FRANCISCO CESAR CARNEVALE
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
7 resultados
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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.
- Malignant paraganglioma in children treated with embolization prior to surgical excision(2016) MIRANDA, Eduardo de Paula; LOPES, Roberto Iglesias; PADOVANI, Guilherme Philomeno; MOSCARDI, Paulo Renato Marcelo; NISHIMURA, Fernanda Gardini Maciel; MENDONCA, Berenice Bilharinho de; CARNEVALE, Francisco Cesar; CRISTOFANI, Lilian Maria; DUARTE, Ricardo Jordao; SROUGI, Miguel; DENES, Francisco TiborBackground: Paragangliomas (PGL) are rare tumors derived from neural crest cells, whose origins may vary along the chain of the sympathetic nervous system. Such tumors are often characterized by secretion of catecholamines, but sometimes they are biochemically inactive, which makes diagnosis often challenging. Malignant paraganglioma is defined by the presence of this tumor at sites where chromaffin cells are usually not found or by local invasion of the primary tumor. Recurrence, either regional or metastatic, usually occurs within 5 years of the initial complete resection but long-term recurrence is also described. Malignancy is often linked to a SDHB mutation. Preoperative embolization has been applied in the surgical management of PGLs with the objective to decrease intra-operative blood loss and surgery length without complications. Case Presentation: We report two cases of patients with abdominal or pelvic malignant PGLs who have been treated surgically at our center after preoperative embolization. Surgery was a very challenging procedure with multiple surgical teams involved and embolization did not prevent major blood loss and intraoperative complications. Patients required adjuvant treatment with either chemotherapy or radiotherapy. Conclusions: Many studies in the adult population have established recommendations for the diagnosis and therapeutic management of PGL, but few studies concern the pediatric population. Because malignant PGL is more important in the pediatric population, screening and early diagnosis of PGL is advisable in children with genetic predisposing. Surgical resection is the mainstay of treatment, but a multimodal approach is often required due to the complexity of cases. The role of preoperative embolization is not established and in our experience it has provided little benefit and major complications.
- Transurethral Resection of the Prostate (TURP) Versus Original and PErFecTED Prostate Artery Embolization (PAE) Due to Benign Prostatic Hyperplasia (BPH): Preliminary Results of a Single Center, Prospective, Urodynamic-Controlled Analysis(2016) CARNEVALE, Francisco C.; ISCAIFE, Alexandre; YOSHINAGA, Eduardo M.; MOREIRA, Airton Mota; ANTUNES, Alberto A.; SROUGI, MiguelTo compare clinical and urodynamic results of transurethral resection of the prostate (TURP) to original and PErFecTED prostate artery embolization (PAE) methods for benign prostatic hyperplasia. We prospectively randomized 30 patients to receive TURP or original PAE (oPAE) and compared them to a cohort of patients treated by PErFecTED PAE, with a minimum of 1-year follow-up. Patients were assessed for urodynamic parameters, prostate volume, international prostate symptom score (IPSS), and quality of life (QoL). All groups were comparable for all pre-treatment parameters except bladder contractility and peak urine flow rate (Q (max)), both of which were significantly better in the TURP group, and IIEF score, which was significantly higher among PErFecTED PAE patients than TURP patients. All groups experienced significant improvement in IPSS, QoL, prostate volume, and Q (max). TURP and PErFecTED PAE both resulted in significantly lower IPSS than oPAE but were not significantly different from one another. TURP resulted in significantly higher Q (max) and significantly smaller prostate volume than either original or PErFecTED PAE but required spinal anesthesia and hospitalization. Two patients in the oPAE group with hypocontractile bladders experienced recurrence of symptoms and were treated with TURP. In the TURP group, urinary incontinence occurred in 4/15 patients (26.7 %), rupture of the prostatic capsule in 1/15 (6.7 %), retrograde ejaculation in all patients (100 %), and one patient was readmitted for temporary bladder irrigation due to hematuria. TURP and PAE are both safe and effective treatments. TURP and PErFecTED PAE yield similar symptom improvement, but TURP is associated with both better urodynamic results and more adverse events.
