FRANCISCO CESAR CARNEVALE
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
79 resultados
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- Effects of Prostatic Artery Embolization on the Dynamic Component of Benign Prostate Hyperplasia as Assessed by Ultrasound Elastography: A Pilot Series(2019) ASSIS, Andre Moreira de; MOREIRA, Airton Mota; CARNEVALE, Francisco Cesar; MARCELINO, Antonio Sergio Zafred; CERRI, Luciana Mendes de Oliveira; ANTUNES, Alberto Azoubel; SROUGI, Miguel; CERRI, Giovanni GuidoPurposeTo determine the effects of prostatic artery embolization (PAE) on prostaticelasticity as assessed by Ultrasound Elastography (US-E), as well as to describe the feasibility and role of US-E as a novel tool in both pre- and post-PAE evaluation.Materials and MethodsThis is a prospective, single-center investigation that included eight patients undergoing PAE for treatment of lower urinary tract symptoms (LUTS) attributed to benign prostate hyperplasia (BPH). Baseline and 3-month follow-up evaluations were performed and included prostate-specific antigen (PSA), uroflowmetry, pelvic magnetic resonance imaging and clinical assessment using the International Prostate Symptom Score (IPSS) questionnaire and the IPSS-Quality of life (QoL) item. US-E with measurement of the prostatic Elastic Modulus (EM) was performed before PAE and at 1-month follow-up.ResultsAfter PAE, US-E showed a significant reduction of prostatic EM as assessed in kPa (33.14 vs. 47.24, -29.8%, p=0.002) and in m/s (3.75 vs. 4.63, -19.0%, p<0.001). Also, the transitional/peripheral zone ratio was significantly reduced by 45.36% (0.53 vs. 0.97, p<0.05). All eight patients presented with significant LUTS improvement after PAE (p<0.05 for IPSS, QoL, prostate volume, peak urinary flow rate and PSA).ConclusionsFindings described in this study suggest that PAE significantly reduces prostaticEM, leading to a positive effect on BPH dynamic component related to prostatic elasticity. Also, it features US-E as an additional tool for pre- and post-PAE evaluation, describing a novel indication for this technology.
- Infusion of Recombinant Human Tissue Plasminogen Activator Through the Superior Mesenteric Artery in the Treatment of Acute Mesenteric Venous Thrombosis(2011) LEAL FILHO, Joaquim Mauricio da Motta; SANTOS, Aline Cristine Barbosa; CARNEVALE, Francisco Cesar; SOUSA JR., Wilson de Oliveira; GRILLO JR., Luiz Sergio Pereira; CERRI, Giovanni GuidoAcute mesenteric venous thrombosis is an uncommon condition that is usually treated with systemic anticoagulation. Catheter-directed thrombolysis through the superior mesenteric artery may be a viable adjunct to treat this morbid condition. In the present article, we have described a case of superior mesenteric venous thrombosis treated with catheter-directed infusion of tissue plasminogen activator through the superior mesenteric artery.
