FRANCISCO CESAR CARNEVALE
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
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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.- The histology of prostate tissue following prostatic artery embolization for the treatment of benign prostatic hyperplasia(2013) CAMARA-LOPES, George; MATTEDI, Romulo; ANTUNES, Alberto A.; CARNEVALE, Francisco C.; CERRI, Giovanni G.; SROUGI, Miguel; ALVES, Venancio A.; LEITE, Katia R. M.Objective: Prostatic artery embolization (PAE) for the treatment of patients with symptomatic benign prostatic hyperplasia (BPH) is believed to be a safe procedure with a low risk of adverse side effects. Artery embolization is a viable treatment option in patients who are refractory to the classic noninvasive treatments. Knowledge of the histological characteristics of prostate tissue following the procedure is still limited. In this study, we describe the microscopic aspects of the prostate following PAE for BPH. Materials and Methods: Two patients underwent transurethral resections of the prostate (TURP) after PAE. Embolizations were performed under local anesthesia with an initial pelvic angiography to evaluate the iliac vessels and the prostate arteries using a 2.8 French microcatheter. The prostate was embolized with 300-500 mu m Microspheres (Embosphere (R)), using complete blood stasis as the end point. The prostate tissues were analyzed histologically to characterize the effects of the embolization. Results: The embolic material within the prostate tissue was easily identified as homogeneous, bright eosin-red spheroids filling the vessel lumens. Ischemic necrosis surrounded or not by chronic inflammatory reactions containing macrophages were considered as a result of the artery embolization. Also, some aspects related to the healing process were observed being fibrotic nodules surrounded by glands with squamous metaplasia of the epithelial lining the most important. In the remaining sections, due to the precocious surgical intervention, the classic findings of BPH were still present with the glandular and stromal hyperplasia associated with nonspecific chronic prostatitis. Conclusions: This is the first description of prostate histology in BPH patients treated by PAE, a new procedure that is being used increasingly as a therapeutic intervention. The recognition of the changes caused by this new modality of treatment has become a very important differential in a chronic granulomatous reaction of the prostate tissue.
- Outcomes of endovascular treatment of renal arterial stenosis in transplanted kidneys(2019) BULL, Alexandre Sallum; PIOVESAN, Affonso Celso; MARCHINI, Giovanni Scala; YAMACAKE, Kleiton Gabriel Ribeiro; ANTONOPOULOS, Ioannis Michel; FALCI, Renato; KANASHIRO, Hideki; EBAID, Gustavo; CARNEVALE, Francisco Cesar; MESSI, Gustavo; NAHAS, William CarlosObjective: To evaluate the effectiveness and outcomes of endovascular treatment of TRAS with PTA. Materials and Methods: We searched our prospectively collected database looking at cases of TRAS between January 2005-December 2011. CCT was the gold-standart for diagnosis of TRAS. Parameters analysed comprised technical aspects, arterial blood pressure variation, and renal function. A minimum follow-up of 24 months was considered. Results: Of the 2221 renal transplants performed in the selected period, 22 (0.9%) patients were identified with TRAS. Fourteen (63.6%) were male and mean age was 377 +/- 14.8years (12-69). Kidney graft was from deceased donnors in 20 (80%) cases. On doppler evaluation, mean blood flow speed after transplantation, at TRAS diagnosis and after TAP was 210.6 +/- 99.5, 417 +/- 122.7 and 182.5 +/- 81.6mL/sec, respectively (p<0.001). For SBP and DBP, there was a significant difference between between preintervention and all post-treatment time points (p<0.001). After 1 month of the procedure, there was stabilization of the Cr level with a significant difference between mean Cr levels along time (p<0.001). After a mean follow-up of 16 +/- 4.2 (3-24) months, overall success rate was 100%. Conclusions: Endovascular treatment with PTA/stenting is a safe and effective option for managing TRAS, ensuring the functionality of the graft and normalization of blood pressure and renal function.