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Biomedical subjects

A M Belli

Publications and source records attributed to A M Belli.

At least 73 records · Page 4Linked to original sources
PubMed1990

Splenic and portal venous thrombosis: a vascular complication of pancreatic disease demonstrated on computed tomography.

Portal and splenic venous thrombosis is a rare but well recognised complication of pancreatic carcinoma and pancreatitis. We report a series of five patients with pancreatic disease in whom CT detected this complication. The appearances on CT are of an enlarged vein with a centre of lower attenuation which does not enhance following intravenous contrast injection, ring enhancement and opacification of collateral veins. Splenic vein thrombosis following pancreatitis should be considered in all patients with pancreatic disease as this complication is increasingly recognised as a cause of upper gastrointestinal haemorrhage from varices.

Humans↗
PubMed1990

The complications of high brachial artery puncture.

Fifty-two angiograms via a high brachial puncture were performed in Sheffield from 1986 to 1988 in patients in whom femoral artery catheterization was not possible or was contraindicated. Follow-up was obtained in 49 procedures. The procedure was initially successful in 43 cases. Twelve patients developed haematomas, graded large in 5, but no intervention for haematoma was required. The radial pulse was diminished or absent at the end of examination in four patients; three of these patients had no associated ischaemia, the pulse returning spontaneously within 24 hours, although remaining chronically reduced in one patient. One patient developed ischaemia due to acute occlusion of the brachial artery--this was successfully treated with immediate angioplasty. Paraesthesiae in the median nerve distribution were noted in two patients. These resolved spontaneously and no permanent neurological problem was seen. We conclude that high brachial artery puncture is a useful alternative when femoral artery puncture is not possible.

Adult↗
PubMed1990

Peripheral arterial occlusions: initial results from percutaneous angioplasty with a hybrid laser probe.

Percutaneous laser-assisted angioplasty performed with a laser-heated metal-capped fiber has been shown to be safe and effective. A hybrid probe was developed that allows a small percentage of laser light to emerge, converting the rest to heat. The probe was used to recanalize 37 peripheral arterial occlusions (10 in the iliac segment, 2-7 cm long, and 27 in the femoropopliteal segment, 1-35 cm long) in 37 patients. Primary success was defined as successful recanalization and continued patency during the first 24 hours, as assessed at physical examination. Primary success in the iliac segments was 70% and in the femoropopliteal segments was 85% (overall, 81%). The only complication was an arterial wall perforation, which had no sequelae. The probe is safe for use in peripheral arterial occlusions. There was no increase in the rate of perforation compared with the rate with the "hot-tip" laser probe, and the technique may have advantages over use of the original "hot-tip" laser probe.

Aged↗
PubMed1990

Peripheral vascular occlusions: mechanical recanalization with a metal laser probe after guide wire dissection.

Fourteen patients underwent recanalization of occlusions of the iliac or femoral artery. Subintimal passage of the guide wire and catheter occurred and was confirmed on angiograms obtained after administration of contrast medium. Recanalization of the true lumen was impossible, despite repeated attempts. Rather than abandon the procedure, the authors advanced a 2.5-mm laser probe to the occlusion, and the lumen was successfully reentered without the application of laser energy in 12 patients. The authors believe this technique is useful in traversing arterial occlusions after a standard guide wire technique has failed. The development of a wire and catheter with similar properties might allow the more widespread use of this technique.

Arterial Occlusive Diseases↗
PubMed1989

Normal lymph node size in the mediastinum: a retrospective study in two patient groups.

The size and number of normal mediastinal lymph nodes seen on computed tomography were studied retrospectively in 110 patients from the Royal Marsden Hospital, Sutton, and St Bartholomew's Hospital, London. The mediastinum was divided into four areas. Lymph nodes were seen in 81% of patients. The number of patients with nodes in a specific area varied from 28% in the right superior mediastinum to 46% in the pretracheal retrocaval space. Seventeen per cent of the areas studied contained one node, 11% contained two or three nodes and 4% had three nodes. Fewer nodes were seen in patients with sparse mediastinal fat. Sixty-seven per cent of patients had nodes measuring 5 mm or less in maximum transverse diameter and 21% of patients had one or more nodes of 6-10 mm. Only a single calcified node measured more than 10 mm. We conclude that the majority of nodes are 5 mm or less in diameter and that almost all normal nodes measure 10 mm or less.

Adult↗
PubMed1989

Percutaneous atherectomy--early experience in Sheffield.

Percutaneous transluminal angioplasty (PTA) of arterial stenoses is a well-established and relatively safe technique in the treatment of peripheral and coronary vascular disease. Recurrence, however, remains a problem. The 'atherectomy' catheter is a new device to provide lumen enlargement by the mechanical removal of atheroma. In Sheffield, 14 lesions in the femoral arteries have been treated by atherectomy, with a reduction in mean diameter stenosis from 88% to 15%. There were no complications. Follow-up ranges from 3 to 15 months, with a mean of 9 months. There has been only one recurrence. It can be used in calcified lesions and may prove to be most useful in the treatment of tough lesions. Further experience and follow-up is necessary, however, to determine whether it has any advantage over balloon dilatation.

Aged↗
PubMed1989

Percutaneous transluminal angioplasty of the distal abdominal aorta.