- Quality of Life and Clinical Symptom Improvement Support Prostatic Artery Embolization for Patients with Acute Urinary Retention Caused by Benign Prostatic Hyperplasia(2013) CARNEVALE, Francisco C.; MOTTA-LEAL-FILHO, Joaquim M. da; ANTUNES, Alberto A.; BARONI, Ronaldo H.; MARCELINO, Antonio S. Z.; CERRI, Luciana M. O.; YOSHINAGA, Eduardo M.; CERRI, Giovanni G.; SROUGI, MiguelPurpose: To show that prostatic artery embolization (PAE) improves quality of life (QoL) and lower urinary tract symptoms in patients with acute urinary retention caused by benign prostatic hyperplasia (BPH). Materials and Methods: This was a single-center prospective study of PAE in 11 patients with BPH managed With indwelling. urinary catheters. International Prostate Symptom Score (IPSS), ultrasound, magnetic resonance (MR) imaging, QoL, and urodynamic tests were used. to assess outcomes. Prostate size ranged from 30 to 90 g, and embolizations were performed with 300-500-mu m Embosphere microspheres. Results: The rate of technical success (ie, bilateral PAE) was 75%, and the rate of clinical success (ie, catheter removal and symptom improvement) was 91% (10 of 11 patients). Postembolization syndrome manifested as mild pain in the perineum, retropubic area, and/or urethra. Ten of 11 patients urinated spontaneously after Foley catheter removal 4-25 days after PAE (mean, 12.1 d). No major complications Were observed. Follow-up ranged from 19 to 48 months. than asymptomatic patient, a discrete area of hypoperfusion: suggesting small ischemia of the bladder was observed on 30-day MR imaging follow-up, but the bladder was normal on 90-day MR imaging. After 1 year, mean prostate volume reduction was greater than 30%, symptoms were mild (mean IPSS, 2.8 +/- 2.1; P = .04),. no erectile dysfunction was observed, and QoL,improved significantly (mean , 0.4 +/- 0.5; P = .001) using the paired t test. Conclusions: Patients with severe symptoms and acute urinary retention caused by BPH can be treated Safely by PAE, which improves clinical symptoms and QoL.
- Prostatic Arterial Embolization versus Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia(2015) BILHIM, Tiago; BAGLA, Sandeep; SAPOVAL, Marc; CARNEVALE, Francisco Cesar; SALEM, Riad; GOLZARIAN, Jafar
- Prostatic Tissue Elimination After Prostatic Artery Embolization (PAE): A Report of Three Cases(2017) LEITE, Leandro Cardarelli; ASSIS, Andre Moreira de; MOREIRA, Airton Mota; HARWARD, Sardis Honoria; ANTUNES, Alberto Azoubel; CARNEVALE, Francisco CesarWe report three cases of spontaneous prostatic tissue elimination through the urethra while voiding following technically successful prostatic artery embolization (PAE) as a treatment for lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH). All patients were embolized with 100- to 300-mu m microspheres alone or in combination with 300- to 500-mu m microspheres. During follow-up prior to eliminating the tissue fragments, the three patients all presented with intermittent periods of LUTS improvement and aggravation. After expelling the prostatic tissue between 1 and 5 months of follow-up, significant improvements in LUTS and urodynamic parameters were observed in all patients. Urethral obstruction after PAE caused by sloughing prostate tissue is a potential complication of the procedure and should be considered in patients with recurrent LUTS in order to avoid inappropriate management.
- KCNJ5 Somatic Mutation Is a Predictor of Hypertension Remission After Adrenalectomy for Unilateral Primary Aldosteronism(2019) VILELA, Leticia A. P.; RASSI-CRUZ, Marcela; GUIMARAES, Augusto G.; MOISES, Caio C. S.; FREITAS, Thais C.; ALENCAR, Natalia P.; PETENUCI, Janaina; GOLDBAUM, Tatiana S.; MACIEL, Ana Alice W.; PEREIRA, Maria Adelaide A.; V, Giovanio Silva; PIO-ABREU, Andrea; ZERBINI, Maria Claudia N.; CAVALCANTE, Aline C. B. S.; CARNEVALE, Francisco C.; PILAN, Bruna; YAMAUCHI, Fernando; SROUGI, Vitor; TANNO, Fabio Y.; CHAMBO, Jose L.; LATRONICO, Ana Claudia; MENDONCA, Berenice B.; V, Maria Candida B. Fragoso; BORTOLOTTO, Luiz A.; DRAGER, Luciano F.; ALMEIDA, Madson Q.Context: Primary aldosteronism (PA) is the most common cause of endocrine hypertension (HT). HT remission (defined as blood pressure <140/90 mm Hg without antihypertensive drugs) has been reported in approximately 50% of patients with unilateral PA after adrenalectomy. HT duration and severity are predictors of blood pressure response, but the prognostic role of somatic KCNJ5 mutations is unclear. Objective: To determine clinical and molecular features associated with HT remission after adrenalectomy in patients with unilateral PA. Methods: We retrospectively evaluated 100 patients with PA (60 women; median age at diagnosis 48 years with a median follow-up of 26 months). Anatomopathological analysis revealed 90 aldosterone-producing adenomas, 1 carcinoma, and 9 unilateral adrenal hyperplasias. All patients had biochemical cure after unilateral adrenalectomy. KCNJ5 gene was sequenced in 76 cases. Results: KCNJ5 mutations were identified in 33 of 76 (43.4%) tumors: p.Gly151Arg (n = 17), p.Leu168Arg (n = 15), and p.GIu145GIn (n = 1). HT remission was reported in 37 of 100 (37%) patients. Among patients with HT remission, 73% were women (P = 0.04), 48.6% used more than three antihypertensive medications (P= 0.0001), and 64.9% had HT duration <10 years (P= 0.0015) compared with those without HT remission. Somatic KCNJ5 mutations were associated with female sex (P = 0.004), larger nodules (P = 0.001), and HT remission (P = 0.0001). In multivariate analysis, only a somatic KCNJ5 mutation was an independent predictor of HT remission after adrenalectomy (P = 0.004). Conclusion: The presence of a KCNJ5 somatic mutation is an independent predictor of HT remission after unilateral adrenalectomy in patients with unilateral PA.