- Metabolomic characterization of renal ischemia and reperfusion in a swine model(2016) MALAGRINO, Pamella Araujo; VENTURINI, Gabriela; YOGI, Patricia Schneider; DARIOLLI, Rafael; PADILHA, Kallyandra; KIERS, Bianca; GOIS, Tamiris Carneiro; MOTTA-LEAL-FILHO, Joaquim Mauricio; TAKIMURA, Celso Kiyochi; GIRARDI, Adriana Castello Costa; CARNEVALE, Francisco Cesar; CANEVAROLO, Rafael; MALHEIROS, Denise Maria Avancini Costa; ZERI, Ana Carolina de Mattos; KRIEGER, Jose Eduardo; PEREIRA, Alexandre CostaAcute kidney injury (AKI) is a serious complication in hospitalized and transplanted patients, and is mainly caused by ischemia/reperfusion (I/R). However, the current diagnosis of AKI based on acute alterations in serum creatinine or urine output is late and unspecific. To identify new systemic biomarkers for AKI, we performed serum and urine metabolomic profile analyses during percutaneous unilateral renal I/R in a well-controlled swine model. For this, serial serum and urine samples obtained during the pre-ischemia, ischemia and reperfusion periods were analyzed by H-1 nuclear magnetic resonance at 600 MHz. Through the metabolic profiles over I/R, we identified eight serum metabolites that increased with ischemia and recovered to basal values after reperfusion, delineating the ischemic period. In addition, we identified 13 urinary metabolites that changed during the early reperfusion reflecting the ischemic kidney, being able to differentiate between pre-ischemia and post I/R periods. All selected metabolites are described in terms of disease pathophysiology (change of energetic pathway and oxidative stress), which suggest that these serum and urinary metabolites are candidate AKI biomarkers. Interestingly, the selected metabolites allowed us to identify, well described NF kappa B, leptin, INF-gamma and insulin pathways, and a new pathway (Huntingtin) that had not been previously implicated in renal I/R. Huntingtin showed different fragment patterns in ischemic versus non-ischemic kidneys. Therefore, the metabolomic profile found in renal I/R led to the identification of candidate disease biomarkers and a new pathway associated with renal injury.
- Retrograde Proximal Anterior Tibial Artery Access for Treating Femoropopliteal Segment Occlusion: A Novel Approach(2016) AFFONSO, Breno Boueri; DOMINGOS, Fernanda Uchiyama Golghetto; LEAL FILHO, Joaquim Mauricio da Motta; MACIEL, Macello Jose Sampaio; CAVALCANTE, Rafael Noronha; BORTOLINI, Edgar; CARNEVALE, Francisco CesarSome challenges have been detected when there are long and complex lesions of femoropopliteal arterial occlusive disease, even with descriptions of the retrograde pedal approaches. The aim of this article is to describe the retrograde proximal anterior tibial artery access for treatment of femoropopliteal segment occlusion when antegrade recanalization failed (retrograde recanalization and rearranging the system into an antegrade position). Technical and clinical success was achieved in 100% of 4 cases, with an improvement of at least 2 Rutherford classes. Minor complication, small hematoma in an anterior compartment of the limb, occurred in 1 patient. No sign of compartmental syndrome was observed.
- Comparative Study Using 100-300 Versus 300-500 mu m Microspheres for Symptomatic Patients Due to Enlarged-BPH Prostates(2016) GONCALVES, Octavio Meneghelli; CARNEVALE, Francisco Cesar; MOREIRA, Airton Mota; ANTUNES, Alberto Azoubel; RODRIGUES, Vanessa Cristina; SROUGI, MiguelThe purpose of the study was to compare safety and efficacy outcomes following prostate artery embolization (PAE) for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with 100-300 versus 300-500 mu m tris-acryl gelatin microspheres. Patients were prospectively treated between August 2011 and June 2013 to receive PAE with 100-300 mu m (group A) or 300-500 mu m (group B) tris-acryl gelatin microspheres. Patients were followed for a minimum of 12 months and were assessed for changes in International Prostate Symptom Score (IPSS), quality of life (QoL) index, prostate volume determined by magnetic resonance imaging, serum prostate specific antigen (PSA), and maximum urine flow rate (Q(max)), as well as any treatment-related adverse events. Fifteen patients were included in each group, and PAE was technically successful in all cases. Both groups experienced significant improvement in mean IPSS, QoL, prostate volume, PSA, and Q(max) (p < 0.05 for all). The differences observed between the two groups included a marginally insignificant more adverse events (p = 0.066) and greater mean serum PSA reduction at 3 months of follow-up (p = 0.056) in group A. Both 100-300 and 300-500 mu m microspheres are safe and effective embolic agents for PAE to treat LUTS-related to BPH. Although functional and imaging outcomes did not differ significantly following use of the two embolic sizes, the greater incidence of adverse events with 100-300 mu m microspheres suggests that 300-500 mu m embolic materials may be more appropriate.