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Biomedical subjects

J F Dyet

Publications and source records attributed to J F Dyet.

At least 19 recordsLinked to original sources
PubMed1999

Long-term follow-up of the Bird's Nest IVC Filter.

AIM: This study is a long-term clinical follow-up of the Bird's Nest Filter which addresses issues such as caval patency, filter integrity, morbidity and mortality. MATERIALS AND METHODS: 78 consecutive patients with Bird's Nest Filters inserted between 1989 and 1994 were recalled for clinical assessment and imaging follow-up. Pre- and post-filter medical histories were obtained from the patients and their medical records. They were examined for clinical signs of inferior vena cava occlusion. Imaging follow-up was by plain abdominal radiography, colour duplex ultrasound and computed tomography. RESULTS: 52 patients were alive and well at 4-6 years. Thirty-day mortality was 5.1%. Three-year mortality was 19.2%. Recurrent pulmonary embolus occurred in 1.3%. IVC occlusion was demonstrated in 4.7%. No evidence of filter migration was seen. Wire prolapse occurred in 70% on abdominal X-ray and asymptomatic performation of the caval wall in 85.3% on CT. Morbidity and mortality were the same whether the patient was anticoagulated or not. CONCLUSION: The Bird's Nest Filter is safe and effective in both the short and long term.

Adult↗
PubMed1998

Comparison of Iotrolan 320 and Iohexol 350 in cardiac angiography: a randomised double-blind clinical study.

OBJECTIVE: A double-blind randomised study was conducted in two British centres, to evaluate the safety, tolerance and efficacy of the new dimeric non-ionic contrast medium Iotrolan 320 in comparison with the monomeric non-ionic compound Iohexol 350 in coronary angiography. METHODS AND MATERIAL: 120 patients were randomised to receive either Iotrolan at a concentration of 320 mgI/ml or Iohexol at a concentration of 350 mgI/ml, during selective coronary angiography and left ventriculography. The variables measured were: maximum increase of the left ventricular end-diastolic pressure up to 6 min after ventriculography, haemodynamic and electrocardiographic variables, arrhythmogenicity, clinical laboratory parameters, tolerance, adverse events and efficacy. RESULTS: Iotrolan resulted in a smaller change of left ventricular end-diastolic pressure compared to Iohexol, but the difference was not statistically significant. Transient changes in left ventricular systolic pressure, intra-arterial systolic pressure, intra-arterial diastolic pressure, and in electrocardiographic parameters, occurred after the injections, but they were not clinically significant. Changes in the clinical laboratory markers from baseline values were comparable between the two groups and confirmed good renal and hepatic tolerance. During the left ventriculogram, Iotrolan resulted in less symptoms compared to Iohexol (P = 0.002). Adverse events, which were mild or moderate in most cases, were observed with no statistical difference between the two agents. The contrast quality of both agents was good with no statistical difference. CONCLUSION: This study did not show a significant difference between Iotrolan 320 and Iohexol 350 with regard to cardiovascular safety or patient tolerance, except for a minor difference in the intensity of heat/warmth sensation.

Adult↗
PubMed1996

Pictorial review: endovascular repair of abdominal aortic aneurysms.

Endovascular repair of abdominal aortic aneurysms is an exciting new procedure. Depending on aneurysm morphology, tube grafts, bifurcated grafts or aorto-uni-iliac systems may be used. Early results are encouraging but many problems will require solving before the technique comes into general use.

Aortic Aneurysm, Abdominal↗
PubMed1994

Balloon or bougie for dilatation of benign esophageal stricture?

Ninety-three adult patients with benign esophageal stricture were randomized to receive balloon or bougie dilatation. Eighty-five patients were eligible for analysis and were followed prospectively for a year. Twenty-four patients required repeat dilatation within a year, but 50 patients completed a year's follow-up without further dilatation. The bougie group initially had a better symptomatic result, experiencing significantly less dysphagia at five months, although this difference had disappeared at one year. Eighteen patients in the balloon group required redilatation for symptoms compared with six in the bougie group. The bougie group had a significantly greater increase in their stricture diameter, and this was still present at one year after dilatation. There was no significant difference in safety or patient acceptability. Balloons are probably more costly to use than bougies. Bougie dilatation is to be preferred to balloon dilatation in adults except in special circumstances.

Aged↗
PubMed1993

The use of the Wallstent in aorto-iliac vascular disease.

Forty-three patients had self-expanding endovascular Wallstents inserted for aorto-iliac arterial disease. A total of 59 Wallstents were inserted into 50 iliac arteries. There were 27 males and 16 females with a mean age of 62.51 years. Included in the series were 19 iliac occlusions, 21 severe atheromatous disease of the aortoiliac segment, two severe dissections following conventional angioplasty and one re-stenosis of a previously dilated iliac segment. All of the stents were successfully deployed but there were five significant complications. One case of distal embolism was treated by surgical embolectomy but the other four were treated by an additional percutaneous technique. At follow-up after 6 months all patients remain symptomatically improved. Aorto-iliac stenting is a cost-effective treatment in selected cases of severe aorto-iliac disease.