- Endovascular repair of a nearly fatal iliac artery injury after endoureterotomy(2013) LOPES, Roberto Iglesias; TORRICELLI, Fabio Cesar Miranda; GOMES, Cristiano Mendes; CARNEVALE, Francisco; BRUSCHINI, Homero; SROUGI, MiguelEndourological methods are attractive procedures for the treatment of ureterointestinal stenosis. However, serious complications may occur. This article reports the case of an endovascular repair of a nearly fatal ruptured common iliac artery pseudoaneurysm after endoureterotomy. A 62-year-old man submitted to bilateral ureteroileostomy developed left ureteroileal anastomosis stricture. Endourological treatment with the Acucise (R) cutting balloon was performed and 4 days after the procedure the patient presented with massive bleeding through the ileal stoma and hypovolemic shock. Arteriography identified the source of bleeding as a pseudoaneurysm of the left common iliac artery. Repair with an endovascular graft stopped the bleeding immediately. Endovascular treatment of vascular injury after endoureterotomy should be considered.
conferenceObject RESIDUAL KNEE PAIN AND SYNOVITIS AFTER TOTAL KNEE ARTHROPLASTY TREATED WITH SELECTED EMBOLIZATION OF GENICULAR ARTERIES(2023) REZENDE, M. U.; VALLE, L. G. M.; ASSIS, A. M.; OCAMPOS, G. P.; CARNEVALE, F. C.; AFFONSO, B. B.; GALASTRI, F. L.; NASSER, F.article 3 Citação(ões) na Scopus Renal pseudoaneurysm after core-needle biopsy of renal allograft successfully managed with superselective embolization(2016) ANTONOPOULOS, Ioannis M.; YAMACAKE, Kleiton Gabriel Ribeiro; TISEO, Bruno C.; CARNEVALE, Francisco C.; JUNIOR, Enio Z.; NAHAS, William C.- Peristomal variceal bleeding treated by coil embolization using a percutaneous transhepatic approach(2016) MACIEL, Macello Jose Sampaio; PEREIRA, Osvaldo Ignacio; LEAL FILHO, Joaquim Mauricio Motta; ZIEMIECKI JUNIOR, Enio; COSME, Susyanne Lavor; SOUZA, Moises Amancio; CARNEVALE, Francisco CesarPeristomal variceal bleeding due to portal hypertension is an entity that has rarely been reported with 3%-4% risk of death. A 68-year-old woman who had undergone a palliative colostomy (colorectal carcinoma) presented with a massive hemorrhage from the colostomy conduit. Considering her oncological status with medial and right hepatic veins thrombosis due to liver metastasis invasion, an emergency transhepatic coil embolization was successfully performed. Standard treatment modality for these cases has not been established. Percutaneous transhepatic coil embolization of varices is a safe and effective choice in patients who present with life threatening bleeding and exhibit contraindications to transjugular intrahepatic portosystemic shunt.