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Scientific Studies Comparing Angiograms With Ultrasound Diagnosis

Ultrasound & Heart Disease

Search Results

 

Results for your query on July 29, 2000
Search all fields for: ultrasound And angiogram
Published in 1966 through 1999
Only select references with abstracts available
Show references published in English only
Show references pertaining to humans
Documents: 1 to 98 of 98
1  

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Holder LE, et al; Current status of radionuclide scrotal imaging. (Semin Nucl Med, 1981 Oct, Abstract available) [MEDLINE]

2 Spes CH, et al; Functional and morphological findings in heart transplant recipients with a normal coronary angiogram: an analysis by dobutamine stress echocardiography, intracoronary Doppler and intravascular ultrasound. (J Heart Lung Transplant, 1999 May, Abstract available) [MEDLINE]
3 Powers TA, et al; Pseudoaneurysm of the profunda femoris artery diagnosed on angiographic phase of bone scan. (Clin Nucl Med, 1979 Oct, Abstract available) [MEDLINE]
4 Harris V, et al; Choledochal cyst with cholelithiasis: 15-yr follow-up. (J Pediatr Surg, 1979 Apr, Abstract available) [MEDLINE]
5 Cho KJ, et al; Angiographic assessment of pancreatic pseudocyst: a reappraisal. (J Can Assoc Radiol, 1976 Sep, Abstract available) [MEDLINE]
6 Suwanwela NC, et al; Takayasu arteritis: ultrasonographic evaluation of the cervico-cerebral arteries. (Int J Cardiol, 1998 Oct, Abstract available) [MEDLINE]
7 Bloom RA, et al; Simultaneous sonographic demonstration of tumor thrombus in the inferior vena cava and patient main renal vein in renal carcinoma. (J Urol, 1983 Aug, Abstract available) [MEDLINE]
8 Burns PN, et al; Ultrasonic Doppler studies of the breast. (Ultrasound Med Biol, 1982, Abstract available) [MEDLINE]
9 Corr P, et al; Colour-flow ultrasound in the detection of penetrating vascular injuries of the neck. (S Afr Med J, 1999 Jun, Abstract available) [MEDLINE]
10 Bachmann R, et al; Dipyridamole scintigraphy and intravascular ultrasound after successful coronary intervention. (J Nucl Med, 1997 Apr, Abstract available) [MEDLINE]

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11 Gao HZ, et al; Relation of donor age and preexisting coronary artery disease on angiography and intracoronary ultrasound to later development of accelerated allograft coronary artery disease. (J Am Coll Cardiol, 1997 Mar, Abstract available) [MEDLINE]
12 Scott PJ, et al; Imaging of pulmonary vascular disease by intravascular ultrasound. (Int J Card Imaging, 1993 Sep, Abstract available) [MEDLINE]
13 Dupouy P, et al; Assessment of coronary vasomotion by intracoronary ultrasound. (Am Heart J, 1993 Jul, Abstract available) [MEDLINE]
14 Rush JA, et al; Doppler sonography in the diagnosis of dural carotidcavernous fistula. (J Clin Neuroophthalmol, 1982 Mar, Abstract available) [MEDLINE]
15 Rao KV, et al; Post transplant acute renal failure: a review. (Clin Exp Dial Apheresis, 1983, Abstract available) [MEDLINE]
16 Baliga KP, et al; Amaurosis fugax: carotid endarterectomy without an angiogram. (J La State Med Soc, 1989 Jul, Abstract available) [MEDLINE]
17 McCarron MJ, et al; Iridocyclitis and an iris mass associated with secondary syphilis. (Ophthalmology, 1984 Oct, Abstract available) [MEDLINE]
18 Van Haeften FF, et al; Post-traumatic intrahepatic arteriovenous fistula. (Injury, 1984 Mar, Abstract available) [MEDLINE]
19 Charnsangavej C, et al; Portal-hepatic venous malformation: ultrasound, computed tomographic, and angiographic findings. (Cardiovasc Intervent Radiol, 1983, Abstract available) [MEDLINE]
20 Roederer GO, et al; Post-endarterectomy carotid ultrasonic duplex scanning concordance with contrast angiography. (Ultrasound Med Biol, 1983 Jan, Abstract available) [MEDLINE]

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21 May J, et al; Endoluminal repair of internal carotid artery aneurysm: a feasible but hazardous procedure. (J Vasc Surg, 1997 Dec, Abstract available) [MEDLINE]
22 Neufang KF, et al; Indications for intravenous and intraarterial digital subtraction angiography (DSA) in the diagnosis of cerebrovascular insufficiency. A new diagnostic concept including ultrasound. (Eur J Radiol, 1985 May, Abstract available) [MEDLINE]
23 Ramaswami G, et al; Peripheral transluminal angioplasty under ultrasound guidance: initial clinical experience and prevalence of lower limb lesions amenable to ultrasound-guided angioplasty. (J Endovasc Surg, 1995 Feb, Abstract available) [MEDLINE]
24 Nakamura S, et al; Focal wall overstretching after high-pressure coronary stent implantation does not influence restenosis. (Catheter Cardiovasc Interv, 1999 Sep, Abstract available) [MEDLINE]
25 Takagi A, et al; Clinical potential of intravascular ultrasound for physiological assessment of coronary stenosis: relationship between quantitative ultrasound tomography and pressure-derived fractional flow reserve. (Circulation, 1999 Jul, Abstract available) [MEDLINE]
26 Pinto FJ; The value of intravascular ultrasound in interventional cardiology. (Rev Port Cardiol, 1999 Feb, Abstract available) [MEDLINE]
27 Chen JC, et al; Can duplex ultrasonography select appropriate patients for carotid endarterectomy? (Eur J Vasc Endovasc Surg, 1997 Dec, Abstract available) [MEDLINE]
28 Heller LI, et al; Intracoronary Doppler assessment of moderate coronary artery disease: comparison with 201Tl imaging and coronary angiography. FACTS Study Group. (Circulation, 1997 Jul, Abstract available) [MEDLINE]
29 Mehra MR, et al; Heterogeneity of cardiac allograft vasculopathy: clinical insights from coronary angioscopy. (J Am Coll Cardiol, 1997 May, Abstract available) [MEDLINE]
30 Fraker DL, et al; Controversies in surgical therapy for APUDomas. (Semin Surg Oncol, 1993 Sep, Abstract available) [MEDLINE]

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31 Gruberg L, et al; Intravascular imaging and physiologic lesion assessment to define critical coronary stenoses. (Ann Thorac Surg, 1999 Oct, Abstract available) [MEDLINE]
32 Graham E, et al; Symptomatic liver hemangioma with intra-tumor hemorrhage treatehd by angiography and embolization during pregnancy. (Obstet Gynecol, 1993 May, Abstract available) [MEDLINE]
33 Gruberg L, et al; Intravascular imaging and physiologic lesion assessment to define critical coronary stenoses. (Ann Thorac Surg, 1999 Oct, Abstract available) [MEDLINE]
34 Lau WY, et al; Spontaneous rupture of hepatic epithelioid haemangio-endothelioma. (Aust N Z J Surg, 1989 Dec, Abstract available) [MEDLINE]
35 Son R, et al; Does use of intravascular ultrasound accelerate arteriopathy in heart transplant recipients? (Am Heart J, 1999 Aug, Abstract available) [MEDLINE]
36 Ludman PF, et al; Incidence and clinical relevance of coronary calcification detected by electron beam computed tomography in heart transplant recipients. (Eur Heart J, 1999 Feb, Abstract available) [MEDLINE]
37 Gupta S, et al; Role of transcutaneous ultrasound in evaluation of graft patency following minimally invasive coronary surgery. (Eur J Cardiothorac Surg, 1998 Oct, Abstract available) [MEDLINE]
38 Moore WS, et al; Recurrent carotid stenosis : results of the asymptomatic carotid atherosclerosis study. (Stroke, 1998 Oct, Abstract available) [MEDLINE]
39 Tsagarakis S, et al; Regionalization of occult pancreatic insulinomas with the arterial stimulation venous sampling (ASVS) technique. (Clin Endocrinol (Oxf), 1997 Dec, Abstract available) [MEDLINE]
40 Tielbeek AV, et al; Evaluation of directional atherectomy studied by intravascular ultrasound in femoropopliteal artery stenosis. (Cardiovasc Intervent Radiol, 1997 Nov, Abstract available) [MEDLINE]

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41 von Birgelen C, et al; Variations of remodeling in response to left main atherosclerosis assessed with intravascular ultrasound in vivo. (Am J Cardiol, 1997 Dec, Abstract available) [MEDLINE]
42 Illig KA, et al; Optimal diagnosis of splenic vein thrombosis: brief clinical report. (Am Surg, 1997 Nov, Abstract available) [MEDLINE]
43 Ninan VT, et al; A comparative study of methods of estimating renal size in normal adults. (Nephrol Dial Transplant, 1990, Abstract available) [MEDLINE]
44 Schmermund A, et al; Coronary artery calcium in acute coronary syndromes: a comparative study of electron-beam computed tomography, coronary angiography, and intracoronary ultrasound in survivors of acute myocardial infarction and unstable angina [see comments] (Circulation, 1997 Sep, Abstract available) [MEDLINE]
45 Young GR, et al; Comparison of magnetic resonance angiography, duplex ultrasound, and digital subtraction angiography in assessment of extracranial internal carotid artery stenosis. (J Neurol Neurosurg Psychiatry, 1994 Dec, Abstract available) [MEDLINE]
46 Peters RJ, et al; In vitro validation of intravascular ultrasound imaging after balloon angioplasty of coronary artery stenoses. (Ultrasound Med Biol, 1996, Abstract available) [MEDLINE]
47 Scott PJ, et al; Imaging of pulmonary vascular disease by intravascular ultrasound. (Int J Card Imaging, 1993 Sep, Abstract available) [MEDLINE]
48 Dupouy P, et al; Assessment of coronary vasomotion by intracoronary ultrasound. (Am Heart J, 1993 Jul, Abstract available) [MEDLINE]
49 Halsey JH; Progressive lacunar infarction with demonstrated patency of the middle cerebral artery. (Stroke, 1986 Sep, Abstract available) [MEDLINE]
50 Jensen RT, et al; Current management of Zollinger-Ellison syndrome. (Drugs, 1986 Aug, Abstract available) [MEDLINE]

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51 Dillon PW, et al; Recombinant tissue plasminogen activator for neonatal and pediatric vascular thrombolytic therapy. (J Pediatr Surg, 1993 Oct, Abstract available) [MEDLINE]
52 Lim TT, et al; Are heart-lung transplant recipients protected from developing transplant coronary artery disease? A case-matched intracoronary ultrasound study. (Circulation, 1996 Oct, Abstract available) [MEDLINE]
53 Bodner G, et al; Aneurysmal portosystemic venous shunt: a case report. (Ultraschall Med, 1999 Oct, Abstract available) [MEDLINE]
54 Chemarin Alibelli MJ, et al; Identification of coronary thrombus after myocardial infarction by intracoronary ultrasound compared with histology of tissues sampled by atherectomy. (Am J Cardiol, 1996 Feb, Abstract available) [MEDLINE]
55 Rautenberg W, et al; Stroke and dolichoectatic intracranial arteries. (Neurol Res, 1992, Abstract available) [MEDLINE]
56 Guan R, et al; Evidence of viral replication in HBsAg positive patients with hepatocellular carcinoma: measurement of serum hepatitis B virus deoxyribonucleic acid (HBV-DNA). (Ann Acad Med Singapore, 1989 Jan, Abstract available) [MEDLINE]
57 Takeuchi T, et al; Aneurysm in the horizontal segment of the anterior cerebral artery confirmed by cerebral vasospasm--case report. (Neurol Med Chir (Tokyo), 1991 May, Abstract available) [MEDLINE]
58 Nicholls SC, et al; Diagnostic significance of flow separation in the carotid bulb. (Stroke, 1989 Feb, Abstract available) [MEDLINE]
59 Takeda H, et al; Functional evaluation of telemedicine with super high definition images and B-ISDN. (Medinfo, 1998, Abstract available) [MEDLINE]
60 Karak PK, et al; Hepatocellular carcinoma--image morphology in 40 patients. (Trop Gastroenterol, 1992 Jan, Abstract available) [MEDLINE]

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61 Chang YJ, et al; Detection of carotid stenosis. From NASCET results to clinical practice. (Stroke, 1995 Aug, Abstract available) [MEDLINE]
62 Eugene JR, et al; Carotid occlusive disease: primary care of patients with or without symptoms. (Geriatrics, 1999 May, Abstract available) [MEDLINE]
63 Egermayer P, et al; Usefulness of D-dimer, blood gas, and respiratory rate measurements for excluding pulmonary embolism [see comments] (Thorax, 1998 Oct, Abstract available) [MEDLINE]
64 Bingzhen C, et al; Side-to-side differences of the common carotid artery diameter in presence of asymmetry of the circle of Willis or different vasculopathies. (Eur J Ultrasound, 1998 Dec, Abstract available) [MEDLINE]
65 Ganger DR, et al; Transjugular intrahepatic portosystemic shunt (TIPS) for Budd-Chiari syndrome or portal vein thrombosis: review of indications and problems [see comments] (Am J Gastroenterol, 1999 Mar, Abstract available) [MEDLINE]
66 Kupari M, et al; Exclusion of coronary artery disease by exercise thallium-201 tomography in patients with aortic valve stenosis. (Am J Cardiol, 1992 Sep, Abstract available) [MEDLINE]
67 Margarit C, et al; Liver transplantation in patients with splenorenal shunts: intraoperative flow measurements to indicate shunt occlusion. (Liver Transpl Surg, 1999 Jan, Abstract available) [MEDLINE]
68 Sillesen H, et al; Doppler examination of the periorbital arteries adds valuable hemodynamic information in carotid artery disease. (Ultrasound Med Biol, 1987 Apr, Abstract available) [MEDLINE]
69 Beveridge CJ, et al; Aortoiliac aneurysm with arteriocaval fistula treated by a bifurcated endovascular stent-graft. (Cardiovasc Intervent Radiol, 1998 May, Abstract available) [MEDLINE]
70 Roy LF, et al; Irreversible renal failure associated with triamterene. (Am J Nephrol, 1991, Abstract available) [MEDLINE]

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71 Geroulakos G, et al; The carotid intima-media thickness as a marker of the presence of severe symptomatic coronary artery disease. (Eur Heart J, 1994 Jun, Abstract available) [MEDLINE]
72 Lee BK, et al; Computed numerical analysis of the biomechanical effects on coronary atherogenesis using human hemodynamic and dimensional variables. (Yonsei Med J, 1998 Apr, Abstract available) [MEDLINE]
73 Windecker S, et al; Interventional cardiology in Europe 1994. Working Group Coronary Circulation of the European Society of Cardiology [see comments] (Eur Heart J, 1998 Jan, Abstract available) [MEDLINE]
74 Egermayer P, et al; Compliance with guidelines for the investigation and management of patients with suspected pulmonary embolism at Christchurch Hospital. (N Z Med J, 1998 Mar, Abstract available) [MEDLINE]
75 Contencin P, et al; Non-endoscopic techniques for the evaluation of the pediatric airway. (Int J Pediatr Otorhinolaryngol, 1997 Sep, Abstract available) [MEDLINE]
76 Nakada SY, et al; Retrospective analysis of the effect of crossing vessels on successful retrograde endopyelotomy outcomes using spiral computerized tomography angiography. (J Urol, 1998 Jan, Abstract available) [MEDLINE]
77 Petti GH Jr; Hyperparathyroidism. (Otolaryngol Clin North Am, 1990 Apr, Abstract available) [MEDLINE]
78 DAlotto C, et al; A comparison of angiography, intravenous digital subtraction angiography and duplex ultrasound in the diagnosis of carotid artery atherosclerosis. (J Can Assoc Radiol, 1985 Sep, Abstract available) [MEDLINE]
79 Welch TJ, et al; Focal nodular hyperplasia and hepatic adenoma: comparison of angiography, CT, US, and scintigraphy. (Radiology, 1985 Sep, Abstract available) [MEDLINE]
80 Das DK, et al; Fine-needle aspiration diagnosis of carotid body tumor: report of a case and review of experience with cytologic features in four cases. (Diagn Cytopathol, 1997 Aug, Abstract available) [MEDLINE]

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81 Heller PB, et al; Clinical-pathologic study of stage IIB, III, and IVA carcinoma of the cervix: extended diagnostic evaluation for paraaortic node metastasis--a Gynecologic Oncology Group study. (Gynecol Oncol, 1990 Sep, Abstract available) [MEDLINE]
82 Herman SD, et al; Magnetic resonance imaging of papillary renal cell carcinoma. (Urol Radiol, 1985, Abstract available) [MEDLINE]
83 Bertucci V, et al; Prognosis in a patient with an initial normal pulmonary angiogram. (Chest, 1994 Apr, Abstract available) [MEDLINE]
84 Doris I, et al; The relevance of detecting carotid artery calcification on plain radiograph. (Stroke, 1993 Sep, Abstract available) [MEDLINE]
85 Reid DB, et al; Intravascular ultrasound assessment in carotid interventions. (J Endovasc Surg, 1996 May, Abstract available) [MEDLINE]
86 Agrifoglio M, et al; Pedicled arterial grafts in coronary surgery: postoperative echo color-Doppler study. (J Cardiovasc Surg (Torino), 1996 Feb, Abstract available) [MEDLINE]
87 Reid DB, et al; The clinical value of three-dimensional intravascular ultrasound imaging. (J Endovasc Surg, 1995 Nov, Abstract available) [MEDLINE]
88 Yamada E, et al; Usefulness of a prototype intravascular ultrasound imaging in evaluation of aortic dissection and comparison with angiographic study, transesophageal echocardiography, computed tomography, and magnetic resonance imaging. (Am J Cardiol, 1995 Jan, Abstract available) [MEDLINE]
89 Giller CA, et al; Prediction of tolerance to carotid artery occlusion using transcranial Doppler ultrasound. (J Neurosurg, 1994 Jul, Abstract available) [MEDLINE]
90 Fraker DL, et al; Controversies in surgical therapy for APUDomas. (Semin Surg Oncol, 1993 Sep, Abstract available) [MEDLINE]

Menu Position #90

91 Graham E, et al; Symptomatic liver hemangioma with intra-tumor hemorrhage treated by angiography and embolization during pregnancy. (Obstet Gynecol, 1993 May, Abstract available) [MEDLINE]
92 Bratzler DW, et al; Carotid endarterectomy in Oklahoma Medicare beneficiaries: patient characteristics and outcomes. (J Okla State Med Assoc, 1996 Dec, Abstract available) [MEDLINE]
93 Heiserman JE, et al; Clinical significance of the flow gap in carotid magnetic resonance angiography. (J Neurosurg, 1996 Sep, Abstract available) [MEDLINE]
94 Lanzetta M; Clinical use of microvascular PTFE grafts. (Microsurgery, 1995, Abstract available) [MEDLINE]
95 Kerber CW, et al; Flow dynamics for radiologists. II. Practical considerations in the live human. (AJNR Am J Neuroradiol, 1994 Jun, Abstract available) [MEDLINE]
96 el Shiekh Mohamed AR, et al; Organ involvement in hepato-intestinal schistosomiasis. (Hepatogastroenterology, 1994 Aug, Abstract available) [MEDLINE]
97 Anderson HV, et al; Cyclic flow variations after coronary angioplasty in humans: clinical and angiographic characteristics and elimination with 7E3 monoclonal antiplatelet antibody. (J Am Coll Cardiol, 1994 Apr, Abstract available) [MEDLINE]
98 Dillon PW, et al; Recombinant tissue plasminogen activator for neonatal and pediatric vascular thrombolytic therapy. (J Pediatr Surg, 1993 Oct, Abstract available) [MEDLINE]


Record 1 from database: MEDLINE
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Title
Current status of radionuclide scrotal imaging.
Author
Holder LE; Melloul M; Chen D
Address
 
Source
Semin Nucl Med, 1981 Oct, 11:4, 232-49
Abstract
Scrotal imaging with technetium-99m sodium pertechnetate consists of a radionuclide angiogram and static scrotal scans. Utilization of this study in patients presenting with an acute scrotum can dramatically reduce the number of surgical explorations for acute epididymitis. It can also aid in other aspects of differential diagnosis in patients presenting with either an acutely enlarged and/or painful scrotum or a scrotal mass. Ambiguities in previous descriptions of perfusion through the spermatic and extraspermatic cord vessels are described and distinguished from scrotal perfusion. The clinical and scintigraphic spectrum of testicular torsion, including spontaneous detorsion, early acute testicular torsion, midphase testicular torsion, and late phase or "missed testicular torsion," is discussed and illustrated. The variety of patterns seen in acute epididymitis, including lateral and medial epididymal location, and focal epididymitis are described, as is the appearance of hydrocele as both a primary and secondary entity. The relationship of scrotal imaging to the overall clinical presentation and evaluation of these patients is emphasized in testicular torsion, torsion of the testicular appendages, epididymitis, abscess, trauma, tumor, spermatocele, and varicocele. The techniques, clinical utility, and relationship to radionuclide imaging of Doppler ultrasound and gray scale ultrasound scanning are reviewed. Doppler ultrasound results in many false negative studies in testicular torsion. Gray scale ultrasound is useful in clarifying the nature of scrotal masses.
Language of Publication
English
Unique Identifier
82061900

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MeSH Heading (Major)
Scrotum|IN/*RI; Technetium|*DU
MeSH Heading
Abscess|RI; Epididymitis|RI; Human; Hydrocele|RI; Male; Spermatic Cord Torsion|RI; Spermatocele|RI; Testicular Neoplasms|RI; Ultrasonics|DU; Varicocele|RI

Publication Type
JOURNAL ARTICLE
ISSN
0001-2998
Country of Publication
UNITED STATES

Record 2 from database: MEDLINE
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Title
Functional and morphological findings in heart transplant recipients with a normal coronary angiogram: an analysis by dobutamine stress echocardiography, intracoronary Doppler and intravascular ultrasound.
Author
Spes CH; Klauss V; Rieber J; Schnaack SD; Tammen AR; Uberfuhr P; Reichart B; Theisen K; Angermann CE; Mudra H
Address
Department of Cardiology, University of Munich, Germany.
Source
J Heart Lung Transplant, 1999 May, 18:5, 391-8
Abstract
BACKGROUND: Coronary angiography is still the routine screening method for cardiac allograft vasculopathy in most transplant centers. This study was designed to analyze functional and morphologic changes in heart transplant recipients with normal angiographic findings. METHODS: Dobutamine stress echocardiography and intracoronary ultrasound were obtained in 56 patients with a normal coronary angiogram 41+/-31 months after heart transplantation. Intracoronary Doppler flow velocity measurements before and after intracoronary adenosine administration were performed in 34 of 56 patients. Any regional wall motion abnormalities detected by stress echocardiography were regarded as abnormal. By quantitative intracoronary ultrasound analysis using a 6-grade scale, a mean grade of all coronary segments >3.0 was defined as significant intimal hyperplasia. RESULTS: Only 17 patients (30%) showed both a normal dobutamine stress echocardiogram and absence of significant intimal hyperplasia by intravascularultrasound. Abnormal findings were observed in 39 patients (70%): both by dobutamine stress echocardiography and intravascular ultrasound in 22 patients, by intravascular ultrasound alone in 11 patients, and by dobutamine stress echocardiography alone in 6 patients. Coronary flow velocity reserve did not discriminate between patients with normal or abnormal intravascular ultrasound or dobutamine stress echocardiographic findings. Conclusions: Only a minority of heart transplant patients with a normal coronary angiogram is free of pathological changes, when assessed by intravascular ultrasound and dobutamine stress echocardiography. Coronary flow velocity reserve does not seem useful to further characterize these patients.
Language of Publication
English
Unique Identifier
99290349

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MeSH Heading (Major)
Cardiotonic Agents|*DU; Coronary Angiography|*; Coronary Disease|*DI/PP; Coronary Vessels|*PA/PP/US; Dobutamine|*DU; Echocardiography|*; Heart Transplantation|*; Ultrasonography, Doppler|*; Ultrasonography, Interventional|*
MeSH Heading
Adenosine|AD/DU; Biopsy; Blood Flow Velocity; Comparative Study; Exercise Test|MT; Human; Injections, Intra-Arterial; Middle Age; Vasodilator Agents|AD/DU

Publication Type
JOURNAL ARTICLE
ISSN
1053-2498
Country of Publication
UNITED STATES

Record 3 from database: MEDLINE
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Title
Pseudoaneurysm of the profunda femoris artery diagnosed on angiographic phase of bone scan.
Author
Powers TA; Harolds JA; Kadir S; Grove RB
Address
 
Source
Clin Nucl Med, 1979 Oct, 4:10, 422-4
Abstract
A case of post-traumatic aneurysm of the profunda femoris artery following self-administration of an intramuscular injection is reported. The diagnosis was made prior to contrast arteriography on the basis of a radionuclide angiogram performed as part of a bone scan. Additional confirmation was obtained by ultrasound examination.
Language of Publication
English
Unique Identifier
80045689

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MeSH Heading (Major)
Aneurysm|ET/RA/*RI; Bone and Bones|*RI; Femoral Artery|*RI
MeSH Heading
Case Report; Contrast Media; False Positive Reactions; Human; Injections, Intramuscular|AE; Male; Middle Age; Phosphates|DU; Technetium|DU; Time Factors; Ultrasonics|DU

Publication Type
JOURNAL ARTICLE
ISSN
0363-9762
Country of Publication
UNITED STATES

Record 4 from database: MEDLINE
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Title
Choledochal cyst with cholelithiasis: 15-yr follow-up.
Author
Harris V; Ramilo J; Radhakrishnan J
Address
 
Source
J Pediatr Surg, 1979 Apr, 14:2, 191-2
Abstract
A 15-yr-old boy, who had had surgery for a choledochal cyst in infancy, was worked up for recurrent right upper quandrant pair. Intravenous cholangiogram and ultrasound demonstrated a choledochal cyst with stones. Angiogram showed only a distorted branch of the gastro-duodenal artery. These findings were confirmed at surgery.
Language of Publication
English
Unique Identifier
79218290

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MeSH Heading (Major)
Common Bile Duct|*SU; Common Bile Duct Calculi|*CO/DI/SU; Cysts|*CN/CO/SU
MeSH Heading
Adolescence; Case Report; Child; Child, Preschool; Cholangiography; Cholelithiasis|CO; Gallbladder|SU; Human; Infant; Jejunum|SU; Male; Ultrasonics|DU

Publication Type
JOURNAL ARTICLE
ISSN
0022-3468
Country of Publication
UNITED STATES

Record 5 from database: MEDLINE
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Title
Angiographic assessment of pancreatic pseudocyst: a reappraisal.
Author
Cho KJ; Reuter SR
Address
 
Source
J Can Assoc Radiol, 1976 Sep, 27:3, 193-5
Abstract
The correct diagnosis was established by angiography in 16 of 21 patients with pancreatic pseudocyst. The characteristic angiographic abnormalities are arcuate stretching of intrapancreatic arteries combined with a filling defect in the parenchymal phase of the angiogram. In the five false negative patients, the diagnosis was not made either because of the small size of the pseudocyst or a primary extrapancreatic location of the lesion. Because of this high false negative rate and the accuracy of B-mode ultrasonic scanning in abdominal cystic lesions, ultrasound should be the primary diagnostic modality in patients with suspected pancreatic pseudocysts.
Language of Publication
English
Unique Identifier
77029014

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MeSH Heading (Major)
Pancreas|*BS; Pancreatic Cyst|DI/*RA
MeSH Heading
Angiography; Diagnostic Errors; Evaluation Studies; Human; Mesenteric Vascular Occlusion|RA; Ultrasonics|DU

