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The Treatment of Hyperparathyroidism by Transcatheter Techniques

  • John L. Doppman
  • Chiu-an Wang

Abstract

Gelfoam embolization of parathyroid adenomas causes temporary remission of hypercalcemia, but collateral circulation revascularizes the gland. Embolization with silicone permanently infarcts the gland, but is associated with all the risks of capillary bed occlusion. The staining of parathyroid adenomas with contrast material avoids the risks of particulate embolization and appears to produce permanent ablation. We carried out embolization or staining procedures in 14 parathyroid adenomas. In three of the four cases in which Gelfoam embolization was performed, hypercalcemia recurred within six months to two years; in the fourth case, in which persistent normocalcemia has been found, intense staining had been demonstrated before embolization. In eight of the remaining 10 cases, adequate staining was achieved, and normocalcemia has been maintained in all up to 36 months.

Key words

Gelfoam Embolism, therapeutic Adenoma Parathyroid, neoplasms Catheters and catheterization Interventional radiology 

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References

  1. 1.
    Doppman, J.L., Marx, S.J., Brennan, M., Beazley, R.M., Geel-hoed, G., Aurbach, G.D.: The blood supply of mediastinal parathyroid adenomas. Ann. Surg. 185: 488–490, 1977PubMedCrossRefGoogle Scholar
  2. 2.
    Doppman, J.L., Marx, S.J., Spiegel, A.M., Mallette, L.E., Wolfe, B.A., Aurbach, G.D.: Treatment of hyperparathyroidism by percutaneous embolization of a mediastinal adenoma. Radiology 115: 37–42, 1975PubMedGoogle Scholar
  3. 3.
    Doppman, J.L., Brown, E.M., Brennan, M.F., Spiegel, A., Marx, S.J., Aurbach, G.D.: Angiographic ablation of parathyroid adenomas. Radiology 130: 577–582, 1979PubMedGoogle Scholar
  4. 4.
    Doppman, J.L., Zapol, W., Pierce, J.: Transcatheter embolization with a silicone rubber preparation: Experimental observations. Invest. Radiol. 6: 304–309, 1971PubMedCrossRefGoogle Scholar
  5. 5.
    Doppman, J.L., Di Chiro, G.: Paraspinal muscle infarction: A painful complication of lumbar artery embolization associated with pathognomic radiographic and laboratory findings. Radiology 119: 609–613, 1976PubMedGoogle Scholar
  6. 6.
    Doppman, J.L., Brennan, M.F., Koehler, J.L., Marx, S.J.: CT scanning for parathyroid localization. J. Comput. Assist. To-mogr. 1: 30–36, 1977CrossRefGoogle Scholar
  7. 7.
    Shimkin, P.M., Doppman, J.L., Powell, D., Marx, S.J., Ket-cham, A.S.: Demonstration of parathyroid adenomas by retrograde thyroid venography. Radiology 103: 63–67, 1972PubMedGoogle Scholar
  8. 8.
    Doppman, J.L.: Parathyroid localization arteriography and venous sampling. Radiol. Clin. North Am. 14: 163–188, 1976PubMedGoogle Scholar
  9. 9.
    Brennan, M.F., Brown, E.M., Marx, S.J., Spiegel, A.M., Broa-dus, A.E., Doppman, J.L., Weber, B., Aurbach, G.D.: Recurrent hyperparathyroidism from an autotransplanted parathyroid adenoma. N. Engl. J. Med. 299: 1057–1059, 1978PubMedCrossRefGoogle Scholar
  10. 10.
    Spigos, D.G., Jonasson, O., Mozes, M., Capek, V.: Partial splenic embolization in the treatment of hypersplenism. Am. J. Roentgenol. 132: 777–782, 1979Google Scholar
  11. 11.
    Lunderquist, A.: Splenic embolization. Presented at 4th Annual Meeting of Society of Cardiovascular Radiology, Dorado Beach, Puerto Rico, 1979Google Scholar

References

  1. 1.
    Wang, C.: The anatomic basis of parathyroid surgery. Ann. Surg. 183: 271–275, 1976PubMedCrossRefGoogle Scholar
  2. 2.
    Wang, C, Cope, O.: The parathyroid glands. In: Management of the Patient with Cancer, 2nd ed., edited by T.F. Nealon. Philadelphia, W.B. Saunders, 1976, pp. 256–264Google Scholar
  3. 1.
    Athanasoulis, C.A.: Translumbar aortography revisited (letter). Am. J. Roentgenol. 133: 562–563, 1979Google Scholar
  4. 1.
    Wang, C., Guyton, S.W.: Hyperparathyroid crisis. Ann. Surg. 190: 782, 1979PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1981

Authors and Affiliations

  • John L. Doppman
    • 1
  • Chiu-an Wang
    • 1
  1. 1.Department of Diagnostic RadiologyThe Clinical Center, National Institutes of HealthBethesdaUSA

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