebouni recently, for the first time in Armenia were performed endovascular interventions in benign prostatic hyperplasia with prostatic arterial embolisation, which also found their permanent place in a routine practice of the clinic. During the last month 4 surgeries of such kind has been carried, with a rather effective results, with early improvement of uroflowmetric parameters, and patients with chronic urinary retention get rid of a urinary catheter. Compared with surgical treatment, prostatic arterial embolization allows to avoid such complication as risk of general anesthesia, risk of bleedings, surgical trauma, a great number of contraindications and postoperative complications, as well as reproductive disorders and impotence.
Such kind of endovascular intervention are carried out only in a few clinics all around the world, and it is necessary to note with pride , that one of those is MC Erebouni.
A 48 years-old patient Kh. A., in 21.11.16 admitted to MC Erebouni for performing selective angiography of the left carotid artery. In other clinic the patient was carried tongue resection for a cancer. After that he was receiving a radiation therapy in the area of neck. Suddenly after a few sessions there was a swelling on the left side of his neck, which led to a compression of the trachea. Puncture of this formation was performed. At CT angiography the patient was suspected possible perforation of the wall of the left external carotid artery, as a consequence of radiation therapy or tumor invasion in the vessel wall. In the last few days the patient was bleeding from the puncture site, about which he asked for endovascular solution to the problem.
In 21.11.16 the patient Kh. A. was performed a selective angiography of the neck arteries. At selective catheterization of the left external carotid artery it started bleeding from the defect location, which was simultaneously closed by intravascular stent-graft, and the branches of the left external carotid artery were embolized with spirals, because the walls of the branches were deformed and sclerotic (probably as effect of radiation therapy) . Bleeding was stopped. Postoperative period was uneventful and the patient was discharged on the second day.
It is necessary to note, that such endovascular surgeries in diseases of various organs are performed only in MC Erebouni, in the presence of special equipment, knowledge, practice, skills and professionalism, that provides high efficiency of treatment. The essence of such endovascular intervention is in radical solution to a big problem by minimally-invasive method, without anesthesia, postoperative wound and a long recovery period, including even the most severe patients, for whom the open surgeries is a greater risk, and are often contraindicated.