Publication Type
JOURNAL ARTICLE
ISSN
0008-2902
Country of Publication
CANADA

Record 6 from database: MEDLINE
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Title
Takayasu arteritis: ultrasonographic evaluation of the cervico-cerebral arteries.
Author
Suwanwela NC; Suwanwela N
Address
Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Source
Int J Cardiol, 1998 Oct, 66 Suppl 1:, S163-73
Abstract
PURPOSE: To present the ultrasonographic findings of the cervico-cerebral arteries in patients with Takayasu arteritis. MATERIALS AND METHODS: We used duplex ultrasound to study the arteries in the neck including the common carotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA) and the vertebral arteries. For the intracranial arteries, transcranial Doppler ultrasound was used to study the blood flow velocities and directions in the middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), ophthalmic artery, basilar and vertebral arteries. The ultrasonographic findings were compared with magnetic resonance angiography (MRA) and standard angiography. RESULTS: Four patients with the diagnosis of Takayasu arteritis were studied. One patient presented with ischemic optic neuropathy and was found to have absent radial pulse. Two patients presented with severe hypertension in young age. The other patient had accidental findings of unmeasurable blood pressure in both arms. One patient had abnormal carotid duplex ultrasound. He was found to have an occlusion of the right ICA. Thickening of the wall of the left ICA was also noted. Reduction of flow velocity in the MCA was demonstrated on TCD. There was evidence of collateral circulation from the contralateral carotid artery demonstrated by reversal of flow in the ipsilateral A1 segment of the ACA. MRA and angiography confirmed the ultrasound findings. Three patients had normal carotid duplex ultrasound but one of them was found to have a severe stenosis at the origin of the common carotid artery by MRA and angiogram. Absence of one vertebral artery was noted in three patients. MRA and angiogram confirmed the occlusion of the same vertebral arteries at their origins. In one patient, reversal of flow in the intracranial part (V4 segment) of the affected vertebral artery indicating collateral flow from contralateral vertebral and basilar arteries was demonstrated. CONCLUSION: Ultrasonography could be used as an additional noninvasive procedure apart from CT angiography, MRI and MRA in patients with Takayasu arteritis. Occlusion and wall thickening of the neck artery could be detected by color coded B-mode and Doppler ultrasound. Transcranial Doppler was useful in evaluation of flow velocity and flow direction of the arteries around the circle of Willis.
Language of Publication
English
Unique Identifier
99135287

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MeSH Heading (Major)
Cerebral Arteries|PP/RA/*US; Takayasu's Arteritis|PP/RA/*US; Vertebral Artery|PP/RA/*US
MeSH Heading
Adolescence; Adult; Angiography; Blood Flow Velocity; Carotid Artery, External|PP/RA/US; Carotid Artery, Internal|PP/RA/US; Case Report; Cerebrovascular Circulation; Child; Collateral Circulation; Comparative Study; Female; Human; Magnetic Resonance Angiography; Male; Middle Age; Ultrasonography, Doppler, Duplex; Ultrasonography, Doppler, Transcranial

Publication Type
JOURNAL ARTICLE
ISSN
0167-5273
Country of Publication
IRELAND

Record 7 from database: MEDLINE
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Title
Simultaneous sonographic demonstration of tumor thrombus in the inferior vena cava and patient main renal vein in renal carcinoma.
Author
Bloom RA; Verstandig A; Gordon RL; Fine H
Address
 
Source
J Urol, 1983 Aug, 130:2, 330-2
Abstract
With the introduction of new imaging modalities the optimal protocol for the evaluation of renal tumors is under close review. Angiographers frequently are faced with the question of whether to proceed to inferior venacavography following a selective renal angiogram that demonstrates a patent renal vein. We report a case of renal cell carcinoma in which the main renal vein was shown by ultrasound to be unequivocally patent but at the same time there was considerable tumor extension into the inferior vena cava. The necessity of full examination of the inferior vena cava, either by venacavography or ultrasound, in all cases of renal cell carcinoma is stressed.
Language of Publication
English
Unique Identifier
83268873

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MeSH Heading (Major)
Adenocarcinoma|*DI; Kidney Neoplasms|*DI; Renal Veins|*; Ultrasonics|*DU; Vena Cava, Inferior|*/RA
MeSH Heading
Aged; Angiography; Case Report; Human; Male

Publication Type
JOURNAL ARTICLE
ISSN
0022-5347
Country of Publication
UNITED STATES

Record 8 from database: MEDLINE
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Return To Menu Position #10

 
Title
Ultrasonic Doppler studies of the breast.
Author
Burns PN; Halliwell M; Wells PN; Webb AJ
Address
 
Source
Ultrasound Med Biol, 1982, 8:2, 127-43
Abstract
The growth of a malignant tumour depends on vascularisation. The ultrasonic Doppler method can detect the blood flow associated with malignant breast tumours, the signals differing qualitatively from those due to benign lesions. Several descriptors of the Doppler signals were tested; benign and malignant lesions are best separated by the difference between the maximum systolic frequencies from suspect and contralateral sites. Corresponding main arterial sites are reliably coincident in normal breast pairs. Consideration of the powers and frequency spectra of Doppler signals leads to the rejection of models of tumour vascularisation giving Doppler signals based on capillary perfusion and on a single feed artery. The data are compatible with a multiple feed artery model, and this is supported by a contrast angiogram. Doppler ultrasound may be useful as a preliminary screening method, in the management of patients with radiologically dense breasts or diffuse dysplasia, and for monitoring unexcised tumours undergoing hormone therapy.
Language of Publication
English
Unique Identifier
82177301

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MeSH Heading (Major)
Auscultation|*IS; Breast Diseases|*DI; Breast Neoplasms|BS/*DI; Ultrasonics|*DU
MeSH Heading
Adenocarcinoma|DI; Adult; Aged; Breast|BS; Diagnosis, Differential; Female; Fibrosarcoma|DI; Human; Middle Age; Models, Biological; Regional Blood Flow; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
ISSN
0301-5629
Country of Publication
ENGLAND

Record 9 from database: MEDLINE
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Title
Colour-flow ultrasound in the detection of penetrating vascular injuries of the neck.
Author
Corr P; Abdool Carrim AT; Robbs J
Address
Department of Radiology, University of Natal, Durban.
Source
S Afr Med J, 1999 Jun, 89:6, 644-6
Abstract
PURPOSE: To determine the sensitivity of colour-flow ultrasound in the detection of penetrating vascular injuries of the neck when compared with conventional angiography. METHOD: We prospectively imaged the neck arteries of all patients with suspected vascular injuries who were referred for angiography by the vascular surgeon over a 6-month period. All sonograms were performed by the same radiologist before angiography using a 7.5 or 10 MHz transducer on the same scanner. Data recorded were the presence or absence of vascular injury, the site of injury, and the type (intimal, dissection, false aneurysm or fistula). Angiography was performed immediately afterwards by a different radiologist. Results were correlated with the angiogram and operative findings. RESULTS: 25 patients were studied. 15 patients had normal ultrasound studies and angiograms. Ultrasound studies were positive in 10 patients (40%), with false aneurysms and arteriovenous fistulas detected in 8 patients; these were confirmed on angiography and at operation. There were intimal injuries in 2 patients (4%) that were undetected on angiography but confirmed at surgery. There were no false-positive or false-negative ultrasound studies. CONCLUSION: Colour-flow ultrasound is sensitive in detecting vascular injuries and is suitable as a screening investigation in patients with penetrating neck injuries.
Language of Publication
English
Unique Identifier
99372162

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MeSH Heading (Major)
Neck Injuries|RA/*US; Ultrasonography, Doppler, Color|*; Wounds, Gunshot|RA/*US; Wounds, Stab|RA/*US
MeSH Heading
Adult; Aneurysm, False|RA/US; Angiography; Arteries|IN/US; Arteriovenous Fistula|RA/US; Female; Human; Male; Prospective Studies; Sensitivity and Specificity

Publication Type
JOURNAL ARTICLE
ISSN
0038-2469
Country of Publication
SOUTH AFRICA

Record 10 from database: MEDLINE
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Title
Dipyridamole scintigraphy and intravascular ultrasound after successful coronary intervention.
Author
Bachmann R; Sechtem U; Voth E; Schröder J; Höpp HW; Schicha H
Address
Department of Nuclear Medicine, University of Cologne, Germany.
Source
J Nucl Med, 1997 Apr, 38:4, 553-8
Abstract
Despite angiographically successful interventions, perfusion defects are not uncommonly observed in postinterventional perfusion scintigrams. The aim of this study was to test the hypothesis that perfusion defects after coronary intervention are associated with a significant residual stenosis in the treated vessel segment detectable by intravascular ultrasound but not by angiography. METHODS: Forty consecutive patients with angiographically successful coronary interventions were prospectively studied by intravascular ultrasound immediately after the intervention. Within 48 hr after the intervention all patients had myocardial scintigraphy using 99mTc-methoxyisobutyl-isonitrile SPECT after dipyridamole stress. Myocardial perfusion defects in the scintigram were assigned to a segmental left ventricular model and compared to the perfusion territory of the treated vessel estimated from the coronary angiogram. RESULTS: Twenty of 40 patients had reversible myocardial perfusion defects. Mean ultrasound area stenosis was 50% in these patients and 33% in patients without perfusion defects (p < 0.002); ultrasound percent plaque area was 75% versus 63% (p < 0.0001), respectively. The best concordance between residual area stenosis and perfusion defects was found for an ultrasound area stenosis > or = 40%. CONCLUSION: Patients with stress-induced myocardial perfusion defects immediately after successful coronary intervention show high-grade residual stenoses that are more pronounced in patients with perfusion defects than in patients with normal postinterventional scintigrams. In addition, vessels serving myocardial regions with perfusion defects showed a significantly higher plaque burden indicating diffuse atherosclerotic changes in the vessel. The evaluation of the postprocedural result by intravascular ultrasound contributes to a better understanding of the discrepancy between the angiographic finding of a widely patent vessel but scintigraphic evidence of impaired perfusion.
Language of Publication
English
Unique Identifier
97276747

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MeSH Heading (Major)
Coronary Vessels|*US; Dipyridamole|*DU; Heart|*RI; Myocardial Revascularization|*; Ultrasonography, Interventional|*
MeSH Heading
Adult; Aged; Coronary Angiography; Coronary Circulation; Coronary Disease|RA/RI/TH/US; Female; Human; Male; Middle Age; Prospective Studies; Sensitivity and Specificity; Stents; Technetium Tc 99m Sestamibi|DU; Tomography, Emission-Computed, Single-Photon

Publication Type
JOURNAL ARTICLE
ISSN
0161-5505
Country of Publication
UNITED STATES

Record 11 from database: MEDLINE
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Title
Relation of donor age and preexisting coronary artery disease on angiography and intracoronary ultrasound to later development of accelerated allograft coronary artery disease.
Author
Gao HZ; Hunt SA; Alderman EL; Liang D; Yeung AC; Schroeder JS
Address
Division of Cardiovascular Medicine, Stanford University School of Medicine, California 94305, USA.
Source
J Am Coll Cardiol, 1997 Mar, 29:3, 623-9
Abstract
OBJECTIVES: This study assessed the influence of donor age and preexisting donor coronary disease on the later development of allograft coronary artery disease, ischemic events and overall survival. BACKGROUND: The increasing demand for heart donors has led to a tendency to liberalize age criteria for donor acceptability. METHODS: A total of 233 consecutive heart transplant recipients who had baseline, early postoperative and follow-up coronary angiograms, as well as a subset of 47 patients with baseline intracoronary ultrasound imaging recordings, were analyzed (mean 3.8 years of follow-up). Patients were subclassified according to the presence of donor coronary artery disease on the baseline angiogram and stratified at age 40 years. RESULTS: patients without evidence of preexisting coronary artery disease on a baseline angiogram (n = 219) were significantly less likely to develop new disease than the 14 patients with preexisting coronary artery disease (p = 0.002). Although older donors exhibited earlier coronary artery disease than younger donors at 3 years of follow-up, there was no difference by 5 years (p = 0.25). There was no difference in survival or probability of developing ischemic events between the groups. Baseline ultrasound imaging revealed substantial disease in 7 of 9 older donated hearts, and in only 7 of 38 younger donated hearts (p = 0.002). Preexisting coronary artery disease, nonuse of calcium channel blocking agents, older donor age, posttransplantation cytomegalovirus infection, elevated very low density lipoprotein levels and previous ischemic heart disease in the recipient were significant predictors of allograft coronary artery disease. CONCLUSIONS: Heart donors with angiographic evidence of preexisting coronary artery disease and older donors are more likely to develop new allograft coronary artery disease by 3 years. However, there is no difference in survival or freedom from ischemic events between younger and older donors at a mean follow-up of 3.8 years.
Language of Publication
English
Unique Identifier
97214522

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MeSH Heading (Major)
Coronary Disease|*/ET/RA; Heart Transplantation|*; Postoperative Complications|*; Tissue Donors|*
MeSH Heading
Adolescence; Adult; Age Factors; Coronary Angiography; Disease Progression; Human; Retrospective Studies; Risk Factors; Support, Non-U.S. Gov't; Transplantation, Homologous; Ultrasonography, Interventional

Publication Type
JOURNAL ARTICLE
ISSN
0735-1097
Country of Publication
UNITED STATES

Record 12 from database: MEDLINE
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Title
Imaging of pulmonary vascular disease by intravascular ultrasound.
Author
Scott PJ; Essop AR; al Ashab W; Deaner A; Parsons J; Williams G
Address
Non-Invasive Heart Unit, Killingbeck Hospital, Leeds, West Yorkshire, UK.
Source
Int J Card Imaging, 1993 Sep, 9:3, 179-84
Abstract
To assess the ability of intravascular ultrasound (IVUS) to image changes in the pulmonary arterial wall associated with pulmonary hypertension (PHT), 10 subjects requiring diagnostic right and left heart catheterization were studied. In addition to measurements of pulmonary artery pressure and pulmonary vascular resistance and pulmonary angiography, when indicated, all underwent simultaneous IVUS imaging in the pulmonary arterial system using a 20 MHz ultrasound transducer mounted on a 2 mm diameter catheter. Four patients had normal pulmonary artery pressures and 6 had varying degrees of PHT. Satisfactory ultrasound images were obtained in 9 out of the 10 patients. In those with normal pulmonary artery pressures ultrasound showed a thin vessel wall with no distinction between separate layers. In patients with systemic PHT, a three-layered vessel wall was apparent and areas compatible with intimal proliferation were seen. In a patient with pulmonary embolic disease areas consistent with mural thrombus were detected at sites of luminal narrowing on the pulmonary angiogram. IVUS is capable of imaging some of the morphological changes in the wall of the pulmonary artery known to occur in longstanding PHT and may therefore become a useful adjunct to haemodynamic measurements and pulmonary angiography for the in vivo assessment of pulmonary vascular disease.
Language of Publication
English
Unique Identifier
94149355

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MeSH Heading (Major)
Hypertension, Pulmonary|PP/*US; Pulmonary Artery|PP/*US; Ultrasonography, Interventional|*
MeSH Heading
Adolescence; Adult; Child; Chronic Disease; Heart Catheterization; Human; Middle Age; Prospective Studies; Pulmonary Wedge Pressure; Support, Non-U.S. Gov't; Vascular Resistance

Publication Type
JOURNAL ARTICLE
ISSN
0167-9899
Country of Publication
UNITED STATES

Record 13 from database: MEDLINE
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Title
Assessment of coronary vasomotion by intracoronary ultrasound.
Author
Dupouy P; Geschwind HJ; Pelle G; Gallot D; Dubois Randé JL
Address
UnitÆe d'hÆemodynamique, INSERM U2, University Hospital Henri Mondor, University of Paris, XII, France.
Source
Am Heart J, 1993 Jul, 126:1, 76-85
Abstract
This study was performed to evaluate the accuracy of intravascular ultrasound for the assessment of coronary artery vasomotion and endothelial function in patients with atherosclerosis. Twenty patients with luminal irregularities on the coronary angiogram and a high cholesterol level (287 +/- 19 mg/dl) (group 1) and six patients with angiographically smooth arteries and a minimally elevated cholesterol level (197 +/- 12 mg/dl) (group 2) were studied. A mechanical intravascular ultrasound probe (4.3F) was placed into the proximal segment of the coronary artery. The ultrasound images were recorded on super VHS videotape and were then digitized allowing the measurement of the lumen area and then the calculation of a mean intimal thickness index. Endothelial function was studied during sympathetic stimulation by a cold pressor test and, after increasing coronary blood flow, by intracoronary papaverine administration; a 1 mg bolus of linsidomine was then administered into the coronary artery. Patients in group 1 had a higher mean intimal thickness (1.52 +/- 0.64 mm) than those in group 2 (0.18 +/- 0.08 mm) (p < 0.001). In response to sympathetic stimulation, a vasoconstricting effect occurred in group 1 (9.5 +/- 1.3 mm2 vs 11.4 +/- 1.2 mm2 at baseline, p < 0.05), while a vasodilating action was observed in the control group (11.6 +/- 2.1 mm2 vs 10.4 +/- 1.8 mm2 at baseline, p < 0.05). After papaverine infusion, a trend toward a vasoconstricting effect was observed in response to increased flow in group 1 (10 +/- 1.3 mm2 vs 11.4 +/- 1.2 mm2 at baseline, p < 0.05). that was not observed in group 2 (9.4 +/- 2 mm2 vs 8.9 +/- 1.9 mm2, p = NS). Linsidomine infusion induced a significant vasodilating effect in both groups (p < 0.001). In conclusion, intravascular ultrasound may be considered a useful tool to assess endothelial function of large coronary arteries and to obtain the precise relationship between wall thickness and the vasomotor response.
Language of Publication
English
Unique Identifier
93311332

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MeSH Heading (Major)
Coronary Arteriosclerosis|*PP/US; Coronary Vessels|*PP/*US; Vasoconstriction|*/DE; Vasodilation|*/DE
MeSH Heading
Aged; Blood Flow Velocity; Case-Control Studies; Cold|DU; Echocardiography; Endothelium, Vascular|DE/PH; Female; Human; Hypercholesterolemia|PP; Male; Middle Age; Molsidomine|AA/PD; Papaverine|PD; Vasodilator Agents|PD

Publication Type
JOURNAL ARTICLE
ISSN
0002-8703
Country of Publication
UNITED STATES

Record 14 from database: MEDLINE
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Title
Doppler sonography in the diagnosis of dural carotidcavernous fistula.
Author
Rush JA; Blackshear WM Jr; Grizzard WS
Address
 
Source
J Clin Neuroophthalmol, 1982 Mar, 2:1, 39-42
Abstract
Intracranial dural fistulas in the region of the cavernous sinus usually occur in middle-aged or elderly women in whom physical findings of ocular pulsation, orbital bruit, and ocular injection are subtle or absent. We examined a 19-year-old man with hemophilia who had a red, mildly proptosed left eye. Typical features of a carotidcavernous sinus fistula were absent except for the presence of dilated, tortuous episcleral vessels. Directional Doppler ultrasound evaluation detected retrograde blood flow in the left frontal vein and thus confirmed the presence of an arteriovenous shunt. After a selective internal carotid angiogram demonstrated a shunt from a dural branch of the internal carotid artery, the patient's symptoms remitted spontaneously. Directional Doppler ultrasonography is a noninvasive test that can detect the presence of a low flow, retrobulbar arteriovenous shunt in the region of the cavernous sinus.
Language of Publication
English
Unique Identifier
84033278

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MeSH Heading (Major)
Arteriovenous Malformations|CO/*DI; Carotid Artery Diseases|CO/*DI; Cavernous Sinus|*; Exophthalmos|*ET
MeSH Heading
Adult; Dura Mater|BS; Human; Male; Ultrasonics|DU/IS

Publication Type
JOURNAL ARTICLE
ISSN
0272-846X
Country of Publication
UNITED STATES

Record 15 from database: MEDLINE
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Title
Post transplant acute renal failure: a review.
Author
Rao KV; Kjellstrand CM
Address
 
Source
Clin Exp Dial Apheresis, 1983, 7:1-2, 127-43
Abstract
Post transplant acute tubular necrosis (ATN) is responsible for approximately 90% of acute renal failure episodes occurring within the first few weeks following renal transplantation. This phenomenon is observed in 34% of cadaver transplant recipients and 9% of those with live donor kidneys. Although the exact cause of post transplant ATN remains unknown, the following factors are thought to be associated with a higher incidence of ATN: 1) donor hypotension, 2) prolonged "warm ischemia time", 3) increased vascular resistance with poor perfusate flow, 4) presence of "ligandin" or excess lactate in the renal perfusate, 5) reduced allograft blood flow, 6) cold lymphocytotoxins in the patient's serum and 7) administration of nephrotoxic drugs particularly to the hypovolemic graft recipients. Therapeutic maneuvers such as hydration of the donors and recipients, harvesting the kidneys from heart beating cadavers, donor pretreatment with massive doses of corticosteroids and alpha-adrenergic blocking agents and warming of the graft immediately after vascular anastomosis, seem to reduce the incidence of ATN. Since the management differs significantly, post transplant ATN has to be distinguished from other causes of acute renal failure such as the renal artery thrombosis, hyperacute rejection and obstruction of the urinary tract. The tests which are of use in the differential diagnosis include, 131-I Hippuran renogram, transplant ultrasound, renal angiogram, retrograde pyelogram and renal transplant biopsy. Patients with established ATN should undergo every other day dialysis, under low dose or regional heparinization, until the creatinine clearance improves to 20 ml/min. The dose of azathioprine has to be reduced to prevent bone marrow toxicity. Even though there are short term disadvantages, the post transplant ATN does not appear to exert any detrimental effects in the long run. However, this issue remains controversial in the published reports.
Language of Publication
English
Unique Identifier
83286033

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MeSH Heading (Major)
Kidney|*TR; Kidney Failure, Acute|DI/*ET; Kidney Transplantation|*; Kidney Tubular Necrosis, Acute|DI/*ET/TH
MeSH Heading
Diagnosis, Differential; Graft Survival; Human; Postoperative Complications; Prognosis

Publication Type
JOURNAL ARTICLE
ISSN
0276-5497
Country of Publication
UNITED STATES

Record 16 from database: MEDLINE
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Title
Amaurosis fugax: carotid endarterectomy without an angiogram.
Author
Baliga KP; Bell WH 3d; Kerstein MD
Address
 
Source
J La State Med Soc, 1989 Jul, 141:7, 35-6
Abstract
The risks of carotid angiography--technical, allergic, cardiac, renal, or emotional--may be lessened or absented by the use of real-time B-mode ultrasound to evaluate carotid artery disease. A patient with amaurosis fugax, a positive fluorescein angiogram, ulceration on ultrasound, and an unremarkable computed tomography scan was operated on without angiography. The pathology was correct and the patient did well.
Language of Publication
English
Unique Identifier
89360926

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MeSH Heading (Major)
Blindness|*ET; Carotid Artery Diseases|CO/*DI/SU; Cerebral Angiography|*; Endarterectomy|*
MeSH Heading
Aged; Case Report; Human; Male; Preoperative Care

Publication Type
JOURNAL ARTICLE
ISSN
0024-6921
Country of Publication
UNITED STATES

Record 17 from database: MEDLINE
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Title
Iridocyclitis and an iris mass associated with secondary syphilis.
Author
McCarron MJ; Albert DM
Address
 
Source
Ophthalmology, 1984 Oct, 91:10, 1264-8
Abstract
A 34-year-old white man developed iridocyclitis and an iris mass. The iridocyclitis was preceded by a nodular rash which spared the palms and soles. An anterior segment fluorescein angiogram was performed which showed numerous permeable vessels. An ultrasound examination of the mass showed that it extended to the ciliary body. He had both a positive RPRCT and FTA-Abs. A skin biopsy was done which disclosed the nodules to be a rare form of secondary syphilis. The patient was treated with topical steroids and a cycloplegic agent, and later prednisone and intravenous penicillin, with eventual resolution of iris mass, iridocyclitis and skin nodules.
Language of Publication
English
Unique Identifier
85087238

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MeSH Heading (Major)
Iris Diseases|*PA; Syphilis|*PA; Syphilis, Cutaneous|*PA; Uveitis, Anterior|*PA
MeSH Heading
Adult; Biopsy; Case Report; Ciliary Body|PA; Conjunctiva|PA; Diagnosis, Differential; Fluorescein Angiography; Human; Iris|PA; Iritis|PA; Male

Publication Type
JOURNAL ARTICLE
ISSN
0161-6420
Country of Publication
UNITED STATES

Record 18 from database: MEDLINE
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Title
Post-traumatic intrahepatic arteriovenous fistula.
Author
Van Haeften FF; Bröker FH
Address
 
Source
Injury, 1984 Mar, 15:5, 311-5
Abstract
A case is reported where, after multiple stab-wounds in the liver, a large intrahepatic arteriovenous fistula producing portal hypertension, a non-obstructive portal thrombus and chronic cholecystitis have developed. The fistula was closed by catheter embolization with surgical access to the left hepatic artery. Occlusion of the arterial flow at some distance from the fistula was rendered ineffectual by the collateral circulation. Deposition of a tufted steel coil exactly on the site of the fistula resulted in obliteration. The portal thrombus, supposedly developed from haemodynamic alterations, appeared to be resolved in a postoperative angiogram. Angiography and, to some degree, ultrasound B-scanning are indispensable for a timely detection of post-traumatic vascular malformations of the liver.
Language of Publication
English
Unique Identifier
84160584

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MeSH Heading (Major)
Arteriovenous Fistula|*ET/RA/TH; Hepatic Artery|*/RA; Liver|*IN; Portal Vein|*/RA; Wounds, Stab|*CO
MeSH Heading
Case Report; Human; Male; Middle Age

Publication Type
JOURNAL ARTICLE
ISSN
0020-1383
Country of Publication
ENGLAND

Record 19 from database: MEDLINE
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Title
Portal-hepatic venous malformation: ultrasound, computed tomographic, and angiographic findings.
Author
Charnsangavej C; Soo CS; Bernardino ME; Chuang VP; Wallace S
Address
 
Source
Cardiovasc Intervent Radiol, 1983, 6:2, 109-11
Abstract
A 59-year-old woman was evaluated for a mass in the right lobe of the liver. Ultrasonography (US) demonstrated multiple anechoic areas with enlargement of portal and hepatic veins. These areas were enhanced uniformly after bolus injection of contrast material during computed tomography (CT). The diagnosis of portal-hepatic venous fistula was confirmed by the portal venous phase of a superior mesenteric angiogram.
Language of Publication
English
Unique Identifier
83285068

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MeSH Heading (Major)
Fistula|*DI/RA; Hepatic Veins|*/RA; Portal Vein|*/RA
MeSH Heading
Angiography; Case Report; Female; Human; Middle Age; Tomography, X-Ray Computed; Ultrasonics|DU

Publication Type
JOURNAL ARTICLE
ISSN
0174-1551
Country of Publication
GERMANY, WEST

Record 20 from database: MEDLINE
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Title
Post-endarterectomy carotid ultrasonic duplex scanning concordance with contrast angiography.
Author
Roederer GO; Langlois Y; Chan AT; Breslau P; Phillips DJ; Beach KW; Chikos PM; Strandness DE Jr
Address
 
Source
Ultrasound Med Biol, 1983 Jan, 9:1, 73-8
Abstract
The results of ultrasonic duplex scanning combined with spectral analysis are compared with the results of contrast angiography in patients after endarterectomy in which recurrence of carotid arterial disease was suspected. Thirty-six patients underwent a duplex scan study within 3 months of their post-operative angiogram, performed at their physician's discretion (44 studies). The overall accuracy of the method was 80%. Our ability to predict a greater than 50% diameter reduction along with total occlusion was 94%. The measure of agreement corrected for chance between arteriography and duplex scanning as expressed by the Kappa statistic was 0.675 +/- SE (K) 0.096. This level of agreement compared favorably to that of inter- and intra-observer variability in reading cerebral angiograms. The accuracy reported justifies the clinical use of ultrasonic duplex scanning in the detection of recurrent stenosis after carotid endarterectomy.
Language of Publication
English
Unique Identifier
83277175

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MeSH Heading (Major)
Carotid Artery Diseases|DI/*SU; Cerebral Angiography|*; Endarterectomy|*; Postoperative Complications|*DI; Ultrasonics|*DU
MeSH Heading
Blood Flow Velocity; Comparative Study; Female; Human; Male; Recurrence; Spectrum Analysis; Support, U.S. Gov't, P.H.S.

