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Transbronchial brush biopsy is indicated when routine methods fail to establish the diagnosis of a pulmonary lesion. More than 50 biopsies have been performed without complications. The diagnostic accuracy of about 50% positive reports will definitively improve with the better selection of cases and with greater experience with this technique.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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PURPOSE: Evaluation of technical success rate, long-term outcome and initial complication rate in patients with fluoroscopically guided port implantation. MATERIAL AND METHODS: Between January 1994 and April 1997 124 ports were implanted under fluoroscopic guidance in 120 patients. Indications for port implantation were anti-cancer chemotherapy, antibiotic and supportive therapy in patients with tumours or cachexia. RESULTS: Implantation was technically successful in 98.4% of the patients. We had a 3.2% minor complication rate that did not necessitate further treatment. One pneumothorax required a chest tube (0.8%). During a total of 17,534 days, complications occurred in 10.8% of all ports, 6.9% of the ports had to be explanted because of these complications. CONCLUSIONS: Insertion of ports under fluoroscopic guidance has a low complication rate and good long-term results. The rate of 93.1% of functioning ports is superior to that reported in other studies. It is less costly and has a lower complication rate than surgical implantation. Therefore it seems to be the method of choice for patients requiring long-term subcutaneous venous access for chemotherapy or supportive therapy in malignant tumours or other emaciating diseases.
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The role of videofluoroscopy in the preoperative evaluation of 38 carcinomas of the oral cavity and oro-/hypopharynx is described. The analysis compared videofluoroscopy with CT and endoscopic assessment, since videofluoroscopy is the only imaging method that can record dynamic motility changes during deglutition. The intraluminal part of the tumour is well visualised by high contrast resolution of the pharyngeal mucosa. The extent of tumorous infiltration can be evaluated via indirect criteria such as leaking, vallecular asymmetry, impaired epiglottic movement with insufficient vestibular closure, pharyngeal wall rigidity, and laryngeal aspiration. Carcinoma of the oral cavity and piriform sinus often do not cause functional swallowing impairments that can be detected by videofluoroscopy. However, in case of carcinoma at the base of the tongue region as the major driving force in bolus movement, videofluoroscopic assessment yields important additional information supplementing CT and endoscopic findings.
Videofluoroscopy of swallowing was performed in 21 patients who had undergone partial horizontal laryngectomy. Food residues were present in most of these patients. Residues of liquid contrast were observed in 85.7% of the patients and residues of consistent contrast in 61.5% of the patients. In most cases, food remnants were to be found in the glossolaryngeal recess. The mechanisms of compensation, additional swallowing, and expiration after swallowing are an important factor in clearing the throat of any residual food. Impaired clearing of food residues results in aspiration. Aspiration of liquid contrast was observed in 76.2% of the patients and aspiration of consistent contrast in 19.1% of the patients (p less than 0.001). Aspiration after swallowing was observed in most of the patients.
The results of 25 ultrasonographically guided percutaneous pericardial drainage procedures and of one pericardiocentesis performed in 25 patients with pericardial fluid collections are reported. After initial puncture of the pericardial cavity under sonographic guidance, dilatation and placement of 5F to 8.3F catheters in Seldinger technique was controlled fluoroscopically in 22 procedures. Clinical indications were emergency treatment of tamponade (n = 6) or urgent treatment of large (n = 14) pericardial effusions. The remaining 6 procedures were performed to establish specific diagnoses of small effusions. Puncture sites were subxiphoid in 23 and left parasternal in 3 cases. The volume of aspirated fluid ranged from 20 to 1710 ml (median: 615 ml). Median duration of pericardial drainage was 3 days (range less than 1 day to 21 days). A specific diagnosis was obtained in 48% of patients. 4 patients had subsequent elective surgical intervention for recurrent effusion or for pericardial biopsy. Three minor complications included one vasovagal reaction and two asymptomatic pneumothoraces. Percutaneous ultrasonically guided and fluoroscopically controlled placement of a pericardial catheter is safe and effective for treatment and diagnosis of pericardial effusions.
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We describe a patient in whom radiation-induced morphea developed after undergoing fluoroscopically guided repair of an abdominal aortic aneurysm.