Endoluminal

The Endoluminal Diagnostic and Therapeutic Service is based on the application of minimally invasive techniques, ensuring the treatment of a multitude of complications derived from tumor growth and the possibility of offering the best support therapy at all times.

NON-VASCULAR PROCEDURES

• Paracentesis: It consists of the evacuation of fluid from the peritoneal cavity, a space found within the abdomen in which fluid can accumulate for different reasons. The abdominal cavity is accessed with a needle through which the fluid is drained. The procedure is outpatient, it is performed using a minimally invasive technique under local anesthesia and under ultrasound guidance. Once performed, the patient presents improvement of the symptoms and can continue normal life at home.
  • Cabrera J, Falcon L, Gorriz E, Granados R, Pardo MD, Quiñones A. Maynar M, Abdominal decompression plays a major role in early postparacentesis haemodynamic changes in cirrhotic patients with tense ascites. Gut. 2001 Mar;48(3):384-389. Editorial: B M J Publishing Group. ISSN: 0017- 5749.
    
• Thoracentesis: It consists of the extraction of fluid from the pleural space, which is located within the chest in which fluid can accumulate for different reasons. The pleural cavity is accessed with a needle through which the fluid is drained. The procedure is outpatient, it is performed using a minimally invasive technique under local anesthesia and under ultrasound guidance. Once performed, the patient presents improvement of the symptoms and can continue normal life at home.
  • Cabrera J, Falcon L, Gorriz E, Granados R, Pardo MD, Quiñones A. Maynar M, Abdominal decompression plays a major role in early postparacentesis haemodynamic changes in cirrhotic patients with tense ascites. Gut. 2001 Mar;48(3):384-389. Editorial: B M J Publishing Group. ISSN: 0017- 5749.
    
• Collection drains: With an ambulatory, minimally invasive technique and under ultrasound / tomographic guidance, with local anesthesia, collections of organic fluid (pus, hematoma and others) are accessed in different parts of the body for their extraction and resolution.
  • Radiología Intervencionista abdominal no vascular. Congreso de Actualización Diagnóstico por Imagen en Patología Abdominal. León (Spain). 3-4 May 1985.
    
• Bile duct drains: Different pathologies can cause obstruction of the bile duct, which is the drainage system of the liver, which causes yellowing of the skin and eyes, the presence of dark urine, white stools and sometimes pain. It is a minimally invasive technique, guided by X-rays and under local anesthesia, accessing the biliary system for the placement of a catheter that will allow the bile to drain into the intestine and into a collecting bag, in order to improve symptoms.
  • Maynar M, López L, Reyes R, Ramírez R, Toledo S, Pulido JM. Percutaneous biliary drainage. Our experience with the Cope system. Joint Meeting of the European and American Society of Cardiovascular and Interventional Radiology. Berlin (Germany), 12-17 June 1988.
    
• Percutaneous gastrostomy: Guided by X-rays, in a minimally invasive, ambulatory way and under local anesthesia, an access to the gastric cavity is made through a catheter for feeding temporarily or permanently.
  • De Gregorio MA, Ramo M, Rubio PJ, Fernández JA, Maynar M, Celaya S, Civeira E. Gastrostomía percutánea para alimentación enteral. Experiencia en 41 casos con técnica Seldinger. Radiología 1993;35(7):467-470.
    
• Percutaneous nephrostomy: It is a minimally invasive procedure guided by ultrasound / X-rays, under local anesthesia, the urinary tract is accessed to place a catheter temporarily that will allow decompression, improving symptoms and limiting damage to kidney function due to obstruction.
  • Travieso MM, Carreira JM, Reyes R, Pulido-Duque JM, Górriz E, Pardo MD, Maynar M. Nefrostomía percutánea bajo control fluoroscópico. Complicaciones de la técnica. Radiología 1998;40(1):21-24.
    
• Double J catheter placement: The urinary tract is accessed guided by X-rays in order to place an indwelling catheter at the level of the ureter to decompress the urinary tract, improving symptoms and limiting damage to kidney function due to obstruction.
  • Maynar M, Izquierdo F, Reyes R. Percutaneous management of ureteral problems. Joint Meeting of the European and American Societies of Cardiovascular and Interventional Radiology. Sardinia (Italy), 25-29 May 1987.
    
• Esophageal stent: There may be narrowing / obstruction in different parts of the esophagus secondary to various pathologies, which make swallowing and therefore eating difficult. With a minimally invasive and X-ray-guided technique, a stent is placed in the lumen of the esophagus, allowing it to recover its caliber and thus facilitating swallowing. It is an outpatient procedure with immediate results.
  • Maynar M, Rösch J. Treatment of malignant esophageal obstruction with silicone-coated metallic self-expanding stents. En: Kollath J, Lierman D, editors. Stents II. Frankfurt: Schenetztor-Verlag; 1992. p. 252-259.
    
