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Biomedical subjects

B T Katzen

Publications and source records attributed to B T Katzen.

At least 73 records · Page 4Linked to original sources
PubMed1981

Low dose streptokinase in the treatment of arterial occlusions.

Twelve patients with arterial occlusions demonstrated by angiography were treated using intraarterial "low dose" streptokinase delivered to the site of occlusion via a 5 French catheter. The catheter was embedded at the site of arterial occlusion if possible, but if not, was placed immediately proximal to the occlusion. Streptokinase was infused at 5,000 U/hr in a volume of about 50 ml using an arterial infusion pump. The technique was applied to vessels of the upper and lower extremities as well as the renal arteries. Of 12 patients infused, 11 had successful thrombolysis. No hemorrhagic complications were encountered. This technique is extremely promising as a method of treatment of thromboses of recent origin, especially in the poor operative candidate, and for angioplasty-related thromboses.

Arterial Occlusive Diseases↗
PubMed1979

Percutaneous transluminal angioplasty with the Grüntzig balloon catheter. A review of 70 cases.

Percutaneous transluminal angioplasty has been used to treat lesions of the iliac, superficial femoral, and renal arterial systems in 70 patients. Overall initial success was achieved in 27/30 lesions, with 4/5 lesions documented to be patent for longer than two years. Although long-term follow-up is at present limited, the reduced cost and morbidity of this procedure are distinct advantages in appropriately selected patients. The close involvement of the vascular surgeon and a "team" approach are necessary. These preliminary results are part of a long-term study to evaluate the efficacy of transluminal angioplasty as well as to define factors that may be of predictive value in patient selection.

Arteriosclerosis↗
PubMed1979

Percutaneous transluminal angioplasty (PTA) with the Grüntzig balloon catheter: technical problems encountered in the first forty patients.

Forty patients have undergone percutaneous transluminal angioplasty (PTA) of the iliac or femoral-popliteal system with the Grüntzig balloon catheter. Technical problems ahve included experience with difficult antegrade puncture, production of intimal flaps, and loss of collateral vessels, as well as the need to develop an approach for recanalization of obstructions and for use of the balloon. Since problems in these areas may jeopardize the success of the procedure, they have been elucidated with some discussion of prevention. Preliminary results on the success of the procedure are included.

Anticoagulants↗
PubMed1979

Percutaneous transhepatic portal venography in the diagnosis and management of gastroesophageal varices.

Percutaneous transhepatic portal venography is a relatively safe method of obtaining both physiologic and morphologic information in patients with portal hypertension. Precise "road mapping" is performed, as well as measurement of free portal pressure. Additionally, transcatheter obliteration of gastroesophageal varices may produce effective cessation of hemorrhage in patients bleeding from this site, as was done on an emergency basis after failure of intra-arterial vasopressin infusion.

Adult↗
PubMed1979

Percutaneous transluminal angioplasty with the Grüntzig balloon catheter.

The results of an ongoing five-year study of percutaneous transluminal angioplasty for the treatment of peripheral vascular disease are presented. A balloon catheter was used for iliac and superficial femoral and popliteal artery dilatation. Forty out of 43 procedures performed were considered to have initial success, with iliac angioplasty showing a greater success rate (96%) than superficial femoral angioplasty (90%). Complications requiring surgical intervention occurred in only 3 patients. Advantages of this technique include local anesthesia, early ambulation, reduced hospital stay, and reproducibility.

Catheterization↗
PubMed1979

Percutaneous transluminal angioplasty for treatment of renovascular hypertension.

Four patients with typical renovascular hypertension due to atherosclerotic stenosis (3 patients) and near occlusion (one patient) were treated with percutaneous transluminal angioplasty (PTA). Two patients had malignant hypertension by clinical standards. All had significant reduction in blood pressure following angioplasty, resulting in either a normotensive state, or management with significantly less antihypertensive medication. Patency and normal renin levels were achieved within two months in 2 patients. Clinical follow-up documented continued reduction in blood pressure. Advantages of the procedure include local anesthesia, relatively little discomfort, repeatability, and the fact that surgery is not precluded if angioplasty is unsuccessful.

Anesthesia, Local↗
PubMed1978

Transcatheter gelfoam embolization of posttraumatic bleeding pseudoaneurysms.

