scholarly journals Improvement in Quality of Life and Decrease in Large‐Volume Paracentesis Requirements With the Automated Low‐Flow Ascites Pump

2020 ◽  
Vol 26 (5) ◽  
pp. 651-661 ◽  
Author(s):  
Florence Wong ◽  
Emily Bendel ◽  
Kenneth Sniderman ◽  
Todd Frederick ◽  
Ziv J. Haskal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Large Volume ◽  
Low Flow ◽  
Large Volume Paracentesis ◽  
Automated Low Flow

Automated low flow ascites (ALFA) pump effectively reduces the number of large volume paracentesis - data from a real world cohort

2020 ◽  
Vol 73 ◽  
pp. S687-S688
Author(s):  
Adam Herber ◽  
Cornelius Engelmann ◽  
Niklas Aehling ◽  
Rhea Veelken ◽  
Dr. Sebastian Rademacher ◽  
...  
Keyword(s):  
Large Volume ◽  
Real World ◽  
Low Flow ◽  
Large Volume Paracentesis ◽  
Automated Low Flow

Quality of life and clinical results after endovascular sclerotherapy: A comparison between intra- and extramuscular low-flow venous malformations

2020 ◽  
pp. 026835552096292
Author(s):  
Annamaria Weitz-Tuoretmaa ◽  
Leo Keski-Nisula ◽  
Riitta Rautio ◽  
Jussi Laranne
Keyword(s):  
Quality Of Life ◽  
Clinical Results ◽  
Post Treatment ◽  
Low Flow ◽  
Subjective Symptoms ◽  
Venous Malformations ◽  
University Hospitals ◽  
Mri Findings ◽  
Mri Scans

Background Based on clinical observations we hypothesized that patients with intramuscular venous malformations (VMs) did worse or needed more sclerotherapy sessions than patients with extramuscular VMs. Purpose To evaluate the difference in treatment and quality of life (QOL) results after Polidocanol sclerotherapy of intra- and extramuscular low-flow VMs. Material and methods Forty-one patients with a VM were treated with Polidocanol in two university hospitals. The results were retrospectively analyzed. Pre- and post-treatment magnetic resonance imaging (MRI) scans were compared. All patients completed a self-evaluating form on symptoms as well as a QOL questionnaire. The results were compared between two groups: intra- and extramuscular VM’s. Results No statistically significant differences between intra- and extramuscular groups concerning QOL and specific dimensions pain, functional problems or cosmetic appearance were found. Radiological changes in MRI examinations did not correlate with any of the subjective symptoms. 56% of the patients benefitted from the treatment according to patient self-evaluation. Conclusion In this material intramuscular VM’s responded to the treatment comparably to extramuscular malformations. Post-treatment MRI findings do not correlate with subjective symptoms or QOL results and thus, a routine post-treatment examination seems to be unwarranted. Subjective symptoms and QOL results are the most important parameters in evaluating the effectiveness of sclerotherapy.

Quality of life after endovascular sclerotherapy of low-flow venous malformations: the efficacy of polidocanol compared with ethanol

2017 ◽  
Vol 59 (8) ◽  
pp. 946-952 ◽  
Author(s):  
Annamaria Weitz-Tuoretmaa ◽  
Leo Keski-Nisula ◽  
Riitta Rautio ◽  
Jussi Laranne
Keyword(s):  
Quality Of Life ◽  
Venous Malformation ◽  
Post Treatment ◽  
Low Flow ◽  
Venous Malformations ◽  
Limited Information ◽  
Ethanol Group ◽  
Clinical Complications ◽  
Ethanol Sclerotherapy

Background Limited information is available on mid-term results and quality of life (QOL) after endovascular sclerotherapy of venous malformations. Purpose To compare two agents—polidocanol and ethanol—with a focus on the influence on QOL after sclerotherapy. Material and Methods Forty-one consecutive patients with a venous malformation in the head and neck area or in the extremities were treated with polidocanol between 2008 and 2013. Pre- and post-treatment magnetic resonance imaging (MRI) scans were compared. All patients completed a self-evaluation form on symptoms as well as a QOL questionnaire. The results were compared with previously obtained material during 1991–2001, comprising 44 consecutive, similarly located venous malformation patients subject to ethanol sclerotherapy. Results No significant clinical complications were observed. Subjectively, 19 (46%) of the patients benefitted from the treatment. QOL results showed that 85% of patients had an index < 39 – where 0 represents the highest and 100 the lowest QOL. Patients in the ethanol group had marginally better overall post-treatment QOL results. Post-treatment MRI in 35 patients showed the size of the malformation unchanged in 19 (54%) patients, in ten (29%) there was a decrease (<50%) while in six (17%) the decrease was more significant (>50%). Post-treatment MRI results did not correlate with either subjective symptoms or QOL results. Conclusion Polidocanol sclerotherapy were found to be an effective, safe, and well tolerated treatment option for low flow venous malformations. Routine MRI for follow-up appears redundant and may be omitted.

