Digital subtraction angiography.
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Angiography↗
Biomedical subjects
A W Stanson
Publications and source records attributed to A W Stanson.
Abdominal angina and neurofibromatosis.
A young man with severe abdominal pain and weight loss due to intestinal ischemia was examined. At operation, the origins of the celiac and superior mesenteric arteries were found to be compressed by plexiform neurofibromatosis. Symptoms were relieved by reconstructive arterial surgery.
Abdomen↗
Computerized tomography following abdominal aortic surgery.
Computerized tomography (CT) is an accurate, noninvasive method for direct imaging of the retroperitoneal space. We have evaluated its effectiveness in diagnosing postoperative aortic graft complications. CT provides an excellent display of the prosthetic graft material. Graft infections, graft hematomas, graft occlusions, anastomotic aneurysms, and true aneurysms can be detected with CT. We believe CT is the diagnostic screening procedure of choice for most patients with suspected aortic graft complications.
Aged↗
Isolated renal artery dissection, presentation, evaluation, management, and pathology.
Isolated nontraumatic renal artery dissection is rare. In this communication, 35 cases are presented; 24 cases (group 1) (22 male, 2 female) were diagnosed angiographically, and 11 (group 2) (10 male, 1 female) were observed at autopsy. In group 1, 23 of the patients were hypertensive when they were first seen, and in 17 of them the hypertension was of recent onset. Additional presenting signs and symptoms included flank pain (10 patients), gross hematuria (5), and headaches (6). Renal function was satisfactory. Renal vein renin levels could be lateralized in 8 of 16 patients. Isotope renograms performed in 18 patients, showed unilateral abnormalities in 7, bilateral abnormalities in 6, and normal results in 5. Angiograms showed that the dissection was unilateral in 18 cases and bilateral in 6 cases. Fibromuscular dysplasia was observed radiographically in 22 cases and was bilateral in 12. In group 1, 13 patients were treated with antihypertensive medication only, and 11 underwent operation. At follow-up (mean 52.0 months), the mean blood pressure were 128/88 mm Hg and 139/89 mm Hg for the medical and surgical groups, respectively. Eleven medical and nine surgical patients continued to require antihypertensive drugs at follow-up. Among the 11 patients in group 2, only 4 were hypertensive. In only one case the dissection may have contributed significantly to the patient's death. These studies indicate that isolated nontraumatic renal artery dissection most commonly occurs in young men with coexistent fibromuscular dysplasia. Hypertension is commonly present and therapy should be directed toward its control. In this study, blood pressure control was effectively accomplished with medical therapy.
Adult↗
Computed tomography and angiography of cavernous hemangiomas of the liver.
Cavernous hemangioma is the most common benign tumor of the liver. Eighteen patients were studied by both computed tomography (CT) and angiography. The angiographic features were classic, consisting of normal hepatic arteries, no tumor vessels, and densely stained blood-filled spaces producing a "cotton-wool" appearance. Before contrast infusion, CT scans showed roughly spherical, well-demarcated low-density masses; afterward there was a peripheral zone of enhancement which varied in thickness and sometimes had a corrugated inner margin, though the center remained low in density and the overall size of the lesion did not change. The authors feel that the CT findings are characteristic and that in some cases angiography is unnecessary.
Angiography↗
Transluminal angioplasty for basilar artery stenosis.
This report describes for the first time the successful use of transluminal balloon-catheter dilation (angioplasty) for high-grade basilar artery atherosclerotic stenotic lesions in two patients with frequent, severe, progressing symptoms that were unresponsive to anticoagulant therapy. Excellent angiographic and short-term clinical results have been obtained. These results and the relative frequency of these lesions justify further evaluation of this approach.
Arterial Occlusive Diseases↗
Use of the Simmons "Sidewinder" femoral-cerebral catheter for abdominal angiography.
The authors describe a single catheter system which allows rapid, routine abdominal angiography. Selective and subselective studies are easily performed, and the catheter can be used without modification for Pitressin infusion and embolization.
Angiography↗
Systemic artery-to-pulmonary vein fistula in osteogenic sarcoma of the chest wall.
An arteriovenous fistula between the systemic and pulmonary circulations may be congenital, as in bronchopulmonary sequestration, or the communication may be acquired. Inflammatory disease, trauma, and, rarely, neoplasm have been implicated as possible causes of acquired communications. We describe a patient who had a systemic artery-to-pulmonary vein fistula that was secondary to a recurrent sarcoma of the chest wall. Review of the literature failed to reveal a previous report of a similar case.
Adult↗
Surgical treatment of congenital pelvic arteriovenous malformation.
Congenital arteriovenous fistulas often pose difficult diagnostic and management problems. Surgical therapy has been associated with a propensity for incomplete obliteration and recurrence. A case of a large congenital pelvic arteriovenous malformation, initially misdiagnosed as an atrial septal defect, was defined by selective roentgenographic and contrast echographic techniques and successfully treated by total surgical excision.
Adult↗
Extracranial angiographic findings in giant cell (temporal) arteritis.
Angiograms of 10 patients with giant cell arteritis who had large-artery and aortic abnormalities were reviewed. The affected arteries had multiple stenotic areas, and occlusions were relatively common, usually located at the end of tapered stenotic segments. Bridging collateral arteries usually refilled the distal portion of the occluded artery. The laterations were seen most frequently in the subclavian, axillary, and brachial arters, and the arteriographic lesions reflected the clinical findings. Such arteriographic abnormalities are suggestive of giant cell arteritis in a patient over the age of 50. The differential diagnosis includes Takayasu's disease, arteriosclerosis, thoracic outlet syndrome, and ergotism.
Aged↗
Routine tomography of the temporomandibular joint.
