ABSTRACT
The experience with laser-assisted angioplasty at a community hospital was reviewed. One hundred twenty patients required angioplasty during a 7-month period, and in only 17-13 of whom had superficial femoral artery occlusions--was the use of lasers deemed appropriate. The success rate was 65% for laser-assisted angioplasty and 98% for balloon angioplasty. Laser-assisted angioplasty was the initial intervention in eight of the 13 superficial femoral artery occlusions. In two cases, a wire had been first advanced across the lesion, and in three cases, attempts to cross the lesion with a wire had been unsuccessful. The availability of the laser did not significantly increase the number of cases amenable to angioplasty, and at present laser angioplasty, does not seem to be cost-effective for community hospitals.
Subject(s)
Angioplasty, Balloon/methods , Arterial Occlusive Diseases/therapy , Hospitals, Community , Laser Therapy , Technology Assessment, Biomedical , Aged , Aged, 80 and over , Angioplasty, Balloon/statistics & numerical data , Female , Femoral Artery , Humans , Iliac Artery , Leg/blood supply , Male , Middle AgedABSTRACT
Intravenous digital subtraction angiography (IVDSA) was used to evaluate 44 patients with suspected otolaryngologic abnormalities. Sixteen had IVDSA for pulsatile tinnitus or suspected glomus tumor of the petrous bone. Nine patients were evaluated because of pulsatile neck masses, and 12 others had suspected tumors of the neck, face, and paranasal sinuses. Seven had IVDSA following head and neck trauma. The technique of examination is described. The current indications of IVDSA in head and neck radiology are discussed. It is concluded that IVDSA is a suitable substitute for conventional angiography for many otolaryngologic conditions and, because of its safety, can be used more liberally.
Subject(s)
Angiography/methods , Otorhinolaryngologic Diseases/diagnostic imaging , Adult , Aged , Carotid Artery Injuries , Facial Neoplasms/diagnostic imaging , Female , Head and Neck Neoplasms/diagnostic imaging , Humans , Male , Middle Aged , Paraganglioma/diagnostic imaging , Paranasal Sinus Neoplasms/diagnostic imaging , Subtraction Technique , Tinnitus/diagnostic imaging , Vertebral Artery/injuries , Wounds, Gunshot/diagnostic imagingABSTRACT
Radiologic procedures used to evaluate patients with suspected glomus tumor have included plain skull radiography, temporal bone tomography, computed tomography, and cerebral angiography. Of these, only angiography has proven reliable as a screening procedure for small glomus tympanicum and jugulare tumors. Digital subtraction angiography was used as the initial examination for suspected paraganglioma in 14 patients. Intravenous digital subtraction angiography proved to be an acceptable screening tool for these highly vascular tumors. Also, intraarterial digital subtraction angiography proved very satisfactory for mapping of tumor blood supply, which greatly simplified preoperative embolization. Effectiveness of therapy was readily ascertained by serial follow-up intravenous digital subtraction angiography.
Subject(s)
Cerebral Angiography/methods , Ear Neoplasms/diagnostic imaging , Glomus Jugulare Tumor/diagnostic imaging , Paraganglioma, Extra-Adrenal/diagnostic imaging , Adult , Aged , Child , Ear, Middle/diagnostic imaging , Female , Humans , Male , Radiographic Image Enhancement/instrumentation , Subtraction Technique , Tinnitus/etiologySubject(s)
Esophagus/diagnostic imaging , Food , Adult , Esophagus/injuries , Humans , Male , Middle Aged , RadiographyABSTRACT
Iohexol, a new non-ionic water-soluble contrast medium, was tested for digital intravenous angiography of the cervical and intracranial vessels. In a double blind study involving 40 adult patients, iohexol and meglumine-Na diatrizoate were compared for safety, patient tolerance, and radiographic image quality. Iohexol was shown to be safe and generally produced less patient discomfort, leading to a lower incidence of motion, swallowing or cough artifacts.
Subject(s)
Angiography/methods , Contrast Media , Diatrizoate Meglumine , Diatrizoate/analogs & derivatives , Iodobenzoates , Subtraction Technique , Triiodobenzoic Acids , Adult , Aged , Cerebral Angiography/methods , Clinical Trials as Topic , Contrast Media/toxicity , Diatrizoate Meglumine/toxicity , Double-Blind Method , Drug Tolerance , Humans , Iohexol , Middle Aged , Neck/blood supply , Triiodobenzoic Acids/toxicityABSTRACT
At the community medical center, we have introduced and successfully applied digital subtraction angiography (DSA) to disease processes seen in 1,144 patients. Although there is a trade-off between increased contrast resolution and decreased spatial resolution with the DSA approach, nonetheless in many vascular beds it provides rapid, safe, and accurate disease diagnosis.
Subject(s)
Angiography/methods , Subtraction Technique , Angiocardiography , Aorta, Abdominal/diagnostic imaging , Aortic Arch Syndromes/diagnostic imaging , Aortic Diseases/diagnostic imaging , Cerebrovascular Disorders/diagnostic imaging , Computers , Coronary Artery Bypass , Female , Heart Ventricles/diagnostic imaging , Hospitals, Community , Humans , Male , Pulmonary Artery/diagnostic imaging , Renal Artery Obstruction/diagnostic imaging , Vascular Diseases/diagnostic imagingABSTRACT
Large numbers of plasmacytes and lymphocytic cells develop at the tip of miniature pipettes containing phytohemagglutinin (PHA) implanted into the brain of adult Lewis rats. The accumulation of lymphoid elements is present in tissue exposed to PHA for 1 week, and it persists in animals which were allowed to survive up to 10 weeks. It did not occur around control or non-active implants. Lymphoid cells usually serve as a morphologic index of immune mediated phenomena, but no evidence was seen in the present study to indicate that they produce damage to axons, dendrites or glial cells of the central nervous system despite direct contact with them. Plasma cells in the brain appear to develop from "dark" cells resembling lymphocytes that migrate into the central nervous system from reactive lymphoid tissue near the tip o.f the implant. Nerve, glial and subependymal cells do not respond with mitogenic activity to PHA.
