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Biomedical subjects

M H Wholey

Publications and source records attributed to M H Wholey.

At least 73 records · Page 4Linked to original sources
PubMed1985

Computed tomographic evaluation of compression of the superior vena cava and its tributaries.

Observations on computed tomography (CT) of 15 patients with compression of the superior vena cava (SVC) and its tributaries are reported and compared with clinical, radiographic and surgical findings. The site of compression in 14 patients was accurately determined by CT, which could delineate the presence of intraluminal clot and extrinsic compression of venous structures, as well as associated mediastinal masses. Collateral superficial vessels were identified in nine patients with contrast-enhanced scans. Contrast-enhanced mediastinal and chest CT was shown to provide detailed anatomic and physiologic information about the etiology of SVC syndrome.

Adult↗
PubMed1985

Cardiovascular applications of digital subtraction angiography.

Continuing interest exists in the cardiovascular applications for digital subtraction angiography. The principal intravenous application is in the evaluation of left ventricular function and the quantitative parameters presently available for digital methods. Intraarterial applications include the ability to screen multiple vascular systems, including the coronary circulation and the carotid or peripheral vascular structures. Quantitative functions available are stenosis sizing, phase and amplitude analysis, and, finally, "road mapping" during cardiovascular interventional procedures. Major expansion of storage capacity, cine pulsing, and immediate access of online data represent a few of the major limitations of the procedure.

Aneurysm↗
PubMed1984

Parathyroid adenomas studied by digital subtraction angiography.

Eighteen patients who had elevated serum calcium and parathormone levels were prospectively studied with intravenous digital subtraction angiography (DSA). Intravenous DSA of the neck and mediastinum was performed in the anteroposterior, the left anterior, and the right anterior oblique projections. The study was considered positive if an abnormal blush or blood supply was noted. Upon operation, 14 patients were confirmed to have parathyroid adenomas, of whom five had positive preoperative DSA examinations. Four patients were followed medically (three negative DSA, one positive DSA). A positive intravenous DSA may be useful to guide neck explorations for parathyroid adenomas; however, the low sensitivity of the study may limit its screening potential.

Adenoma↗
PubMed1984

Patients with hemoptysis examined by Tc-99m sulfur colloid and Tc-99m-labeled red blood cells: a preliminary appraisal.

A prospective study of 16 patients with hemoptysis was conducted over a 2 1/2-year period. Technetium-99m sulfur colloid (Tc-SC) and technetium-99m-labeled red blood cells (Tc-RBC) were sequentially used to identify the general area of bleeding. Tc-SC accurately located the bleeding area in 3 patients and Tc-RBC identified the bleeding area in 8; there were no false-positive studies. Tc-SC scans were positive at 6-10 minutes and all patients had positive Tc-RBC studies. In general, the scans accurately located the source of bleeding as determined by bronchoscopy and/or surgery. Because of the small sample, statistically significant differences between both techniques were not ascertained. Both Tc-SC and Tc-RBC may prove to be helpful, minimally invasive imaging procedures for determining the general area of hemorrhage in patients with clinically significant hemoptysis. Although a trend suggests that Tc-RBC is a more sensitive method, further comparison is needed for corroboration.

Adult↗
PubMed1982

Hemobilia detected by Tc-99m labeled red blood cells.

Tc-99m labeled red blood cells were successfully used to determine the site of hemorrhage in a 67-year-old man with hemobilia. A false hepatic artery aneurysm was confirmed at angiography and ultimately successfully embolized. The relative merits of using Tc-99m labeled red blood cells for detecting sources of upper gastrointestinal bleeding are discussed.

Aged↗
PubMed1981

Carotid artery occlusion in the management of selected giant intracranial aneurysms and carotid cavernous fistula: percutaneous use of the balloon catheter.

The percutaneous technique of balloon catheter occlusion of internal and common carotid arteries can produce long-term obliteration of aneurysms and fistulae. Fourteen difficult aneurysms and one carotid-cavernous fistula of the internal carotid artery were thus treated, with success achieved in 13 cases. This technique permits careful control of the occlusion. If neurologic symptoms develop during the procedure, rapid balloon deflation can reverse the deficits in most cases.

Adult↗
PubMed1981

Scintigraphic detection of pulmonary hemorrhage using Tc-99m-sulfur colloid.

Pulmonary hemorrhage, whether in the form of hemoptysis or bleeding into the pleural space, may be a life threatening problem. While fiberoptic bronchoscopy and selective bronchial and intercostal angiography are the major diagnostic modalities, these techniques are not without risks. Two patients are described-one with massive hemoptysis from a bronchogenic carcinoma; another with pleural bleeding from a torn intercostal artery-in whom Tc-99m-sulfur colloid scintigraphy accurately located the source of hemorrhage. We conclude that Tc-99m-sulfur colloid scintigraphy may be a helpful noninvasive method to increase the sensitivity and specificity of fiberoptic bronchoscopy and bronchial angiography in patients with massive pulmonary bleeding.