Percutaneous Transluminal Angioplasty (PTA) has become widely practised and is a significant advance in the treatment of arterial disease. Its use in the treatment of atheromatous abdominal aortic stenoses in thirteen patients is described. Technical success was achieved in all with no complications. In a follow-up period from 7 to 70 months all patients have benefitted and 85% remain symptom free.

Adult↗
PubMed1988

Graft versus host disease: findings on plain abdominal radiography.

The plain abdominal radiographs of 31 patients who had undergone bone marrow transplantation were reviewed retrospectively to determine the radiological abnormalities caused by intestinal graft versus host disease. Abnormal radiological signs were observed in 95% of patients with acute graft versus host disease but none were sufficiently characteristic to differentiate between patients with and without acute intestinal graft versus host disease.

Adolescent↗
PubMed1988

The appearance of the inferior thyroid veins on computed tomography.

Computed tomography (CT) scans of the mediastinum in 80 patients were reviewed retrospectively to determine the nature of small opacities which are identified on contiguous cuts. These structures varied in number from one to five. The pattern of enhancement, appearance on contiguous CT sections and position in the mediastinum led us to believe that these represent inferior thyroid veins. To our knowledge their appearance on CT has not been reported previously.

Adult↗
PubMed1988

The renal rind sign: a new ultrasound indication of inflammatory disease in the abdomen.

The width of the right anterior extrarenal tissue is increased on ultrasound examination in patients with abdominal inflammatory disease. Thickened perirenal fascia associated with acute pancreatitis has previously been reported on computed tomography. A case report has described increased echogenicity of the pararenal space on ultrasound in children with pancreatitis but increased width of the space between the liver and the renal capsule has not hitherto been described in association with inflammatory disease in the abdomen in adults. We have observed it in acute cholecystitis, acute pancreatitis, acute appendicitis, a perforated duodenal ulcer, a leaking anastomosis with a right subphrenic abscess following total gastrectomy and in a patient with septicaemia and liver abscesses. Normal values were obtained in 100 patients without detectable or known disease and were found to be between 1 and 6 mm (mean 2.5 mm) in men and 1 and 5 mm (mean 1.8 mm) in women. The patients with abdominal disease who demonstrated this sign had values ranging from 9-11 mm (mean 10 mm).

Abdomen↗
PubMed1988

Aortic angioplasty.

Percutaneous transluminal angioplasty is a well-recognized and accepted alternative to surgery in the treatment of arterial stenoses in the peripheral vasculature, coronary arteries and aortic branches such as the renal arteries. Its application in the abdominal aorta is less well described but in selected patients and with experienced operators it has been shown to be effective.

Angioplasty, Balloon↗
PubMedDate not supplied

Evaluation and complications of direct graft puncture in thrombolysis and other interventional techniques.

PURPOSE: To evaluate the value and complications of direct graft puncture in conducting interventional procedures in synthetic vascular bypass grafts. METHODS: We retrospectively reviewed 65 direct graft punctures in 50 patients undergoing a variety of interventional vascular procedures. In two patients the grafts were found to be infected and the procedures abandoned. RESULTS: Complications encountered included hematomas that did not require treatment in three patients, and four hematomas requiring surgical drainage. One graft became infected (despite prophylactic cefuroxime), after three consecutive punctures over a 10-day period for a variety of interventions. All the patients who developed hematomas had undergone pharmacological thrombolysis. CONCLUSION: Direct graft puncture is a relatively safe technique, with a minimal risk of infection and hemostatic complications attributable to thrombolysis. In 31 of the 41 patients undergoing successful thrombolysis, additional percutaneous procedures were undertaken, and these were facilitated by the direct graft puncture route.

Aged↗
PubMedDate not supplied

Ruptured suprarenal artery aneurysm: angiographic diagnosis and treatment by selective embolization.

The case of a 78-year-old man with retroperitoneal hemorrhage due to a ruptured right inferior suprarenal artery aneurysm is presented. The diagnosis was made by angiography which allowed immediate embolization of the neck of the aneurysm, controlling hemorrhage and obviating the need for surgery. The patient made a full recovery with no evidence of further hemorrhage.

Aged↗
PubMedDate not supplied

Iatrogenic arteriovenous fistula in a renal allograft: the result of a TAD guidewire injury.

A case is presented of an iatrogenic arteriovenous fistula developing in a renal allograft following guidewire manipulation during transplant renal artery angioplasty. Hyperdynamic flow through the fistula was causing a shunt of blood away from the renal cortex as demonstrated on sonography and scintigraphy. Selective embolization was performed, correcting the maldistribution of flow to the peripheral renal cortex. The diagnosis and difficulty in management of asymptomatic renal arteriovenous fistulae is also discussed.

Angiography↗
PubMedDate not supplied

Anastomoses of the ovarian and uterine arteries: a potential pitfall and cause of failure of uterine embolization.

Four women with symptomatic uterine fibroids were treated by uterine artery embolization (UAE). In all cases both uterine arteries were embolized via a single femoral puncture with polyvinyl alcohol using a selective catheter technique. In three cases, the ovarian artery was not visible on the initial angiogram before embolization, but appeared after the second uterine artery had been treated. In one case of clinical failure following UAE, a repeat angiogram demonstrated filling of the fibroids from the ovarian artery. Anastomoses between uterine and ovarian arteries may cause problems for radiologists performing UAE and are a potential cause of treatment failure.

Adult↗