Diagnostic angiography combined with transcatheter therapeutic embolization is a simple and effective means of treating complex clinical situations associated with posttraumatic hemorrhage. Bleeding pseudoaneurysms, even when large, can be readily managed by this combined modality with resultant decrease in morbidity and hospital stay. Five patients with posttraumatic pseudoaneurysms are presented. All five were treated by transcatheter therapeutic embolization with Gelfoam. Of these five cases, three involved extremities, one involved the retroperitoneal space, and the last was of renal origin. Two of the five cases still required surgical intervention after initial successful therapeutic embolization, one for recurrent bleeding from collaterals and the other for evacuation of a massive pseudoaneurysm which was causing distraction of fracture fragments. The early use of angiography in suspected cases of posttraumatic hemorrhage, together with careful evaluation of potential collateral supply, is stressed. The use of transcatheter therapeutic embolization in the extremities as presented here is yet another example of the ever-broadening applicability of this technique.

Adult↗
PubMed1977

Selective hepatic artery embolization to control massive hepatic hemorrhage after trauma.

Two patients who sustained liver trauma with intrahepatic and intraperitoneal hemorrhage are reported. Selective and subselective arteriography identified the hemorrhagic artery in each case. Transcatheter therapeutic embolization successfully stopped the hemorrhage acutely in one patient and produced almost complete cessation of hemorrhage in the other patient. No further blood replacement was required after the emoblization procedures. Liver function tests were abnormal prior to embolization and gradually improved afterward. Neither patient required surgery, and both were discharged from the hospital. Each patient has remained free of symptoms for 5 and 4 months, respectively. Arteriography offers accurate diagnostic information and therapeutic potential in patients who experience hemorrhage following trauma. In addition, therapeutic embolization may offer decreased morbidity and reduced hospital stay. Successful results of therapeutic embolization depend on awareness of its usefulness and upon rapid mobilization of angiographic and support personnel.

Adult↗
PubMed1977

Ruptured mycotic splenic artery aneurysm: angiographic diagnosis.

A case of ruptured artery aneurysm is presented, emphasizing the pre-operative angiographic diagnosis of a difficult clinical problem. Although some patients have been operated on without angiography, this may prove of some difficulty if the diagnosis is not suspected. Awareness of potential routes of spread along soft tissue planes from the pancreatic bed may be of considerable importance in establishing the diagnosis.

Aneurysm, Infected↗
PubMed1976

Angiographic manifestions of regional enteritis.

Regional enteritis may be a protean disease, easily diagnosed when the common clinical presentation is noted. Occasionally, however, "atypical" features lead to the clinical suspicion of neoplastic disease. Four patients underwent angiographic evaluation in this clinical setting, all demonstrating similar changes in the mesenteric arteries. A serrated, "corkscrew" pattern was present and corresponded well to the perivascular fibrosis noted histologically. Recognition of this angiographic pattern may be important in differentiating neoplastic from inflammatory disease processes.

Aged↗
PubMed1976

Transcatheter therapeutic arterial embolization.

Transcatheter therapeutic arterial embolization was employed in 11 patients with gastrointestinal hemorrhage and 8 patients with bleeding from other sites. Hemorrhage was stopped successfully in all of the patients with gastrointestinal bleeding and 6 of the 7 patients with active bleeding from other sites. There were no significant complications or sequelae, although ischemia msy cause problems in such patients. Embolization is of considerable value when pharmacological therapy fails or is not appropriate due to the site of bleeding. In some cases it may represent the definitive treatment, as in pelvic trauma or renal hemorrhage; in others, embolization may serve to halt bleeding long enough to permit surgery. Therapeutic embolization should be considered whenever active extravasation of contrast material is demonstrated.

Adolescent↗
PubMed1976

Angiographic manifestations of bilateral Wilms' tumor.

Two cases of bilateral Wilms' tumor are presented with discussion of angiographic features. Emphasis is placed on selective angiography in addition to inferior vena cavography for complete evaluation. Because of the incidence of bilateral disease, and the highly vascular nature of the tumor, selective angiography of the contralateral side should be considered in the initial evaluation of unilateral Wilms'tumor. Evaluation of the interface between tumor and normal parenchyma is extremely important in bilateral disease, in anticipation of partial nephrectomy.

Angiography↗
PubMed1976

Bilateral subclavian steal syndrome.

Two cases of bilateral subclavian steal syndrome are presented, demonstrating complete occlusion at the origin of both subclavian arteries with distal reconstitution via reversal of blood flow through the vertebrobasilar system. Since unsuspected subclavian artery obstruction may present significant angiographic hazard, careful physical examination including blood pressures in both upper extremities and auscultation of the neck is necessary in order to avoid undesirable complications.

Female↗