Routine lateral tomography of the temporomandibular joint has resulted in a three-fold increase in the detection of positive findings. The technique is easily accomplished, eliminates the problem of superimposition of unwanted structures, permits a true lateral view of the condyle and condylar fossa, and allows small articular surface abnormalities to be identified. Although the entrance skin dose to the patient's face in the beam is about two times greater per exposure than that for our previous conventional open and closed lateral views, we believe that the increased dose is reasonable and the resulting improved diagnostic accuracy outweighs this disadvantage.
Adult↗
Large artery involvement in giant cell (temporal) arteritis.
Of 248 patients with giant cell arteritis, 34 had evidence that the disease affected the aorta or its major branches. Symptoms suggestive of large artery involvement were intermittent claudication of an extremity, paresthesias, and Raynaud's phenomenon. Physical findings included absent or decreased large artery pulses and bruits over large arteries. Four patients presented with decreased upper extremity pulses as the initial manifestation of their arteritis. Nine other patients under treatment for temporal arteritis or polymyalgia rheumatica first developed evidence of large artery involvement as corticosteroid therapy was tapered or discontinued. Angiography, performed in 10 patients, was helpful in indicating arteritis rather than atherosclerosis as the cause of large artery disease. Three patients died with aortic rupture, and, at autopsy, widespread giant cell arteritis was found. However, when corticosteroids were given in adequate doses, the response was favorable in most patients; intermittent claudication decreased and the pulses improved.
Adrenal Cortex Hormones↗
Temperature acclimation effects on monkey liver ribo- and deoxyribonucleic acid and on ribonucleic acid of other organs.
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Acclimatization↗
Management of inferior pancreaticoduodenal artery aneurysms: a 4-year, single center experience.
Inferior pancreaticoduodenal artery aneurysms are uncommon visceral artery aneurysms usually difficult to resect, and, if untreated, have a propensity to rupture with catastrophic results. We reviewed the clinical and treatment records of four patients encountered in our institution within the last 4 years. Three patients presented as bleeding emergencies from single aneurysms and were successfully treated by transcatheter embolization using coaxial technique and a variety of embolic agents. One nonemergent, asymptomatic patient had surgical resection of two inferior pancreaticoduodenal artery aneurysms due to unfavorable anatomy for embolization. Embolization therapy appears to be the treatment of choice in the emergency setting. Patients with unsuitable anatomy for embolization may still require surgical intervention.
Aneurysm↗
Aortic dissection: review of value and limitations of two-dimensional echocardiography in a six-year experience.
The utility of transthoracic two-dimensional echocardiography in patients with aortic dissection was assessed by retrospective analysis in 67 patients: 31 patients with DeBakey type I, 21 patients with type II, 10 patients with type III, and five patients with false-positive diagnoses. Aortic dissection was correctly identified by two-dimensional echocardiography in 49 patients; 13 had false-negative diagnoses. Therefore the sensitivity was 79%, and the positive predictive accuracy was 91%. Transthoracic two-dimensional echocardiography is a reasonable screening technique for diagnosis of aortic dissection.
Acute Disease↗
Polyarteritis nodosa: spectrum of angiographic findings.
The purpose of this study was to review the positive angiographic findings in patients with polyarteritis nodosa (PAN). The authors reviewed the angiograms of 56 consecutive patients (25 women and 31 men; age range, 18-81 years; mean age, 55 years) with PAN and arterial abnormalities consistent with necrotizing vasculitis. Aneurysms were present in 27 patients and segments of ectasia were present in seven patients, for a total of 34 (61%) of 56 patients with aneurysmal lesions. The remaining 22 (39%) patients had arterial lesions that were occlusive: luminal irregularity, stenosis, or occlusion. All but one of the patients with an aneurysm also had occlusive lesions. Therefore, 55 (98%) of the 56 patients were found to have occlusive lesions. Skeletal muscle arteries were affected in 18 patients, nine in the extremities. The most frequent finding in patients with PAN was occlusive arterial lesions. Although the presence of aneurysms increases specificity for the diagnosis of PAN, many patients have only occlusive lesions. Involvement of skeletal muscle arteries was common.
Adult↗
Spontaneous dissections of the renal arteries in a patient with previous spontaneous dissections of the internal carotid arteries.
An otherwise healthy 35-year-old woman suffered spontaneous dissections of both internal carotid arteries. She made an excellent recovery but was left with occlusion of the left internal carotid artery and a residual subcranial dissecting aneurysm of the right artery--both were asymptomatic. Eight years later, spontaneous dissections of both renal arteries occurred. The exact nature of the underlying arterial disease is not clear. Although fibromuscular dysplasia is suspected, other undetermined arteriopathy cannot be excluded.
Adult↗
Imaging findings in extracranial (giant cell) temporal arteritis.
Patients with extracranial giant cell arteritis (GCA) present with occlusive arterial lesions that may be detected with multiple imaging modalities: arteriography, intravenous angiography (IV-DSA), CT scanning, and magnetic resonance angiography (MRA). The lesions often present with a typical arteriographic pattern of bilateral stenoses or occlusions with a smooth, tapered appearance in the subclavian, axillary and proximal brachial arteries. A few patients have aneurysmal lesions. Less commonly involvement may be found in the femoral arteries and their branches. Angiographic study of 65 patients (56 women, 9 men; average age, 65) revealed involvement of the upper extremities in 61 patients, and lower extremities in 13, while 9 had both areas affected. Detection of these lesions requires a diagnostic modality that depicts the vessel lumen such as: angiographic techniques, CT scanning with reconstructed images, and MRA. However, inflammation of the arterial wall cannot be detected by these means. Standard CT imaging with contrast enhancement, and certain MR sequences as well as ultrasound permit identification of the edema and inflammation of the vessel wall. This is an important marker for active disease.
Angiography↗