title: Efficacy and safety of PAIR for cystic echinococcosis: experience on a large series of patients from Bulgaria.
abstract: We report our experience with puncture, aspiration, injection, and reaspiration (PAIR) for the treatment of cystic echinococcosis in Bulgaria. PAIR was performed in 230 patients with 348 echinococcal cysts. At 12-month follow-up, 77.6% of the cysts, all cystic echinococcosis (CE) 1 and CE3a cysts according to the World Health Organization Informal Working Group classification, showed various degrees of obliteration. In 11.5% of cysts, all of which were > 10 cm-type CE1, a significant amount of fluid persisted, and they were punctured again. Of those, 16 (4.6%) contained protoscolices and were treated by a second PAIR. The remaining 24 (6.9%) cysts were treated by simple aspiration or drainage. No significant reduction in size and no changes in the structure were observed in 10.9% of cysts, all of which were classified as CE2 or CE3b. Complications developed in 25.2% of patients, including severe anaphylactic reaction in two (0.9%) patients. Our experience confirms that PAIR is a successful first-choice treatment when a stage-specific approach is taken.
authors.affiliation: Clinical Center of Gastroenterology, University Hospital Queen Joanna-Institute for Specialization and Improvement of Medical Doctors, Sofia, Bulgaria. bgolemanov@yahoo.com
authors.forename: Branimir
authors.initials: B
authors.lastname: Golemanov
authors.forename: Nikola
authors.initials: N
authors.lastname: Grigorov
authors.forename: Rumiana
authors.initials: R
authors.lastname: Mitova
authors.forename: Jordan
authors.initials: J
authors.lastname: Genov
authors.forename: Dimitar
authors.initials: D
authors.lastname: Vuchev
authors.forename: Francesca
authors.initials: F
authors.lastname: Tamarozzi
authors.forename: Enrico
authors.initials: E
authors.lastname: Brunetti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000871:Anthelmintics / Q000627:therapeutic use; D002031:Bulgaria / Q000453:epidemiology; D004443:Echinococcosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy*; D000431:Ethanol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use; D013396:Suction; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D012462:Saline Solution, Hypertonic; D000431:Ethanol