RESUMO
Selective intra-arterial infusions of streptokinase (SK) were made in 50 arteries of 45 patients with a variety of acute thromboembolic conditions. The most common regimen was 5,000 units of SK/hour for 24 to 48 hours with a simultaneous heparin infusion of 250 to 500 units/hour. Significant lysis occurred in 80% of cases, with 74% of the patients benefiting clinically. Minor bleeding, usually from puncture sites, occurred in 30% of the patients. Major hemorrhages, requiring transfusion or surgery, developed in four patients (8%). No hemorrhagic strokes or fatalities were directly attributable to SK infusion. Coagulation parameters were determined before infusion, 4 and 24 hours after infusion, and every 24 hours thereafter. Significant alterations of coagulation parameters developed promptly, but were not very useful in predicting either clinical response or hemorrhage. Selective intra-arterial infusion of SK is a moderately effective and safe therapeutic technique in acute peripheral arterial thromboembolic disease. A comparison with prior reports suggests that selective low-dose infusion provides a moderate gain in benefit-risk ratio over systemic infusion.
Assuntos
Angiografia , Estreptoquinase/administração & dosagem , Tromboembolia/tratamento farmacológico , Coagulação Sanguínea/efeitos dos fármacos , Esquema de Medicação , Avaliação de Medicamentos , Fibrinogênio/análise , Hemorragia/etiologia , Humanos , Infusões Intra-Arteriais , Plasminogênio/análise , Estreptoquinase/efeitos adversos , Tromboembolia/diagnóstico por imagemRESUMO
The clinical and radiological features of idiopathic aneurysmal dilatation of the ileum in 3 adult patients are described. This uncommon lesion presents as an aperistaltic saccular segment in direct continuity with the normal ileal lumen. On barium examination of the small bowel, however, it may closely resemble and be mistaken for a Meckel's diverticulum. Previous reports about this entity manifesting in the pediatric age group are reviewed.
Assuntos
Aneurisma/diagnóstico por imagem , Doenças do Íleo/diagnóstico por imagem , Adulto , Aneurisma/patologia , Sulfato de Bário , Diagnóstico Diferencial , Dilatação Patológica/patologia , Feminino , Humanos , Doenças do Íleo/patologia , Masculino , Divertículo Ileal/diagnóstico por imagem , Pessoa de Meia-Idade , RadiografiaAssuntos
Aneurisma Aórtico/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ureter/diagnóstico por imagem , Obstrução Ureteral/diagnóstico por imagem , Aorta Abdominal/diagnóstico por imagem , Aneurisma Aórtico/complicações , Humanos , Inflamação , Masculino , Pessoa de Meia-Idade , Obstrução Ureteral/etiologiaRESUMO
In the case reported herein, hemobilia was caused by an aneurysm of the left gastric artery which arose as a separate vessel from the aorta. The role of subselective angiography in the evaluation of hemobilia is emphasized.
Assuntos
Aneurisma/complicações , Hemobilia/etiologia , Estômago/irrigação sanguínea , Aneurisma/diagnóstico por imagem , Angiografia , Hemobilia/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estômago/diagnóstico por imagemRESUMO
Accurate diagnosis of aneurysms of the thoracic aorta and its major branches can easily be performed by CT scanning of the mediastinum. The use of contrast enhancement aids in the diagnosis and allows distinction between flowing and clotted blood within the aneurysm. CT scanning of these lesions seen on chest radiographs may obviate the need for arteriography for diagnosis.