Publication Type
JOURNAL ARTICLE
ISSN
0301-5629
Country of Publication
ENGLAND

Record 21 from database: MEDLINE
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Title
Endoluminal repair of internal carotid artery aneurysm: a feasible but hazardous procedure.
Author
May J; White GH; Waugh R; Brennan J
Address
Department of Surgery, University of Sydney, Australia.
Source
J Vasc Surg, 1997 Dec, 26:6, 1055-60
Abstract
PURPOSE: The aim of this study was to report the repair of an aneurysm of the internal carotid artery using the endoluminal method. METHODS: A 70-year-old male patient noted a swelling in the right side of his neck 22 years after endarterectomy of the right internal carotid artery. Duplex ultrasound confirmed the clinical diagnosis of aneurysm of the internal carotid artery. Further investigation included contrast-enhanced computed tomographic (CT) scanning and carotid angiography performed via a retrograde femoral approach. The aneurysm contained thrombus and was 3 cm in diameter and in length. It extended superiorly from a point 0.5 cm above the carotid bifurcation to a point estimated to be 2 cm from the base of the skull. Repair of the aneurysm was undertaken using the endoluminal method. A self-expanding endograft 8 mm in diameter and 4 cm in length was introduced through a 12F sheath in the common carotid artery. An on-table completion angiogram of the right-sided extracranial carotid arteries and the intracranial internal carotid artery and branches was obtained. RESULTS: The completion angiogram and postoperative CT scan confirmed exclusion of the aneurysm sac from the circulation. The patient awoke from anesthesia with complete paralysis of the left arm. Recovery of movement commenced 1 hour later. A brain CT scan demonstrated the event to be an embolic stroke. Strength had returned by 7 days. Function of the arm was good 1 month after operation, but coordination for fine movements was lacking. At the 6-month follow-up, good arm function was maintained. A duplex ultrasound scan demonstrated not only continued exclusion of the aneurysm sac but occlusion of the endograft, also. CONCLUSIONS: Endoluminal repair of aneurysms of the internal carotid artery is feasible but carries the risk of major morbidity as a result of peripheral embolization and early occlusion of the endograft.
Language of Publication
English
Unique Identifier
98085811

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MeSH Heading (Major)
Aneurysm|RA/*SU; Carotid Artery Diseases|RA/*SU; Vascular Surgical Procedures|*AE/*MT
MeSH Heading
Aged; Angiography; Carotid Artery, Internal|SU; Carotid Stenosis|ET; Case Report; Cerebrovascular Disorders|ET; Feasibility Studies; Human; Male; Tomography, X-Ray Computed

Publication Type
JOURNAL ARTICLE
ISSN
0741-5214
Country of Publication
UNITED STATES

Record 22 from database: MEDLINE
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Title
Indications for intravenous and intraarterial digital subtraction angiography (DSA) in the diagnosis of cerebrovascular insufficiency. A new diagnostic concept including ultrasound.
Author
Neufang KF; Friedmann G
Address
 
Source
Eur J Radiol, 1985 May, 5:2, 139-46
Abstract
For screening of arteriosclerotic lesions of the carotid bifurcation duplex scanning (B-mode imaging plus doppler flow analysis) is the method of first choice, because it is really noninvasive and offers the same results as intravenous DSA (IV DSA). IV DSA should not be performed as a screening procedure unless ultrasound examinations are not available or are inadequate. Except for patients with isolated unilateral stenosis of the internal carotid artery near the bifurcation confirmed with both duplex scanning and IV DSA, arteriography is required for therapy planning. Aortic arch angiogram, selective extra- and intracranial carotid arteriography and--if necessary--vertebral and subclavian arteriography can be performed with intraarterial DSA (IA DSA). The application of DSA to catheter arteriography will help to reduce further the potential risk of adverse reactions related to high intravasal contrast doses specially in the cerebral circulation, but will not turn arteriography into a risk-free procedure. Postoperative examinations of the carotid bifurcation can be performed with ultrasound as well as with IV DSA. Extracranial bypasses are best demonstrated with IV DSA. Extraintracranial bypasses can be demonstrated only with IA DSA.
Language of Publication
English
Unique Identifier
85203939

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MeSH Heading (Major)
Angiography|*MT; Carotid Artery Diseases|DI/*RA/SU; Intracranial Arteriosclerosis|DI/*RA/SU; Ultrasonography|*
MeSH Heading
Follow-Up Studies; Human; Postoperative Care; Preoperative Care; Subtraction Technique

Publication Type
JOURNAL ARTICLE
ISSN
0720-048X
Country of Publication
GERMANY, WEST

Record 23 from database: MEDLINE
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Title
Peripheral transluminal angioplasty under ultrasound guidance: initial clinical experience and prevalence of lower limb lesions amenable to ultrasound-guided angioplasty.
Author
Ramaswami G; al Kutoubi A; Nicolaides AN; Dhanjil S; Griffin M; Ryan MF
Address
Irvine Laboratory for Cardiovascular Investigation and Research, St. Mary's Hospital, London, United Kingdom.
Source
J Endovasc Surg, 1995 Feb, 2:1, 27-35
Abstract
PURPOSE: Currently, endovascular techniques require monitoring by radiographic imaging for accurate catheter placement. The aim of this study was first to determine the feasibility of angioplasty under ultrasound guidance using a special catheter system. Based on this outcome, the second goal was to investigate the prevalence of lesions amenable to ultrasound-guided angioplasty. METHODS: A balloon catheter system (Echomark) has been developed, which allows accurate catheter guidance by ultrasound imaging. An ultrasound-sensitive piezoelectric sensor positioned in the middle of the balloon portion of the angioplasty catheter is interfaced to an external duplex scanner via the catheter system. The exact position of the balloon relative to the transducer is calculated and reproduced on the screen of the duplex scanner to guide balloon positioning. In the feasibility assessment of the procedure, 16 patients with disabling claudication and rest pain were selected for balloon angioplasty under ultrasound guidance based on arteriographic and hemodynamic lesion criteria of > 50% stenosis with a peak systolic velocity ration > 2.5 in a lesion < 4 cm long that could be imaged by duplex ultrasonography. A fall in the peak systolic velocity ratio below 2.0 was selected for a procedural endpoint corresponding to < 30% residual stenosis on the completion angiogram. In the second part of the study, the prevalence of stenoses amenable to ultrasound-guided angioplasty was studied in 80 patients presenting with symptoms of peripheral arterial disease. RESULTS: In the feasibility study, 20 stenoses (5 common iliac, 6 external iliac, and 8 superficial femoral arteries and 1 graft) meeting the inclusion criteria were subjected to ultrasound-guided angioplasty with confirmation by completion angiography. The procedure was possible in 18 (90%) of the 20 stenoses. The two failures occurred in iliac arteries that could not be imaged by duplex scanning due to obesity, bowel gas, and/or vessel wall calcification. In one case, the peak systolic velocity ratio exceeded 2.5 despite a satisfactory control arteriogram; redilation was performed, and the ratio fell below 2.0. In the second part of the study, 21 (26.2%) of the 80 patients had 29 stenoses that were amenable to angioplasty according to angiographic criteria (> 50% stenosis and < 4 cm length). All these stenoses were evaluated with duplex scanning to determine their suitability for angioplasty under ultrasound guidance. Twenty-three (79%) of the 29 lesions selected for angioplasty were well visualized by duplex, and angioplasty would have been possible based on our initial clinical experience. CONCLUSIONS: Angioplasty under ultrasound control is a feasible technique for peripheral lesions. Ultrasound allows monitoring of both anatomical and hemodynamic parameters during angioplasty and thus provides a procedural endpoint that correlates to the control angiogram. A large proportion (79%) of stenoses deemed suitable for angioplasty can be well visualized by ultrasound, but obesity, vessel wall calcification, and bowel gas may limit the ability to obtain a satisfactory ultrasound image. Ultrasound-guided angioplasty is a potentially useful procedure that warrants further investigation.
Language of Publication
English
Unique Identifier
97378510

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MeSH Heading (Major)
Angioplasty, Balloon|*MT; Arterial Occlusive Diseases|*TH; Leg|*BS; Ultrasonography, Interventional|*
MeSH Heading
Constriction, Pathologic; Feasibility Studies; Femoral Artery; Human; Iliac Artery; Intermittent Claudication; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
ISSN
1074-6218
Country of Publication
UNITED STATES

Record 24 from database: MEDLINE
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Title
Focal wall overstretching after high-pressure coronary stent implantation does not influence restenosis.
Author
Nakamura S; Di Francesco L; Finci L; Reimers B; Adamian M; Di Mario C; Colombo A
Address
Division of Cardiology, Ohta General Hospital, Gunma, Japan.
Source
Catheter Cardiovasc Interv, 1999 Sep, 48:1, 24-30
Abstract
To determine if vessel wall overstretching during coronary stenting is associated with a higher restenosis rate, the intravascular ultrasound morphological evaluation was performed following ultrasound criteria. A total of 468 lesions with successful coronary Palmaz-Schatz stenting guided by intravascular ultrasound were classified into the no overstretching group (n = 295) and the overstretching group (n = 147). There were 26 lesions not classifiable due to the poststent morphology. Balloon-to-vessel ratio was 1.12 +/- 0.17 in the no focal overstretching group and 1. 20 +/- 0.20 in the overstretching group (P < 0.0002). Follow-up angiogram was performed in 77% of no focal overstretching group and in 75% of the focal overstretching group. The restenosis rate of the no focal overstretching group was 19.8% and 20.9% in the focal overstretching group, respectively (P = 0.65). Focal overstretching was more frequent following balloon oversizing. No increase in restenosis rate, found in focal overstretched stented lesions, leads us to the hypothesis of a regulation of smooth-muscle-cell proliferation activated by the normalization of blood flow and of shear stress, when stent implantation succeeds in optimally improving the lumen. Cathet. Cardiovasc. Intervent. 48:24-30, 1999. Copyright 1999 Wiley-Liss, Inc.
Language of Publication
English
Unique Identifier
99396750

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MeSH Heading (Major)
Coronary Disease|PP/RA/*TH/US; Coronary Vessels|*/PP/US; Stents|*
MeSH Heading
Coronary Angiography; Female; Human; Male; Middle Age; Recurrence; Stress, Mechanical; Ultrasonography, Interventional

Publication Type
JOURNAL ARTICLE
ISSN
1522-1946
Country of Publication
UNITED STATES

Record 25 from database: MEDLINE
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Title
Clinical potential of intravascular ultrasound for physiological assessment of coronary stenosis: relationship between quantitative ultrasound tomography and pressure-derived fractional flow reserve.
Author
Takagi A; Tsurumi Y; Ishii Y; Suzuki K; Kawana M; Kasanuki H
Address
Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan.
Source
Circulation, 1999 Jul, 100:3, 250-5
Abstract
BACKGROUND: Little is known regarding intravascular ultrasound (IVUS) criteria to determine the functional severity of coronary stenosis. Recently, fractional flow reserve (FFR) has emerged as a lesion-specific index of the functional severity of a coronary stenosis that is independent of systemic hemodynamic variability. The present study was undertaken to determine the IVUS parameters for the physiological severity of coronary stenosis. METHODS AND RESULTS: Fifty-one lesions in 42 patients were evaluated by means of quantitative coronary angiogram, IVUS, and intracoronary pressure measurements. The FFR was calculated as the ratio of the distal coronary pressure divided by the proximal coronary pressure under hyperemia. We considered a value of the FFR <0.75 as significant in determining inducible ischemia, according to the previous studies. The minimal luminal area (MLA) and the area stenosis were measured by IVUS. By regression analysis, the MLA showed a positive correlation with the FFR value (r(2)=0.62, P<0.0001). The area stenosis had a significant inverse correlation with the value of FFR (r(2)=0.60, P<0.0001). The IVUS thresholds that maximized the sensitivity and specificity were MLA <3.0 mm(2) (sensitivity, 83.0%; specificity, 92.3%) and area stenosis >0.6 (sensitivity, 92.0%; specificity, 88.5%). The combination of both criteria (MLA <3.0 mm(2) and area stenosis <0.6) without exception met a value of the FFR <0.75. CONCLUSIONS: Anatomic parameters obtained by IVUS showed a significant correlation to the FFR values. The present study demonstrated that the combination of the MLA and area stenosis measured by IVUS can be an anatomic predictor for the physiological impact of coronary epicardial stenosis.
Language of Publication
English
Unique Identifier
99341925

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MeSH Heading (Major)
Coronary Disease|*PP/US; Coronary Vessels|*PP/US; Ultrasonography|*MT
MeSH Heading
Comparative Study; Coronary Angiography; Female; Human; Male; Middle Age; Multivariate Analysis; Pressure; Support, Non-U.S. Gov't; Tomography|MT

Publication Type
CLINICAL TRIAL; JOURNAL ARTICLE
ISSN
0009-7322
Country of Publication
UNITED STATES

Record 26 from database: MEDLINE
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Title
The value of intravascular ultrasound in interventional cardiology.
Author
Pinto FJ
Address
University Hospital Santa Maria, Lisbon University Medical School, Division of Cardiology, Portugal. hfjpinto@fml.fm.ul.pt
Source
Rev Port Cardiol, 1999 Feb, 18 Suppl 1:, I97-104
Abstract
Intracoronary ultrasound (ICUS) is a new imaging technique with the unique ability to study vessel wall morphology in vivo, accurately displaying the details of vessel structure. The coronary angiogram represents only a projectional image of the vessel lumen without providing any information concerning vascular wall architecture. Interventional cardiology has developed over the last years with the appearance of new devices and consequently new challenges. The selection of an appropriate device and the assessment of any intervention, as well as the understanding of its mechanisms is essential to perform a better intervention. The use of a tool, such as ICUS, able to identify vessel wall anomalies, complementing coronary angiography, seems to be an appropriate method in the regard. The last years have witnessed an array of studies demonstrating the advantages and disadvantages of ICUS in the setting of interventional cardiology. Despite some contradictions in the literature, the result of a new technology still under scrutiny, it is possible to summarise some of the major achievements: Lesion assessment before coronary interventions for selection of treatment, including calcium detection, plaque eccentricity, diffuse atherosclerotic disease, type of vessel remodelling; ICUS during balloon angioplasty has helped in balloon diameter selection, identification of pseudo successful results and presence/severity of wall dissections, as well as the search of predictors of restenosis; during rotational and directional atherectomy, ICUS can help in the definition of the lesion most suitable for rotational atherectomy, showing if there is a diffuse sub endothelial calcification, excluding unsuitable lesions, selecting cut direction and directly assessing the adequacy of plaque removal; during stent implantation it helps to determine if there was a complete apposition, detect residual narrowing or proximal/distal stenoses or dissections requiring further treatment. Some new concepts have been introduced by ICUS, such as the negative remodelling as one of the mechanisms of restenosis. New developments are under way, including combined devices, looking forward ultrasound, high frequency probes, imaging wires, tissue characterisation and three dimensional technology. Therefore, ICUS has reached enough maturity to be considered an important tool in the catheterization laboratory, complementing the information provided by coronary angiography. However, some more research needs to be done to answer some important questions regarding the whole array of potential applications in an environment of cost containment as the one we live in today.
Language of Publication
English
Unique Identifier
99207405

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MeSH Heading (Major)
Cardiology|*MT; Ultrasonography, Interventional|*
MeSH Heading
Angioplasty, Transluminal, Percutaneous Coronary; Atherectomy, Coronary; Coronary Disease|TH/US; Human; Stents; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
0304-4750
Country of Publication
PORTUGAL

Record 27 from database: MEDLINE
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Title
Can duplex ultrasonography select appropriate patients for carotid endarterectomy?
Author
Chen JC; Salvian AJ; Taylor DC; Teal PA; Marotta TR; Hsiang YN
Address
Department of Surgery, Vancouver Hospital, British Columbia, Canada.
Source
Eur J Vasc Endovasc Surg, 1997 Dec, 14:6, 451-6
Abstract
OBJECTIVES: This study investigated the reliability of carotid duplex ultrasound (DUS) to identify appropriate candidates for carotid endarterectomy (CEA) according to a panel of vascular specialists. DESIGN: Prospective study. MATERIAL: 102 patients with 145 carotid bifurcation stenosis or occlusions. METHODS: All patients who required a carotid angiogram were evaluated using DUS followed by carotid angiography. A blinded panel of four vascular specialists individually decided whether CEA would be appropriate for each patient based on pre-angiographic information. Angiograms were then shown to panelists to see if their management decision was altered by the angiogram. RESULTS: For stenosis > or = 80% on DUS (n = 60), panelists unanimously agreed on CEA without angiography in 57 lesions. In 50 lesions (87.7%), angiography showed > or = 70% stenosis and the management plan remained unchanged. For the other seven lesions, intracranial aneurysms (n = 2), tandem intracranial lesion (n = 1), unsuspected proximal common carotid lesion (n = 1), a 40% stenotic lesion (n = 1), and high carotid bifurcations (n = 2) were seen. In lesions with 50-79% stenosis on DUS (n = 66), none of the panelists recommended CEA without prior angiography. Eighteen (27%) of these lesions were > or = 70% stenosed on angiogram. Complications of angiograms included one stroke, one haematoma, and one severe allergic reaction. CONCLUSION: Carotid duplex ultrasonography without angiography can reliably select lesions appropriate for surgery only when critical stenosis > or = 80% is chosen. Routine angiography is recommended for carotid stenosis of 50-79% when CEA is considered.
Language of Publication
English
Unique Identifier
98128648

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MeSH Heading (Major)
Carotid Stenosis|RA/*SU/*US; Endarterectomy, Carotid|*
MeSH Heading
Cerebral Angiography; Comparative Study; Human; Patient Selection; Prospective Studies; Reproducibility of Results

Publication Type
JOURNAL ARTICLE
ISSN
1078-5884
Country of Publication
ENGLAND

Record 28 from database: MEDLINE
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Title
Intracoronary Doppler assessment of moderate coronary artery disease: comparison with 201Tl imaging and coronary angiography. FACTS Study Group.
Author
Heller LI; Cates C; Popma J; Deckelbaum LI; Joye JD; Dahlberg ST; Villegas BJ; Arnold A; Kipperman R; Grinstead WC; Balcom S; Ma Y; Cleman M; Steingart RM; Leppo JA
Address
Winthrop-University Hospital, Mineola, NY 11501, USA.
Source
Circulation, 1997 Jul, 96:2, 484-90
Abstract
BACKGROUND: Coronary angiography may not reliably predict whether a stenosis causes exercise-induced ischemia. Intracoronary Doppler ultrasound may enhance diagnostic accuracy by providing a physiological assessment of stenosis severity. The goal of this study was to compare intracoronary Doppler ultrasound with both 201Tl imaging and coronary angiography. METHODS AND RESULTS: Fifty-five patients with 67 stenotic coronary arteries underwent coronary angiography with intracoronary Doppler ultrasound and had exercise 201Tl testing within a 1-week period. Coronary flow reserve was measured, and analyses were performed by independent core laboratories. The mean stenosis was 59+/-12%; 51 of 67 stenoses were intermediate in severity (40% to 70%). A coronary flow reserve < 1.7 predicted the presence of a stress 201Tl defect in 56 of 67 stenoses (agreement=84%; kappa=0.67; 95% CI=0.48 to 0.86). In the patients who achieved 75% of their predicted maximum heart rate, the Doppler and 201Tl imaging data agreed in 46 of 52 stenoses (agreement=88%; kappa=0.77; 95%CI=0.57 to 0.97). Scatter was evident when angiography was compared with coronary flow reserve (r=.43), and the angiogram did not reliably predict the results of the 201Tl stress test (kappa=0.21; agreement=57% to 63%). CONCLUSIONS: Doppler-derived coronary flow reserve accurately predicts the presence of exercise-induced ischemia on stress 201Tl imaging, and coronary angiography does not reliably assess the physiological significance of an intermediate coronary stenosis.
Language of Publication
English
Unique Identifier
97386367

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MeSH Heading (Major)
Coronary Angiography|*; Coronary Disease|*/PP/RI/US; Tomography, Emission-Computed, Single-Photon|*; Ultrasonography, Doppler|*
MeSH Heading
Aged; Comparative Study; Coronary Circulation; Female; Human; Male; Middle Age; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
ISSN
0009-7322
Country of Publication
UNITED STATES

Record 29 from database: MEDLINE
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Title
Heterogeneity of cardiac allograft vasculopathy: clinical insights from coronary angioscopy.
Author
Mehra MR; Ventura HO; Jain SP; Ramireddy K; Ali A; Stapleton DD; Smart FW; Ramee SR; Collins TJ; White CJ
Address
Department of Internal Medicine, Ochsner Medical Institutions, New Orleans, Louisiana 70121, USA.
Source
J Am Coll Cardiol, 1997 May, 29:6, 1339-44
Abstract
OBJECTIVES: With this study, we sought to examine the heterogeneity of cardiac allograft vasculopathy in vivo using coronary angioscopy as an adjunct to intravascular ultrasound, and we evaluated the clinical relations of immunologic and nonimmunologic risk factors with the different forms of cardiac allograft vasculopathy detected angioscopically. BACKGROUND: Intravascular ultrasound detects vascular intimal proliferation accurately but is limited in its ability to delineate morphologic characteristics. Coronary angioscopy can evaluate intimal surface morphology by direct visualization and can differentiate pathologically distinct forms of plaque topography on the basis of color and contour. METHODS: We studied 107 consecutive heart transplant recipients with intravascular ultrasound and angioscopy at the time of their annual angiogram, and we assessed the relation of nonimmunologic and immunologic risk factors to the development of cardiac allograft vasculopathy distinguished angioscopically into a pigmented (yellow) or nonpigmented (white) intimal thickening. We further evaluated the clinical differences in cardiac events among these two forms of angioscopically heterogeneous forms of cardiac allograft vasculopathy. RESULTS: Significant clinical predictors of nonpigmented intimal thickening were advanced donor age and lower mean cyclosporine levels, whereas hyperlipidemia, cumulative prednisone dose and time since transplantation correlated with pigmented intimal hyperplasia. In addition, comparisons between the two angioscopic groups revealed increased intimal thickening, serum cholesterol, low density lipoprotein cholesterol, acute allograft rejection and time since transplantation in the group with pigmented intimal thickening (p < 0.05). With regard to cardiac events, nonpigmented plaque was more frequently found in the sudden death group (53% vs. 20%, p = 0.05), whereas the nonsudden cardiac event group had a significantly higher prevalence of pigmented plaque (80% vs. 47%, p = 0.07). CONCLUSIONS: These findings indicate that cardiac allograft vasculopathy is a heterogeneous disease with varied morphologic expressions with different clinical implications. Furthermore, this investigation provides insight into the cohesive, yet diverse influences of various factors, particularly immunosuppression, in these forms of cardiac allograft vasculopathy.
Language of Publication
English
Unique Identifier
97283099

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MeSH Heading (Major)
Coronary Disease|*ET/PA/US; Coronary Vessels|*PA/US; Heart Transplantation|*AE
MeSH Heading
Adult; Angioscopy; Death, Sudden, Cardiac|EP/ET; Female; Graft Rejection|CO; Human; Hyperplasia|PA; Immunosuppression|AE; Male; Middle Age; Pigmentation; Risk Factors; Tunica Intima|PA; Ultrasonography, Interventional

Publication Type
JOURNAL ARTICLE
ISSN
0735-1097
Country of Publication
UNITED STATES

Record 30 from database: MEDLINE
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Title
Controversies in surgical therapy for APUDomas.
Author
Fraker DL; Norton JA
Address
National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Source
Semin Surg Oncol, 1993 Sep, 9:5, 437-42
Abstract
Location of gastrinomas by means of portal venous sampling is a technique in which venous blood from various sites in the portal system around the pancreas and duodenum is obtained and assayed for gastrin levels. A gradient of 50% or greater compared to systemic gastrin levels from a given location regionally identifies the site of gastrin overproduction, thereby locating the tumor. The only area in which venous sampling may help, in the authors' opinion, is in the small subset of patients who have occult gastrinoma not imaged with any other modality, in the body or tail of the pancreas that cannot be found with intraoperative ultrasound or palpation. It is considered that a secretin angiogram is equally effective and is a simpler procedure. Similarly, in insulinoma regional location of the tumor by means of a calcium angiogram has eliminated the usefulness of portal venous sampling. Controversial areas of surgical treatment of APUDomas often reflect a balance between the risks and benefits of aggressive surgery, as data to support an aggressive surgical approach to obtain improved survival often do not exist. For example, if patients with occult MTC can undergo cervical reexploration with minimal or no morbidity the potential benefit of removing malignant disease, warrants this approach. Similarly, if patients with MEN-1 can be explored safely with resection of pancreatic and duodenal tumors, then this position can be defended. On the other hand, if a subgroup of patients with MEN-2 and pheochromocytomas can be spared bilateral adrenalectomy without compromising their long-term outcome in terms of disease-free survival, then this conservative approach is warranted.(ABSTRACT TRUNCATED AT 250 WORDS)
Language of Publication
English
Unique Identifier
94069183

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MeSH Heading (Major)
Apudoma|*SU
MeSH Heading
Adrenal Gland Neoplasms|SU; Carcinoma, Medullary|SU; Gastrinoma|SU; Human; Insulinoma|SU; Multiple Endocrine Neoplasia|SU; Pancreatic Neoplasms|SU; Pheochromocytoma|SU; Thyroid Neoplasms|SU

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
8756-0437
Country of Publication
UNITED STATES

Record 31 from database: MEDLINE
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Title
Intravascular imaging and physiologic lesion assessment to define critical coronary stenoses.
Author
Gruberg L; Mintz GS; Satler LF; Kent KM; Pichard AD; Leon MB
Address
Intravascular Ultrasound Imaging and Cardiac Catheterization Laboratories, Washington, DC, USA.
Source
Ann Thorac Surg, 1999 Oct, 68:4, 1547-51
Abstract
Despite the fact that the coronary angiogram is the gold-standard in assessing a coronary artery stenosis for the purposes of clinical decision making, it has many limitations. Alternative methods are available. This article discusses three of these: intravascular ultrasound, coronary flow reserve, and fractional flow reserve.
Language of Publication
English
Unique Identifier
20008911

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MeSH Heading (Major)
Coronary Disease|PP/SU/*US; Ultrasonography, Interventional|*
MeSH Heading
Blood Flow Velocity|PH; Collateral Circulation|PH; Comparative Study; Coronary Angiography; Coronary Circulation|PH; Female; Human; Male; Middle Age; Sensitivity and Specificity; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
0003-4975
Country of Publication
UNITED STATES

