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A C Moncure

Publications and source records attributed to A C Moncure.

62 records · Page 4Linked to original sources
PubMed1982

Transluminal angioplasty of the iliac and femoropopliteal arteries. Current status.

Transluminal angioplasty for the management of atherosclerosis obliterans has been performed in 160 patients for 100 iliac and 98 femoropopliteal lesions. The procedure was performed percutaneously except in eight patients in whom operative exposure was required. Angioplasty was technically successful in all 100 iliac artery lesions. There was hemodynamic and clinical improvement in 92 lesions. The procedure was technically successful in 84 of the 98 femoropopliteal artery lesions with hemodynamic improvement in 74 and clinical improvement in 78. There were ten complications directly related to the angioplasty and six related to the arteriographic procedure. Cumulative patency rates for the angioplasties were 92% and 75% at three years for iliac and femoropopliteal lesions, respectively. These promising results suggest that transluminal angioplasty has a definite role in the management of atherosclerosis obliterans of iliac and femoropopliteal arteries.

Adult↗
PubMed1980

Tender pulsatile abdominal mass. Abdominal aortic aneurysm or not?

Twenty-nine patients had symptomatic pulsatile abdominal masses. Initially six patients underwent emergency surgical exploration without prior arteriography. An abdominal aortic aneurysm was found in only one patient. In the next 23 patients, in whom arteriography was performed, no aneurysm was detected and emergency surgery could be avoided. In patients with symptomatic pulsatile abdominal masses, in the absence of hypovolemic shock the initial diagnostic study should be abdominal angiography. It is an accurate and safe procedure, and supplies the necessary preoperative information should abdominal aortic surgery become necessary. If, however, no aneurysm is found, valuable information is still obtained with regard to the underlying disease process.

Abdomen, Acute↗
PubMed1980

Intraoperative localization of small bowel bleeding sites with combined use of angiographic methods and methylene blue injection.

Superselective catheter placement with angiographic techniques and methylene blue injection at laparotomy through a prepositioned angiographic catheter have helped to localize small bowel bleeding lesions. The technique has been applied successfully in two patients with arteriovenous malformations and one patient with bleeding mucosal ulcerations of the small bowel.

Adult↗
PubMed1979

Variable manifestations of vascular injury during lumbar disk surgery.

Major vascular injury is an unusual but well-recognized complication of lumbar disk surgery. Clinical manifestation of such injuries may be extremely variable. Isolated arterial laceration is most common, with early manifestation due to retroperitoneal hemorrhage. There are often few external signs of blood loss, however, and the diagnosis may not be recognized initially. Formation of an arteriovenous fistula or false aneurysm produces even fewer early signs, and diagnosis is often delayed for weeks or years. Six cases are described that illustrate the full spectrum of acute and chronic manifestations of such injuries. Two cases of acute hemorrhage due to arterial trauma were seen; one case was recognized intraoperatively and one in the recovery room. In four cases arteriovenous fistulae developed and were diagnosed from eight hours to eight years postoperatively. Two cases also had associated false aneurysms, one the probable source of pulmonary emboli and one the principal manifestation of the vascular injury.

Abdomen↗
PubMed1976

Repair of inflammatory tracheoesophageal fistula.

Benign acquired tracheoesophageal fistula is uncommon. Erosin of the membranous wall of the trachea and the anterior esophageal wall by the high-pressure cuff on a tracheostomy tube, often against the anvil of a nasogastric tube, may produce such fistulas. Techniques for closure have included patching the tracheal defect with muscle and, often, multiple staged procedures, planned or unplanned. Since any cuff lesion severe enough to cause a fistula necessarily damages the trachea circumferentially at the same level, definitive correction must include circumferential tracheal resection as well as closure of the fitstula. Five patients with tracheoesophageal fistula due to cuff perforation had repair by such a single-stage procedure. Through an anterior approach the involved trachea was resected, primary anastomosis was done, and the esophagus was closed in layers. In 3 of these 5 patients muscle was interposed for added security. One patient had undergone a prior attempt at repair elsewhere. One required a second resection of trachea for subsequent stomal stenosis. Repair in 2 additional patients with fistulas of complex origin related to direct trauma, sepsis, and foreign body involved adaptation of the basic technique to the special problem; 1 of these procedures was necessarily staged. Results in all 7 patients have been good.

Adult↗
PubMed1976

Gastrointestinal hemorrhage from adhesion-related mesenteric varices.

As a result of this retrospective analysis of hemorrhage from a porta-systemic venous shunt occurring within the small intestine, we believe that the early diagnosis of the syndrome is strongly suggested by the presence of varices in unusual locations demonstrated by the venous phase of mesenteric arteriography. In all patients portal hypertension was present, and in all the affected bowel was adherent to postoperative adhesions on old suture lines. The syndrome was treated variously with lysis of adhesions, bowel resection, or portal-systemic shunt. Those patients with excellent hepatic reserve survived and had no further gastrointestinal bleeding.

Adult↗