RESUMO
PURPOSE: The objective of this prospective study was to evaluate whether Doppler imaging characteristics can be used to predict spontaneous thrombosis of femoral artery pseudoaneurysms (PAs). METHODS: Eleven post-cardiac catheterization PAs were monitored with color Doppler sonography. Total volume of the lesion, volume filled with free-flowing blood, length and width of the neck of the PA, and its anatomic position were evaluated. RESULTS: All of the PAs in our series underwent spontaneous thrombosis. PAs with necks 0.9 cm or longer underwent spontaneous thrombosis in 9.8 days on average, while PAs with necks shorter than 0.9 cm required an average of 52 days to thrombose. CONCLUSIONS: PAs with longer neck lengths are more likely to thrombose in a shorter period than are those with shorter necks. It may thus be worthwhile to await spontaneous resolution when the aneurysmal neck length is 0.9 cm or more.
Assuntos
Falso Aneurisma/diagnóstico por imagem , Artéria Femoral/diagnóstico por imagem , Trombose/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Falso Aneurisma/etiologia , Falso Aneurisma/fisiopatologia , Velocidade do Fluxo Sanguíneo , Cateterismo Cardíaco/efeitos adversos , Feminino , Artéria Femoral/fisiopatologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Trombose/etiologiaRESUMO
IRC are rare entities characterized by fever and unilateral flank pain resistant to antibiotic therapy. In our series of nine IRC in eight patients, the predominant sonographic finding was an abnormal echogenic texture of the cyst contents, in contrast to previous reports that stressed the frequency of wall thickening as a sign of infection. Sonographically guided cyst aspiration and drainage of eight cysts in seven patients provided diagnostic material and resulted in relief of symptoms. Although the cause of IRC is uncertain, these entities may be more common than previously suspected.
Assuntos
Infecções por Escherichia coli/diagnóstico por imagem , Infecções por Escherichia coli/cirurgia , Doenças Renais Císticas/diagnóstico por imagem , Doenças Renais Císticas/cirurgia , Adulto , Idoso , Bacteriúria/microbiologia , Bacteriúria/patologia , Drenagem , Escherichia coli/isolamento & purificação , Feminino , Humanos , Leucócitos/patologia , Masculino , Pessoa de Meia-Idade , UltrassonografiaRESUMO
Transcervical fallopian tube catheterization is rapidly gaining favor as a minimally invasive diagnostic and therapeutic technique. On occasion, the presence of filmy adhesions not identified on HSG obstruct the passage of the cannula to the cornual angle. We describe the design and operative characteristics of a new transcervical adhesiolysis device that if used under the guidance of DRM mapping, can restore the shape of the uterine cavity and allow completion of the procedure during the same session.
Assuntos
Cateterismo , Tubas Uterinas , Aderências Teciduais/terapia , Adulto , Desenho de Equipamento , Feminino , Fluoroscopia , Humanos , Histerossalpingografia , Processamento de Imagem Assistida por Computador , Instrumentos Cirúrgicos , Fatores de Tempo , Aderências Teciduais/diagnóstico por imagem , VaginaRESUMO
Ten infertile women 20 to 40 years of age, with a standard HSG diagnosis of unilateral proximal tubal obstruction, underwent a transvaginal catheterization and recanalization of the fallopian tubes. To set a fluoroscopic real-time guidance technique for improving the results of transvaginal catheterization and recanalization of the fallopian tubes and to increase its marginal safety, catheterization was performed under digital road mapping guidance. Transcervical catheterization resulted in an immediate patency of the obstructed tube in all 10 women. Three women conceived 2 to 3 months after the procedure. The improved catheterization technique enables good results in the diagnosis and treatment of proximal tubal obstructions.