• Colonic stent: Different causes can produce obstruction of the colon, even leading to occlusion that makes stool difficult. Guided by X-rays and with a minimally invasive technique, a stent is placed inside the colon, allowing it to recover its caliber and colonic transit. It is an outpatient procedure with immediate results.
  • Maynar M, de Gregorio MA, Mainar A, Tejero E, Castañeda-Zúñiga W, Colonic Stenting. In: Baum T, Pentecost M, Abrams’ Angiography: Interventional Radiology, Second Edition. Lippincott Williams & Wilkins 2006.
    
• Tracheal / bronchial stent: The obstruction of the airway due to different pathologies can cause difficulty in breathing. Guided by X-rays and with a minimally invasive technique, a stent is placed inside the airway, allowing it to recover its caliber and airflow to the lungs. It is an outpatient procedure with immediate results.
  • López L, Varela A, Rubio J, Rodríguez A, Pulido JM, Maynar M. The use of the Gianturco self-expandable stents in the tracheobronchial tree (Abstr). American Review of Respiratory Disease 1990;141(4).
    
• Radiofrequency ablation: It is an alternative complementary treatment for some tumor lesions. Through a minimally invasive technique guided by ultrasound / tomography, an electrode is directed to the center of the lesion through which different doses of radiofrequency are administered that produce heat, cauterizing the lesion, helping to reduce its size.
  
• Vertebroplasty: Various pathological vertebral fractures of different causes can be treated in a minimally invasive way and under local anesthesia, which consist of the application of bone cement to the interior of the body of the vertebra in order to regain its height and reduce pain.
  • Robaina F, Díaz F, Casal M, Górriz E, Maynar M, de Vera J. Spinal cord stimulation in vasospastic pain (Abstr.). Pain 1990;5:76.
    
• Spinal pain management (root blocks, facet, epidural): Compression of nerve structures in the spine, secondary to different tumor lesions, is an important cause of spinal pain and extramias. The selective application of anti-inflammatory / corticosteroid medications in a minimally invasive and tomography-guided manner allows rapid pain relief.
  • Robaina F, Díaz F, Casal M, Górriz E, Maynar M, de Vera J. Spinal cord stimulation in vasospastic pain (Abstr.). Pain 1990;5:76.

• Percutaneous biopsies: With special waters biopsies of tumor lesions are taken in different parts of the body. The imaging methods that allow guiding the procedure (ultrasound, tomography, mammography), accompany the path of the needle, making the procedure safer and with reliable results.
  • Górriz E, Reyes R, Pulido-Duque JM, Rubio P, San Román JLG, Maynar M. Transjugular hepatic biopsy with coaxial 18 G needle (Abstr.). Cardiovascular and Interventional Radiology 1994;17(2):93.

VASCULAR PROCEDURES

• Central line placement: Guided by ultrasound and under local anesthesia, a catheter is placed through the large caliber vein in the neck that allows the administration of medications, transfusions, parenteral feeding or taking laboratory tests, avoiding the need for multiple punctures in the veins of the extremities.
  • Carreira JM, Pulido-Duque JM, Argilés JM, Pardo MD, Górriz E, Reyes R, Maynar M. Colocación percutánea y seguimiento de catéteres venosos centrales. Nuestra experiencia. XXIII Congreso Nacional de la Sociedad Española de Radiología Médica. Palma de Mallorca (Spain). 18-22 May 1996.
    
• Placement of PICC (Peripherally Inserted Central Catheter): Under local anesthesia, a catheter is placed through a vein in the arm, which reaches a large-caliber vein in the chest, allowing the administration of medications, transfusions, parenteral feeding or taking laboratory tests, avoiding the need for multiple punctures in veins. of the extremities.
  • Catéteres centrales para perfusión de drogas. 43 Congreso Argentino de Radiología. Diagnóstico por Imágenes y Terapia Radiante. Buenos Aires (Argentina), 26-29 October 1997.
    
• Reservoir catheter placement: In cases where the administration of chemotherapy is necessary, the placement of a device that is located under the skin in the pectoral region is required, by which it can be easily administered. The device is long-lasting until the completion of your cancer treatment. It is placed under local anesthesia, on an outpatient basis.
  • De Gregorio MA, Miguelena JM, Encarnación C, Maynar M, Fernández JA, Alfonso ER, Pulido JM. Reservorios subcutáneos. Un eficaz y seguro procedimiento de acceso a vías centrales en la sala de Radiología. Radiología 1993;35(6):409-413.
    
• Extrinsic compression vascular stent: Compression of tumor lesions on vascular structures can end up reducing blood flow. Using a minimally invasive technique, guided by X-rays and under local anesthesia, stents are placed within the lumen of the blood vessels to prevent their obstruction from progressing.
  • Irving JD, Robert F. Dondelinger, John F. Reidy, Hans Schild, Dick R, Adam A, Maynar M, Zollikofer CL. Gianturco self-expanding stents: clinical experience in the vena cava and large veins. Cardiovasc Intervent Radiol. 1992 Sep-Oct;15(5):328-333.