Aortic Diseases↗
PubMed1993

The use of the Wallstent endovascular prosthesis in the treatment of malignant obstruction of the superior vena cava.

Seventeen patients (10 men and seven women) aged 48-76 years (mean 63.4) who were suffering from malignant superior vena caval obstruction had Wallstents implanted percutaneously to relieve the obstruction. Fifteen of the patients had previously been treated by radiotherapy or chemotherapy, with either failure to remit or later recurrence. Six patients required thrombolysis prior to stenting. All patients had rapid relief of the obstructive symptoms. This was sustained in 15 patients to date or at death. Two patients, both of whom had pre-stent lysis, developed stent thrombosis following withdrawal of anticoagulation at 4 months and 7 days respectively. Stenting has been shown to be extremely effective at relieving superior vena caval obstruction in these patients and is usually the only method available in this condition when other treatments fail. Whether all patients presenting with malignant superior vena caval obstruction should be stented de novo remains to be proven.

Aged↗
PubMed1993

Balloon angioplasty of adult aortic coarctation.

OBJECTIVE: To examine the use of balloon angioplasty in the treatment of native adult aortic coarctation. DESIGN: Haemodynamic and angiographic studies to establish the diagnosis of aortic coarctation were established before carrying out the procedure in all patients. SETTING: All the studies and angiographic procedures were performed in a large district general hospital within the departments of cardiology and radiology. There was careful perioperative monitoring. The mean hospital stay was three days. PATIENTS: 15 adult patients (with clinical, haemodynamic, and angiographic evidence of native aortic coarctation) were considered for this treatment. 13 were offered balloon angioplasty. One was excluded, as there was no significant gradient across the lesion. One patient had complete atresia at the site of the coarctation. INTERVENTIONS: Percutaneous transluminal balloon angioplasty was carried out with balloon catheters diameter 2 mm less than the diameter of the aorta immediately below the left subclavian artery to minimise the possibility of tearing the aortic wall. MAIN OUTCOME MEASURES: Abolition or significant reduction of the preoperative gradient was achieved in all 13 patients treated. Reduction in blood pressure of the upper limb was also achieved in all of the patients. Only four patients required continued antihypertensive treatment. Two patients developed false aneurysms after the procedure and required surgery. No deaths occurred. These results compare favourably with conventional surgery and are much more economical. CONCLUSIONS: Balloon angioplasty could become the first line treatment for all patients with native adult aortic coarctation, but longer term follow up is required to validate this.

Adolescent↗
PubMed1990

Percutaneous angioplasty of the superior gluteal artery in the treatment of buttock claudication.

A 65-year-old man developed bilateral buttock claudication due to stenosis of the main stem of the left internal iliac artery and stenoses of the left and right superior gluteal branches of the internal iliac arteries. These stenoses were successfully dilated by percutaneous angioplasty using coronary angioplasty equipment. Percutaneous angioplasty is shown to be an effective method of treatment of buttock claudication caused by stenoses of the internal iliac and superior gluteal arteries.

Aged↗
PubMed1990

Outpatient arteriography--a safe and practical proposition?

Ninety-five patients, who underwent fine catheter peripheral angiography as outpatients, were followed up and assessed to determine the safety of this procedure. No patients reported any major side effects and in particular no patients experienced a rebleed from the arterial puncture site. This procedure could be safely adopted in any radiology department.

Ambulatory Care↗
PubMed1989

Six cases of subclavian stenosis treated by percutaneous angioplasty.

Percutaneous angioplasty was performed on six patients with proximal left subclavian artery stenosis. The lesions treated included short band like stenoses and longer atheromatous segments and were all haemodynamically significant. The subclavian arteries were all successfully dilated using a standard angioplasty technique and there were no residual complications. Percutaneous angioplasty is shown to be an effective method of treatment of subclavian stenosis.

Aged↗
PubMed1983

The radiological measurement of oesophageal stricture diameter.

A radiographic method of measuring the diameter of oesophageal strictures is described. Both a liquid bolus and a solid sphere were used. The measurements obtained were compared with measurements obtained at endoscopy. It is suggested that the most effective method is to determine the maximum size of barium sphere which will pass through a stricture.

Barium Sulfate↗
PubMed1976

The small bowel enema: description and experience of a technique.

A method of examining the small bowel, involving duodenal intubation is described. Good visualization of all parts of the small bowel is obtained using an air-barium double contrast technique. The technique is compared and contrasted with the more conventional methods of small bowel examination, and its advantages and disadvantages discussed. The authors relate their experience with the technique, indicating the abnormalities which can be shown, and list the type of clinical problems where the technique may be most usefully employed.

Barium Sulfate↗