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Wrong Martins Pisco?

Martins Pisco

Director of Interventional Radiology

Saint Louis Hospital

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Email: m***@***.it


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Saint Louis Hospital

110 W James Dr St

Kenner, Louisiana,70062

United States

Background Information

Employment History

Professor At the Faculty of Medical Sciences

New University of Lisbon , Portugal

Web References(29 Total References)

Rock-a-bye Baby - Fibroids1.com

fibroids1.com [cached]

"This study is significant because it shows comparable fertility rates between the two primary uterussparing treatments widely available to treat fibroids: uterine fibroid embolization (UFE) and surgical myomectomy, which is considered the gold standard for symptomatic fibroids in women who wish to conceive," said João Martins Pisco, M.D., an interventional radiologist at St. Louis Hospital in Lisbon, Portugal.
"These results are surprising because other studies have favored surgical myomectomy over UFE for women who want to conceive. In this study of 743 women, UFE had a fertility rate of 58.1 percent, which is comparable to surgical fibroid removal (myomectomy), which has a fertility rate of 57 percent," noted Pisco. "Our study proves that UFE not only allows women who were unable to conceive to become pregnant but also allows them to have normal pregnancies with similar complication rates as the general population in spite of being a high risk group," he added. "In the future, UFE will probably be a first-line treatment option even for women who wish to conceive and are unable due to the presence uterine fibroids," he noted. Uterine fibroids are benign tumors in the uterus that can cause prolonged, heavy menstrual bleeding that can be severe enough to cause anemia or require transfusion, disabling pelvic pain and pressure, urinary frequency, pain during intercourse, miscarriage, interference with fertility and an abnormally large uterus resembling pregnancy. Twenty to 40 percent of American women 35 and older have uterine fibroids, and nearly 50 percent of premenopausal African American women have fibroids of a significant size. An increasing number of women are delaying pregnancy until their late thirties, which is also the most likely time for fibroids to develop, said Pisco. There is conflicting evidence in the medical literature regarding the impact of fibroids on pregnancy; however, the risk and type of complication appear to be related to the size, number and location. Women may not know they have fibroids (asymptomatic) and undergo in vitro fertilization treatments-rather than getting treatment for fibroids. "We want women to know that uterine fibroids may be a cause of infertility, that their treatment is mandatory and that UFE may be the only effective treatment for some women," said Pisco. The complication rate of the pregnancies was expected to be higher than the general population because these were high-risk patients who had already undergone fertility treatments and were unable to conceive," said Pisco. "However, the percentage of the spontaneous abortions (11.1 percent), preterm delivery (10.0 percent) and low birth weight (13.3 percent) was the same as the general population," he stated. This was a small retrospective study based on patients being treated for fibroids by UFE in a single institution, said Pisco. He said that larger, multicentered, randomized prospective studies are needed comparing UFE and myomectomy.

2012 Society of Interventional Radiology

haimovitchmedtech.com [cached]

Indeed, in a study of 152 patients presented during a session here on embolization techniques and procedures, Joao Martins Pisco, MD, director of interventional radiology at St. Louis Hospital (Lisbon, Portugal) reported "clinical success" for 83% of the patients who had a one-year follow-up.
Pisco noted that in patients with symptomatic BPH and failed drug therapy, "PAE appears safe and provides good short and medium term results."

Successful Pregnancies Seen After Uterine Fibroid Embolization - Pregnancy

www.centersite.net [cached]

UFE could become the first-line treatment for women with fibroids who want to get pregnant, particularly for those with numerous or very large fibroids, study author Joao Pisco, M.D., Ph.D., director of interventional radiology at the Saint Louis Hospital in Libson, Portugal, told HealthDay.
With a fibroid recurrence rate of more than 60 percent among these women, UFE might be an important option, Pisco said.


In one study, Joao Martins Pisco, M.D., of St. Louis Hospital in Lisbon, Portugal, and colleagues performed prostate artery embolization (PAE) on 1,000 men.
The investigators evaluated all patients over the short term (one, three, and six months), 807 patients over the medium term (every six months between six months and three years), and 406 patients over the long term (every year after three years). "We found that, over the short term, 89 percent of patients were better. For the medium term, we found that 82 percent of patients improved, and over the long term, 78 percent were better," Pisco said. The investigators did another analysis of 112 patients who also suffered acute urinary retention before undergoing PAE and found that 94.6 percent of these patients had their catheter removed between two and 90 days after treatment. Over longer-term follow-up, over 75 percent had no recurrence of their acute urinary retention symptoms. "There are a number of complications tied to open surgery as compared to PAE, including incontinence, impotence, and other ailments, which are less likely with PAE. I strongly believe in four to five years, this will be standard treatment for benign prostatic hyperplasia," Pisco said.

Endovascular Today - Long-Term Data Presented for Prostatic Artery Embolization to Treat BPH

evtoday.com [cached]

The study investigators, led by João Martins Pisco, MD, also found that PAE is especially effective in men with BPH who also have acute urinary retention or the inability to voluntarily urinate and in patients with very large prostates who are normally treated with open surgery.
In the SIR announcement, Dr. Pisco, who is an interventional radiologist at St. Louis Hospital in Lisbon, Portugal, stated, "Our results demonstrate that this minimally invasive treatment is successful in the long term and should always be presented to patients who are exploring options to resolve their BPH." Dr. Pisco continued, "PAE gives men with BPH a treatment option that is less invasive than other therapies and allows them to return to their normal lives sooner. Time and time again, I see patients who are relieved to find out about PAE because they are not able to tolerate medications for BPH due to their side effects. These men also don't want traditional surgery because it involves greater risks, has possible sexual side effects, and has a recovery time that is relatively long compared to PAE, which is generally performed under local anesthesia and on an outpatient basis." As summarized by SIR, Dr. Pisco and colleagues performed PAE on 1,000 men between March 2007 and March 2016. Dr. Pisco advised that although the study demonstrated that PAE was highly successful, the treatment may not be appropriate for all patients, such as those with advanced arterial atherosclerosis that may be caused by smoking or diabetes. He also noted that investigators are now conducting a study comparing the effectiveness of PAE with a sham treatment to address any possible placebo effect that may have occurred during the study with these 1,000 patients.

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