Balloon tamponade for the treatment of inadvertent subclavian arterial catheter placement.
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Adult↗
Biomedical subjects
P F Jaques
Publications and source records attributed to P F Jaques.
Radiologic placement of long-term central venous catheters: a review.
The need for long-term placement of catheters within the central venous system is continually expanding and follows the increasing use of hemodialysis, total parenteral nutrition, and long-term chemotherapy for neoplastic and infectious diseases. Whereas these catheters have traditionally been placed by surgeons in an operating room, it is now clear that they can be effectively placed by interventional radiologists using percutaneous techniques within an interventional/angiographic suite. This review is based on the radiologic percutaneous placement of nearly 1,500 central venous catheters including approximately 500 tunneled Hickman/Leonard catheters, 350 double-lumen cuffed dialysis catheters, and 150 chest wall subcutaneous ports.
Axillary Vein↗
Balloon choice for metallic stent dilation.
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Catheterization↗
Variations in liver-colon anatomic relationship: relevance to interventional radiology.
PURPOSE: To determine the prevalence of significant variations in liver-colon anatomy in an unselected patient population and evaluate the potential effect of these variations on liver-related interventional procedures. PATIENTS AND METHODS: All abdominal computed tomographic (CT) scans were reviewed prospectively over a 4-month period. Cases that revealed variant hepatocolic anatomy were selected and analyzed for the position of the colon, gallbladder, and duodenum; liver morphology; and the anatomic relations of the right portal vein. RESULTS: Seventeen (3.3%) of 517 abdominal CT scans demonstrated variant hepatocolic anatomic relations. In seven cases, liver lobar morphology was normal, but the colon was interposed between the chest wall and the liver. The remaining 10 cases were characterized by hypoplasia or aplasia of one or both segments of the left lobe. In these cases the right portal vein was anteriorly exposed and was close to the gallbladder and transverse colon. In all 17 cases it was qualitatively judged that technical modifications might be needed in the performance of various interventional procedures, including percutaneous biliary drainage, biopsies, and transjugular intrahepatic portosystemic shunt creation. CONCLUSION: Variations in liver-colon anatomic relations in isolation or secondary to hepatic developmental anomalies may have a significant potential impact on the performance of various fluoroscopically guided hepatobiliary interventional procedures.
Cholecystography↗
The first rib as a fluoroscopic marker for subclavian vein access.
PURPOSE: To determine whether the anatomic relationship between the subclavian vein (SCV) and the first rib is sufficiently constant to allow safe and reproducible fluoroscopically guided SCV puncture. MATERIALS AND METHODS: Forty-four subclavian venograms were obtained from 42 consecutive adult patients. Position and width of the SCV crossing over the first rib were recorded by using radial coordinates. Based on this anatomic study, 42 SCV access procedures were performed with use of the first rib as a fluoroscopic marker. Technical success, complications, number of 21-gauge needle passes, physician experience, and patients' body habitus were recorded. RESULTS: Mean angular position of SCV/first rib crossover was 94.7 degrees (standard deviation [SD], 7.42 degrees). Mean radial width of the SCV was 14.9 degrees (SD, 3.1 degrees). On 25 of the 44 subclavian venograms (60%), the SCV/first rib crossover lay within the 90 degrees-99 degrees segment, and on 36 of 44 (82%) it lay within the 85 degrees-104 degrees segment. Technical success in accessing the SCV was 100% (42 of 42 procedures). Two minor complications involved subclavian artery puncture with the 21-gauge needle without sequelae. The mean number of needle passes required was 2.86 (median, 1.7). There was no correlation between needle passes and patients' body habitus or physician experience. CONCLUSION: The SCV is reliably constant in its relation to the first rib. The first rib alone provides a reliable fluoroscopic marker for safe SCV access without the need for ultrasound guidance or peripheral contrast material administration.
Adult↗
Lymphatic visualization during renal transplant rejection.
Intrarenal microlymphatic filling was observed during a microangiographic and histologic study of unmodified canine allograft rejection. The extent of lymphatic visualization was correlated with the pathophysiologic state of the allograft. An example of renal lymphatic visualization following arterial perfusion of a human specimen is also presented. During early rejection, as microvascular and histologic alteration became more severe, there was prominent visualization of lymphatics. However, in late rejection, as cortical necrosis developed, lymphatic filling was less evident. Lymphatic visualization following arterial perfusion during rejection depends on progressive loss of microvascular integrity, contrast extravasation and subsequent filling of lymphatics which are acting as an alternate route of drainage for the excess interstitial edema present due to immune injury.
Angiography↗
Fulminant systemic necrotizing arteritis: CT findings.
Fulminant necrotizing arteritis can be a rapidly fatal disease with protean manifestations often suggesting other diagnoses. We present two cases with angiographic and CT correlation and discuss CT findings that are suggestive of the diagnosis.
Angiography↗