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Biomedical subjects

S Kadir

Publications and source records attributed to S Kadir.

At least 37 records · Page 2Linked to original sources
PubMed1987

Long-segment femoropopliteal stenoses: is angioplasty a boon or a bust?

Analysis of 193 femoropopliteal angioplasties demonstrated patency rates in the stenotic group of 75.5% at 6 months and 54.4% at 54 months. The patency rates for the occlusive group were 93.7% at 6 months and 72.9% at 54 months; these rates were significantly better than those in patients with stenoses. A group of 14 patients with long-segment (greater than 7 cm) stenosis had the highest risk of early failure, with a 6-month patency of 23.1%. After removal of the long-segment stenosis group from the results, there were no significant differences between the long-term patencies for stenotic and occlusive lesions. If angioplasty of long stenoses is attempted, a high initial success rate but early failure should be anticipated.

Angioplasty, Balloon↗
PubMed1987

Mesoatrial shunts for Budd-Chiari syndrome and inferior vena cava thrombosis: angiographic and hemodynamic evaluations.

When inferior vena caval obstruction complicates the Budd-Chiari syndrome, conventional portosystemic shunts are not possible. The mesoatrial shunt has been devised to enable portal and sinusoidal decompression in these patients. Findings in 12 patients with Budd-Chiari syndrome and inferior vena caval obstruction in whom a mesoatrial shunt was performed are reported. Preoperative inferior vena cavography with pressure measurements is essential to determine the appropriate shunt procedure. Postoperatively, shunt patency is assessed with superior mesenteric arterial portography. Where possible, transvenous catheterization of the shunt is performed to confirm patency and assess hemodynamic function.

Adult↗
PubMed1987

Percutaneous transcatheter recanalization in the management of acute renal failure due to sudden occlusion of the renal artery to a solitary kidney.

Percutaneous angioplasty was attempted in 5 patients with acute renal failure due to occlusion of the artery to a solitary functioning kidney. Angioplasty was technically successful in all patients. Renal function was completely restored in 3 and renal perfusion improved in 1 patient. In the fifth patient, renal function did not return despite ultrasound and radionuclide scan evidence of renal reperfusion. Transcatheter thrombolytic therapy was attempted in 2 patients, 1 of whom also underwent angioplasty. In this patient, perfusion was restored to most of the kidney. In the other patient an infrarenal aortic occlusion was present. During thrombolytic therapy, intrarenal microembolization occurred from lysis of the aortic thrombus, leading to irreversible renal damage.

Acute Kidney Injury↗
PubMed1987

The value of preoperatively placed percutaneous biliary catheters in reconstruction of the proximal part of the biliary tract.

Between May 1982 and January 1986, 55 patients with strictures of the proximal part of the biliary tract have been reconstructed with Silastic (silicone rubber) transhepatic biliary stents after the preoperative percutaneous placement of Ring catheters into one or both of the hepatic ducts. Twenty-five patients had tumors of the proximal portion of the biliary tract, 19 had sclerosing cholangitis and the remaining 11 had benign strictures of the biliary tract. Ring catheters were placed into both the right and left hepatic ducts in 38 of the 55 patients. In the remaining 17 patients, a single Ring catheter was advanced beyond the stricture and into the duodenum in 50 of the 55 patients. The preoperative percutaneous placement of Ring catheters into the right and left hepatic ducts has proved to be a useful technical aide in the operative management of patients with lesions of the proximal part of the biliary tract. Having these catheters in place at the time of the operation helps significantly in dissecting the extrahepatic biliary tree and bifurcation and are subsequently used to place the transhepatic Silastic stents that are used in the reconstruction of the biliary tract.

Biliary Tract Diseases↗
PubMed1986

Upper-extremity venography using digital subtraction angiography.

Venography to evaluate the patency of upper-extremity veins was performed with digital subtraction angiography (DSA) and conventional angiography. Venous thrombosis was easily diagnosed, and the innominate veins and superior vena cava were more easily visualized using DSA. Iodine concentration for DSA was one-third that of conventional venography, and the examination time was reduced by 50% using DSA. Patient comfort and acceptance were greater with DSA. DSA is a superior technique for upper-extremity vein evaluation in cooperative patients.

Adult↗
PubMed1986

Comparison of recurrent varicocele anatomy following surgery and percutaneous balloon occlusion.

Venography of 44 recurrent varicoceles in 37 patients demonstrated different anatomical patterns of recurrence in surgical patients (26) compared to those treated by percutaneous balloon occlusion (18). The 3 types of patterns identified included parallel, renal vein and transcrotal collateral pathways. Virtually all surgical recurrences were owing to mid retroperitoneal (27 per cent) or low (inguinal) parallel collaterals (58 per cent). The majority of post-balloon occlusion recurrences were due to either high retroperitoneal parallel (44 per cent) or renal vein collaterals (28 per cent). Surgical recurrences were treated easily with percutaneous balloon occlusion. However, 39 per cent of the patients with recurrences following balloon embolization were not anatomical candidates for repeat percutaneous occlusion. We conclude that venous collaterals are identified easily by renal venography, and knowledge of these collaterals is helpful in planning further surgical or radiological treatment.

Embolization, Therapeutic↗
PubMed1986

Right-sided varicocele: technique and clinical results of balloon embolotherapy from the femoral approach.

Among 227 patients undergoing outpatient balloon embolotherapy for varicocele, venography of the right internal spermatic vein (ISV) was attempted in 48. A percutaneous technique from the right femoral vein was used for all patients. The right ISV was successfully occluded with detachable balloons in 41 of 46 (89%), while in five (11%), the right ISV could not be embolized. A competent valve was found in two patients. The right ISV alone was embolized in ten patients: one had a solitary right varicocele, six had left varicoceles but competent valves in the left ISV, and three had recurrent left varicoceles after successful left ISV occlusion. Bilateral ISV embolization was achieved in 31 patients. Long-term follow-up study was available for 25 patients; 12 couples (48%) achieved a pregnancy. Percutaneous balloon occlusion of right varicoceles is a safe, effective outpatient technique.