Assuntos
Cateterismo/métodos , Doenças das Tubas Uterinas/terapia , Fluoroscopia/métodos , Adulto , Colo do Útero , Doenças das Tubas Uterinas/diagnóstico por imagem , Feminino , Humanos , Intensificação de Imagem Radiográfica , Fatores de TempoRESUMO
Directional atherectomy alone or with supplemental percutaneous transluminal angioplasty was used to treat peripheral vascular lesions in 77 patients (85 procedures). Lesions involved 17 iliac arteries, 45 infrainguinal arteries, and 23 laser extremity vein bypass grafts. Technical success, defined as reduction of stenosis diameter to 30% or less of the normal vessel diameter, was achieved in 78 of 85 (92%) cases. The complication rate was 21% (18 of 85 procedures). Most complications were minor and were related to puncture sites. Patients underwent noninvasive follow-up studies, including measurement of ankle-brachial index and segmental pressures, plethysmography, and clinical examination. The mean follow-up period was 13.5 months. The probability of 1-, 2-, and 3-year patency for lesions treated with atherectomy alone was 92%, 84%, and 84%, respectively. Kaplan-Meier survival analysis revealed no difference in 2- to 3-year patency rate on the basis of lesion location or presence of calcification, eccentricity, or ulceration. Diabetic patients, however, had a higher restenosis rate than did patients who were not diabetic (P less than .03).
Assuntos
Arteriosclerose/terapia , Idoso , Idoso de 80 Anos ou mais , Angiografia , Angioplastia com Balão , Arteriosclerose/diagnóstico por imagem , Cateterismo , Feminino , Seguimentos , Humanos , Perna (Membro)/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Grau de Desobstrução VascularRESUMO
Of 13,203 transfemoral diagnostic and therapeutic cardiac catheterization procedures performed between January 1, 1980 and December 31, 1990, 73 (0.55%) were complicated by pseudoaneurysm (PA) formation, and 15 (0.11%) by arteriovenous fistulas (AVF). The rate of PA increased progressively from 0.44% (1980-1987), to 0.59% (1987-1989), to 0.92% (1990), with no corresponding change in the incidence of AVF. The rising incidence of PA complicating transfemoral cardiac catheterization was associated closely with the use of larger diameter catheters and aggressive antiocoagulation during coronary interventions, but findings during surgical repair suggested that puncture of the superficial femoral (SFA), rather than the common femoral artery (CFA), was an important avoidable cause of some PA and AVF. A technique for fluoroscopic localization of the puncture site to avoid inadvertent SFA puncture and the associated increased risk of complication is proposed.
Assuntos
Aneurisma/diagnóstico por imagem , Fístula Arteriovenosa/diagnóstico por imagem , Cateterismo Cardíaco/instrumentação , Artéria Femoral/lesões , Aneurisma/cirurgia , Fístula Arteriovenosa/cirurgia , Cateterismo Cardíaco/efeitos adversos , Artéria Femoral/diagnóstico por imagem , Humanos , Radiografia , Estudos Retrospectivos , Fatores de RiscoRESUMO
Distal popliteal arterial variations may influence the success of femorodistal popliteal and tibial arterial reconstructions. Two patients whose bypass procedures were initially unsatisfactory because of a poor choice for anastomosis stimulated a review of variations in the distal popliteal artery in 1000 femoral arteriograms. The popliteal arterial anatomy could be assessed in 605 extremities and the tibial arterial anatomy in 495 extremities. Seventy-five variant cases were identified. Normal branching of the popliteal artery was present in 92.2%. Among the 7.8% incidence of variants, the majority (72%) were either high origin of the anterior tibial artery or a trifurcation pattern. Of variant patterns to the foot (5.6%), the most common was that in which the supply to the distal posterior tibial artery arose from the peroneal artery. We propose a unified classification of the popliteal and tibial arterial variations that encompasses both anatomic areas. Variant arterial supply to the foot can be suspected when the infrapopliteal vessels show a hypoplastic or aplastic anterior or posterior tibial artery and compensatory hypertrophy of the peroneal artery. Knowledge of these variants is important to angiographers and vascular surgeons.
Assuntos
Artéria Poplítea/diagnóstico por imagem , Angiografia , Humanos , Artéria Poplítea/anormalidadesRESUMO
A case report of a pelvic lymphocele developing after lymphadenectomy for staging of prostatic carcinoma is described. This collection was successfully managed by percutaneous catheter drainage. The incidence, pathophysiology, clinical symptomatology, differential diagnosis, and treatment options of pelvic lymphocele are reviewed. We believe that percutaneous catheter drainage is currently the optimal treatment modality.
