ABSTRACT
Optically diverged direct argon laser light energy was used prior to conventional balloon angioplasty to recanalize 30 occluded peripheral arteries in 26 patients. Three of five (60%) iliac and 22 of 25 (88%) femoropopliteal lesions ranging in length from 1 to 47 cm (mean, 17.3 cm) were successfully treated, for an overall technical success rate of 83%. In the femoropopliteal system, 13 of 14 (93%) procedures in lesions less than 20 cm and nine of 11 (82%) procedures in lesions greater than 20 cm were treated successfully. No statistically significant differences in success rate based on lesion site, lesion length, degree of lesion calcification, or severity of peripheral vascular disease were found. Major complications were a laser perforation resulting in treatment failure in one case (3%) and a successfully treated distal embolus in another (3%). No reocclusions occurred in the immediate postoperative period. While long-term follow-up will be required to assess continued patency, this system can potentially increase the number of patients amenable to conventional balloon angioplasty and is currently advocated as an alternative to amputation in patients in whom surgical bypass grafting is contraindicated or unfeasible.
Subject(s)
Arteriosclerosis/surgery , Laser Therapy , Leg/blood supply , Aged , Aged, 80 and over , Arteriosclerosis/diagnostic imaging , Embolism/etiology , Female , Femoral Artery/diagnostic imaging , Humans , Iliac Artery/diagnostic imaging , Laser Therapy/adverse effects , Male , Middle Aged , Popliteal Artery/diagnostic imaging , Radiography , ReperfusionABSTRACT
Twenty patients with massive or recurrent hemoptysis underwent percutaneous transcatheter embolotherapy between 1979 and 1986 for the following diseases: cavitary aspergillosis (n = 4); cystic fibrosis (n = 4); tuberculosis (n = 3); bronchogenic carcinoma (n = 3); bronchiectasis (n = 3); small cell lung carcinoma 6 years after irradiation (n = 1); congenital heart disease, after Glenn and Blalock anastomoses (n = 1); and unknown interstitial disease (n = 1). Bronchial arteries were embolized in all but one patient. In nine patients (45%) nonbronchial systemic collateral arteries contributed significantly to areas of pathologic pulmonary tissue and frequently were the major arterial supply. These nonbronchial systemic collaterals included branches of the subclavian and axillary arteries (n = 7), intercostal arteries (n = 5), and phrenic arteries (n = 3) and accounted for 59.5% of the total number of arteries embolized. Recognition and occlusion of nonbronchial systemic collaterals providing blood to hypervascular pulmonary lesions is essential for successful percutaneous embolotherapy of hemoptysis.
Subject(s)
Bronchial Arteries , Collateral Circulation , Embolization, Therapeutic , Hemoptysis/therapy , Lung/blood supply , Adolescent , Adult , Aged , Female , Hemoptysis/etiology , Humans , Male , Middle AgedABSTRACT
Fifty-three samples of gallbladder bile were obtained at the time of cholecystectomy from patients with the clinical diagnosis of acute or chronic cholecystitis. Five bile samples from patients with clinically normal gallbladders also were obtained. Proton magnetic resonance (MR) relaxation times, protein content, and water content were determined for the bile samples, and the data were grouped according to pathologic diagnosis, which disclosed 11 cases of acute cholecystitis, 41 cases of chronic cholecystitis, and six normal gallbladders. There was no significant difference in the mean T1 and T2 values between the groups with acute and chronic cholecystitis. Patients with chronic cholecystitis were found to have more concentrated bile than those with acute cholecystitis. Protein content varied widely within both groups of patients. We conclude that T1 and T2 relaxation times do not reliably differentiate acute from chronic cholecystitis.