scholarly journals Automated low-flow ascites pump for the treatment of cirrhotic patients with refractory ascites

2017 ◽  
Vol 10 (2) ◽  
pp. 283-292 ◽  
Author(s):  
Guido Stirnimann ◽  
Vanessa Banz ◽  
Federico Storni ◽  
Andrea De Gottardi
Keyword(s):  
Low Flow ◽  
Refractory Ascites ◽  
Organ Shortage ◽  
Efficacy And Safety ◽  
Novel Treatments ◽  
Intrahepatic Portosystemic Shunt ◽  
Cirrhotic Patients ◽  
Large Volume Paracentesis ◽  
Volume Controlled ◽  
Automated Low Flow

Cirrhotic patients with refractory ascites (RA) can be treated with repeated large volume paracentesis (LVP), with the insertion of a transjugular intrahepatic portosystemic shunt (TIPS) or with liver transplantation. However, side effects and complications of these therapeutic options, as well as organ shortage, warrant the development of novel treatments. The automated low-flow ascites pump (alfapump®) is a subcutaneously-implanted novel battery-driven device that pumps ascitic fluid from the peritoneal cavity into the urinary bladder. Ascites can therefore be aspirated in a time- and volume-controlled mode and evacuated by urination. Here we review the currently available data about patient selection, efficacy and safety of the alfapump and provide recommendations for the management of patients treated with this new method.

scholarly journals Continuous low flow ascites drainage through the urinary bladder via the Alfapump system in palliative patients with malignant ascites

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Christina Fotopoulou ◽  
Thomas Berg ◽  
Annekristin Hausen ◽  
René Hennig ◽  
Rajiv Jalan ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Primary Tumour ◽  
Wound Dehiscence ◽  
Malignant Ascites ◽  
Median Number ◽  
Low Flow ◽  
Day Range ◽  
Large Volume Paracentesis ◽  
Post Implantation

Abstract Background Malignant Ascites (MA) is a therapeutic dilemma significantly impairing patients’ quality of life (QoL). The Sequana Medical alfapump System (AP), a subcutaneous, externally rechargeable, implantable device, continually draining ascites via the urinary bladder, has been well established in liver cirrhosis, but not yet in MA. The AP-system was evaluated in cancer patients in reducing the need for large volume paracentesis (LVP). Methods A retrospective multicentre evaluation of all eligible patients who received an AP for MA-palliation was performed. AP was evaluated for its ability to reduce LVP and cross-correlated with adverse events (AE), survival and retrospective physician-reported QoL. Results Seventeen patients with median age of 63 years (range: 18–81), 70.6% female, across 7 primary tumour types were analysed. Median duration of AP-implantation was 60 min (range: 30–270) and median post-implantation hospital stay: 4 days (range: 2–24). Twelve protocol-defined AE occurred in 5 patients (29.4%): 4 kidney failures, 4 pump/catheter-related blockages, 3 infections/peritonitis and 1 wound dehiscence. Median ascitic volume (AV) pumped daily was 303.6 ml/day (range:5.6–989.3) and median total AV drained was 28 L (range: 1–638.6). Median patient post-AP-survival was 111 days (range:10–715) and median pump survival was 89 days (range: 0–715). Median number of paracenteses was 4 (range: 1–15) per patient pre-implant versus 1 (range: 0–1) post-implant (p = 0.005). 71% of patients were reported to have an improvement of at least one physician reported QoL-parameters. Conclusions AP appears to be effective in palliating patients with MA by an acceptable morbidity profile. Its broader implementation in oncology services should be further explored. Trial registration NCT03200106; June 27, 2017.

Sign in / Sign up

Export Citation Format

Share Document