Assuntos
Drenagem/métodos , Excisão de Linfonodo/efeitos adversos , Doenças Linfáticas/terapia , Linfocele/terapia , Humanos , Linfocele/etiologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias da Próstata/patologiaRESUMO
The Simon nitinol filter for percutaneous interruption of the vena cava to prevent pulmonary embolism is currently undergoing a multicenter clinical trial. Preliminary clinical results are reported as work in progress. The results in 44 patients at two centers are analyzed in detail, and major events are reported from 103 patients in 17 centers in the United States during a 10-month period. The filter was successfully inserted via the femoral or jugular route in all patients through a 9-F catheter. The placement procedure was easy and without significant complications. Follow-up studies included plain radiography, ultrasonography, magnetic resonance (MR) imaging, and clinical evaluation. No filter migration or perforation occurred among the 103 patients. Symptomatic occlusions occurred in 7%-9%, comparable to other series, and some asymptomatic occlusions were detected with MR imaging only. The implications of occlusion of the filter are discussed.
Assuntos
Ligas , Filtração/instrumentação , Veia Cava Inferior , Adulto , Idoso , Idoso de 80 Anos ou mais , Ensaios Clínicos como Assunto , Feminino , Filtração/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Embolia Pulmonar/prevenção & controle , Radiografia , Veia Cava Inferior/diagnóstico por imagemRESUMO
Primary lymphoma of the brain in AIDS is being observed with increased frequency; five pathologically proven cases are presented. Although the CT patterns may correlate well with patterns previously described in lymphoma, occasionally an irregular ring-like lesion may occur which is difficult to distinguish from toxoplasmosis or other inflammatory processes without appropriate pathological material.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Neoplasias Encefálicas/diagnóstico por imagem , Linfoma não Hodgkin/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Gânglios da Base/diagnóstico por imagem , Neoplasias Encefálicas/complicações , Diagnóstico Diferencial , Feminino , Lobo Frontal/diagnóstico por imagem , Humanos , Linfoma não Hodgkin/complicações , Masculino , Tálamo/diagnóstico por imagemRESUMO
We describe a patient with a false aneurysm of the lingual artery of uncertain etiology and present the ultrasound, computed tomography and angiographic findings.
Assuntos
Aneurisma/diagnóstico , Língua/irrigação sanguínea , Idoso , Aneurisma/diagnóstico por imagem , Aneurisma/patologia , Artérias/patologia , Feminino , Humanos , Tomografia Computadorizada por Raios X , Língua/diagnóstico por imagem , Língua/patologia , UltrassonografiaRESUMO
We describe a patient in whom thoracic aortography performed following blunt chest trauma revealed what appeared to be a traumatic tear of the proximal descending aorta. As the patient initially refused surgery, aortography was repeated 18 days later, confirming these findings. At thoracic aortotomy the aorta appeared normal; there was no hematoma or tear. We believe this to be the first reported case of false-positive aortography following blunt chest trauma (see Note added in proof).
Assuntos
Aortografia , Traumatismos Torácicos/diagnóstico por imagem , Ferimentos não Penetrantes/diagnóstico por imagem , Adulto , Aorta Torácica , Ruptura Aórtica/diagnóstico por imagem , Ruptura Aórtica/etiologia , Reações Falso-Positivas , Feminino , Humanos , Traumatismos Torácicos/complicações , Ferimentos não Penetrantes/complicaçõesRESUMO
The advent of radiologic percutaneous drainage of abdominal abscesses has revealed that a significant percentage involve a fistulous communication to other organs or structures. We present two cases in which abscessograms revealed unsuspected fistulous communication to an incompletely or intermittently obstructed biliary tree with retained stones.
Assuntos
Colelitíase/complicações , Abscesso Hepático/etiologia , Idoso , Colelitíase/diagnóstico por imagem , Colelitíase/terapia , Drenagem , Feminino , Humanos , Abscesso Hepático/diagnóstico por imagem , Abscesso Hepático/terapia , Pessoa de Meia-Idade , RadiografiaRESUMO
A high prevalence of schizophrenia was noted in an Israeli Yemenite immigrant town. In order to throw light on the aetiology all the schizophrenic patients in the care of one family doctor were investigated with respect to various social factors--age at diagnosis, interval since immigration, family status, geographic area of origin. In a practice population of 1185 adults, thirty schizophrenic patients were identified (2.5%). The patients fall into two groups--those diagnosed at a relatively advanced age, born in the Yemen, and parents to an adolescent child; and those Israeli-born diagnosed at the younger age more typical of the disease. The social history of this immigrant community is described and a correlation is suggested between their socio-cultural disintegration and schizophreniform breakdown in the parental generation.