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Biomedical subjects

W O Bank

Publications and source records attributed to W O Bank.

At least 37 records · Page 2Linked to original sources
PubMed1983

Occlusion of a hepatic artery to portal vein fistula with bucrylate.

A 49-year-old woman with cirrhosis and portal hypertension was evaluated for a portal-systemic shunt procedure following recurrent variceal hemorrhage. The preoperative visceral angiogram demonstrated a hepatic arterial to portal venous fistula, presumably a complication of a previous liver biopsy. The fistula was successfully closed using isobutyl-2-cyanoacrylate (Bucrylate) delivered through a flow-directed, calibrated-leak balloon microcatheter.

Angiography↗
PubMed1983

Algorithms in the management of cerebrovascular disease.

We present a diagnostic approach to the various clinical presentations of patients with cerebrovascular disease. It involves grouping the patients into five categories: (1) asymptomatic, (2) transient neurologic episodes, (3) unstable neurologic deficits, (4) prolonged neurologic deficits and (5) completed stroke. An algorithm is given for each category and an approach to management is outlined. The algorithms are clinically validated by reviewing the results of 185 reconstructive operations performed on patients with manifestations of cerebrovascular disease who were managed following the algorithms.

Angiography↗
PubMed1982

Ultrasound visualization of the 5-F catheter.

A simple in vitro experiment showed that the 5-F angiographic catheter can be visualized on sonograms. Subsequent in vivo imaging showed that small catheters can be seen sonographically in many locations. Ultrasound is proposed as an effective presurgical procedure in order to determine whether a catheter fragment remains near an arterial puncture or has embolized distally.

Angiography↗
PubMed1981

Treatment of intracerebral arteriovenous malformations with isobutyl 2-cyanoacrylate: initial clinical experience.

From November 1976 to September 1979, 46 patients with intracranial arteriovenous malformations or fistulas participated in a clinical study using isobutyl 2-cyanoacrylate (IBCA), with tantalum, for palliative or preoperative occlusion of the blood supply to the abnormalities. Although failure to obtain satisfactory position of a functioning microcatheter precluded deposition of IBCA 10 times, a total of 51 of a possible 62 feeding vessels were occluded with the tantalum-impregnated glue. The technique, results, and complications are discussed in light of the clinical follow-up, which varied from 12 to 48 months.

Adolescent↗
PubMed1981

Renal failure after major angiography can be avoided with hydration.

A reported 12% incidence of acute renal failure after angiography prompted this prospective study to substantiate or repudiate this seemingly excessive rate. In 537 consecutive patients undergoing cerebral, abdominal, or peripheral angiography, there was no instance of renal failure following the procedure. The results of this study indicate that when adequate hydration is maintained, angiography does not pose a "significant hazard" of renal failure as previously reported, even in patients with underlying medical problems.

Acute Kidney Injury↗
PubMed1980

Renal failure after major angiography.

A recently reported 12 per cent incidence of renal failure following angiography prompted our prospective study to substantiate or repudiate this seemingly excessive rate. In 100 consecutive patients, there was no instance of renal failure following angiography. The results of our study indicate that when adequate hydration is maintained angiography does not pose a "significant hazard" of renal failure as previously reported, even in patients with underlying medical problems.

Acute Kidney Injury↗
PubMed1980

Neurologic complications of angiography in patients with critical stenosis of the carotid artery.

We retrospectively studied 85 patients with angiographically demonstrable critical carotid stenosis. None suffered either immediate or delayed complications after angiography. In patients with critical stenosis of the carotid artery, the benefits of cerebral angiography clearly outweigh the small potential risk when the procedure is performed with meticulous attention to technical detail.

Carotid Artery Diseases↗
PubMed1980

Neurologic complications of angiography for cerebrovascular disease.

A recent study reported a 12.2% incidence of cerebral complications (5.2% permanent) after cerebral angiography in 147 patients. Because this was markedly different from our experience, we initiated a retrospective study of 301 patients who had undergone cerebral angiography for hemisphere transient ischemia or amaurosis fugax. There was only a 1.3% rate of transient complications (none permanent) in our patients. The benefits of cerebral angiography in patients with suspected cerebrovascular occlusive disease overwhelm the small potential risk of the procedure.

Cerebral Angiography↗
PubMed1979

Medical hypnosis during therapeutic embolizations of the carotid and vertebral arteries.

Iatrogenic neurological deficit constitutes the greatest risk during therapeutic embolization in the vascular territories of the carotid and vertebral arteries. Constant monitoring of the patient's neurological status is therefore essential. The authors discuss the use of medical hypnosis to circumvent general anesthesia and to reduce chemical sedation to a minimum. Their experience with this technique is presented.

Anesthesia, General↗
PubMed1979

Cyanoacrylate occlusion of carotid-cavernous fistula with preservation of carotid artery flow.

We report a new treatment for carotid-cavernous fistula. Using a flow-guided, balloon-tipped microcatheter, we catheterize the fistula itself, verify balloon entry into the fistula with fluoroscopy and x-ray films, and then infuse the tissue adhesive isobutyl-2-cyanoacrylate with careful fluoroscopic control. Three patients have had their fistulas occluded, with preservation of flow through the internal carotid artery. This balloon microcatheter allows the radiologist to perform a reversible test occlusion. All three patients had neurological changes during or after the procedure, and in one we inadvertently occluded several distal middle cerebral artery branches without permanent neurological deficit. No patient became blind or developed 3rd, 4th, or 6th nerve palsy from the treatment. This technique seems to have promise as another method for the obliteration of carotid-cavernous fistula.

Arteriovenous Fistula↗
PubMed1979

Calibrated leak balloon microcatheter: a device for arterial exploration and occlusive therapy.

In quest of an endarterial treatment for intracranial arteriovenous malformations and fistulas, a microcatheter which can be flow-guided into third- and fourth-order branches of the intracranial arteries was developed. This permits controlled deposition of a vascular occlusive polymer (isobutyl-2 cyanoacrylate). Goals and experimental techniques are reviewed and clinical experience on the first 25 patients is presented. Complications included one stroke and three catheters glued in place, but refinements in technique have permitted avoidance of complications over the 14 months before this report.

Animals↗
PubMed1978

Reduced morbidity in gas myelography.

Gas myelography is a useful technique in the evaluation of the spinal canal and its contents. Although it has been greatly simplified and the high-resolution imaging greatly improved, morbidity remains a problem. Removal of the gas at the end of the examination through the lumbar route significantly decreases morbidity. This can be achieved through the same needle if the examination is performed via a lumbar puncture. Insertion of a second needle in the lumbar region may be necessary if the cervical or cisternal puncture is employed for gas introduction.

Headache↗