Record 32 from database: MEDLINE
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Title
Symptomatic liver hemangioma with intra-tumor hemorrhage treated by angiography and embolization during pregnancy.
Author
Graham E; Cohen AW; Soulen M; Faye R
Address
Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia.
Source
Obstet Gynecol, 1993 May, 81:5 ( Pt 2), 813-6
Abstract
BACKGROUND: Cavernous hemangiomas are the most common benign tumors of the liver and are found in about 2% of autopsy patients. The vast majority are small (less than 4 cm) and asymptomatic, but there have been a few reported cases of these lesions leading to severe pain and even spontaneous fatal hemorrhage. Estrogen may cause the growth of liver hemangiomas, but there is a paucity of information concerning the effect of pregnancy upon these lesions. CASE: A patient presented at 18 weeks' gestation with the acute onset of vomiting and epigastric pain. A right upper-quadrant ultrasound scan found a 9-cm hypodense lesion within the liver, and magnetic resonance imaging (MRI) suggested a hemangioma. The lesion was believed to be inoperable, and selective catheterization of the common hepatic artery was performed. An angiogram demonstrated a round vascular mass 12 cm in diameter occupying much of the left side of the liver, with the vascular supply from the middle hepatic artery and to a lesser extent from the left hepatic artery. Embolization was performed, and a post-embolization image demonstrated satisfactory occlusion of the vessels treated. The patient's epigastric pain resolved after the procedure. The lesion was observed with monthly ultrasound and regressed to about 50% of its original size. The patient was scheduled for an elective primary cesarean delivery at 39 weeks to avoid possible rupture of the hepatic hemangioma during the second stage of labor. Her cesarean and postpartum course were uncomplicated. CONCLUSION: A symptomatic liver hemangioma with intratumor hemorrhage can be successfully treated with embolization during pregnancy. Because of the paucity of reported cases, it is uncertain whether vaginal birth is contraindicated in these patients.
Language of Publication
English
Unique Identifier
93226306

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MeSH Heading (Major)
Embolization, Therapeutic|*; Hemangioma, Cavernous|RA/*TH; Hemorrhage|RA/*TH; Liver Neoplasms|RA/*TH; Pregnancy Complications, Neoplastic|RA/*TH
MeSH Heading
Adult; Angiography; Case Report; Female; Hepatic Artery; Human; Pregnancy

Publication Type
JOURNAL ARTICLE
ISSN
0029-7844
Country of Publication
UNITED STATES

Record 33 from database: MEDLINE
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Title
Intravascular imaging and physiologic lesion assessment to define critical coronary stenoses.
Author
Gruberg L; Mintz GS; Satler LF; Kent KM; Pichard AD; Leon MB
Address
Intravascular Ultrasound Imaging and Cardiac Catheterization Laboratories, Washington, DC, USA.
Source
Ann Thorac Surg, 1999 Oct, 68:4, 1547-51
Abstract
Despite the fact that the coronary angiogram is the gold-standard in assessing a coronary artery stenosis for the purposes of clinical decision making, it has many limitations. Alternative methods are available. This article discusses three of these: intravascular ultrasound, coronary flow reserve, and fractional flow reserve.
Language of Publication
English
Unique Identifier
20008911

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MeSH Heading (Major)
Coronary Disease|PP/SU/*US; Ultrasonography, Interventional|*
MeSH Heading
Blood Flow Velocity|PH; Collateral Circulation|PH; Comparative Study; Coronary Angiography; Coronary Circulation|PH; Female; Human; Male; Middle Age; Sensitivity and Specificity; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
0003-4975
Country of Publication
UNITED STATES

Record 34 from database: MEDLINE
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Title
Spontaneous rupture of hepatic epithelioid haemangio-endothelioma.
Author
Lau WY; Dewar GA; Li AK
Address
Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT.
Source
Aust N Z J Surg, 1989 Dec, 59:12, 972-4
Abstract
A 69 year old man presented with haemoperitoneum due to spontaneous rupture of a hepatic epithelioid haemangio-endothelioma. The tumour was found by ultrasound and coeliac angiogram to be locally advanced, involving both lobes of the liver. The bleeding was stopped by transcatheter arterial embolization. The diagnosis was established 4 weeks later by a Trucut biopsy under ultrasound guidance. The patient refused further treatment by radiation and chemotherapy, so he was observed closely. Chest radiography carried out 3 months later revealed multiple pulmonary secondaries. Despite his disseminated disease, he was well and enjoying a normal active life 4 months after embolization.
Language of Publication
English
Unique Identifier
90088359

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MeSH Heading (Major)
Hemangioendothelioma|*CO/DI/PA; Hemoperitoneum|*ET/TH; Liver Neoplasms|*CO/DI/PA
MeSH Heading
Aged; Case Report; Embolization, Therapeutic; Human; Male; Rupture, Spontaneous

Publication Type
JOURNAL ARTICLE
ISSN
0004-8682
Country of Publication
AUSTRALIA

Record 35 from database: MEDLINE
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Title
Does use of intravascular ultrasound accelerate arteriopathy in heart transplant recipients?
Author
Son R; Tobis JM; Yeatman LA; Johnson JA; Wener LS; Kobashigawa JA
Address
University of California, Department of Medicine/Cardiology, Irvine, USA.
Source
Am Heart J, 1999 Aug, 138:2 Pt 1, 358-63
Abstract
BACKGROUND: Intravascular ultrasound (IVUS) is a sensitive method for assessing allograft vasculopathy in heart transplant recipients, but it is not known whether this instrumentation traumatizes the transplanted arteries and affects progression of arteriopathy. METHODS AND RESULTS: Yearly coronary angiograms were obtained in 86 patients who underwent heart transplantation between January 1991 and May 1995. Patients were divided into 3 groups: (1) no IVUS performed after transplantation (group 1, n = 47); (2) IVUS of the left anterior descending artery (LAD) performed only at year 1 (group 2, n = 13); and (3) IVUS of the LAD performed at both baseline (within 2 months after transplantation) and year 1 after transplantation (group 3, n = 26). Coronary angiography measurements of lumen diameter were performed at 5 segments along the length of the LAD and left circumflex artery (LCX) from baseline through the second-year studies except in group 2, which did not receive a baseline angiogram; IVUS measurements were obtained at 10 cross sections from each artery. At baseline, there was no significant difference in vessel diameter for either the LAD or the LCX artery between the IVUS (group 3) and no IVUS (group 1) groups. Within each group, the lumen of both the LAD and LCX narrowed from baseline to year 1 (group 1: 3.3 +/- 0.6 mm to 2.8 +/- 0.5 mm in LAD, P =.001; 3. 3 +/- 0.6 mm to 3.0 +/- 0.5 mm in LCX, P =.006; group 3: 3.5 +/- 0.7 mm to 3.1 +/- 0.6 mm in LAD, P =.01; 3.1 +/- 0.6 mm to 2.8 +/- 0.5 mm in LCX, P = 0.07), but there were no significant differences between the instrumented artery (LAD) and control artery (LCX) or further changes observed at year 2. There were also no significant differences in the percent reductions at year 1 and year 2 between arteries or between groups. By IVUS, from baseline to year 1 in group 3, the plaque cross-sectional area (CSA) increased (1.6 +/- 1. 9 to 2.3 +/- 1.7 mm(2), P <.0001), the lumen CSA decreased (12.7 +/- 3.7 to 11.7 +/- 3.3 mm(2), P =.04), and the maximum lumen diameter decreased (4.2 +/- 0.6 to 4.0 +/- 0.6 mm, P =.04). CONCLUSIONS: The use of IVUS is not associated with acceleration of arteriopathy in heart transplantation recipients. Luminal narrowing occurs predominantly during the first year after transplantation. There was no significant change in lumen dimensions during the second year.
Language of Publication
English
Unique Identifier
99355524

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MeSH Heading (Major)
Coronary Arteriosclerosis|*US; Heart Transplantation|*AE/*US; Ultrasonography, Interventional|*
MeSH Heading
Adult; Aged; Coronary Angiography; Disease Progression; Female; Human; Male; Middle Age; Retrospective Studies

Publication Type
JOURNAL ARTICLE
ISSN
0002-8703
Country of Publication
UNITED STATES

Record 36 from database: MEDLINE
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Title
Incidence and clinical relevance of coronary calcification detected by electron beam computed tomography in heart transplant recipients.
Author
Ludman PF; Lazem F; Barbir M; Yacoub M
Address
Royal Brompton and Harefield Hospital NHS Trust, London, U.K.
Source
Eur Heart J, 1999 Feb, 20:4, 303-8
Abstract
BACKGROUND: Patients treated by cardiac transplantation who survive beyond one year are at significant risk from fatal coronary artery disease. The development of coronary artery calcification in these patients is discussed and methods available to detect it are reviewed. OBJECTIVES: To assess the clinical importance of coronary artery calcium in heart transplant recipients. METHODS: In a cohort of 102 cardiac transplant recipients, electron beam computed tomography was used to measure calcium in the coronary arterial wall 63 days to 9.1 years (median 4.6 years) after transplantation. The results were compared with angiographic findings and with conventional coronary disease risk factors. The patients were followed for a mean of 2.12 years (1.2-4.02 years) to assess the relationship between these findings and future cardiac events. RESULTS: Forty-one (40.2%) had a stenosis of > 24% in one or more major coronary artery at angiography. Forty-six (45%) had a coronary calcium score > 0. The absence of calcium had a negative predictive value with respect to angiographic disease in any vessels of 87.5%. Logistic regression revealed that dyslipidaemia, systemic hypertension and organ ischaemic time were significant predictors of calcification. At follow-up, both an abnormal coronary angiogram and coronary calcium were found to be the only significant predictors of late events. Multivariate analysis suggested that the detection of coronary calcium did not offer any additional predictive information over that provided by the angiogram itself. CONCLUSION: Electron beam computed tomography is well suited to the assessment of calcium in the coronary arteries of heart transplant recipients, although the mechanisms of this calcification remain poorly understood. Calcium is detected more frequently than would be suggested by studies using intravascular ultrasound. It is associated with the presence of angiographic disease, and with some conventional risk factors for coronary disease. At follow-up the presence of coronary calcium was associated with an adverse clinical outcome, as it is in conventional ischaemic heart disease.
Language of Publication
English
Unique Identifier
99199698

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MeSH Heading (Major)
Calcinosis|*DI/*EP/ET; Coronary Disease|*DI/*EP/ET; Coronary Vessels|*PA; Heart Transplantation|*AE
MeSH Heading
Adult; Aged; Cohort Studies; Comparative Study; Coronary Angiography; Female; Follow-Up Studies; Human; Incidence; Logistic Models; Male; Middle Age; Multivariate Analysis; Predictive Value of Tests; Risk Assessment; Sensitivity and Specificity; Tomography, X-Ray Computed

Publication Type
JOURNAL ARTICLE
ISSN
0195-668X
Country of Publication
ENGLAND

Record 37 from database: MEDLINE
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Title
Role of transcutaneous ultrasound in evaluation of graft patency following minimally invasive coronary surgery.
Author
Gupta S; Murgatroyd F; Widenka K; Spyt TJ; De Bono DP
Address
Department of Cardiology and Cardiac Surgery, Glenfield Hospital, Leicester, UK.
Source
Eur J Cardiothorac Surg, 1998 Oct, 14 Suppl 1:, S88-92
Abstract
OBJECTIVE: Recent development in minimally invasive coronary surgery prompted us to carry out prospective evaluation of patients undergoing coronary artery bypass grafting through left anterior small thoracotomy. METHODS: Between April 1996 and February 1997, 15 patients (age 32-70, 12 male) were operated on. The left internal thoracic artery (LITA) basal flow was assessed by means of transcutaneous Duplex ultrasound scanning with pulsed waved Doppler. Eight patients were studied in the immediate postoperative period (2-4 days) and seven patients (1-7 months) following revascularisation. In addition to that, nine patients underwent coronary angiography. RESULTS: LITA graft flows were quantifiable in all 15 patients. In two patients there was a significant reduction in both time-averaged velocity and total flow. The subsequent coronary angiogram revealed severe (>50%) stenosis of LITA graft in both patients. One of these patients had a reversible obstruction documented by Duplex scanning and coronary angiography. Systolic measures did not differ between normal (13) and stenosed grafts (2), but diastolic time-averaged velocity (indicating coronary run-off) and total flow appeared lower in the latter. CONCLUSIONS: LITA flow following left anterior small thoracotomy surgery can be evaluated non-invasively. Measurement of diastolic flow (i.e. coronary perfusion rather than internal thoracic branch run-off) and total flow is useful in estimating graft function.
Language of Publication
English
Unique Identifier
99029937

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MeSH Heading (Major)
Graft Occlusion, Vascular|RA/*US; Internal Mammary-Coronary Artery Anastomosis|*
MeSH Heading
Adult; Aged; Blood Flow Velocity; Coronary Angiography; Coronary Circulation; Female; Human; Male; Middle Age; Prospective Studies; Support, Non-U.S. Gov't; Surgical Procedures, Minimally Invasive; Thoracotomy; Time Factors; Ultrasonography, Doppler, Duplex; Ultrasonography, Doppler, Pulsed; Vascular Patency

Publication Type
JOURNAL ARTICLE
ISSN
1010-7940
Country of Publication
NETHERLANDS

Record 38 from database: MEDLINE
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Title
Recurrent carotid stenosis : results of the asymptomatic carotid atherosclerosis study.
Author
Moore WS; Kempczinski RF; Nelson JJ; Toole JF
Address
Department of Surgery, University of California at Los Angeles School of Medicine, California.
Source
Stroke, 1998 Oct, 29:10, 2018-25
Abstract
BACKGROUND and PURPOSE: We sought to determine the incidence of recurrent carotid stenosis in patients in the Asymptomatic Carotid Atherosclerosis Study (ACAS) who had undergone carotid endarterectomy and were prospectively followed with Doppler ultrasound for up to 5 years. METHODS: The ACAS database was interrogated to determine the rate of recurrent carotid stenosis (>/=60%) based up angiogram-validated Doppler data, with a 90% and a 95% positive predictive value, as well as information concerning the technologists' interpretation of percent stenosis. These 3 parameters are reported for each of 3 time intervals: within 3 months of operation (residual disease), between 3 and 18 months (early restenoses), and between 18 and 60 months (late restenosis). RESULTS: Of the 825 patients randomized to the surgical arm of the study, 720 actually underwent carotid endarterectomy, and 645 had complete ultrasound data. The aggregate incidence of residual and recurrent carotid stenosis for all time intervals ranged from 12.7% to 20.4%, depending on the positive predictive value confidence level desired. Residual disease occurred in 4.1% to 6.5%; true, early restenosis was found in 7.6% to 11.4%; and late restenosis occurred in 1.9% to 4.9%. None of the traditional risk factors showed a statistically significant effect on recurrent stenosis. The use of patch angioplasty closure reduced overall risk of restenosis from 21.2% to 7.1%, from 16.7% to 4.6%, and from 27.4% to 8.2%, depending on the PPV confidence level desired (P<0.001). Of the 136 patients judged to have recurrent stenosis, only 8 (5.9%) underwent reoperation (only 1 for symptoms). There was no correlation between late stroke and recurrent stenosis. CONCLUSIONS: Carotid endarterectomy is a durable procedure with a low rate of true restenosis, particularly when patch angioplasty is used to close the arteriotomy.
Language of Publication
English
Unique Identifier
98429649

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MeSH Heading (Major)
Atherosclerosis|*SU; Carotid Artery Diseases|*SU; Carotid Stenosis|*EP/*US; Endarterectomy|*MT
MeSH Heading
Angioplasty; Female; Human; Incidence; Male; Postoperative Complications; Prospective Studies; Recurrence; Risk Factors; Support, U.S. Gov't, P.H.S.; Survival Analysis

Publication Type
CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
ISSN
0039-2499
Country of Publication
UNITED STATES

Record 39 from database: MEDLINE
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Title
Regionalization of occult pancreatic insulinomas with the arterial stimulation venous sampling (ASVS) technique.
Author
Tsagarakis S; Kaskarelis J; Malagari C; Platis O; Trivizas P; Vrachliotis G; Thalassinos N
Address
Department of Endocrinology, Diabetes and Metabolism, Evangelismos Hospital, Athens, Greece.
Source
Clin Endocrinol (Oxf), 1997 Dec, 47:6, 753-7
Abstract
Non-invasive modalities (ultrasound, computerized tomography, MRI and somatostatin receptor scintigraphy) often fail to localize insulinomas smaller than 1.5 cm in diameter. Recently, regionalization of such occult insulinomas was facilitated by the arterial stimulation and venous sampling (ASVS) technique, using calcium as the insulin secretagogue. However, so far experience with this technique has been limited to a few tertiary referrals centres worldwide. In these case studies we report our experience in three consecutive patients with occult insulinomas. Three consecutive patients (all men 34, 51 and 56 years of age) with insulin-mediated hypoglycaemia were studied. Diagnosis of insulin hypersection was established by the finding of a high amended insulin: blood sugar ratio during fasting. Localization of a pancreatic mass lesion was unsuccessful by ultrasound, CT and/or MRI in all patients. Two patients had negative octreotide scans. In all patients after the infusion of calcium sequentially into the gastroduodenal, splenic and the superior mesenteric arteries, insulin levels rose significantly in right hepatic vein samples giving rise to diagnostic gradients from the splenic artery (in 2 patients) and gastroduodenal artery (in 1 patient), regionalizing insulinomas in the tail and head or neck of the pancreas respectively. The simultaneously obtained angiogram was positive in only 1 patient, in whom it corresponded to the insulin gradient. Regionalization of these occult tumours was subsequently confirmed at laparoscopy in the 2 patients operated. It is concluded, that the arterial stimulation venous sampling technique is an effective method in regionalizing occult insulinomas and should complement invasive angiography whenever the latter procedure is performed.
Language of Publication
English
Unique Identifier
98159319

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MeSH Heading (Major)
Calcium|*DU; Insulin|*BL; Insulinoma|BL/*DI; Neoplasms, Unknown Primary|BL/*DI; Pancreatic Neoplasms|BL/*DI
MeSH Heading
Adult; Case Report; Hepatic Veins; Human; Injections, Intra-Arterial; Male; Mesenteric Artery, Superior; Middle Age; Pancreas|BS; Sensitivity and Specificity; Splenic Artery

Publication Type
JOURNAL ARTICLE
ISSN
0300-0664
Country of Publication
ENGLAND

Record 40 from database: MEDLINE
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Title
Evaluation of directional atherectomy studied by intravascular ultrasound in femoropopliteal artery stenosis.
Author
Tielbeek AV; Vroegindeweij D; Gussenhoven EJ; Buth J; Landman GH
Address
Department of Radiology, Catharina Hospital, Michelangelolaan 2, NL-5623 EJ Eindhoven, The Netherlands.
Source
Cardiovasc Intervent Radiol, 1997 Nov, 20:6, 413-9
Abstract
PURPOSE: To evaluate the role of intravascular ultrasound (IVUS) before and after directional atherectomy (DA) in the treatment of femoropopliteal artery stenosis. METHODS: In 12 patients with 16 stenoses IVUS was performed before and immediately after an angiographically successful DA. This was defined as a diameter reduction (DR) < or = 50%, which was calculated using the minimal lumen diameter compared with the diameter of a nearby "normal" segment. In the presence of residual plaque on IVUS an additional DA was performed. Endpoints studied were DR < or = 30% on IVUS compared with the IVUS findings of the angiographically normal reference segment, or when no additional atherosclerotic material could be removed by further DA passages. RESULTS: Additional DA (mean 1.6 per lesion) had to be performed in all patients. Initial DA increased the cross-sectional free lumen area (FLA) from 3.8 +/- 2.0 mm2 to 8.1 +/- 2.7 mm2 (p = 0.0004). Additional DA increased FLA to 9.3 +/- 2.3 mm2 (p = 0.002) after the second passage and to 9.8 +/- 2.4 mm2 (p = 0.09) after the final DA run. The plaque area (PLA) before DA decreased from 18.1 +/- 4.2 mm2 to 15.4 +/- 4.8 mm2 (p = 0.002) after the first passage, and to 13.5 +/- 5.0 mm2 (p = 0.004) and 12. 8 +/- 4.4 mm2 (p = 0.07) after the second and final DA runs, respectively. PLA of the reference segment (9.5 +/- 5.7 mm2) was significantly smaller (p = 0.006) than the final PLA of the treated lesion, indicating a large amount of retained plaque. As a result of DA there was an increase in the area bordered by the medial layer, i. e., the total vessel area (from 21.9 +/- 4.7 mm2 to 23.0 +/- 4.7 mm2), significantly in eccentric and soft lesions. On IVUS, dissection and plaque rupture after the final passage was seen in 12 of 16 stenoses; two dissections were seen on the completion angiogram. After the final passage in all stenoses except three, the DR with IVUS was < or = 30%. CONCLUSION: Lumen enlargement following DA is predominantly due to plaque excision. Vessel expansion combined with plaque excision varies in different stenoses and is an important factor in eccentric and soft lesions. Despite additional DA considerable plaque remains.
Language of Publication
English
Unique Identifier
98022845

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MeSH Heading (Major)
Arterial Occlusive Diseases|SU/*US; Atherectomy|*IS; Endosonography|*IS; Femoral Artery|SU/*US; Popliteal Artery|SU/*US
MeSH Heading
Aged; Aged, 80 and over; Angiography; Comparative Study; Female; Human; Intermittent Claudication|SU/US; Ischemia|SU/US; Leg|BS; Male; Middle Age; Sensitivity and Specificity

Publication Type
JOURNAL ARTICLE
ISSN
0174-1551
Country of Publication
UNITED STATES

Record 41 from database: MEDLINE
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Title
Variations of remodeling in response to left main atherosclerosis assessed with intravascular ultrasound in vivo.
Author
von Birgelen C; Airiian SG; Mintz GS; van der Giessen WJ; Foley DP; Roelandt JR; Serruys PW; de Feyter PJ
Address
Thoraxcenter, University Hospital Rotterdam-Dijkzigt, Erasmus University Rotterdam, The Netherlands.
Source
Am J Cardiol, 1997 Dec, 80:11, 1408-13
Abstract
Histopathologic studies have demonstrated that vessels enlarge to compensate for an increase in plaque burden; this has been confirmed in vivo using intravascular ultrasound (IVUS). The initial studies suggested a biphasic course of lesion formation with (1) preservation of lumen dimensions up to a plaque burden of approximately 40%, and (2) luminal narrowing as plaque burden further increases. In this study, we used IVUS and angiography to assess the extent of left main (LM) atherosclerosis in 107 patients undergoing catheter-based procedures of the left anterior descending or left circumflex coronary arteries. Using IVUS, atherosclerotic plaques were found in all LM arteries, but only 26 (24%) had varying degrees of luminal narrowing on the angiogram. Nevertheless, there was an inverse relation (r = -0.62, p <0.0001) between the minimal lumen area and the plaque burden (i.e., plaque + media divided by total vessel area) that was not restricted to plaque burden values >40% (or >30%), but persisted at plaque burden values of 20% to 40%. In addition, LM arteries with a plaque burden <40% had a similar total vessel area as did LM arteries with a plaque burden > or =40% (22.9 +/- 6.1 vs 21.8 +/- 4.8 mm2, p = 0.30). These data suggest that lumen dimensions may not be preserved even if plaque occupies no more than 20% to 40% of the total vessel area. Thus, there is more variation in remodeling response during earlier stages of plaque accumulation within the LM artery than is commonly suggested.
Language of Publication
English
Unique Identifier
98060633

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MeSH Heading (Major)
Coronary Arteriosclerosis|RA/*US; Coronary Vessels|*US; Ultrasonography, Interventional|*
MeSH Heading
Adult; Aged; Aged, 80 and over; Comparative Study; Coronary Angiography|MT; Female; Human; Male; Middle Age; Prospective Studies; Regression Analysis; Reproducibility of Results

Publication Type
JOURNAL ARTICLE
ISSN
0002-9149
Country of Publication
UNITED STATES

Record 42 from database: MEDLINE
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Title
Optimal diagnosis of splenic vein thrombosis: brief clinical report.
Author
Illig KA; Spitzer RM; Oates TK
Address
Department of Surgery, University of Rochester, New York, USA.
Source
Am Surg, 1997 Nov, 63:11, 1005-6
Abstract
The presence of splenic vein thrombosis is sometimes very difficult to diagnose. We present a patient in whom the splenic vein was thought to be patent by ultrasound and conventional celiac angiography. Because of high clinical suspicion and continued bleeding, he underwent a selective intra-arterial digital splenic angiogram. The venous phase clearly showed proximal (hilar) splenic vein occlusion with filling via collaterals in real time. Splenectomy confirmed the diagnosis. We believe that a selective intra-arterial digital splenic angiogram is the radiographic study of choice for suspected splenic vein thrombosis.
Language of Publication
English
Unique Identifier
98023683

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MeSH Heading (Major)
Splenic Vein|*RA; Thrombosis|*RA
MeSH Heading
Aged; Angiography, Digital Subtraction; Case Report; Human; Male

Publication Type
JOURNAL ARTICLE
ISSN
0003-1348
Country of Publication
UNITED STATES

Record 43 from database: MEDLINE
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Title
A comparative study of methods of estimating renal size in normal adults.
Author
Ninan VT; Koshi KT; Niyamthullah MM; Jacob CK; Gopalakrishnan G; Pandey AP; Shastry JC
Address
Department of Nephrology, Radiology and Urology, Christian Medical College & Hospital, Vellore, India.
Source
Nephrol Dial Transplant, 1990, 5:10, 851-4
Abstract
One hundred live related voluntary kidney donors were studied prospectively. During donor nephrectomy the actual kidney bipolar length was measured and compared to the renal bipolar length estimated from abdominal sonogram, abdominal plain X-ray, intravenous pyelogram, and renal angiogram. Ultrasound was found to measure the kidney more accurately (mean difference between estimated size and actual = -3.4 mm +/- SD 6.96), than plain X-ray (mean difference from actual 13mm +/- SD 5.24), IVP (mean difference from actual 16.9 mm +/- SD 5.74), and renal angiogram (mean difference from actual 15.2 mm +/- SD 5.77).
Language of Publication
English
Unique Identifier
91204211

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MeSH Heading (Major)
Kidney|*AH/RA/US
MeSH Heading
Adult; Aged; Angiography; Comparative Study; Evaluation Studies; Female; Human; Male; Middle Age; Tissue Donors

Publication Type
JOURNAL ARTICLE
ISSN
0931-0509
Country of Publication
GERMANY

Record 44 from database: MEDLINE
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Title
Coronary artery calcium in acute coronary syndromes: a comparative study of electron-beam computed tomography, coronary angiography, and intracoronary ultrasound in survivors of acute myocardial infarction and unstable angina [see comments]
Author
Schmermund A; Baumgart D; Görge G; Seibel R; Grönemeyer D; Ge J; Haude M; Rumberger J; Erbel R
Address
Department of Cardiology, University Clinic Essen, Germany. schmermund.axel@mayo.edu
Source
Circulation, 1997 Sep, 96:5, 1461-9
Abstract
BACKGROUND: Quantification of coronary artery calcified plaques by electron-beam CT (EBCT) may predict cardiovascular events. However, whereas advanced coronary atherosclerotic plaques can be identified, mildly stenotic lipid-rich (soft) plaques may be difficult to detect. The value of EBCT in a subgroup of patients has therefore been questioned. To investigate this, we evaluated patients with acute coronary syndromes by EBCT and compared the results with coronary angiography and, in patients with an indeterminate angiogram, intracoronary ultrasound (ICUS). METHODS AND RESULTS: EBCT was performed in 118 consecutive patients (57+/-11 years of age) with previous myocardial infarction (n=101) or unstable angina (n=17). A standard protocol requiring a CT density >130 Hounsfield units in an area > or =1.03 mm2 was used for the definition of coronary artery calcium. We found that 110 patients had moderate to severe coronary artery disease by coronary angiography, and 8 had either mildly stenotic plaques at a single site (4 patients, confirmed by ICUS) or nonatherosclerotic causes of the unstable coronary syndrome (4 patients). One hundred and five of the 110 patients (96%) with moderate to severe angiographic disease but only 1 of the 8 other patients (13%) had a positive EBCT. Patients with acute coronary syndromes and negative EBCTs were significantly younger than patients with positive EBCTs (46+/-12 versus 58+/-10 years, P<.001), and a higher percentage was actively smoking (100% of the smokers versus 46%, P<.05). CONCLUSIONS: The vast majority of patients with acute coronary syndromes and at least moderate angiographic disease have identifiable coronary calcium by EBCT. Those patients with negative EBCTs have minimal or no atherosclerotic plaque formation. They are younger and tend to be active cigarette smokers.
Language of Publication
English
Unique Identifier
97459572

