A new procedure for the treatment of colorectal neoplastic obstructions is described. This procedure involves the following phases: 1) placing a stent at the point of the stenosis of the colon, which enables the acute obstruction phase to be overcome; 2) recovering the general state of the patient, analyzing the development of the disease, and mechanically preparing the colon; 3) performing regulated and final surgery. In two patients, these three phases have been completed without complication and with excellent results. This procedure is both safe and effective and could become the method of choice for the treatment of colorectal neoplastic obstructions.

To evaluate the usefulness of stent implantation as a palliative treatment in patients with acute colonic obstruction who are not surgical candidates. Twenty-four patients (eight women, 16 men; age range, 60-98 years) with acute colonic obstruction underwent colonic stent placement. In nine patients, the procedure was considered a primary palliative treatment; seven patients had a previous diagnosis of disseminated neoplastic disease, and two were not surgical candidates because of their poor general condition. In the remaining 15 patients, stent placement was considered the definitive palliative treatment after tumor staging. The mean time of follow-up was 8.4 months (range, 1-24 months) for patients who lived and 6.3 months (range, 1-12 months) for those who died. Stent placement was successful in all patients. Clinical and radiographic findings of bowel obstruction resolved within 24 hours after stent placement in 23 (96%) patients. None of the patients required colostomy for bowel decompression after immediate stent placement. Complications developed in 10 (42%) patients: Two (8%) patients had mild rectal bleeding; three (12%), abdominal pain; two (8%), malpositioning of the stent; two (8%), pseudo-obstructive episodes due to fecal impaction; and one (4%), occlusive tumor ingrowth into the stent lumen. One (4%) patient underwent surgery to resolve stent malfunction due to poor positioning. Two (8.3%) patients--one with malpositioning of the prosthesis and the other with stent occlusion--required a new stent. The remaining complications required no further treatment. The mortality rate at 6 months was 24%. Eight patients were alive at the time this article was written. Colorectal stent placement resulted in successful palliation of acute colonic obstruction in patients with disseminated neoplastic disease.

To compare safety and efficacy of vascular plugs (VPs) and fibered platinum coils (FPCs) for embolization in pelvic congestion syndrome (PCS). A randomized, prospective, single-center study enrolled 100 women with PCS from January 2014 to January 2015. Patients were randomly assigned to 2 groups, and embolization was performed with FPCs (n = 50) or VPs (n = 50). Mean age of patients was 42.7 years ± 7.60, and mean visual analog scale (VAS) score for pelvic pain before treatment was 7.4 ± 7.60. Primary outcome (clinical success at 1 y using a VAS), number of devices, procedure and fluoroscopy times, radiation doses, costs, and complications were compared, and participants were followed at 1, 3, 6, and 12 months. Clinical success and subjective improvement were not significantly different at 1-year follow-up (89.7% for FPCs vs 90.6% for VPs; P = .760). Mean number of devices per case was 18.2 ± 1.33 for FPCs and 4.1 ± 0.31 for VPs (P < .001). Three FPCs and 1 VP migrated to pulmonary vasculature approximately 3-6 months after the embolization procedure; all were retrieved without complications. The FPC group had a significantly longer fluoroscopy time (33.4 min ± 4.68 vs 19.5 min ± 6.14) and larger radiation dose (air kerma 948.0 mGy ± 248.45 vs 320.7 mGy ± 134.33) (all P < .001). Embolization for PCS resulted in pain relief in 90% of patients; clinical success was not affected by embolic device. VPs were associated with decreased fluoroscopy time and radiation dose.