ABSTRACT
A traumatic pseudoaneurysm of the abdominal aorta eluded detection at initial laparotomy, but was later detected serendipitously. Early abdominal x-ray film and appreciation of paraspinal bullet fragments could have led to its earlier detection. A portable abdominal x-ray film should be a routine part of the preoperative resuscitation of abdominal gunshot wounds.
Subject(s)
Abdominal Injuries/diagnostic imaging , Aneurysm, False/diagnostic imaging , Aortic Aneurysm, Abdominal/diagnostic imaging , Wounds, Gunshot/diagnostic imaging , Abdominal Injuries/complications , Adolescent , Aneurysm, False/etiology , Aortic Aneurysm, Abdominal/etiology , Humans , Male , Tomography, X-Ray Computed , Wounds, Gunshot/complicationsSubject(s)
Biopsy, Needle/instrumentation , Catheterization/methods , Vagina/diagnostic imaging , Adult , Cysts/therapy , Drainage/methods , Female , Humans , Pelvis , UltrasonographyABSTRACT
Percutaneous aspiration thromboembolectomy (PAT) for management of a spontaneous arterial embolus, or following a complication of balloon angioplasty, was initially described in 1984. Instrument developments using a new clot aspiration system have facilitated this procedure. We report a case where PAT was successful in retrieving a spontaneous arterial embolus, and describe this new technique. We feel that PAT broadens the armamentarium of the vascular surgeon in the management of emboli to the distal circulation, where the results for operative embolectomy are frequently less than ideal.
Subject(s)
Embolectomy/methods , Embolectomy/instrumentation , Embolism/diagnostic imaging , Embolism/surgery , Humans , Male , Middle Aged , Radiography , Suction/instrumentation , Suction/methods , Tibial Arteries/diagnostic imaging , Tibial Arteries/surgeryABSTRACT
The authors have designed a new coaxial system for translumbar aortography and studies of the pelvis and the legs from low or high aortic puncture sites. A no. 4 French pigtail catheter with a maximum flow rate of 18 mL/s is mounted coaxially on a 32-cm-long, 20-gauge, thin-walled, two-part needle. The needle cannula accepts a guide wire of diameter 0.021 in (0.53 mm), over which the catheter can be advanced craniad for aortography or caudad for arteriography of the leg. After the first injection of contrast agent, the catheter can usually be easily redirected to complete the study. Such studies were successfully completed in 73 of 79 consecutive patients; the aorta could not be cannulated in 2, and the catheter could not be redirected in 4. The sole complications were asymptomatic extravasation of the contrast agent in one patient and moderately severe back pain that resolved spontaneously in another. The authors describe the technique, as well as variations that have been developed to overcome aortic abnormalities.