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MeSH Heading (Major)
Angina, Unstable|*ME/RA/US; Calcium|*ME; Coronary Disease|*ME; Coronary Vessels|*ME; Myocardial Infarction|*ME/RA/US
MeSH Heading
Acute Disease; Aged; Arteries|ME; Coronary Angiography; Echocardiography; Female; Human; Male; Middle Age; Support, Non-U.S. Gov't; Syndrome; Tomography|MT; Ultrasonography, Interventional

Publication Type
JOURNAL ARTICLE
ISSN
0009-7322
Country of Publication
UNITED STATES

Record 45 from database: MEDLINE
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Title
Comparison of magnetic resonance angiography, duplex ultrasound, and digital subtraction angiography in assessment of extracranial internal carotid artery stenosis.
Author
Young GR; Humphrey PR; Shaw MD; Nixon TE; Smith ET
Address
Walton Centre for Neurology and Neurosurgery, Rice, Liverpool, UK.
Source
J Neurol Neurosurg Psychiatry, 1994 Dec, 57:12, 1466-78
Abstract
The results of a prospective study comparing ultrasound, intra-arterial digital subtraction angiography, and magnetic resonance angiography in the assessment of the degree of extracranial internal carotid artery stenosis are reported in patients with symptoms of recent carotid territory ischaemia. A total of 70 patients and 137 vessels were examined by all three techniques. The results obtained by each technique were reported blind. The mean difference (SD) for the comparison of magnetic resonance angiography and digital subtraction angiography was -0.7 (14)%, for ultrasound and digital subtraction angiography 3.1 (15)%, and for magnetic resonance angiography and ultrasound -3.8 (15)%. The level of agreement was greater for the more tightly stenosed vessels. With the assumption that the results of the digital subtraction angiogram reflect the true situation, the sensitivity and specificity in the detection of > or = 30% stenoses were 93% and 82% with ultrasound and 89% and 82% with magnetic resonance angiography; for stenoses > or = 70% 93% and 92% with ultrasound and 90% and 95% with magnetic resonance angiography; and for stenoses of 70-99% 89% and 93% with ultrasound and 86% and 93% with magnetic resonance angiography. For occlusion the values were 93% and 99% with ultrasound and 80% and 99% with magnetic resonance angiography. Increased sensitivity and specificity were obtained when analysis was confined to those vessels in which ultrasound and magnetic resonance angiography were in agreement over classification. It is thus possible to accurately categorize the degree of stenosis of the extracranial internal carotid artery from a combination of ultrasound and magnetic resonance angiography. The adoption of this combination for the investigation of patients before carotid endarterectomy removes the risk associated with conventional angiography and represents an important advance in the management of carotid stenosis.
Language of Publication
English
Unique Identifier
95096899

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MeSH Heading (Major)
Angiography, Digital Subtraction|*; Carotid Stenosis|CL/*DI/EP; Magnetic Resonance Imaging|*; Ultrasonography, Doppler, Duplex|*
MeSH Heading
Adult; Aged; Carotid Artery, Internal; Comparative Study; Female; Human; Male; Middle Age; Prospective Studies; Sensitivity and Specificity; Severity of Illness Index; Single-Blind Method; Support, Non-U.S. Gov't

Publication Type
CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE
ISSN
0022-3050
Country of Publication
ENGLAND

Record 46 from database: MEDLINE
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Title
In vitro validation of intravascular ultrasound imaging after balloon angioplasty of coronary artery stenoses.
Author
Peters RJ; Kok WE; van der Wal AC; Visser CA
Address
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
Source
Ultrasound Med Biol, 1996, 22:8, 999-1005
Abstract
Systematic studies of intravascular ultrasound imaging of in vitro balloon angioplasty on coronary arteries with a greater than 50% diameter stenosis on angiogram have not been performed. We used 23 plasma-perfused postmortem human coronary arteries with an angiographic diameter stenosis of > or = 50%. After balloon dilation the vessels were examined by 30-MHz intravascular ultrasound imaging (IVUS) and the presence of ruptures and dissections was noted. Ruptures were defined as disruptions of the vessel wall in a radial direction, and dissections were defined as disruptions in a circumferential direction. After pressure fixation they were studied by histology. On IVUS, 24 vessel wall disruptions were diagnosed in 14 arteries. On histology, 29 disruptions were diagnosed in 19 arteries. The sensitivity of IVUS for the detection of disruptions was 79%, the specificity was 75%. Total agreement was 79%. Accuracy was better for dissections (total agreement 96%) than for ruptures (total agreement 74%). Shadowing behind calcium and close contact of the catheter to the arterial wall were important sources of error in the IVUS analysis. We conclude that intravascular ultrasound imaging is accurate for the detection of disruptions after balloon angioplasty of angiographically significant coronary artery stenoses.
Language of Publication
English
Unique Identifier
97158151

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MeSH Heading (Major)
Angioplasty, Balloon|*MT; Coronary Disease|PA/RA/TH/*US; Ultrasonography, Interventional|*MT
MeSH Heading
Comparative Study; Coronary Angiography; Human; In Vitro; Sensitivity and Specificity; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
ISSN
0301-5629
Country of Publication
ENGLAND

Record 47 from database: MEDLINE
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Title
Imaging of pulmonary vascular disease by intravascular ultrasound.
Author
Scott PJ; Essop AR; al Ashab W; Deaner A; Parsons J; Williams G
Address
Non-Invasive Heart Unit, Killingbeck Hospital, Leeds, West Yorkshire, UK.
Source
Int J Card Imaging, 1993 Sep, 9:3, 179-84
Abstract
To assess the ability of intravascular ultrasound (IVUS) to image changes in the pulmonary arterial wall associated with pulmonary hypertension (PHT), 10 subjects requiring diagnostic right and left heart catheterization were studied. In addition to measurements of pulmonary artery pressure and pulmonary vascular resistance and pulmonary angiography, when indicated, all underwent simultaneous IVUS imaging in the pulmonary arterial system using a 20 MHz ultrasound transducer mounted on a 2 mm diameter catheter. Four patients had normal pulmonary artery pressures and 6 had varying degrees of PHT. Satisfactory ultrasound images were obtained in 9 out of the 10 patients. In those with normal pulmonary artery pressures ultrasound showed a thin vessel wall with no distinction between separate layers. In patients with systemic PHT, a three-layered vessel wall was apparent and areas compatible with intimal proliferation were seen. In a patient with pulmonary embolic disease areas consistent with mural thrombus were detected at sites of luminal narrowing on the pulmonary angiogram. IVUS is capable of imaging some of the morphological changes in the wall of the pulmonary artery known to occur in longstanding PHT and may therefore become a useful adjunct to haemodynamic measurements and pulmonary angiography for the in vivo assessment of pulmonary vascular disease.
Language of Publication
English
Unique Identifier
94149355

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MeSH Heading (Major)
Hypertension, Pulmonary|PP/*US; Pulmonary Artery|PP/*US; Ultrasonography, Interventional|*
MeSH Heading
Adolescence; Adult; Child; Chronic Disease; Heart Catheterization; Human; Middle Age; Prospective Studies; Pulmonary Wedge Pressure; Support, Non-U.S. Gov't; Vascular Resistance

Publication Type
JOURNAL ARTICLE
ISSN
0167-9899
Country of Publication
UNITED STATES

Record 48 from database: MEDLINE
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Title
Assessment of coronary vasomotion by intracoronary ultrasound.
Author
Dupouy P; Geschwind HJ; Pelle G; Gallot D; Dubois Randé JL
Address
UnitÆe d'hÆemodynamique, INSERM U2, University Hospital Henri Mondor, University of Paris, XII, France.
Source
Am Heart J, 1993 Jul, 126:1, 76-85
Abstract
This study was performed to evaluate the accuracy of intravascular ultrasound for the assessment of coronary artery vasomotion and endothelial function in patients with atherosclerosis. Twenty patients with luminal irregularities on the coronary angiogram and a high cholesterol level (287 +/- 19 mg/dl) (group 1) and six patients with angiographically smooth arteries and a minimally elevated cholesterol level (197 +/- 12 mg/dl) (group 2) were studied. A mechanical intravascular ultrasound probe (4.3F) was placed into the proximal segment of the coronary artery. The ultrasound images were recorded on super VHS videotape and were then digitized allowing the measurement of the lumen area and then the calculation of a mean intimal thickness index. Endothelial function was studied during sympathetic stimulation by a cold pressor test and, after increasing coronary blood flow, by intracoronary papaverine administration; a 1 mg bolus of linsidomine was then administered into the coronary artery. Patients in group 1 had a higher mean intimal thickness (1.52 +/- 0.64 mm) than those in group 2 (0.18 +/- 0.08 mm) (p < 0.001). In response to sympathetic stimulation, a vasoconstricting effect occurred in group 1 (9.5 +/- 1.3 mm2 vs 11.4 +/- 1.2 mm2 at baseline, p < 0.05), while a vasodilating action was observed in the control group (11.6 +/- 2.1 mm2 vs 10.4 +/- 1.8 mm2 at baseline, p < 0.05). After papaverine infusion, a trend toward a vasoconstricting effect was observed in response to increased flow in group 1 (10 +/- 1.3 mm2 vs 11.4 +/- 1.2 mm2 at baseline, p < 0.05). that was not observed in group 2 (9.4 +/- 2 mm2 vs 8.9 +/- 1.9 mm2, p = NS). Linsidomine infusion induced a significant vasodilating effect in both groups (p < 0.001). In conclusion, intravascular ultrasound may be considered a useful tool to assess endothelial function of large coronary arteries and to obtain the precise relationship between wall thickness and the vasomotor response.
Language of Publication
English
Unique Identifier
93311332

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MeSH Heading (Major)
Coronary Arteriosclerosis|*PP/US; Coronary Vessels|*PP/*US; Vasoconstriction|*/DE; Vasodilation|*/DE
MeSH Heading
Aged; Blood Flow Velocity; Case-Control Studies; Cold|DU; Echocardiography; Endothelium, Vascular|DE/PH; Female; Human; Hypercholesterolemia|PP; Male; Middle Age; Molsidomine|AA/PD; Papaverine|PD; Vasodilator Agents|PD

Publication Type
JOURNAL ARTICLE
ISSN
0002-8703
Country of Publication
UNITED STATES

Record 49 from database: MEDLINE
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Title
Progressive lacunar infarction with demonstrated patency of the middle cerebral artery.
Author
Halsey JH
Address
 
Source
Stroke, 1986 Sep, 17:5, 1028-30
Abstract
Two cases of progressive hemiplegia were closely followed by daily clinical examination. In both, the CT scan and CSF were normal on admission. In both, objective aggravation occurred in three or more steps over four days, progressing from minor finger clumsiness to total paralysis of the arm. In both cases a second CT scan a day after appearance of hemiplegia demonstrated a lacune in the corona radiata just above the internal capsule. In one case an intravenous digital subtraction angiogram demonstrated patency of the middle cerebral artery during the course of the progression. In the other case, serial study with transcranial Doppler ultrasound documented the continued patency of the middle cerebral artery. These two cases demonstrate that it is not necessary to postulate transient occlusion of the middle cerebral artery as an essential mechanism for progressive lacunar infarction.
Language of Publication
English
Unique Identifier
87019996

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MeSH Heading (Major)
Cerebral Arteries|*PA; Ischemic Attack, Transient|CO/*PA
MeSH Heading
Aged; Aged, 80 and over; Case Report; Female; Hemiplegia|ET; Human; Male; Support, U.S. Gov't, P.H.S.; Tomography, X-Ray Computed; Ultrasonics

Publication Type
JOURNAL ARTICLE
ISSN
0039-2499
Country of Publication
UNITED STATES

Record 50 from database: MEDLINE
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Title
Current management of Zollinger-Ellison syndrome.
Author
Jensen RT; Maton PN; Gardner JD
Address
 
Source
Drugs, 1986 Aug, 32:2, 188-96
Abstract
Patients with Zollinger-Ellison syndrome require that management decisions be made to control the gastric acid hypersecretion and treatment directed at the gastrinoma itself. The advent of newer antisecretory drugs and increased knowledge of the natural history of this disease have led to major changes in the management of each of these two areas. Recent studies have demonstrated that treatment with the currently available histamine H2-receptor antagonists (cimetidine, ranitidine) with or without an anticholinergic agent will control gastric acid secretion in almost all patients. These studies have also shown that most patients require higher doses than those used routinely to treat peptic ulcer, treatment is only successful if an adequate dose of antisecretory drug is used and must be monitored by measuring gastric acid hypersecretion, and established criteria to regulate the dose must be used. Newer more potent antisecretory drugs such as famotidine or omeprazole will facilitate management of gastric hypersecretion but are not yet currently available. Highly selective vagotomy should be considered in those patients who require high doses of cimetidine or ranitidine. Total gastrectomy should be reserved for those patients unwilling or unable to take oral medication. Although aggressive surgery is not warranted in most patients because overall prognosis is excellent, tumour status should be assessed in all patients by imaging studies (CT scan, ultrasound, selective angiogram). Patients without metastatic disease and without the MEN-1 syndrome (multiple-endocrine-neoplasia type 1) should undergo exploratory laparotomy by a surgeon experienced in treating this disease, with studies suggesting a cure rate of approximately 20%.(ABSTRACT TRUNCATED AT 250 WORDS)
Language of Publication
English
Unique Identifier
86300362

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MeSH Heading (Major)
Zollinger-Ellison Syndrome|*TH
MeSH Heading
Combined Modality Therapy; Gastrectomy; Gastric Acid|DE/SE; Histamine H2 Antagonists|TU; Human; Parathyroid Glands|SU; Vagotomy

Publication Type
JOURNAL ARTICLE
ISSN
0012-6667
Country of Publication
NEW ZEALAND

Record 51 from database: MEDLINE
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Title
Recombinant tissue plasminogen activator for neonatal and pediatric vascular thrombolytic therapy.
Author
Dillon PW; Fox PS; Berg CJ; Cardella JF; Krummel TM
Address
Department of Surgery, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
Source
J Pediatr Surg, 1993 Oct, 28:10, 1264-8; discussion 1268-9
Abstract
Thrombotic vascular occlusion may complicate the clinical course of many neonatal and pediatric pathologic processes. Systemic thrombolytic therapy with heparin, urokinase, or streptokinase may not be appropriate in the critically ill neonate because these agents generate a diffuse coagulopathic state. Direct surgical intervention for repair may be precluded by the small size of the vessels involved. Recombinant tissue plasminogen activator (rTPA) induces only a minimal proteolytic state while inducing thrombolysis within the local environment of the clot. We report our experience with regional rTPA infusion in four critically ill patients with venous and arterial thrombotic disorders. there were two brachial artery occlusive lesions--a neonate with iatrogenic occlusion due to a misplaced intravenous catheter and a 2-year-old child with inadvertent arterial ligation during an attempted venous cutdown. Two venous lesions consisted of a full-term neonate with renal vein/inferior vena caval thrombosis and a 32-week infant with partial superior vena caval thrombosis due to a Broviac catheter. Systemic thrombolytic therapy was contraindicated in these patients because of underlying illnesses. Pretherapy vascular evaluation included Doppler examination and angiography. The rTPA infusion was continued until there was evidence of clot lysis by ultrasound, angiogram, or venogram. Infusion rate of rTPA was adjusted according to fibrinogen levels. All three neonates responded successfully to rTPA therapy. Two neonates required only bolus administration and one responded to combined bolus and continuous infusion therapy after 58 hours. rTPA failed to reverse brachial artery occlusion in the 2-year-old child with purpura fulminans.(ABSTRACT TRUNCATED AT 250 WORDS)
Language of Publication
English
Unique Identifier
94087437

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MeSH Heading (Major)
Brachial Artery|*/RA; Salvage Therapy|*MT; Thrombolytic Therapy|*MT; Thrombosis|*DT/RA; Tissue Plasminogen Activator|*AD; Vena Cava, Inferior|*/RA; Vena Cava, Superior|*/RA
MeSH Heading
Case Report; Critical Illness; Female; Human; Iatrogenic Disease; Infant, Newborn; Infusions, Intravenous; Male; Recombinant Proteins|AD

Publication Type
JOURNAL ARTICLE
ISSN
0022-3468
Country of Publication
UNITED STATES

Record 52 from database: MEDLINE
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Title
Are heart-lung transplant recipients protected from developing transplant coronary artery disease? A case-matched intracoronary ultrasound study.
Author
Lim TT; Botas J; Ross H; Liang DH; Theodore J; Hunt SA; Oesterle SN; Yeung AC
Address
Division of Cardiovascular Medicine, Stanford University School of Medicine, CA 94305, USA.
Source
Circulation, 1996 Oct, 94:7, 1573-7
Abstract
BACKGROUND: Accelerated coronary artery disease is a major cause of mortality in heart transplant recipients; however, it does not appear to play a major role in the clinical outcome of heart-lung transplant recipients. The purpose of this study was to determine whether the incidence and severity of transplant coronary artery disease as detected by intracoronary ultrasound in heart-lung transplant recipients are less than those encountered in heart transplant recipients. METHODS AND RESULTS: We studied the left anterior descending coronary artery with the use of intracoronary ultrasound imaging in 22 heart-lung transplant recipients at the time of their routine annual coronary angiogram. Twenty-two heart transplant recipients were case matched for number of years after transplant at ultrasound study, recipient age, donor age, and diagnosis of nonischemic cardiomyopathy. Mean intimal area, intimal index, Stanford class, and incidence of at least moderate disease (Stanford class > or = 3) were measured and calculated in each group and then compared between the two groups. Mean intimal area (1.6 +/- 2.5 versus 3.8 +/- 2.8 mm2), mean intimal index (0.07 +/- 0.10 versus 0.22 +/- 0.14), mean Stanford class (1.7 +/- 1.0 versus 2.7 +/- 1.2), and incidence of Stanford class > or = 3 (14% versus 45%) were significantly lower in the heart-lung transplant recipient group. CONCLUSIONS: The incidence and severity of transplant coronary artery disease are much less in patients receiving heart-lung transplants than in those receiving heart transplants alone.
Language of Publication
English
Unique Identifier
96438456

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MeSH Heading (Major)
Coronary Disease|ET/*US; Heart-Lung Transplantation|*; Postoperative Complications|*US
MeSH Heading
Adult; Coronary Vessels|US; Female; Human; Incidence; Male; Postoperative Period; Support, U.S. Gov't, P.H.S.; Ultrasonography, Interventional

Publication Type
JOURNAL ARTICLE
ISSN
0009-7322
Country of Publication
UNITED STATES

Record 53 from database: MEDLINE
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Title
Aneurysmal portosystemic venous shunt: a case report.
Author
Bodner G; Glück A; Springer P; König P; Perkmann R
Address
Abteilung fÂur Radiodiagnostik, UniversitÂatsklinik Innsbruck.
Source
Ultraschall Med, 1999 Oct, 20:5, 215-7
Abstract
A case of an aneurysmal portosystemic venous shunt detected by colour Doppler ultrasound (CDUS) is presented. A young female patient complained of postprandial fatigue and had paroxysmal tachycardia. A direct vascular communication between right portal vein and right hepatic vein was found at CDUS and confirmed by direct portal angiogram. Using detachable coils a complete occlusion of the intrahepatic shunt was obtained. Reports from the literature regarding portovenous aneurysms are reviewed.
Language of Publication
English
Unique Identifier
20061767

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MeSH Heading (Major)
Aneurysm|ET/SU/*US; Cardiovascular Abnormalities|SU/*US; Hepatic Veins|*AB/SU/US; Portal Vein|*AB/SU/US; Ultrasonography, Doppler, Color|*
MeSH Heading
Adult; Case Report; Fatigue; Female; Human; Postprandial Period; Tachycardia

Publication Type
JOURNAL ARTICLE
ISSN
0172-4614
Country of Publication
GERMANY

Record 54 from database: MEDLINE
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Title
Identification of coronary thrombus after myocardial infarction by intracoronary ultrasound compared with histology of tissues sampled by atherectomy.
Author
Chemarin Alibelli MJ; Pieraggi MT; Elbaz M; Carrié D; Fourcade J; Puel J; Tobis J
Address
Department of Cardiology, CHU Toulouse, France.
Source
Am J Cardiol, 1996 Feb, 77:5, 344-9
Abstract
This study compares the ability of intracoronary ultrasound (ICUS) to identify thrombus by means of actual criteria, with the histologic studies of tissues removed by directional atherectomy in patients treated previously with thrombolytic therapy. Coronary angiography and intravascular ultrasound imaging were performed before atherectomy in 34 patients who had received intravenous thrombolytic therapy for acute myocardial infarction a mean of 6 days before. The lesion morphology and the percentage of stenosis were defined on the angiogram. The ultrasound characteristics of the narrowing were described as intraluminal thrombus, mural thrombus, mixed plaque, and dense plaque. Thirty patients were studied. Thrombus was suspected in 8 patients on angiography. By ICUS, the presence of thrombus was predicted in 21 patients. Histologic studies of excised tissues found thrombus in 20 of the 30 patients. When ICUS was compared with histology, the true-positive rate was 80% and the false-positive rate was 50%; the true-negative rate was 50% and the false-negative rate was 20%. The correlation between observers was high. These observations suggest that ICUS may be useful in identifying fresh thrombus. The findings of this study help to confirm the criteria for diagnosing intraluminal thrombus by ICUS imaging.
Language of Publication
English
Unique Identifier
96179988

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MeSH Heading (Major)
Atherectomy, Coronary|*; Coronary Thrombosis|ET/*PA/RA/*US; Ultrasonography, Interventional|*
MeSH Heading
Adult; Aged; Comparative Study; Coronary Angiography; Coronary Vessels|PA/US; Female; Human; Male; Middle Age; Myocardial Infarction|CO; Sensitivity and Specificity

Publication Type
JOURNAL ARTICLE
ISSN
0002-9149
Country of Publication
UNITED STATES

Record 55 from database: MEDLINE
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Title
Stroke and dolichoectatic intracranial arteries.
Author
Rautenberg W; Aulich A; Röther J; Wentz KU; Hennerici M
Address
Department of Neurology, Klinikum Mannheim, University of Heidelberg, Germany.
Source
Neurol Res, 1992, 14:2 Suppl, 201-3
Abstract
During a 6-year-period, in 45 patients the diagnosis of dolichoectatic intracranial arteries was established. Dolichoectasia of the vertebrobasilar system was the most frequent finding (n = 39). Twenty-two patients presented with brain stem ischaemia, and 10 patients had ischaemic hemispheric events. Six patients had symptoms due to compression of cranial nerves. Hydrocephalus was observed once. Peak and mean flow velocities in 39 patients with dolichoectatic basilar arteries as revealed by transcranial Doppler ultrasound were significantly reduced (p less than 0.00001) when compared with an age-adjusted control group of 20 patients without evidence of vertebrobasilar dolichoectasia on angiogram. Non-invasive MR-angiography offered an excellent imaging of the vascular abnormality. The combined use of CT, TCD, MRI and MR-angiography allows reliable non-invasive diagnosis of dolichoectatic intracranial arteries. This condition seems to play an underestimated role in stroke patients, in particular with respect to the vertebrobasilar circulation.
Language of Publication
English
Unique Identifier
92396334

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MeSH Heading (Major)
Brain Ischemia|*ET/RA/US; Cerebral Arteries|AH/*PA/US; Cerebrovascular Disorders|*ET/RA/US; Ischemic Attack, Transient|*ET/RA/US
MeSH Heading
Brain Stem; Cerebral Angiography; Cerebral Infarction|RA/US; Echoencephalography; Female; Human; Magnetic Resonance Imaging; Male; Middle Age

Publication Type
JOURNAL ARTICLE
ISSN
0161-6412
Country of Publication
ENGLAND

Record 56 from database: MEDLINE
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Title
Evidence of viral replication in HBsAg positive patients with hepatocellular carcinoma: measurement of serum hepatitis B virus deoxyribonucleic acid (HBV-DNA).
Author
Guan R; Yap I; Wong L; Tan LH; Oon CJ; Wee A
Address
Department of Medicine & Pathology, National University Hospital, Singapore.
Source
Ann Acad Med Singapore, 1989 Jan, 18:1, 8-11
Abstract
Sera from 60 consecutive patients with hepatocellular carcinoma (HCC) diagnosed by either a positive histology or at least two of the following: CT scan, hepatic ultrasound, hepatic angiogram and raised alpha-foetoprotein levels, were studied to determine their Hepatitis B surface antigen (HBsAg) status and the frequency of continuing viral replication. Markers of Hepatitis B virus (HBV) infection were detected using enzyme and radioimmunoassays. Hepatitis B DNA (HBV-DNA) was measured by molecular hybridization using a labelled recombinant HBV-DNA probe. Sera from 30 HBsAg positive 'healthy' carriers were used as controls. Forty-seven (78%) patients were HBsAg positive. Evidence of previous HBV infection was present in 12 of 13 HBsAg negative patients. 30% of HBsAg positive patients were HBeAg positive, 62% were anti-HBe positive and 8% had no 'e' markers. Serum HBV-DNA was present in 21 (45%) HBsAg positive patients: 10 (71%) HBeAg positive patients, 10 (35%) anti-HBe positive patients and 1 (25%) patient without any 'e' markers. Serum HBV-DNA levels were less than 0.6 ng/ml in 16 (76%) patients. HBV-DNA was absent in all HCC patients who were HBsAg negative. The frequency of serum HBV-DNA positivity was higher in 30 patients with HCC when compared with 30 age and sex matched healthy HBsAg positive individuals (57% vs 13% p less than 0.01). A sizeable proportion of HBsAg positive HCC patients have on-going viral replication and this is present in patients who were thought to have stopped replicating (anti-HBe positive patients).(ABSTRACT TRUNCATED AT 250 WORDS)
Language of Publication
English
Unique Identifier
89226955

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MeSH Heading (Major)
Carcinoma, Hepatocellular|IM/*MI; DNA, Viral|*BL; Hepatitis B Surface Antigens|*AN; Hepatitis B Virus|*PH; Liver Neoplasms|IM/*MI; Lung Neoplasms|IM/*MI; Virus Replication|*
MeSH Heading
Adolescence; Adult; Aged; DNA Probes; Female; Hepatitis B e Antigens|AN; Hepatitis B Antibodies|AN; Human; Male; Middle Age; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
ISSN
0304-4602
Country of Publication
SINGAPORE

Record 57 from database: MEDLINE
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Title
Aneurysm in the horizontal segment of the anterior cerebral artery confirmed by cerebral vasospasm--case report.
Author
Takeuchi T; Ogawa H; Kimura S
Address
Neurosurgical Department, Municipal of Higashimatsuyama Hospital, Saitama.
Source
Neurol Med Chir (Tokyo), 1991 May, 31:5, 272-6
Abstract
A rare aneurysm in the horizontal segment (A1) of the right anterior cerebral artery was found in a 58-year-old male presenting with subarachnoid hemorrhage. No obvious bleeding source was observed on the day of onset, but 7 days later, a definite diagnosis was made based on the discovery of cerebral vasospasm by a repeat angiogram. The aneurysm was clipped via the right frontotemporal approach 15 days after onset. He suddenly developed neurological symptoms such as consciousness disturbance, right hemiplegia, and aphasia on the 4th postoperative day, when remission of the cerebral vasospasm was confirmed by transcranial Doppler ultrasound examinations and cerebral angiography. The ischemic symptoms were probably due to cerebral embolus caused by intraluminal thrombi, which had formed during the maximum phase of vasospasm and became detached during the remission phase.
Language of Publication
English
Unique Identifier
92018607

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MeSH Heading (Major)
Cerebral Arterial Diseases|*CO/RA/SU; Intracranial Aneurysm|*CO/RA/SU; Ischemic Attack, Transient|*ET/RA/SU
MeSH Heading
Case Report; Cerebral Angiography; Human; Male; Middle Age; Postoperative Complications; Subarachnoid Hemorrhage|ET; Tomography, X-Ray Computed