Adult↗
PubMed1981

Percutaneous transluminal dilation of aortocoronary saphenous vein bypass grafts.

To evaluate the efficacy of percutaneous transluminal angioplasty as a possible alternative to repeated open heart surgery for symptomatic aortocoronary saphenous vein graft stenoses, the procedure was initiated at Shadyside Hospital in January 1978. Percutaneous transluminal angioplasty has been used in nine aortocoronary graft stenoses and 11 native coronary artery stenoses. Of the nine grafts, eight (88 percent) were successfully dilated, including three that had been totally closed as visualized by angiography. Of the 11 coronary dilations, only four (36 percent) resulted in improved flow. The more favorable results experienced with the graft dilations was thought to be due to the nature of the occlusive processes affecting these grafts. The fibrous intimal proliferative disease that is found in most grafts is easily compressible, while the nature of the disease in the coronary arteries is not so readily predictable. Better instrumentation and careful evaluation before and after angioplasty will improve the results and extend the indications for coronary artery and saphenous vein graft transluminal angioplasty.

Adult↗
PubMed1980

Cardiovascular radiology in Peking: trends for the future.

The author outlines his visit to the People's Republic of China, and relates his observations. Comments about the present state of cardiovascular radiology in China, her special health care and economic problems, and the potential for educational exchange are offered.

Cardiovascular Diseases↗
PubMed1980

Percutaneous transluminal angioplasty in the management of occlusive disease involving the coronary arteries and saphenous vein bypass grafts: preliminary results.

Since January, 1978, we have evaluated 18 patients in whom segmental occlusive disease of the aorta-coronary saphenous vein graft or the native coronary circulation was present. The significantly occluded vessels were restored to relatively normal circulation by means of percutaneous transluminal dilatation in 10 of these patients, with technical failures in seven patients and the occurrence of a thrombosis during the procedure in one other. Successful dilatation occurred in six of the seven patients with saphenous vein graft stenosis. Percutaneous transluminal angioplasty of the native coronary arteries in 11 patients resulted in five successful dilatations. All dilatation procedures are performed with the use of local anesthesia with an open-heart team standing by. In the event of technical failure or incipient thrombosis with developing infarction, the patient is transferred for immediate bypass. On the basis of these early results, we have developed guidelines of the indications for percutaneous transluminal dilatation of the coronary arteries and their saphenous vein grafts. The need for improved instrumentation to broaden these guidelines is discussed. Case histories of five patients are presented, and a summary table for all 18 patients is also provided. Certain inherent complications are discussed, but our preliminary results are encouraging, particularly with regard to stenoses of saphenous vein bypass grafts.

Adult↗
PubMed1978

Splenic infarction and spontaneous rupture of the spleen after therapeutic embolization.

Patients with major hematologic disorders who have hypersplenism and alterations in their immune mechanism are subject to a higher incidence of bacteremia after embolization procedures. In certain instances, these infectious complications can be fatal. Medical splenectomy for hematologic disorders is sometimes complicated by massive splenic infarction and spontaneous rupture; spontaneous rupture appears to be a function of both infarct size and underlying infectious complications. Prophylactic measures can be employed to avoid these complications after interventional splenic embolization.

Abscess↗
PubMed1978

Superior vena cava syndrome: a complication of transvenous pacemaker implantation.

Superior vena cava syndrome developed in 4 of 1,000 patients in whom a transvenous pacemaker had been implanted. In all cases, endocardial leads were inserted through the cephalic vein and positioned at the apex of the right ventricle. The classical signs and symptoms of superior vena cava hypertension were observed from two weeks to one year after implantation, and the diagnosis was confirmed by cavography. Symptoms resolved following heparin therapy and long-term anticoagulation.

Aged↗
PubMed1977

The technology of balloon catheters in interventional angiography.

Balloon catheters with expansion capabilities from 1 mm to 6 cm have been developed. They feature torque control and can be selectively positioned within vessels as easily as the ordinary diagnostic angiographic catheters. The balloons can be utilized for hemorrhage control, conventional embolectomy, operative angiography, vena cava occlusion, and purposeful vascular thrombosis or dearterialization. In the event of unsuccessful control, the balloon can be readily deflated and removed within minutes.

Angiography↗
PubMed1976

Bronchial artery embolization for massive hemoptysis.

Improved angiographic techniques have proved that therapeutic embolization is effective in controlling massive hemorrhage in selected sites of the gastrointestinal tract and central nervous system. We have controlled massive hemoptysis in five cases with use of our improved techniques and bronchial artery embolization. Because mortality due to massive hemoptysis in both benign and malignant disease is high, therapeutic bronchial artery embolization is the preferable approach in some cases.

Adult↗