• Vascular angioplasty: Different pathologies can condition narrowing of the vascular structures (arterial and venous), reducing blood flow. By means of a minimally invasive technique and by inflating special balloons inside the vascular lumen, its caliber is restored, restoring blood flow and improving the perfusion of the organs that it irrigates..
  • Maynar M, Rodríguez JC, Fernández A, Palop L, Reyes R, Pulido JM. Transluminal angioplasty of transplant renal artery stenosis. Seminars in Interventional Radiology 1988;5(2):161-165.
    
• Vascular drainage (Superior / inferior vena cava syndrome): Tumor lesions located at the level of the thorax can cause an occlusion of the drainage veins in the neck that may require the placement of a minimally invasive drain, which allows temporary relief of symptoms while the cause of obstruction is resolved through treatment surgical / medical.
  • Maynar M, Cabrera J, Pulido Duque JM, Reyes R, Gorriz E, Rostagno R, Castañeda-Zuñiga. Transjugular intrahepatic shunt: Early experience. American Journal of Radiology 1993; 161:301-306
    
• Chemoembolization: It is an alternative complementary treatment for some tumor lesions. Using a minimally invasive X-ray-guided technique, the arteries that feed the tumors are entered in order to deliver chemotherapy directly to the lesion and embolize / occlude the arteries that feed it, helping to reduce its size.
  • Interventional cardiovascular techniques in small animal practice-embolotherapy and chemoembolization. J Am Vet Med Assoc. 2005 Aug 1;227(3):402-9. Editor: Amer Veterinary Medical Assoc. ISSN: 0003-1488.
    
• Radioembolization: It is an alternative complementary treatment for some tumor lesions. Using a minimally invasive X-ray-guided technique, the arteries that feed the tumors are entered in order to deliver radioactive particles directly into the lesion to attack the tumor cells and embolize / occlude the arteries that feed it, helping to narrow its size.
  • Interventional cardiovascular techniques in small animal practice-embolotherapy and chemoembolization. J Am Vet Med Assoc. 2005 Aug 1;227(3):402-9. Editor: Amer Veterinary Medical Assoc. ISSN: 0003-1488.
    
• Pre-surgical embolization of tumors: Some tumor lesions present marked vascularization, which represents a risk of bleeding during surgery. Pre-surgical tumor embolization consists of embolizing / occluding the arteries that nourish the tumor and thus prevent bleeding during the surgical intervention..
  • Maynar M, Martínez F, Saenz J, Romero T, Camaño T, Gragera F, Falcon D. Therapeutic embolization with absolute ethanol in renal tumors. Annual Postgraduate Course and Joint Meeting of the European Society of Cardiovascular and Interventional Radiology and the European College of Angiography. Viena (Austria), 22-27 April 1985.

• Treatment of tumor bleeding: In certain conditions, tumors can present bleeding that, if left untreated, can have catastrophic consequences. Using a minimally invasive technique, it is possible to reach the interior of these lesions and embolize their blood vessels using special materials, thus managing to control bleeding and avoid its complications.
  • Górriz E, Carreira JM, Reyes R, Vicente JM, Pulido-Duque JM, Romero A, Maynar M. Transcatheter embolization of symptomatic hepatic venous malformations. Eur Radiol. 1998;8(8):1416-1419.

• Vena Cava Filter placement: A Vena Cava filter is a small device that is used in such cases to prevent a pulmonary embolism. In local anesthesia, a main vein in the neck or groin is punctured to access the inferior vena cava (main vein that drains most of the lower extremities). The device is permanently inserted into the vein, but can be removed at your oncologist’s request. The procedure can be performed on an outpatient basis.
  • Maynar  M,  Segarra  A,  Pulido-Duque  JM,  Reyes  R,  Cabrera  P,  Górriz  E. Interrupción  percutánea  de  la  vena  cava  inferior.  En:  Jareño  A,  Cercas  A,  editores.  Embolismo  pulmonar  agudo:  Progresos  y  problemas.  Barcelona: Hoechst Ibérica; 1992. p.110-120.

• Venous Fibrinolysis: Venous thromboembolism in the setting of a paraneoplastic syndrome is a frequent complication in cancer patients. Intravenous fibrinolysis is catheter-directed thrombolysis that treats vascular blockages and improves blood flow by dissolving abnormal blood clots. To dissolve clots in the venous system a catheter is inserted under local anesthesia through a vein in the groin, arm, or behind the knee. A thrombolytic drug is administered through this catheter overnight to dissolve the clots until the vein recovers its natural blood flow.
  • Marini M, López-Fernández MF, Llerena J, Rodríguez E, Maynar M, Castañeda-Zúñiga  W.  Fibrinolytic  treatment  in  acute  venous  thrombosis.  En:  Castañeda-Zúñiga  W,  Tadavarthy  SM,  Qian  Z,  Ferral  H,  Maynar  M,  editors.  Interventional  Radiology.  3rd ed.  Baltimore:  Williams  &  Wilkins; 1997. p. 815-830.