Publication Type
JOURNAL ARTICLE
ISSN
0470-8105
Country of Publication
JAPAN

Record 58 from database: MEDLINE
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Title
Diagnostic significance of flow separation in the carotid bulb.
Author
Nicholls SC; Phillips DJ; Primozich JF; Lawrence RL; Kohler TR; Rudd TG; Strandness DE Jr
Address
Department of Surgery, University of Washington School of Medicine, Seattle.
Source
Stroke, 1989 Feb, 20:2, 175-82
Abstract
Pulsatile blood flow within the normal carotid sinus involves at least two distinct components. That near the flow divider is laminar and antegrade, whereas a boundary layer separation zone in the posterolateral aspect exhibits transient blood flow reversal. It is now possible to document these flow velocity components using pulsed Doppler ultrasound methods. When atherosclerosis develops, it preferentially involves the posterolateral bulb region, obliterating the normal configuration of the sinus with consequent loss of the flow separation zone. It was therefore hypothesized that if flow separation could be detected, it should be predictive of a normal angiogram. To assess this, we evaluated 20 symptomatic patients and two with only bruits found by duplex scanning to have flow separation in either one or both carotid bulbs and who also underwent cerebral angiography. Initial diagnoses were stroke in seven, reversible ischemic neurologic deficit in one, transient ischemic attack in 12, and bruit in two. Flow separation was bilateral in 13 patients (59%). There were 15 patients with symptoms in the territory of a carotid bulb exhibiting flow separation. By angiography, of the 35 bulbs with boundary layer separation, 27 (77%) were normal, with the remainder showing lesions that reduced the diameter of the vessel by 20% or less. Final diagnoses of the 15 patients with symptoms ipsilateral to a carotid sinus exhibiting flow separation were fibromuscular disease in two, lacunar stroke in three, dissection in two, subclavian steal in one, cardiogenic embolus in three, migraine in one, hyperventilation syndrome in one, kink of the mid-internal carotid artery in one, and no diagnosis in one.(ABSTRACT TRUNCATED AT 250 WORDS)
Language of Publication
English
Unique Identifier
89146772

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MeSH Heading (Major)
Carotid Sinus|*PH/RA; Cerebrovascular Disorders|*DI
MeSH Heading
Carotid Arteries|RA; Cerebral Angiography; Human; Regional Blood Flow; Support, U.S. Gov't, P.H.S.; Ultrasonography

Publication Type
JOURNAL ARTICLE
ISSN
0039-2499
Country of Publication
UNITED STATES

Record 59 from database: MEDLINE
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Title
Functional evaluation of telemedicine with super high definition images and B-ISDN.
Author
Takeda H; Matsumura Y; Okada T; Kuwata S; Komori M; Takahashi T; Minatom K; Hashimoto T; Wada M; Fujio Y
Address
Department of Medical Information Science, Osaka University Hospital, Suita, Japan. takeda@hp-info.med.osaka-u.ac.jp
Source
Medinfo, 1998, 9 Pt 1:, 311-4
Abstract
In order to determine whether a super high definition (SHD) image running at a series of 2048 resolution x 2048 line x 60 frame/sec was capable of telemedicine, we established a filing system for medical images and two experiments for transmission of high quality images were performed. All images of various types, produced from one case of ischemic heart disease were digitized and registered into the filing system. Images consisted of plain chest x-ray, electrocardiogram, ultrasound cardiogram, cardiac scintigram, coronary angiogram, left ventriculogram and so on. All images were animated and totaled a number of 243. We prepared a graphic user interface (GUI) for image retrieval based on the medical events and modalities. Twenty one cardiac specialists evaluated quality of the SHD images to be somewhat poor compared to the original pictures but sufficient for making diagnoses, and effective as a tool for teaching and case study purposes. The system capability of simultaneously displaying several animated images was especially deemed effective in grasping comprehension of diagnosis. Efficient input methods and creating capacity of filing all produced images are future issue. Using B-ISDN network, the SHD file was prefetched to the servers at Kyoto University Hospital and BBCC (Bradband ISDN Business chance & Culture Creation) laboratory as an telemedicine experiment. Simultaneous video conference system, the control of image retrieval and pointing function made the teleconference successful in terms of high quality of medical images, quick response time and interactive data exchange.
Language of Publication
English
Unique Identifier
99312463

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MeSH Heading (Major)
Computer Communication Networks|*IS; Computer Graphics|*; Image Processing, Computer-Assisted|*IS; Telemedicine|*IS
MeSH Heading
Computer Systems; Evaluation Studies; Human; Microcomputers; Signal Processing, Computer-Assisted; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
Country of Publication
CANADA

Record 60 from database: MEDLINE
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Title
Hepatocellular carcinoma--image morphology in 40 patients.
Author
Karak PK; Mukhopadhyay S; Berry M
Address
Department of Radio-Diagnosis, A.I.I.M.S., Ansari Nagar New Delhi, India.
Source
Trop Gastroenterol, 1992 Jan, 13:1, 21-6
Abstract
A retrospective analysis of image morphology in 40 patients with histologically proved hepatocellular carcinoma including two cases of fibrolamellar carcinoma is presented. Ultrasound and CT scan were done in all the patients. Angiogram was done in 15 of these patients to provide a surgical roadmap before hepatic resection. Detailed analysis of clinical features, biochemical parameters and image morphology is presented.
Language of Publication
English
Unique Identifier
93032602

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MeSH Heading (Major)
Carcinoma, Hepatocellular|PA/RA/*US; Liver Neoplasms|PA/RA/*US
MeSH Heading
Adolescence; Adult; Aged; Angiography; Comparative Study; Female; Human; Male; Middle Age; Retrospective Studies; Tomography, X-Ray Computed

Publication Type
JOURNAL ARTICLE
ISSN
0250-636X
Country of Publication
INDIA

Record 61 from database: MEDLINE
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Title
Detection of carotid stenosis. From NASCET results to clinical practice.
Author
Chang YJ; Golby AJ; Albers GW
Address
Stanford Stroke Center, Calif 94304-1705, USA.
Source
Stroke, 1995 Aug, 26:8, 1325-8
Abstract
BACKGROUND AND PURPOSE: Results from large multicenter studies have shown that carotid endarterectomy, performed with low perioperative morbidity and mortality, is beneficial for patients with symptomatic carotid stenosis > or = 70% as calculated according to strict angiographic criteria. To apply these results in clinical practice, individual institutions should determine whether locally implemented duplex ultrasonography adequately identifies patients with > or = 70% stenosis and whether the degree of stenosis reported by local angiographers correlates with strict angiographic measurements. METHODS: We compared estimates of carotid stenosis obtained by duplex ultrasonography and the radiologists' reports from conventional cerebral angiography with each other and with results obtained using North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. RESULTS: One hundred seventy-one vessels were available for review. In 155 (91%) of the cases, the reports from the ultrasound and angiogram were in agreement with regard to whether the stenosis was > or = 70% or < 70%. In 11 of the 16 cases where there was a disparity between the studies, the ultrasound was in closer agreement with measurements obtained using NASCET criteria. Nine of the angiography reports overestimated the degree of stenosis compared with NASCET measurements; twice angiography underestimated the stenosis. Twice the ultrasound underestimated the stenosis, and three times it overestimated the stenosis. CONCLUSIONS: Duplex ultrasonography was highly sensitive for detecting significant carotid stenosis at our institution; however, angiography reports often graded the degree of stenosis to be more severe than measurements obtained using NASCET criteria. Institutions that evaluate patients for carotid endarterectomy should investigate the correlation between their ultrasound and angiographic studies so that the results of carotid endarterectomy trials can be accurately applied.
Language of Publication
English
Unique Identifier
95357819

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MeSH Heading (Major)
Carotid Stenosis|*DI; Coronary Angiography|*; Ultrasonography, Doppler, Duplex|*
MeSH Heading
Comparative Study; Human; Sensitivity and Specificity

Publication Type
JOURNAL ARTICLE
ISSN
0039-2499
Country of Publication
UNITED STATES

Record 62 from database: MEDLINE
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Title
Carotid occlusive disease: primary care of patients with or without symptoms.
Author
Eugene JR; Abdallah M; Miglietta M; Vernenkar VV; Pascual R; Briones R; Barnes T; Hager J
Address
St. Barnabas Hospital, Bronx, NY, USA.
Source
Geriatrics, 1999 May, 54:5, 24-6, 29-30, 33 passim
Abstract
Of the half-million strokes that occur each year in the United States, 20 to 30% can be directly linked to carotid occlusive disease. The degree of stenosis involving the carotid bifurcation is an important predictor of stroke risk. Asymptomatic disease may be diagnosed on routine physical exam or screening of the carotid bifurcation in patients with risk factors for ischemic strokes. Symptomatic disease includes transient ischemic attacks, stroke in evolution, and complete stroke. Duplex ultrasound scanning is the standard test for the initial evaluation of carotid artery disease. Patients undergoing surgery should also have magnetic resonance angiography or an angiogram of the carotid vessels. Stroke prevention includes lifestyle modification such as cessation of smoking, strict dietary and medical management of hyperlipidemia, diabetes, and hypertension. Antiplatelet, anticoagulant, and thrombolytic therapy can be used where indicated.
Language of Publication
English
Unique Identifier
99293518

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MeSH Heading (Major)
Carotid Stenosis|CO/*DI/DT/SU; Primary Health Care|*
MeSH Heading
Aged; Algorithms; Carotid Arteries|PA/RA/SU/US; Cerebrovascular Disorders|ET; Human; Magnetic Resonance Angiography; Risk Factors

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
0016-867X
Country of Publication
UNITED STATES

Record 63 from database: MEDLINE
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Title
Usefulness of D-dimer, blood gas, and respiratory rate measurements for excluding pulmonary embolism [see comments]
Author
Egermayer P; Town GI; Turner JG; Heaton DC; Mee AL; Beard ME
Address
Canterbury Respiratory Research Group, Christchurch School of Medicine, New Zealand.
Source
Thorax, 1998 Oct, 53:10, 830-4
Abstract
BACKGROUND: A study was undertaken to assess the usefulness of the SimpliRED D-dimer test, arterial oxygen tension, and respiratory rate measurement for excluding pulmonary embolism (PE) and venous thromboembolism (VTE). METHODS: Lung scans were performed in 517 consecutive medical inpatients with suspected acute PE over a one year period. Predetermined end points for objectively diagnosed PE in order of precedence were (1) a post mortem diagnosis, (2) a positive pulmonary angiogram, (3) a high probability ventilation perfusion lung scan when the pretest probability was also high, and (4) the unanimous opinion of an adjudication committee. Deep vein thrombosis (DVT) was diagnosed by standard ultrasound and venography. RESULTS: A total of 40 cases of PE and 37 cases of DVT were objectively diagnosed. The predictive value of a negative SimpliRED test for excluding objectively diagnosed PE was 0.99 (error rate 2/249), that of PaO2 of > or = 80 mm Hg (10.7 kPa) was 0.97 (error rate 5/160), and that of a respiratory rate of < or = 20/min was 0.95 (error rate 14/308). The best combination of findings for excluding PE was a negative SimpliRED test and PaO2 > or = 80 mm Hg, which gave a predictive value of 1.0 (error rate 0/93). The predictive value of a negative SimpliRED test for excluding VTE was 0.98 (error rate 5/249). CONCLUSIONS: All three of these observations are helpful in excluding PE. When any two parameters were normal, PE was very unlikely. In patients with a negative SimpliRED test and PaO2 of > or = 80 mm Hg a lung scan is usually unnecessary. Application of this approach for triage in the preliminary assessment of suspected PE could lead to a reduced rate of false positive diagnoses and considerable resource savings.
Language of Publication
English
Unique Identifier
99209448

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MeSH Heading (Major)
Antifibrinolytic Agents|*BL; Fibrin Fibrinogen Degradation Products|*AN; Pulmonary Embolism|BL/CO/*DI
MeSH Heading
Biological Markers|AN; Human; Lung|RI; Oxygen|BL; Predictive Value of Tests; Prospective Studies; Reagent Kits, Diagnostic; Respiration Disorders|CO; Support, Non-U.S. Gov't; Thrombophlebitis|CO/DI

Publication Type
JOURNAL ARTICLE
ISSN
0040-6376
Country of Publication
ENGLAND

Record 64 from database: MEDLINE
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Title
Side-to-side differences of the common carotid artery diameter in presence of asymmetry of the circle of Willis or different vasculopathies.
Author
Bingzhen C; Yasaka M; Kimura K; Nagatsuka K; Minematsu K; Yamaguchi T
Address
Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.
Source
Eur J Ultrasound, 1998 Dec, 8:3, 219-21
Abstract
Based on angiographic and carotid ultrasonographic findings in 60 patients with stroke or other diseases, we studied what factors affected the side-to-side differences of the common carotid artery diameter (CCAD). The side-to-side differences of the CCAD were within 0.7 mm in patients with normal cerebral angiogram, but a difference above 0.7 mm was found in many patients with asymmetry of the circle of Willis or different vasculopathies, such as the carotid artery occlusion, cerebral arteriovenous malformation and aortitis.
Language of Publication
English
Unique Identifier
99139084

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MeSH Heading (Major)
Carotid Artery, Common|RA/*US; Cerebrovascular Disorders|RA/*US; Circle of Willis|RA/*US
MeSH Heading
Aortitis|RA/US; Female; Human; Male; Middle Age; Support, Non-U.S. Gov't; Ultrasonography, Doppler, Duplex

Publication Type
JOURNAL ARTICLE
ISSN
0929-8266
Country of Publication
IRELAND

Record 65 from database: MEDLINE
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Title
Transjugular intrahepatic portosystemic shunt (TIPS) for Budd-Chiari syndrome or portal vein thrombosis: review of indications and problems [see comments]
Author
Ganger DR; Klapman JB; McDonald V; Matalon TA; Kaur S; Rosenblate H; Kane R; Saker M; Jensen DM
Address
Department of Internal Medicine, Rush Presbyterian St Luke's Medical Center, Chicago, Illinois 60612, USA.
Source
Am J Gastroenterol, 1999 Mar, 94:3, 603-8
Abstract
OBJECTIVE: The aim of this study was to evaluate the role of transjugular intrahepatic portosystemic shunt (TIPS) in patients who present with portal vein thrombosis (PVT) or Budd-Chiari Syndrome (BCS). METHODS: Nine patients with recent PVT and four patients with BCS underwent TIPS. The diagnosis was confirmed by color Doppler ultrasound and by angiogram in most patients. Patients were followed clinically and had TIPS checked periodically for patency. The end point was mortality, subsequent surgical shunting or orthotopic liver transplantation (OLT). RESULTS: TIPS was placed in 13 of 15 (87%) patients with BCS or PVT. The mean decrease in pressure gradient was 56%. Median and mean follow-up were 14 months and 16.9 months. Procedure related complications occurred in two of 13 (15%), both in the PVT group. Direct procedural mortality was one of 13 (8%). The majority of patients with PVT (five of eight) underwent OLT. Of the remaining three, one patient subsequently developed a cavernous transformation of portal vein but is stable, one patient is stable, without further variceal bleeding, and one patient died because of multiple organ failure. In patients with BCS, three of four (75%) did well with TIPS, but one patient required immediate surgical shunting after occlusion of the TIPS. Two patients underwent OLT and the fourth patient is stable 2 yr later but has cirrhosis on biopsy. CONCLUSIONS: In patients with BCS, TIPS placement is effective and can be used as a bridge to liver transplantation. TIPS in the noncavernous PVT group should only be recommended when cirrhosis and uncontrollable variceal bleeding are present.
Language of Publication
English
Unique Identifier
99184442

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MeSH Heading (Major)
Hepatic Vein Thrombosis|*SU; Portal Vein|*; Portasystemic Shunt, Transjugular Intrahepatic|*/AE; Venous Thrombosis|*SU
MeSH Heading
Adult; Aged; Female; Follow-Up Studies; Human; Liver Transplantation; Male; Middle Age; Reoperation; Treatment Outcome

Publication Type
JOURNAL ARTICLE
ISSN
0002-9270
Country of Publication
UNITED STATES

Record 66 from database: MEDLINE
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Title
Exclusion of coronary artery disease by exercise thallium-201 tomography in patients with aortic valve stenosis.
Author
Kupari M; Virtanen KS; Turto H; Viitasalo M; Mänttäri M; Lindroos M; Koskela E; Leinonen H; Pohjola Sintonen S; Heikkilä J
Address
First Department of Medicine, Helsinki University Central Hospital, Finland.
Source
Am J Cardiol, 1992 Sep, 70:6, 635-40
Abstract
In many patients with valvular aortic stenosis (AS), management decisions may be possible without invasive studies if coexistent coronary artery disease (CAD) can be ruled out noninvasively. The use of thallium-201 single-photon emission computed tomography to the exclusion of CAD was studied in 44 patients aged 41 to 78 years with AS. In addition to cardiac catheterization and selective coronary angiography, patients underwent a cardiac ultrasound study and thallium-201 myocardial perfusion imaging at rest and after bicycle ergometer exercise. Two thirds of the patients had critical AS (valve area index less than or equal to 0.5 cm2/m2) but none had left ventricular systolic dysfunction. Twenty-one patients had angiographically significant CAD (greater than or equal to 50% diameter stenosis in greater than or equal to 1 coronary artery), whereas 23 had either a fully normal angiogram (n = 17) or mild (less than 50%) stenoses (n = 6). Each patient with significant CAD had an abnormal thallium-201 tomogram, either a strictly segmental perfusion defect (n = 19), or a patchy nonsegmental abnormality (n = 2); however, 10 of 23 patients free of significant CAD had similar results. Thus, the sensitivity and specificity of an abnormal scintigram were 100 and 57%, respectively. If only segmental perfusion defects typical of CAD had been considered abnormal, then the sensitivity of the test would have been 90% and the specificity 70%. Patients with false abnormal scintigrams had more severe AS and more angiographically nonsignificant CAD than those with true normal findings.(ABSTRACT TRUNCATED AT 250 WORDS)
Language of Publication
English
Unique Identifier
92377707

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MeSH Heading (Major)
Aortic Valve Stenosis|*CO; Coronary Disease|CO/DI/*RI; Heart|*RI; Thallium Radioisotopes|*DU; Tomography, Emission-Computed, Single-Photon|*
MeSH Heading
Coronary Angiography; Echocardiography; Exercise Test; Female; Heart Catheterization; Human; Male; Middle Age; Sensitivity and Specificity; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
ISSN
0002-9149
Country of Publication
UNITED STATES

Record 67 from database: MEDLINE
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Title
Liver transplantation in patients with splenorenal shunts: intraoperative flow measurements to indicate shunt occlusion.
Author
Margarit C; Lázaro JL; Charco R; Hidalgo E; Revhaug A; Murio E
Address
Unidad de Trasplante HepÆatico, Hospital General Vall HebrÆon, Spain.
Source
Liver Transpl Surg, 1999 Jan, 5:1, 35-9
Abstract
Two patients with previous distal splenorenal shunts (DSRSs) performed 6 years earlier underwent liver transplantation (LT). A preoperative selective mesenteric artery angiogram showed collateral veins draining mesenteric venous flow into the shunt. Intraoperative flow measurements were performed to assess the steal of portal venous flow by the shunt and determine the need for shunt occlusion. Portal vein, hepatic artery, and shunt flows were measured by ultrasound transit-time flow probes in the native liver and after graft implantation with and without temporary shunt occlusion. Hemodynamic studies showed that long-standing DSRSs are high-flow shunts that steal portal flow. After graft implantation, DSRS flows remained high. Occlusion of the shunts produced an increase in portal vein flow at an amount similar to those of splenorenal shunt. Thus, the flow measurements showed persistent steal by the shunts after graft implantation and, therefore, the DSRSs were occluded but splenectomy was not performed. We conclude that the decision to occlude a DSRS should be based on the demonstration of steal of portal flow by the shunt and reversibility once the shunt is occluded. Splenectomy is not required when the DSRS is occluded.
Language of Publication
English
Unique Identifier
99091922

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MeSH Heading (Major)
Liver Transplantation|*/PH; Portal System|*/PH; Splenorenal Shunt, Surgical|*
MeSH Heading
Adult; Carcinoma, Hepatocellular|SU; Case Report; Collateral Circulation; Female; Human; Intraoperative Period; Liver Cirrhosis|SU/VI; Liver Neoplasms|SU; Male; Middle Age; Regional Blood Flow

Publication Type
JOURNAL ARTICLE
ISSN
1074-3022
Country of Publication
UNITED STATES

Record 68 from database: MEDLINE
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Title
Doppler examination of the periorbital arteries adds valuable hemodynamic information in carotid artery disease.
Author
Sillesen H; Schroeder T; Steenberg HJ; Hansen HJ
Address
 
Source
Ultrasound Med Biol, 1987 Apr, 13:4, 177-81
Abstract
The periorbital flow direction and internal carotid artery (ICA) angiogram were compared to the ICA pressure gradient across the stenosis and the distal ICA pressure in 51 patients subjected to carotid endarterectomy. All 17 patients with inverted periorbital flow had stenoses exceeding 50%. The remaining 16 patients with the same degree of stenosis had antegrade flow, which was also observed in all patients with less than 50% stenosis. In 16 of 17 patients with inverted periorbital flow, the mean pressure gradient exceeded 10 mmHg, whereas 33 of 34 patients with antegrade flow had gradients of 12 mmHg or less. For diagnostic purpose, the periorbital Doppler test is inferior to direct Doppler examination or angiography. However, as an adjunct to direct techniques, patients can be classified into 3 groups: Patients with less than 50% stenosis, Patients with 50% stenosis or more and good collaterals and, Patients with 50% stenosis or more and insufficient collaterals.
Language of Publication
English
Unique Identifier
87235809

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MeSH Heading (Major)
Carotid Artery Diseases|*DI/PP/SU; Orbit|*BS; Ultrasonography|*
MeSH Heading
Arteries|PP; Carotid Artery, Internal|PP/SU; Comparative Study; Endarterectomy; Hemodynamics; Human; Regional Blood Flow; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
ISSN
0301-5629
Country of Publication
ENGLAND

Record 69 from database: MEDLINE
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Title
Aortoiliac aneurysm with arteriocaval fistula treated by a bifurcated endovascular stent-graft.
Author
Beveridge CJ; Pleass HC; Chamberlain J; Wyatt MG; Rose JD
Address
Department of Radiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
Source
Cardiovasc Intervent Radiol, 1998 May, 21:3, 244-6
Abstract
A 71-year-old patient with high-output cardiac failure was found to have an aneurysmal distal aorta with evidence of an arteriocaval fistula on ultrasound scanning. CT demonstrated an aneurysm of the distal aorta and right common iliac artery and an intraarterial digital subtraction angiogram confirmed an arteriocaval fistula. In view of the patient's cardiac failure and general condition an endovascular stent was considered. The right internal iliac artery was occluded with Tungsten coils prior to the insertion of a bifurcated stent-graft. This resulted in total occlusion of the aneurysm and obliteration of the arteriocaval fistula. To our knowledge such a case has not been previously reported.
Language of Publication
English
Unique Identifier
98289745

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MeSH Heading (Major)
Aortic Aneurysm|CO/RA/*SU; Arteriovenous Fistula|CO/RA/*SU; Stents|*
MeSH Heading
Aged; Angiography, Digital Subtraction; Case Report; Human; Iliac Artery; Male; Tomography, X-Ray Computed; Venae Cavae

Publication Type
JOURNAL ARTICLE
ISSN
0174-1551
Country of Publication
UNITED STATES

Record 70 from database: MEDLINE
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Title
Irreversible renal failure associated with triamterene.
Author
Roy LF; Villeneuve JP; Dumont A; Dufresne LR; Duran MA; Morin C; Jobin J
Address
Department of Medicine, St-Luc Hospital, Montreal, Canada.
Source
Am J Nephrol, 1991, 11:6, 486-8
Abstract
A 66-year-old man was admitted with acute oliguric renal failure. The patient was known to have chronic heart failure (ejection fraction 13%) and his medication included furosemide, digoxin and triamterene. Physical examination was unremarkable, and blood pressure was 170/80 mm Hg. Serum creatinine was 1,173 mumol/l. Renal ultrasound, CT scan and angiogram were normal. Despite correction of potential reversible factors and discontinuation of triamterene, renal function did not improve. Renal biopsy showed tubular obstruction with deposition of birefringent crystals and interstitial lymphocytic infiltration; the crystals emitted a blue autofluorescence at 425 nm, typical of triamterene. Renal tissue contained large amounts of triamterene (6.44 mg/g kidney at the initial biopsy and 400 micrograms/g kidney 5 months later). Triamterene has been previously reported to cause acute reversible renal failure, but to our knowledge, this is the first case of irreversible renal failure due to intratubular obstruction by triamterene crystal deposition.
Language of Publication
English
Unique Identifier
92303643

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MeSH Heading (Major)
Kidney|*ME/PA; Kidney Failure, Acute|*CI/PA; Triamterene|*AE/TU
MeSH Heading
Aged; Biopsy; Case Report; Heart Failure, Congestive|DT; Human; Male

Publication Type
JOURNAL ARTICLE
ISSN
0250-8095
Country of Publication
SWITZERLAND

Record 71 from database: MEDLINE
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Title
The carotid intima-media thickness as a marker of the presence of severe symptomatic coronary artery disease.
Author
Geroulakos G; OGorman DJ; Kalodiki E; Sheridan DJ; Nicolaides AN
Address
Vascular Section, St Mary's Hospital Medical School, London, U.K.
Source
Eur Heart J, 1994 Jun, 15:6, 781-5
Abstract
High resolution ultrasound can be used for the accurate measurement of intima-media thickness (IMT). The within-observer coefficient of variation of the IMT of two carotids measured seven times each on different days by two different observers was between 4% and 8%, and the mean absolute difference of the IMT of 68 carotids measured independently by two observers was 0.11 +/- 0.11 mm (mean value +/- SD). Seventy-five consecutive male patients who underwent coronary angiography for assessment of chest pain and 40 normal controls matched for age and sex, were examined with high resolution B-mode ultrasound. The IMT of the common carotid artery for the controls was 0.71 +/- 0.16 mm and for the patients 0.91 +/- 0.18 mm (P < 0.005). In patients with normal coronary angiogram the IMT was 0.73 +/- 0.1 mm, and this increased in each of the subgroups with coronary stenosis compared to patients who had a normal coronary angiogram. In the group with one-vessel disease it was 0.91 +/- 0.17 mm (P < 0.05, ANOVA), in the group with two-vessel disease it was 0.96 +/- 0.17 mm (P < 0.01), and in the group with three-vessel disease it was 0.99 +/- 0.21 mm (P < 0.01). There was a significant linear trend between IMT and the number of involved vessels (P < 0.0001, r = 0.44). An IMT > or = 0.85 mm was derived from the studied population of 75 patients as a criterion for the prediction of coronary artery disease (CAD).(ABSTRACT TRUNCATED AT 250 WORDS)
Language of Publication
English
Unique Identifier
94374340

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MeSH Heading (Major)
Carotid Artery Diseases|EP/*US; Cerebral Arteriosclerosis|EP/*US; Coronary Arteriosclerosis|EP/RA/*US
MeSH Heading
Carotid Artery, Common|US; Coronary Angiography; Human; Male; Middle Age; Observer Variation; Predictive Value of Tests; Support, Non-U.S. Gov't; Tunica Intima|US; Tunica Media|US