Angioplasty, Balloon↗
PubMed1986

In situ saphenous vein bypass grafts: angiographic evaluation and interventional repair of complications.

In situ saphenous vein grafts are being used with increasing frequency for bypass procedures involving the femoral and popliteal arteries. Complications of these procedures include anastomotic stenoses and persistent arteriovenous fistulae that may result in failure of the graft. Balloon angioplasty and embolotherapy with detachable balloons were employed successfully in three or four recent cases of patients with complications from in situ grafts. Tailored angiography is essential for evaluating in situ grafts, and interventional techniques are extremely useful for managing complications.

Aged↗
PubMed1986

Percutaneous spermatic vein occlusion: evaluation of sclerosing agents in experimental animals.

The 5%-20% rate of recurrence of testicular varicoceles after embolotherapy has been a persistent clinical problem. Three sclerosing agents--sodium tetradecyl sulfate 3%, absolute ethanol, and 100 degrees C contrast material--were evaluated in canine spermatic veins for degree and durability of venous occlusion. Pathologic examination for perivenous, pulmonary, and neural changes was performed. Both sodium tetradecyl sulfate and absolute ethanol were effective sclerosants, but sodium tetradecyl sulfate was technically easier to use. The use of a sclerosant in conjunction with balloons or coils is the safest, most effective technique for occluding variococeles and minimizing postembolotherapy recurrences.

Animals↗
PubMed1986

Long-term results of superficial femoral artery angioplasty.

Short-term results of superficial femoral artery and popliteal percutaneous transluminal angioplasty have been good, but long-term results and factors influencing long-term patency are less commonly reported. One hundred thirty-seven superficial femoral artery angioplasties with follow-up for 54 months were reviewed. The 4-year patency for stenoses was 61% and for occlusions was 68%. If the initial result was clinically successful, the 4-year patency was not influenced by the quality or patency of runoff or by the length of the occlusion. Nineteen patients returned for redilatation, eight of whom had developed new lesions. Patency was adversely affected in patients with diabetes or with long-segment stenoses. Modifications of equipment and technique that may improve long-term patency rates are discussed.

Angioplasty, Balloon↗
PubMed1986

Acute renal failure following percutaneous transhepatic cholangiography. A retrospective study.

We analyzed retrospectively the incidence of potential nephrotoxic effects of radiographic contrast material associated with percutaneous transhepatic cholangiography and percutaneous biliary drainage. Of 72 consecutive patients who underwent these procedures, three developed acute renal insufficiency (defined as a rise in the serum creatinine concentration of greater than 2 mg/dL [greater than 180 mumol/L]) following administration of contrast medium. In two patients, abdominal roentgenograms taken after the procedure showed persistently opaque kidneys, indicating that contrast material had gained access to the circulation. Percutaneous transhepatic cholangiography and percutaneous biliary drainage may be associated with nephrotoxic effects of radiographic contrast material, and patients with recognized risk factors may benefit from prophylactic hydration regimens as recommended for other procedures.

Acute Kidney Injury↗
PubMed1985

Nonoperative management of benign postoperative biliary strictures.

Selected benign biliary strictures can be treated safely and successfully by percutaneous balloon dilatation. Primary biliary strictures appear to be less responsive to balloon dilatation alone and require stenting with large catheters (16-20 F) for several months to permit scarring around the catheter. A long period of healing around such a large-bore stent is crucial to the success of such treatment. The most important physiologic indicators for successful dilatation are a long period of stricture challenge with a catheter placed proximal to the dilated segment to allow bile to drain internally across the previously strictured segment, and a near anatomic result as demonstrated by cholangiogram.

Adolescent↗
PubMed1985

Biliary catheter drainage complicated by hemobilia: treatment by balloon embolotherapy.

Seventeen patients experienced severe hemobilia following percutaneous (nine patients) or surgical (eight patients) placement of biliary drainage catheters. Fourteen patients bled early after catheter placement (0.5-32 weeks; mean, 5.4 weeks) and three bled late during long-term biliary drainage (1.1-3.6 years; mean, 2 years). Hepatic angiography demonstrated the source of bleeding in 15 (88%) patients (hepatic artery pseudoaneurysm in ten, hepatic artery-portal vein fistula in four, varix along the tube tract in one) but showed no source of bleeding in two. Thirteen patients with hemobilia were treated with embolotherapy, using detachable balloons in 12. The advantages of this technique included the ability to flow-direct the balloon without selective catheterization; the ability to test-inflate the balloon at the site of the aneurysm or fistula during angiographic study and adjust its position before detachment; and preservation of the hepatic artery proximal and distal to the inflated balloon, thus preserving hepatic function following embolization.

Adult↗
PubMed1985

Percutaneous transhepatic biliary drainage for bile leaks and fistulas.

Percutaneous transhepatic cholangiography and biliary drainage were performed in 12 patients with major injuries to the bile ducts manifested by biliary leaks and fistulas. Eleven of the 12 patients had had inadvertent biliary trauma during surgery. In six patients, the biliary leaks sealed with percutaneous drainage. In other patients requiring definitive surgical procedures on the biliary tract, initial percutaneous drainage allowed these procedures to be delayed until the patients' clinical condition improved. Percutaneous biliary drainage is an important adjunct to the management of patients with traumatic extravasation of bile into the peritoneal cavity or biliary-cutaneous fistula.

Abscess↗