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Biomedical subjects

D B Nunn

Publications and source records attributed to D B Nunn.

34 records · Page 2Linked to original sources
PubMed1978

Complications of peripheral arteriography.

This paper offers an analysis of possible complications of peripheral arteriography. Complications are considered in terms of the most common fundamental problems: 1) reactions to contrast media; 2) vasovagal response to arterial puncture; 3) local hemorrhage; 4) vein and nerve injuries in vicinity of arterial puncture site; 5) subintimal injection of contrast material; 6) arterial thromboembolism; 7) special problems related to catheters and guide wires; and 8) intravascular injection of foreign substances. The paper also provides ten examples of specific clinical conditions caused by arteriographic procedures. Finally, various safeguards in the prevention of complications are discussed.

Angiography↗
PubMed1975

Trachea--innominate artery fistula following tracheostomy. Successful repair using an innominate vein graft.

This report discusses the first recorded patient in whom a trachea--innominate artery fistula after tracheostomy was treated successfully by resection of the eroded segment of artery followed by graft replacement using the patient's left innominate vein. The mechanism of vessel erosion and its prevention are discussed. Also, suitable methods are presented for obtaining temporary control of the severe hemorrhage associated with a tracheoarterial fistula while simultaneously maintaining an adequate airway.

Adolescent↗
PubMed1975

Carotid endarterectomy: an analysis of 234 operative cases.

This paper offers a computer-assisted analysis of the author's experience with 234 carotid endarterectomy procedures in 188 patients. The patients' ages, sex, smoking habits, symptoms, carotid bruits, arteriographic findings and associated diseases are summarized. There were 28 operations in asymptomatic patients, 170 operations in patients with transient ischemic attacks (TIA), 35-operations in patients with a completed stroke and one operation in a patient with a stroke in evolution. After surgery, transient neurologic deficits were noted in both the asymptomatic group (two instances) and the group with TIA (5 instances); permanent neurologic deficits followed 4 operations in the TIA group (2.4% incidence). Two operative deaths occurred in the TIA group (1.2% mortality), and 10 deaths occured after operation for a completed stroke (28.6% mortality). Nine of the deaths in the completed stroke group followed operations performed less than 2 weeks after a stroke. A 100% followup was obtained, and the average period of followup was 48 months. Of the patients surviving operation, all in the asymptomatic group were judged functionally normal, 94% of the TIA group were either functionally normal or improved, 76% with a completed stroke were improved, and the patient with a stroke in evolution was unchanged. There were 69 late deaths with heart disease accounting for 58% of the deaths and stroke another 17%.

Adult↗
PubMed1975

Anastomotic aneurysms.

This report is concerned with an analysis of 16 anastomotic aneurysms which developed in 12 patients after arterial surgery in which dacron sutures were used for all graft anastomoses. Knitted dacron grafts had been used in all but two of the original surgical procedures; a woven dacron graft had been used in one procedure and a saphenous vein graft in the other. The majority of anastomotic aneurysms occurred in the femoral triangle at the site of an end-to-side anastomosis. Five anastomotic aneurysms were caused by infection, and a variety of etiologic factors were responsible for the 11 non-infected aneurysms. Fourteen anastomotic aneurysms in 10 patients were treated surgically. A good result had been obtained in six patients; one patient required amputation of an extremity and three patients died postoperatively as a result of cardiac disease or pulmonary embolization. This report also contains a discussion of the factors affecting the occurrence of anastomotic aneurysms and a description of specific operative measures designed to decrease the incidence of these aneurysms.

Aneurysm↗
PubMedDate not supplied

Pulmonary arteriovenous fistulas in association with hereditary hemorrhagic telangiectasia and carotid aneurysm.

A case is presented of a patient with multiple bilateral pulmonary arteriovenous fistulas, hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber Disease), and an intracranial carotid aneurysm. Over a twenty-five year period, the patient has survived several life-threatening complications, and has successfully undergone staged bilateral pulmonary lobectomies and clipping of the carotid aneurysm. Preoperative evaluation included cardiac catheterization studies both with and without temporary balloon occlusion of the pulmonary artery. The pathogenesis, clinical features, pathophysiologic changes, and treatment of pulmonary arteriovenous fistulas are discussed.

Adult↗