Publication Type
JOURNAL ARTICLE
ISSN
0195-668X
Country of Publication
ENGLAND

Record 72 from database: MEDLINE
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Title
Computed numerical analysis of the biomechanical effects on coronary atherogenesis using human hemodynamic and dimensional variables.
Author
Lee BK; Kwon HM; Kim D; Yoon YW; Seo JK; Kim IJ; Roh HW; Suh SH; Yoo SS; Kim HS
Address
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Source
Yonsei Med J, 1998 Apr, 39:2, 166-74
Abstract
The objectives of this investigation were to evaluate biomechanical factors in the atherosclerotic process using human in vivo hemodynamic parameters and computed numerical simulation qualitatively and quantitatively. The three-dimensional spatial patterns of steady and pulsatile flows in the left coronary artery were simulated, using a finite volume method. Coronary angiogram and Doppler ultrasound measurement of the proximal left coronary flow velocity were performed in humans. Inlet wave velocity distribution obtained from in vivo data of the intravascular Doppler study allowed for input of in vitro numerical simulation. Hemodynamic variables, such as flow velocity, pressure and shear stress of the left anterior descending coronary bifurcation site were calculated. We found that there were spatial fluctuation of flow-velocity and recirculation areas at the curved outer wall of the left anterior descending coronary artery, which were due to the differences of flow-velocity and shear stress, especially during the declaration phase of pulsatile flow. This study suggests that rheologic properties may be a part of the atherogenic process in the coronary bifurcated and curved areas.
Language of Publication
English
Unique Identifier
98248810

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MeSH Heading (Major)
Coronary Arteriosclerosis|*ET/*PP; Coronary Vessels|*PP; Hemodynamics|*PH; Models, Cardiovascular|*
MeSH Heading
Biomechanics; Blood Flow Velocity|PH; Blood Pressure|PH; Homeostasis|PH; Human; Pulsatile Flow; Stress, Mechanical

Publication Type
JOURNAL ARTICLE
ISSN
0513-5796
Country of Publication
KOREA

Record 73 from database: MEDLINE
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Title
Interventional cardiology in Europe 1994. Working Group Coronary Circulation of the European Society of Cardiology [see comments]
Author
Windecker S; Meyer BJ; Bonzel T; Fabian J; Heyndrickx G; Morice MC; Mühlberger V; Piscione F; Rothman M; Wijns W; van den Brand M; Meier B
Address
University Hospital, Bern, Switzerland.
Source
Eur Heart J, 1998 Jan, 19:1, 40-54
Abstract
The working group Coronary Circulation of the European Society of Cardiology conducts an annual survey of cardiac interventions in Europe with the support of the national societies of cardiology. A detailed questionnaire about cardiac interventions performed during 1994 was mailed to all members of the European Society of Cardiology. Incomplete or absent data from eight national members precluded their inclusion in the final analysis. Thus, this report summarizes the cardiac interventions performed during 1994 in 29 of 37 members of the European Society of Cardiology, representing a total population of approximately 490 million inhabitants. CORONARY ANGIOGRAPHY: A total of 922,687 coronary angiograms were reported during 1994, representing an increase of 22% compared with 1993 and of 35% compared with 1992. The mean incidence of coronary angiograms was 1881/10(6) inhabitants, ranging from 4417/10(6) inhabitants in Germany to 35/10(6) inhabitants in Romania, Germany, France, Great Britain, and Italy with 50% of the European population performed 73% of all cardiac interventions. CORONARY ANGIOPLASTY: During 1994, a total of 224,722 coronary angioplasty (PTCA) procedures were reported in Europe, an increase of 22% compared with 1993 and of 52% compared with 1992. Adjusted per capita, the mean incidence of coronary angioplasty was 458/10(6) inhabitants, ranging from 1091/10(6) inhabitants in Germany to 6/10(6) inhabitants in Romania. On average, the ratio PTCA per coronary angiogram was 0.24, ranging from 0.37 in the Netherlands to 0.06 in Cyprus. Ad hoc PTCA accounted for 22% of all PTCA cases. The majority (81%) of PTCAs were restricted to a single vessel. Major complications were reported in 2% of patients undergoing PTCA, including death (0.3%), myocardial infarction (1.0%) and need for emergency coronary artery bypass grafting (0.7%). CORONARY STENTING: Coronary stents were utilized in 21,599 coronary interventions during 1994, an increase of 235% compared with 1993 and thus representing the fastest growth in interventional cardiology. The number of European countries employing stents during coronary angioplasty grew from 14 during 1993 to 24 during 1994. Elective use (38%) became the most frequent indication for coronary stenting during 1994, replacing bail-out stenting as the primary indication during 1993. OTHER NEW DEVICES: Other new interventional therapeutic devices were employed in 8827 cases. Only the Rotablator was used more frequently during 1994 as compared with 1993. All other new therapeutic devices showed a decline. Coronary ultrasound was utilized in 3032 interventions and coronary angioscopy in 304 cases during 1994. NON-CORONARY INTERVENTIONS: Valvuloplasty remained the most frequent non-coronary intervention in Europe during 1994 with a total of 2622 mitral. 609 pulmonary and 506 aortic valvuloplasties. CATHETERIZATION FACILITIES: The number of facilities per 10(6) inhabitants performing invasive cardiac procedures in Europe during 1994 ranged from 7.7 in Iceland to 0.2 in Romania (European mean 2.9). The number of trained operators per 10(6) inhabitants ranged from 24 in Germany to 0.4 in Romania (European mean 10). During 1994, a mean of 701 coronary angiograms and 170 PTCAs were performed per catheterization facility in Europe (range: 1052 coronary angiograms and 293 PTCAs per facility in Norway to 218 coronary angiograms and 37 PTCAs per facility in Romania). CONCLUSIONS: The number of both coronary angiograms and coronary angioplasties continues to grow at an annual rate of approximately 20% in Europe. There is a wide range in the amount of revascularization procedures performed between western and eastern European countries. However, countries with the lowest numbers of coronary angiograms and coronary angioplasties, e.g. Romania, also show the fastest annual growth. About one quarter of all patients undergoing coronary angiography are subsequently revascularized by coronary angioplasty. (ABSTRACT TRUN
Language of Publication
English
Unique Identifier
98163905

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MeSH Heading (Major)
Angioplasty, Transluminal, Percutaneous Coronary|IS/*SN; Coronary Angiography|IS/*SN; Coronary Disease|*/DI/TH; Stents|*SN
MeSH Heading
Data Collection; Europe; Human; Treatment Outcome

Publication Type
JOURNAL ARTICLE
ISSN
0195-668X
Country of Publication
ENGLAND

Record 74 from database: MEDLINE
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Title
Compliance with guidelines for the investigation and management of patients with suspected pulmonary embolism at Christchurch Hospital.
Author
Egermayer P; Town GI
Address
Department of Medicine, Christchurch School of Medicine.
Source
N Z Med J, 1998 Mar, 111:1061, 70-3
Abstract
AIMS: (1) To assess the level of compliance of clinicians at Christchurch Hospital with published local guidelines for the diagnostic management of indeterminate lung scans and for the treatment of pulmonary embolism. (2) To evaluate diagnostic outcomes and the methods used to arrive at the diagnosis. METHODS: Retrospective case analysis of 94 consecutive cases of suspected pulmonary embolism referred for a lung scan after August 1993 and a further 70 consecutive cases referred after August 1995. RESULTS: Few clinicians followed the recommendations for the further assessment of indeterminate lung scans. Pulmonary angiography was rarely performed and serial femoral ultrasound was never employed. The majority of patients diagnosed with pulmonary embolism did not have a high probability ventilation/perfusion (VQ) scan or a pulmonary angiogram to support the diagnosis. The use of heparin was overcautious and inconsistent. Major divergences from recommendations were observed in over 50% of cases in which heparin was used to treat pulmonary embolism. CONCLUSIONS: This audit has uncovered a wide diversity of practice in many aspects of the assessment and management of pulmonary embolism and significant deviations from the published guidelines. Underutilisation of objective imaging methods for establishing the diagnosis implies overreliance on clinical impressions, which are known to be unreliable. A review of the guidelines and further educational initiatives are indicated.
Language of Publication
English
Unique Identifier
98210723

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MeSH Heading (Major)
Guideline Adherence|*SN; Practice Guidelines|*; Pulmonary Embolism|*DI/DT
MeSH Heading
Adolescence; Adult; Aged; Aged, 80 and over; Algorithms; Anticoagulants|TU; Female; Heparin|TU; Hospitals; Human; Male; Medical Audit; Middle Age; New Zealand; Retrospective Studies; Support, Non-U.S. Gov't; Warfarin|TU

Publication Type
JOURNAL ARTICLE
ISSN
0028-8446
Country of Publication
NEW ZEALAND

Record 75 from database: MEDLINE
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Title
Non-endoscopic techniques for the evaluation of the pediatric airway.
Author
Contencin P; Gumpert LC; de Gaudemar I; Chaussain M; Dupont C
Address
UnitÆe d'ORL, HÈopital Saint-Vincent-de-Paul, UniversitÆe Paris V, France.
Source
Int J Pediatr Otorhinolaryngol, 1997 Sep, 41:3, 347-52
Abstract
In children with stridor, a detailed evaluation of the airway is often required to assess precisely its anatomical and functional status. Various methods of assessment have been developed and airway management may include, as well as rigid and flexible endoscopy, the use of imaging techniques such as plain X-rays, a barium oesophagogram, ultrasound, a CT scan, a magnetic resonance image (MRI) and an angiogram, as well as respiratory function tests including acoustic rhinometry and flow volume loops or even pH monitoring. This article aims to highlight the valuable information these alternative techniques can provide.
Language of Publication
English
Unique Identifier
98011580

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MeSH Heading (Major)
Airway Obstruction|*DI/ET; Pulmonary Ventilation|*
MeSH Heading
Angiography; Child; Child, Preschool; Human; Magnetic Resonance Imaging; Tomography, X-Ray Computed

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
0165-5876
Country of Publication
IRELAND

Record 76 from database: MEDLINE
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Title
Retrospective analysis of the effect of crossing vessels on successful retrograde endopyelotomy outcomes using spiral computerized tomography angiography.
Author
Nakada SY; Wolf JS Jr; Brink JA; Quillen SP; Nadler RB; Gaines MV; Clayman RV
Address
Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
Source
J Urol, 1998 Jan, 159:1, 62-5
Abstract
PURPOSE: Using spiral computerized tomography (CT) angiography, we sought to evaluate the incidence of a crossing vessel in a group of adults with primary ureteropelvic junction obstruction who had previously undergone successful retrograde endopyelotomy. MATERIALS AND METHODS: A total of 16 patients who had undergone successful Acucise balloon incision endopyelotomy for ureteropelvic junction obstruction, all with followup greater than 2 years, underwent a spiral CT angiogram with intravenous contrast material to identify those with a crossing vessel. Contrast enhanced CT was performed with dual phase technique on a Somatom-Plus-S CT scanner using prototype software. After 180-degree linear interpolation of the projection data, transaxial images of the affected kidney were reconstructed. In addition, at the time of the study all patients completed analog followup pain scales and quality of life assessment questionnaires. RESULTS: Among the 16 patients 6 (38%) had anterior or posterior crossing vessels based on spiral CT angiography. No patient had both types. By analog pain scale patients had 80% mean improvement in pain (range 63 to 100). CONCLUSIONS: In our series nearly 40% of patients with anterior or posterior crossing vessels had a long-term (greater than 2 years) successful outcome with retrograde endopyelotomy. Endopyelotomy continues to be our initial mode of therapy among adults with primary ureteropelvic junction obstruction. In our opinion the adverse influence of the crossing vessel is not sufficient to justify the added expense of preoperative angiography, spinal CT or endoluminal ultrasound.
Language of Publication
English
Unique Identifier
98063084

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MeSH Heading (Major)
Renal Artery|*RA; Renal Veins|*RA; Tomography, X-Ray Computed|*MT; Ureteral Obstruction|*RA/SU
MeSH Heading
Adult; Angiography; Human; Kidney Calices|SU; Quality of Life; Retrospective Studies; Treatment Outcome; Ureter|SU

Publication Type
JOURNAL ARTICLE
ISSN
0022-5347
Country of Publication
UNITED STATES

Record 77 from database: MEDLINE
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Title
Hyperparathyroidism.
Author
Petti GH Jr
Address
Division of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, California.
Source
Otolaryngol Clin North Am, 1990 Apr, 23:2, 339-55
Abstract
Primary hyperparathyroidism can be caused by a solitary parathyroid adenoma and sometimes by hyperplastic parathyroid glands, multiple adenomas, or carcinoma. In the majority of patients, the diagnosis is made tentatively by chemistry profiles that show elevated serum calcium. It is confirmed by repeated serum calcium values and PTH determination. The parathyroid abnormality, if an adenoma, can usually be localized preoperatively by thallium-technetium scan, ultrasound, or computed tomography. In the case of persistent disease with hypercalcemia, an angiogram with selective venous sampling for PTH is helpful. At exploration, both sides of the neck may need exploration. A unilateral procedure may be sufficient, if the preoperative localization tests are confirmatory and if biopsy of another "normal" gland shows normal histologic findings. During the postoperative period, suction drains will lessen the likelihood of hematoma formation and serum calcium levels are monitored for the first 3 to 5 days. Symptomatic patients with low calcium levels receive intravenous and oral calcium supplements until values are brought to the low-normal range. Supplements are tapered as the calcium in the serum rises. The majority of patients who undergo parathyroid surgery will benefit both symptomatically and metabolically.
Language of Publication
English
Unique Identifier
90245417

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MeSH Heading (Major)
Hyperparathyroidism|DI/EC/ET/*SU; Parathyroid Neoplasms|*CO
MeSH Heading
Adult; Aged; Case Report; Cost-Benefit Analysis; Female; Human

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
0030-6665
Country of Publication
UNITED STATES

Record 78 from database: MEDLINE
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Title
A comparison of angiography, intravenous digital subtraction angiography and duplex ultrasound in the diagnosis of carotid artery atherosclerosis.
Author
DAlotto C; Pelz DM; Rankin RN
Address
 
Source
J Can Assoc Radiol, 1985 Sep, 36:3, 200-8
Abstract
Duplex ultrasonography and intravenous digital subtraction angiography (IV-DSA) were used as the initial diagnostic studies in 124 patients referred for evaluation of neurological disorders possibly related to carotid bifurcation disease in the neck. Conventional angiograms were subsequently performed in 29 patients. Diagnostic images were obtained in 100% of the angiograms, 94% of the duplex ultrasonograms and 89% of the IV-DSA studies. Using the angiogram as the reference standard for plaque detection, duplex ultrasonography had a sensitivity of 0.93 and specificity of 0.83. Doppler velocity ratio alone was used to detect all patients with angiographically demonstrated disease but demonstrated a specificity of only 0.35. IV-DSA showed a sensitivity of 0.93 and specificity of 0.91. IV-DSA and duplex ultrasonography agreed in the assessment of degree stenosis in over 90% of cases and we conclude that these two modalities have approximately the same sensitivity and specificity for detecting atherosclerotic disease at the carotid bifurcations.
Language of Publication
English
Unique Identifier
86008399

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MeSH Heading (Major)
Arteriosclerosis|*DI; Atherosclerosis|*DI; Carotid Artery Diseases|*DI; Subtraction Technique|*; Ultrasonography|*
MeSH Heading
Adult; Aged; Carotid Artery, External|RA; Carotid Artery, Internal|RA; Comparative Study; Female; Human; Male; Middle Age

Publication Type
JOURNAL ARTICLE
ISSN
0008-2902
Country of Publication
CANADA

Record 79 from database: MEDLINE
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Title
Focal nodular hyperplasia and hepatic adenoma: comparison of angiography, CT, US, and scintigraphy.
Author
Welch TJ; Sheedy PF 2d; Johnson CM; Stephens DH; Charboneau JW; Brown ML; May GR; Adson MA; McGill DB
Address
 
Source
Radiology, 1985 Sep, 156:3, 593-5
Abstract
The authors reviewed 23 cases of focal nodular hyperplasia and 13 cases of hepatic adenoma, all of which were confirmed pathologically. All solitary masses that exhibited normal or increased uptake of technetium 99m-sulfur colloid were shown to be hyperplasia; while previous criteria such as a central blood supply on angiograms or a central scar on computed tomography (CT) or ultrasound (US) scans were helpful, they were relatively infrequent. A mass that was slightly hypodense and homogeneous on a CT or US scan and highly vascular with an intense capillary stain on an angiogram was almost always hyperplasia. Acute hemorrhage within a focal hepatic tumor was common in adenoma but did not occur in hyperplasia.
Language of Publication
English
Unique Identifier
85271186

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MeSH Heading (Major)
Adenoma|*DI/RA/RI; Liver|*PA; Liver Neoplasms|*DI/RA/RI
MeSH Heading
Adolescence; Adult; Angiography; Comparative Study; Female; Human; Hyperplasia|DI; Male; Middle Age; Tomography, X-Ray Computed; Ultrasonography

Publication Type
JOURNAL ARTICLE
ISSN
0033-8419
Country of Publication
UNITED STATES

Record 80 from database: MEDLINE
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Title
Fine-needle aspiration diagnosis of carotid body tumor: report of a case and review of experience with cytologic features in four cases.
Author
Das DK; Gupta AK; Chowdhury V; Satsangi DK; Tyagi S; Mohan JC; Khan VA; Malhotra V
Address
Institute of Cytology and Preventive Oncology (ICMR), New Delhi, India.
Source
Diagn Cytopathol, 1997 Aug, 17:2, 143-7
Abstract
A 45-yr-old female presented with a left upper cervical swelling of 4 yr duration. The clinical suspicion of carotid body tumor (CBT) was confirmed by imaging findings, fine-needle aspiration (FNA) cytology, and histology of the resected tumor. Review of our experience with four cases including the present one during 10 yr (1984-1994) showed that the age of the patients ranged from 35 to 45 yr with a mean of 40.8 yr. All four cases were females and had left-sided upper cervical swelling. Clinically one case was diagnosed as cervical lymphadenopathy and there was clinical suspicion of CBT in two cases. Findings of digital subtraction angiogram in four cases and ultrasonography including Doppler ultrasound vascular imaging in three cases were consistent with CBT. The cytodiagnosis was CBT in three cases and inadequate (blood only) in one case. The analysis of detailed cytologic features in three cases revealed blood-rich aspirate with poor to moderate cellularity, indistinct cell outline, and acinar formation. Giant bare nuclei, spindle-shaped tumor cells, and cytoplasmic granulations were observed in two cases each. Histopathology of the resected tumors in two cases confirmed the cytodiagnosis of CBT. FNA cytology played a useful role in arriving at a tissue diagnosis of this rare neoplasm.
Language of Publication
English
Unique Identifier
97403254

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MeSH Heading (Major)
Biopsy, Needle|*; Carotid Body|*PA/RA/US; Carotid Body Tumor|*PA
MeSH Heading
Adult; Case Report; Female; Human; Magnetic Resonance Angiography; Middle Age; Neck|PA/RA/US; Tomography, X-Ray Computed

Publication Type
JOURNAL ARTICLE
ISSN
8755-1039
Country of Publication
UNITED STATES

Record 81 from database: MEDLINE
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Title
Clinical-pathologic study of stage IIB, III, and IVA carcinoma of the cervix: extended diagnostic evaluation for paraaortic node metastasis--a Gynecologic Oncology Group study.
Author
Heller PB; Maletano JH; Bundy BN; Barnhill DR; Okagaki T
Address
Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia 19104.
Source
Gynecol Oncol, 1990 Sep, 38:3, 425-30
Abstract
Three hundred twenty patients were entered into GOG Protocol 63, a clinical-pathologic study of stage IIB, III, and IVA cervical carcinoma. Following the completion of FIGO staging prerequisites, patients had computerized tomography (CT), a lymph-angiogram (LAG), and an ultrasound (US) of the aortic area. If any study was positive, a cytologic or histologic evaluation by fine-needle aspiration or selective paraaortic lymphadenectomy was performed. Paraaortic node dissection was mandated for patients with negative extended staging studies. Results of extended staging evaluations were compared with histologic or cytologic results. Two hundred sixty-four patients were eligible and evaluable. One hundred sixty-seven patients (63%) were stage IIB, 89 (34%) were stage III, and 8 (3%) were stage IVA. Positive paraaortic nodes occurred in 21% of stage IIB, 31% of stage III, and 13% of stage IVA. LAG sensitivity was 79% with a specificity of 73%. Sensitivity of CT and US was 34 and 19%, respectively, with specificities of 96 and 99%, respectively. The frequency of false-negative results with LAG for patients with stage IIB disease was 6%. This decrease is consistent with a stable sensitivity and specificity. These findings suggest that a negative LAG may be adequate to eliminate surgical staging in subgroups with low risk of metastasis to the aortic nodes. Until new noninvasive testing methods are developed, LAG appears to be the most reliable noninvasive examination to evaluate spread of cervical cancer to aortic nodes.
Language of Publication
English
Unique Identifier
91033212

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MeSH Heading (Major)
Cervix Neoplasms|CO/*PA; Lymphatic Metastasis|*DI; Para-Aortic Bodies|*PA
MeSH Heading
Adult; Aged; Comparative Study; Female; Human; Laparotomy|AE; Lymphography; Middle Age; Support, U.S. Gov't, P.H.S.; Tomography, X-Ray Computed; Ultrasonography

Publication Type
JOURNAL ARTICLE
ISSN
0090-8258
Country of Publication
UNITED STATES

Record 82 from database: MEDLINE
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Title
Magnetic resonance imaging of papillary renal cell carcinoma.
Author
Herman SD; Friedman AC; Siegelbaum M; Ramchandani P; Radecki PD
Address
 
Source
Urol Radiol, 1985, 7:3, 168-71
Abstract
The authors report magnetic resonance (MR) studies in a case of papillary renal cell carcinoma. The preoperative ultrasound and computed tomographic scans suggested either a hemorrhagic cyst or a carcinoma, but the angiogram demonstrated avascularity. The magnetic resonance scan was more consistent with carcinoma than complicated cyst. We report the MR findings with pathologic correlation.
Language of Publication
English
Unique Identifier
86071844

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MeSH Heading (Major)
Carcinoma, Papillary|*DI/RA; Carcinoma, Renal Cell|*DI/RA; Kidney Neoplasms|*DI/RA
MeSH Heading
Case Report; Human; Male; Middle Age; Nuclear Magnetic Resonance|DU; Tomography, X-Ray Computed

Publication Type
JOURNAL ARTICLE
ISSN
0171-1091
Country of Publication
UNITED STATES

Record 83 from database: MEDLINE
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Title
Prognosis in a patient with an initial normal pulmonary angiogram.
Author
Bertucci V; Asch MR; Balter MS
Address
Department of Medicine, Mount Sinai Hospital, Toronto, Canada.
Source
Chest, 1994 Apr, 105:4, 1257-8
Abstract
A 58-year-old man with pleuritic chest pain and an indeterminate lung scan had normal results of Duplex ultrasound studies of the lower limbs and a normal pulmonary angiogram. Recurrent symptoms led to repeated pulmonary angiography and a diagnosis of pulmonary embolism. This case emphasizes the possibility of missing an initial, or developing a subsequent, pulmonary embolism despite a normal angiogram and reinforces the need for serial studies if a noninvasive strategy for the diagnosis of pulmonary embolism is to be employed.
Language of Publication
English
Unique Identifier
94215377

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MeSH Heading (Major)
Pulmonary Artery|*RA; Pulmonary Embolism|*RA
MeSH Heading
Case Report; False Negative Reactions; Human; Male; Middle Age; Prognosis

Publication Type
JOURNAL ARTICLE
ISSN
0012-3692
Country of Publication
UNITED STATES

Record 84 from database: MEDLINE
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Title
The relevance of detecting carotid artery calcification on plain radiograph.
Author
Doris I; Dobranowski J; Franchetto AA; Jaeschke R
Address
Department of Radiology, Hamilton General Hospital, Ontario, Canada.
Source
Stroke, 1993 Sep, 24:9, 1330-4
Abstract
BACKGROUND AND PURPOSE: The aim of this study was to determine the potential value of carotid artery calcification observed on plain radiographs in patients referred for carotid angiogram in the diagnosis of carotid artery stenosis. METHODS: One hundred sixty consecutive patients with suspected carotid artery stenosis underwent both plain radiographs of the carotid arteries and digital subtraction angiography of the same vessels. In addition, 108 of these patients also had duplex ultrasound of the same vascular area. The clinical usefulness of the carotid artery calcification was assessed by calculating the likelihood ratios for different test results against results of angiography and duplex ultrasound. RESULTS: There is a statistically significant association between the degrees of calcification and carotid disease as demonstrated by angiography (P = .0001), although positive correlations of the degrees of stenosis and calcification was only fair (Spearman correlation coefficient r = .4). The sensitivity of carotid calcification in detecting clinically significant stenosis assuming any calcification is abnormal was 89% with a specificity of 46%. The likelihood ratios for 50% stenosis by angiography varied from 0.24 (no calcification) to 3.41 (level III) and for 50% stenosis by duplex ultrasound varied from 0.21 (no calcification) to more than 5.87 (level III). Assessments of the degree of calcification based on plain radiographs had excellent reproducibility (all intraclass correlation coefficients were greater than .9). CONCLUSIONS: In this population with a high prevalence of carotid artery disease, there is an association between the presence of carotid calcification and atheromatous disease. If subsequent studies were to show this to apply in the general population, this could be of value in identifying asymptomatic patients at increased risk.
Language of Publication
English
Unique Identifier
93369850

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MeSH Heading (Major)
Calcinosis|CO/EP/*RA/US; Carotid Artery Diseases|CO/EP/*RA/US; Carotid Stenosis|CO/EP/*RA/US
MeSH Heading
Aged; Female; Human; Likelihood Functions; Male; Middle Age

Publication Type
JOURNAL ARTICLE
ISSN
0039-2499
Country of Publication
UNITED STATES

Record 85 from database: MEDLINE
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Title
Intravascular ultrasound assessment in carotid interventions.
Author
Reid DB; Diethrich EB; Marx P; Wrasper R
Address
Glasgow Royal Infirmary, Scotland.
Source
J Endovasc Surg, 1996 May, 3:2, 203-10
Abstract
PURPOSE: To demonstrate the clinical value of intravascular ultrasound (IVUS) imaging in monitoring stent deployment in the cervical carotid arteries. METHODS AND RESULTS: Two-dimensional (2D) and three-dimensional (3D) IVUS imaging has been used routinely in more than 100 patients following carotid stenting and the completion angiogram to detect evidence of inaccurate stent deployment. Axial 2D views were used to measure diameters and cross-sectional areas and provide the basis for 3D reconstruction. These composited images produced single-frame views of entire vascular segments, with definition of vessel wall morphology, stent placement, and angioplasty-induced defects. This information was used in the decision to apply further treatment to the area in order to maximize luminal diameter and/or correct defects. CONCLUSIONS: IVUS imaging is an important component of carotid artery stent procedures. It more accurately visualizes stent placement and vessel wall morphology than arteriography, information critical to the intraprocedural assessment process.
Language of Publication
English
Unique Identifier
96391165

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MeSH Heading (Major)
Angioplasty, Balloon|*; Carotid Stenosis|TH/*US; Intraoperative Care|*MT; Stents|*
MeSH Heading
Human; Reproducibility of Results; Ultrasonography|IS/MT

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
1074-6218
Country of Publication
UNITED STATES

Record 86 from database: MEDLINE
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Title
Pedicled arterial grafts in coronary surgery: postoperative echo color-Doppler study.
Author
Agrifoglio M; Di Matteo S; Antona C; Zanobini M; Alamanni F; Biglioli P
Address
Department of Cardiac Surgery, University of Milan, Italy.
Source
J Cardiovasc Surg (Torino), 1996 Feb, 37:1, 53-7
Abstract
In 1994 a mid-term postoperative echo color-Doppler ultrasound was performed to check the pedicled arterial conduits used in coronary surgery, such as the left and right internal mammary arteries (LIMA, RIMA) and the right gastroepiploic artery (RGEA). This evaluation was made in 31 patients with a previous nonemergent complete arterial myocardial revascularization. The pedicled arterial grafts studied were 71 (31 LIMA, 15 RIMA and 25 RGEA). The Doppler spectrum (combined systolic/diastolic waveform), the diameter and the flow of every arterial graft was always identified (100% of detection) and there was a statistical significative difference between mean RGEA flow versus mean LIMA and RIMA flow (p<0.05). All the conduits studied were characterized by a good diastolic and end-diastolic velocity, evidence of normal graft patency. The postoperative angiogram of the LIMA, RIMA and RGEA conduits was performed in 27/31 (87.1%) patients and it showed 100% patency of arterial grafts used and of anastomoses. The echo color-Doppler data were compared to postoperative angiographic results. The echo color-Doppler imaging of the pedicled arterial grafts used in coronary surgery seems to be a promising technique for the postoperative serial assessment of the LIMA, RIMA and RGEA conduit function, because it is noninvasive, safe, easy, quick to perform and the preliminary results of echo color-Doppler ultrasound versus angiography are satisfactory.
Language of Publication
English
Unique Identifier
96189147

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MeSH Heading (Major)
Coronary Artery Bypass|*MT; Ultrasonography, Doppler, Color|*
MeSH Heading
Adult; Aged; Comparative Study; Coronary Angiography; Data Interpretation, Statistical; Epigastric Arteries|TR; Evaluation Studies; Female; Human; Internal Mammary-Coronary Artery Anastomosis; Male; Middle Age; Postoperative Period

Publication Type
JOURNAL ARTICLE
ISSN
0021-9509
Country of Publication
ITALY

Record 87 from database: MEDLINE
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Title
The clinical value of three-dimensional intravascular ultrasound imaging.
Author
Reid DB; Douglas M; Diethrich EB
Address
Glasgow Royal Infirmary, Scotland, United Kingdom.
Source
J Endovasc Surg, 1995 Nov, 2:4, 356-64
Abstract
Two-dimensional (2D) intravascular ultrasound (IVUS) imaging can now be reconstructed into three dimensions from serial 2D images captured following a "pullback" of the IVUS catheter through the target site. Three-dimensional (3D) reconstructions provide "longitudinal" and "volume" images. The former is similar to an angiogram and can be examined in three dimensions by rotating the image around its longitudinal axis, providing clinically useful information during endovascular procedures. The volume view takes longer to create and is not an exact reconstruction, but it provides images that can be rotated into any spatial position. It visualizes the luminal aspect of the vessel particularly well. The clinical value of 3D IVUS is in the diagnosis of vascular disease and the assessment of endovascular interventions. Three-dimensional IVUS, which provides better, more informative images than 2D IVUS, can be particularly useful intraprocedurally in detecting inaccurate deployment of intravascular stents and endoluminal grafts.
Language of Publication
English
Unique Identifier
97378550

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MeSH Heading (Major)
Arteries|*US; Image Processing, Computer-Assisted|*MT; Ultrasonography, Interventional|*MT
MeSH Heading
Human; Sensitivity and Specificity; Vascular Diseases|SU/US

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
1074-6218
Country of Publication
UNITED STATES

Record 88 from database: MEDLINE
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Title
Usefulness of a prototype intravascular ultrasound imaging in evaluation of aortic dissection and comparison with angiographic study, transesophageal echocardiography, computed tomography, and magnetic resonance imaging.
Author
Yamada E; Matsumura M; Kyo S; Omoto R
Address
First Department of Surgery, Saitama Medical School, Japan.
Source
Am J Cardiol, 1995 Jan, 75:2, 161-5
Abstract
The aim of this study was to evaluate the accuracy of information obtained with a prototype intravascular ultrasound (IVUS) system in chronic aortic dissection by comparing results with angiography, transesophageal echocardiography (TEE), computed tomography, or magnetic resonance imaging. We assigned 15 patients to IVUS imaging after they underwent angiography. The detection rate of the intimal flap was 100% in all segments of the aorta, and the detection rate of the intimal tear was 0%, 50%, 50%, and 77.8% in the ascending, arch, descending, and abdominal aorta, respectively. IVUS demonstrated 100% of the celiac and renal arteries, and 80% of the superior mesenteric arteries as well as their relation to dissection. It clarified the origin of 12 of 60 main abdominal branches (20%) which were not clear on the angiogram. It also determined the distal extent of the dissection in all cases. With regard to the size of the vessel, there was a good correlation between IVUS and computed tomographic values (r = 0.98, p < 0.01). No complications occurred in any patient. IVUS accurately demonstrated thrombus or spontaneous echo contrast in the false lumen that was confirmed with computed tomography or TEE, or both. It was especially useful in evaluating the abdominal aorta with regard to determining the size of the vessel, the extent of dissection, the relation of the branches to the false lumen, and the detection of intimal tears--important information for follow-up of patients and for planning surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
Language of Publication
English
Unique Identifier
95109497

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MeSH Heading (Major)
Aneurysm, Dissecting|DI/RA/*US; Aortic Aneurysm|DI/RA/*US; Ultrasonography, Interventional|*
MeSH Heading
Adult; Aged; Aorta|PA/US; Aortography; Chronic Disease; Comparative Study; Echocardiography, Transesophageal; Evaluation Studies; Female; Human; Iliac Artery|US; Magnetic Resonance Imaging; Male; Mesenteric Arteries|US; Middle Age; Renal Artery|US; Tomography, X-Ray Computed

Publication Type
JOURNAL ARTICLE
ISSN
0002-9149
Country of Publication
UNITED STATES

Record 89 from database: MEDLINE
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Title
Prediction of tolerance to carotid artery occlusion using transcranial Doppler ultrasound.
Author
Giller CA; Mathews D; Walker B; Purdy P; Roseland AM
Address
Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas.
Source
J Neurosurg, 1994 Jul, 81:1, 15-9
Abstract
Surgical sacrifice of the carotid artery is a frequently anticipated event during the treatment of certain aneurysms and tumors. The ability to predict tolerance to carotid artery occlusion is therefore of benefit when planning procedures in which the carotid artery is at risk. A trial of carotid artery occlusion using an angiographic balloon during concurrent neurological examination or blood flow studies is an accepted method for testing tolerance, but it carries the risks of an angiogram and cannot be performed at the bedside. Transcranial Doppler ultrasound (TCD) is a noninvasive modality that permits measurement of blood velocity in cerebral vessels. The immediate effects of carotid artery occlusion on middle cerebral artery (MCA) perfusion can be obtained by insonating this artery during manual carotid artery compression. To compare the TCD response to carotid artery compression with the data obtained with more formal testing, the MCA of 22 patients was insonated during manual carotid artery compression and the results compared with the clinical tolerance to balloon occlusion in all patients and to blood flow studied by single photon emission computerized tomography before or during balloon occlusion in 14 of the 22 patients. Surgery was planned to treat giant unruptured aneurysms in 17 cases, intracranial tumors in three, a carotid-cavernous fistula in one, and a carotid artery injury in one. Fifteen patients showed a reduction in TCD flow velocities by no more than 65%; of these, 14 (93%) clinically tolerated the balloon occlusion test. Of the seven patients showing a TCD flow velocity decrease of more than 65%, six (86%) developed a transient focal deficit during the occlusion. It is concluded that the change in MCA velocity measured with TCD studies during manual carotid artery occlusion is a useful predictor of the clinical and blood flow responses to a trial of carotid artery occlusion with an angiographic balloon.
Language of Publication
English
Unique Identifier
94267570

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MeSH Heading (Major)
Carotid Arteries|PH/RA/*SU/*US; Cerebral Arteries|PH/*US; Ultrasonography, Doppler, Transcranial|*
MeSH Heading
Adult; Aneurysm|SU; Balloon Dilatation; Blood Flow Velocity; Brain Neoplasms|SU; Carotid Artery Diseases|SU; Carotid Artery, Internal|PH; Cerebral Angiography; Cerebral Ischemia, Transient|ET/US; Comparative Study; Constriction; Forecasting; Human; Regional Blood Flow|PH; Tomography, Emission-Computed, Single-Photon

Publication Type
JOURNAL ARTICLE
ISSN
0022-3085
Country of Publication
UNITED STATES

Record 90 from database: MEDLINE
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Title
Controversies in surgical therapy for APUDomas.
Author
Fraker DL; Norton JA
Address
National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Source
Semin Surg Oncol, 1993 Sep, 9:5, 437-42
Abstract
Location of gastrinomas by means of portal venous sampling is a technique in which venous blood from various sites in the portal system around the pancreas and duodenum is obtained and assayed for gastrin levels. A gradient of 50% or greater compared to systemic gastrin levels from a given location regionally identifies the site of gastrin overproduction, thereby locating the tumor. The only area in which venous sampling may help, in the authors' opinion, is in the small subset of patients who have occult gastrinoma not imaged with any other modality, in the body or tail of the pancreas that cannot be found with intraoperative ultrasound or palpation. It is considered that a secretin angiogram is equally effective and is a simpler procedure. Similarly, in insulinoma regional location of the tumor by means of a calcium angiogram has eliminated the usefulness of portal venous sampling. Controversial areas of surgical treatment of APUDomas often reflect a balance between the risks and benefits of aggressive surgery, as data to support an aggressive surgical approach to obtain improved survival often do not exist. For example, if patients with occult MTC can undergo cervical reexploration with minimal or no morbidity the potential benefit of removing malignant disease, warrants this approach. Similarly, if patients with MEN-1 can be explored safely with resection of pancreatic and duodenal tumors, then this position can be defended. On the other hand, if a subgroup of patients with MEN-2 and pheochromocytomas can be spared bilateral adrenalectomy without compromising their long-term outcome in terms of disease-free survival, then this conservative approach is warranted.(ABSTRACT TRUNCATED AT 250 WORDS)
Language of Publication
English
Unique Identifier
94069183

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MeSH Heading (Major)
Apudoma|*SU
MeSH Heading
Adrenal Gland Neoplasms|SU; Carcinoma, Medullary|SU; Gastrinoma|SU; Human; Insulinoma|SU; Multiple Endocrine Neoplasia|SU; Pancreatic Neoplasms|SU; Pheochromocytoma|SU; Thyroid Neoplasms|SU

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
8756-0437
Country of Publication
UNITED STATES

Record 91 from database: MEDLINE
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Title
Symptomatic liver hemangioma with intra-tumor hemorrhage treated by angiography and embolization during pregnancy.
Author
Graham E; Cohen AW; Soulen M; Faye R
Address
Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia.
Source
Obstet Gynecol, 1993 May, 81:5 ( Pt 2), 813-6
Abstract
BACKGROUND: Cavernous hemangiomas are the most common benign tumors of the liver and are found in about 2% of autopsy patients. The vast majority are small (less than 4 cm) and asymptomatic, but there have been a few reported cases of these lesions leading to severe pain and even spontaneous fatal hemorrhage. Estrogen may cause the growth of liver hemangiomas, but there is a paucity of information concerning the effect of pregnancy upon these lesions. CASE: A patient presented at 18 weeks' gestation with the acute onset of vomiting and epigastric pain. A right upper-quadrant ultrasound scan found a 9-cm hypodense lesion within the liver, and magnetic resonance imaging (MRI) suggested a hemangioma. The lesion was believed to be inoperable, and € selective catheterization of the common hepatic artery was performed. An angiogram demonstrated a round vascular mass 12 cm in diameter occupying much of the left side of the liver, with the vascular supply from the middle hepatic artery and to a lesser extent from the left hepatic artery. Embolization was performed, and a post-embolization image demonstrated satisfactory occlusion of the vessels treated. The patient's epigastric pain resolved after the procedure. The lesion was observed with monthly ultrasound and regressed to about 50% of its original size. The patient was scheduled for an elective primary cesarean delivery at 39 weeks to avoid possible rupture of the hepatic hemangioma during the second stage of labor. Her cesarean and postpartum course were uncomplicated. CONCLUSION: A symptomatic liver hemangioma with intratumor hemorrhage can be successfully treated with embolization during pregnancy. Because of the paucity of reported cases, it is uncertain whether vaginal birth is contraindicated in these patients.
Language of Publication
English
Unique Identifier
93226306

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MeSH Heading (Major)
Embolization, Therapeutic|*; Hemangioma, Cavernous|RA/*TH; Hemorrhage|RA/*TH; Liver Neoplasms|RA/*TH; Pregnancy Complications, Neoplastic|RA/*TH
MeSH Heading
Adult; Angiography; Case Report; Female; Hepatic Artery; Human; Pregnancy

Publication Type
JOURNAL ARTICLE
ISSN
0029-7844
Country of Publication
UNITED STATES

Record 92 from database: MEDLINE
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Title
Carotid endarterectomy in Oklahoma Medicare beneficiaries: patient characteristics and outcomes.
Author
Bratzler DW; Oehlert WH; Murray CK; Bumpus LJ; Moore LL; Piatt DS
Address
Oklahoma Foundation for Medical Quality, Inc., Oklahoma city 73118-9984, USA.
Source
J Okla State Med Assoc, 1996 Dec, 89:12, 423-9
Abstract
BACKGROUND AND OBJECTIVES: Ischemic stroke represents the third leading cause of death and the most common cause of permanent disability in the United States. Carotid endarterectomy has been widely utilized as a procedure to reduce the risk of stroke and represents the most commonly performed peripheral arterial surgery. This cooperative project was initiated to assess the appropriateness of carotid endarterectomies performed on Medicare beneficiaries and the postoperative outcomes (mortality and stroke) in these patients. METHODS: Retrospective review was performed on the inpatient medical records of 774 patients who underwent 813 carotid endarterectomy procedures in eight hospitals during calendar years 1993 and 1994. Medicare claims data were also analyzed for all carotid endarterectomies performed in Oklahoma during calendar years 1992 through 1995. RESULTS: A history of transient ischemic attack or stroke in the distribution of the operated carotid artery was documented in 57% of the cases. The majority of patients had preoperative ultrasound imaging of the carotid arteries and a preoperative angiogram was performed before 96% of the procedures. Accepted indications for the surgery were documented for 98% of the procedures. Stroke or death within 30 days of the date of the carotid endarterectomy occurred after 4.9% (0-8.8% by hospital) of the procedures. CONCLUSIONS: This project demonstrated considerable variation between hospitals in the outcomes of patients undergoing carotid endarterectomy and the potential for improved care of patients with regard to discharge planning, education, and use of anticoagulant or antiplatelet medications postoperatively.
Language of Publication
English
Unique Identifier
97151949

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MeSH Heading (Major)
Endarterectomy, Carotid|*SN; Medicare|*SN
MeSH Heading
Adult; Aged; Confidence Intervals; Human; Middle Age; Oklahoma|EP; Retrospective Studies; Treatment Outcome; United States

Publication Type
JOURNAL ARTICLE
ISSN
0030-1876
Country of Publication
UNITED STATES

Record 93 from database: MEDLINE
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Title
Clinical significance of the flow gap in carotid magnetic resonance angiography.
Author
Heiserman JE; Zabramski JM; Drayer BP; Keller PJ
Address
Division of Neuroradiology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Source
J Neurosurg, 1996 Sep, 85:3, 384-7
Abstract
Magnetic resonance (MR) angiography offers a safe, noninvasive alternative to conventional angiography in patients with suspected carotid stenosis; however, it tends to overestimate the severity of stenosis. Loss of the MR signal with a resulting flow gap is a frequent finding in cases of high-grade stenosis. The authors undertook this study to define the range of carotid stenosis associated with a flow gap on two-dimensional time-of-flight (2DTF)-MR angiography. Blinded evaluations were made of 102 common carotid bifurcations in 51 patients who had undergone both conventional angiography and 2DTF-MR angiography. The percent of diameter stenosis was calculated from the conventional angiogram using the method adopted by the Asymptomatic Carotid Atherosclerosis Study (ACAS) trial. An MR flow gap was noted if there was a segment of the vessel that was completely free of signal with a reappearance of the signal distally. According to conventional angiography, the minimum percentage of stenosis associated with a flow gap is 56%. Flow gaps were present in 20 of 22 arteries (sensitivity 91%) with stenosis of 60% or more and in two of the 66 arteries (specificity 97%) with less than 60% stenosis. Flow gaps were present in all arteries with stenosis of 70% or more. Complete occlusion was correctly identified in 10 of 10 cases. These results demonstrate that the presence of a flow gap on 2DTF-MR angiography is a reliable marker of clinically significant carotid stenosis (measuring 60% or more), with sensitivity and specificity comparable to duplex carotid ultrasound. In addition, MR angiography can be used to screen the intracranial circulation for significant vascular pathology in patients being considered for carotid endarterectomy.
Language of Publication
English
Unique Identifier
96350212

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MeSH Heading (Major)
Carotid Stenosis|*PA/RA; Cerebral Ischemia|*PA/RA; Magnetic Resonance Angiography|*
MeSH Heading
Adult; Aged; Cerebral Angiography; Human; Middle Age; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
ISSN
0022-3085
Country of Publication
UNITED STATES

Record 94 from database: MEDLINE
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Title
Clinical use of microvascular PTFE grafts.
Author
Lanzetta M
Address
Sydney Hospital Hand Unit, Australia.
Source
Microsurgery, 1995, 16:6, 412-5
Abstract
This paper reports on the first clinical case where a polytetrafluoroethylene (PTFE) graft of less than 3 mm in diameter was implanted in the arterial system of a patient to bridge a vascular defect. A 1.5 cm long, 1.5 mm diameter prosthesis was interposed in the superficial palmar arch of a man who sustained a laceration of the palm of his dominant hand. The graft was implanted by means of the 3M Precise Microvascular Anastomotic System on one end, and by conventional microsurgical technique on the other end. There were no postoperative complications. The patient resumed his pre-injury activities 9 weeks after trauma. Serial Doppler ultrasound examinations showed normal blood flow and complete patency of the graft. An angiogram performed 12 weeks postoperatively confirmed the patency of the prosthesis. Twelve months post-operatively the patient is free from complications. The use of small diameter PTFE prostheses may be considered when planning grafting procedures for microvascular defects.
Language of Publication
English
Unique Identifier
96087827

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MeSH Heading (Major)
Blood Vessel Prosthesis|*; Hand|*BS; Ischemia|*SU; Polytetrafluoroethylene|*
MeSH Heading
Adult; Anastomosis, Surgical; Case Report; Human; Male

Publication Type
JOURNAL ARTICLE
ISSN
0738-1085
Country of Publication
UNITED STATES

Record 95 from database: MEDLINE
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Title
Flow dynamics for radiologists. II. Practical considerations in the live human.
Author
Kerber CW; Liepsch D
Address
Department of Radiology, University of California, San Diego.
Source
AJNR Am J Neuroradiol, 1994 Jun, 15:6, 1076-86
Abstract
Although the rules about flows seem complex and even at times suggest chaos, some general principles can be extracted and used by the radiologist. Normal arteries damp disturbances, tolerate our catheters well, and generally cause the blood's slipstreams to swirl. It seems that the swirls and the energy that accompanies the passage of those swirls are prime determiners of the development of degenerative changes, most importantly of atherosclerosis and berry aneurysms. Knowing this, we now must direct our research to look beyond today's practical applications and this simplistic summary. Radiologists who trained during the angiography era are often incredulous when they see the richness of information found in physiologic flow models. For years, contrast agents have hidden the elegant complexity of blood flow. Now, however, we have two new powerful machines: the Doppler gray-scale ultrasound and the MR scanner. These machines routinely demonstrate flow data that we do not as yet use. As angiographers we have a natural and unconscious bias to make images produced by our new machines look like the classic angiogram. It is a powerful and pervasive bias. We still call angiography our "gold standard." We must overcome that bias. As valuable as angiography has been to radiology, it may no longer be our benchmark. A new standard is ready to be developed. The MR scanner even now not only allows calculation of global flow in vessels but also analyzes individual slipstreams. The images shown here are only the beginning. Keep our old mindset, and the limits and utility of the MR scanner will not be explored by radiologists. However, if we physicians, especially radiologists, reenter the field of fluid dynamics, all of science and our patients will benefit. We have broad shoulders to stand on and see into the future. Harvey, Hales, Galen, and Poiseuille: all were physicians; they added immeasurably to the foundations of rheology and our understanding of flowing blood. We must be willing to do likewise.
Language of Publication
English
Unique Identifier
94354049

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MeSH Heading (Major)
Blood Circulation|*PH; Cardiovascular Physiology|*; Cardiovascular System|*PH
MeSH Heading
Aging|PH; Arteries|PH; Blood Flow Velocity; Catheterization; Human; Kinetics; Models, Biological; Radiology; Rheology

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, ACADEMIC
ISSN
0195-6108
Country of Publication
UNITED STATES

Record 96 from database: MEDLINE
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Title
Organ involvement in hepato-intestinal schistosomiasis.
Author
el Shiekh Mohamed AR; al Karawi MA; Yasawy MI
Address
Gastroenterology Department, Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia.
Source
Hepatogastroenterology, 1994 Aug, 41:4, 370-6
Abstract
The endoscopic, radiological and histological findings in several of our patients with Schistosoma mansoni infection are described. Seventy-two patients with hepatosplenic schistosomiasis. Endoscopic sclerotherapy was effective in 45 patients with bleeding varices. Ultrasound of the liver was suggestive of periportal fibrosis in 48 of these 72 patients, in 30 of whom liver biopsy demonstrated a Schistosoma granuloma or periportal fibrosis. Gastroscopy revealed congestion, erosions or ulcerations in the stomach in 40 of these patients and in the duodenum in 23 patients. Schistosoma ova and inflammatory changes were seen in endoscopic biopsies from the stomach in three out of twelve and five out of eight duodenal biopsies. The colonoscopic findings were suggestive of schistosomiasis in 98 out of 216 patients with colonic schistosomiasis. Eight patients had schistosomal polyps and one had colonic calcifications. Schistosoma ova were seen in surgical specimens from patients presenting with an acute abdomen due to appendicitis in six, cholecystitis in three and mesenteric vein thrombosis in three. In one of the latter the mesenteric angiogram showed an internal mesenteric vein blocked by ova.
Language of Publication
English
Unique Identifier
95048108

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MeSH Heading (Major)
Liver Diseases, Parasitic|*PA; Schistosomiasis mansoni|*PA
MeSH Heading
Colonic Diseases|PA; Duodenal Diseases|PA; Esophageal Diseases|PA; Human; Splenic Diseases|PA; Stomach Diseases|PA

Publication Type
JOURNAL ARTICLE
ISSN
0172-6390
Country of Publication
GERMANY

Record 97 from database: MEDLINE
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Title
Cyclic flow variations after coronary angioplasty in humans: clinical and angiographic characteristics and elimination with 7E3 monoclonal antiplatelet antibody.
Author
Anderson HV; Kirkeeide RL; Krishnaswami A; Weigelt LA; Revana M; Weisman HF; Willerson JT
Address
Cardiology Division, University of Texas Health Science Center, Houston 77225.
Source
J Am Coll Cardiol, 1994 Apr, 23:5, 1031-7
Abstract
OBJECTIVES. We tested the hypothesis that cyclic alterations in coronary artery blood flow that occurred after coronary angioplasty could be attenuated or abolished by a monoclonal antibody to the platelet surface membrane GP IIb/IIIa receptor. BACKGROUND. Coronary artery cyclic flow variations may occur after coronary angioplasty in experimental animal models and humans. In animal models of coronary thrombosis, cyclic alterations in flow often have preceded thrombotic occlusion or reocclusion. Several agents that inhibit platelet function have been shown to attenuate or eliminate cyclic flow variations in these models. METHODS. We monitored coronary artery flow in 27 patients for 30 min after coronary angioplasty, using 0.018-in. (0.046 cm) coronary guide wires with pulsed wave Doppler ultrasound transducers on the distal tips. Clinical data were collected and quantitative analyses performed on coronary arteriograms made before and after the angioplasty procedures. We compared findings in patients with and without cyclic flow variations detected. RESULTS. There were 20 men and 7 women. Mean age was 58 years, and 63% had unstable angina. They received standard doses of nitrates, aspirin, heparin, calcium channel antagonists and other medications clinically indicated. Nevertheless, we detected cyclic flow variations in five patients (19%). Four of these patients had stable flow restored with intravenous injection of 0.25 mg/kg normal body weight of monoclonal antibody c7E3 Fab to the platelet GP IIb/IIIa receptor. In one patient, stable flow was restored by repeat dilation when an immediate angiogram revealed renarrowing. Patients developing cyclic alterations in flow had longer lesions (18.7 +/- 7.5 mm vs. 13.1 +/- 5.7 mm, p < 0.05) that had responded less well to angioplasty (stenosis postangioplasty 47 +/- 13% vs. 33 +/- 15%, p < 0.05). CONCLUSIONS. Cyclic alterations in coronary artery blood flow may occur in some patients after coronary angioplasty, despite the use of standard antiplatelet, antithrombotic and antivasospastic medications. We found that they could be eliminated by this monoclonal antibody that blocks the final common event of platelet aggregation.
Language of Publication
English
Unique Identifier
94193908

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MeSH Heading (Major)
Angioplasty, Transluminal, Percutaneous Coronary|*; Antibodies, Monoclonal|*TU; Coronary Circulation|*DE; Coronary Disease|*PP/RA/*TH/US; Immunoglobulins, Fab|*TU; Platelet Aggregation Inhibitors|*TU
MeSH Heading
Adult; Aged; Coronary Angiography; Female; Human; Male; Middle Age; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
ISSN
0735-1097
Country of Publication
UNITED STATES

Record 98 from database: MEDLINE
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Title
Recombinant tissue plasminogen activator for neonatal and pediatric vascular thrombolytic therapy.
Author
Dillon PW; Fox PS; Berg CJ; Cardella JF; Krummel TM
Address
Department of Surgery, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
Source
J Pediatr Surg, 1993 Oct, 28:10, 1264-8; discussion 1268-9
Abstract
Thrombotic vascular occlusion may complicate the clinical course of many neonatal and pediatric pathologic processes. Systemic thrombolytic therapy with heparin, urokinase, or streptokinase may not be appropriate in the critically ill neonate because these agents generate a diffuse coagulopathic state. Direct surgical intervention for repair may be precluded by the small size of the vessels involved. Recombinant tissue plasminogen activator (rTPA) induces only a minimal proteolytic state while inducing thrombolysis within the local environment of the clot. We report our experience with regional rTPA infusion in four critically ill patients with venous and arterial thrombotic disorders. there were two brachial artery occlusive lesions--a neonate with iatrogenic occlusion due to a misplaced intravenous catheter and a 2-year-old child with inadvertent arterial ligation during an attempted venous cutdown. Two venous lesions consisted of a full-term neonate with renal vein/inferior vena caval thrombosis and a 32-week infant with partial superior vena caval thrombosis due to a Broviac catheter. Systemic thrombolytic therapy was contraindicated in these patients because of underlying illnesses. Pretherapy vascular evaluation included Doppler examination and angiography. The rTPA infusion was continued until there was evidence of clot lysis by ultrasound, angiogram, or venogram. Infusion rate of rTPA was adjusted according to fibrinogen levels. All three neonates responded successfully to rTPA therapy. Two neonates required only bolus administration and one responded to combined bolus and continuous infusion therapy after 58 hours. rTPA failed to reverse brachial artery occlusion in the 2-year-old child with purpura fulminans.(ABSTRACT TRUNCATED AT 250 WORDS)
Language of Publication
English
Unique Identifier
94087437

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MeSH Heading (Major)
Brachial Artery|*/RA; Salvage Therapy|*MT; Thrombolytic Therapy|*MT; Thrombosis|*DT/RA; Tissue Plasminogen Activator|*AD; Vena Cava, Inferior|*/RA; Vena Cava, Superior|*/RA
MeSH Heading
Case Report; Critical Illness; Female; Human; Iatrogenic Disease; Infant, Newborn; Infusions, Intravenous; Male; Recombinant Proteins|AD

Publication Type
JOURNAL ARTICLE
ISSN
0022-3468
Country of Publication
UNITED STATES

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