PubMed Health⌕ Search

Biomedical subjects

A M Belli

Publications and source records attributed to A M Belli.

At least 55 records · Page 3Linked to original sources
PubMed1995

Clinical outcome and restenosis following percutaneous transluminal angioplasty for ischaemic rest pain or ulceration.

The role of percutaneous transluminal angioplasty in the management of severe leg ischaemia is controversial. To investigate further the efficacy of angioplasty and the clinical consequences of restenosis, a randomly selected cohort of 29 patients with ischaemic rest pain or ulceration was studied for 6 months after a technically successful balloon angioplasty. All patients had digital subtraction arteriography at the end of follow-up. Seven of 15 patients undergoing the procedure for rest pain had sustained relief from the initial dilatation. Partial or complete healing was noted in all 14 patients with ulceration and was maintained at 6 months in 11 despite significant (greater than 30 per cent) restenosis at the angioplasty site in eight. There were no complications or clinical deterioration associated with the procedure. Angioplasty is an effective method for treating the severely ischaemic leg, especially when used to achieve ulcer healing; restenosis is often clinically unimportant.

Aged↗
PubMed1995

A potential pitfall in bronchial artery embolization.

Two cases of patients with massive haemoptysis undergoing bronchial arteriography are described. Both had collateral vessels which filled the right subclavian artery from the right intercosto-bronchial trunk. Such vessels form a potential route for the passage of embolic material into the subclavian artery and its branches during therapeutic bronchial artery embolization. To avoid this potential complication, super selective catheterization with the positioning of the catheter tip well into the bronchial artery beyond the origin of the intercostal artery and any large collateral vessels is recommended.

Adult↗
PubMed1995

Anomalous splenic artery aneurysm: demonstration on CT scanning and angiography.

An asymptomatic 35-year-old female was found to have a congenital aneurysm of an anomalous splenic artery arising from the superior mesenteric artery on routine investigation for infertility. Demonstration on CT and angiography is presented and the pathogenesis, natural history, management, and implications during pregnancy are discussed.

Adult↗
PubMed1994

Superior vena caval obstruction managed by the Gianturco Z Stent.

Twenty patients with superior vena caval obstruction (SVCO) due to malignancy were managed using the Gianturco Z Stent. Three patients had adjunctive thrombolysis. The primary clinical success was 90% (18/20 patients). Thirteen patients were free of SVCO to death or follow-up without re-intervention (primary patency = 65%). Three patients had re-intervention for recurrent symptoms, two successfully (secondary long-term patency = 75%). Stenting of the SVC is a valuable, under-used technique for the symptomatic relief of superior vena caval obstruction.

Humans↗
PubMed1994

Recanalization using a low speed rotational device (ROTACS) in total occlusions of the femoropopliteal artery.

A low speed rotational catheter system (ROTACS) was used to recanalize total occlusions of the femoropopliteal artery in two patient groups. In Group A, previous attempts to recanalize the occlusions using standard guidewires and catheters had failed. Group B had undergone no previous attempts at recanalization. The ROTACS was successful in recanalizing 85% and 77% of occlusions in Group A and Group B, respectively. All these patients subsequently underwent technically successful balloon dilatation. One month follow-up revealed a high rate of reocclusion (45%) in Group A but no reocclusions in Group B. Comparison of the two groups therefore does not suggest that the ROTACS device is responsible for early reocclusions. We conclude that the ROTACS has a role in recanalizing total femoropopliteal artery occlusions in the small group of patients in whom conventional recanalization attempts have failed.

Arterial Occlusive Diseases↗
PubMed1994

Directional atherectomy in the treatment of anastomotic neointimal hyperplasia associated with prosthetic arterial grafts: technique and preliminary results.

The development of anastomotic neointimal hyperplasia is a common cause of late prosthetic arterial bypass graft failure. The cost and morbidity of graft failure are high, hence the widespread use of graft surveillance programmes in order to detect graft-related stenoses before they progress to occlusion. However, the optimal treatment of stenoses secondary to neointimal hyperplasia is not clear, with a number of authors reporting poor results with both balloon angioplasty and surgical revision. We report our early experience with the Simpson atherectomy catheter in the treatment of anastomotic neointimal hyperplasia associated with prosthetic arterial grafts at eight sites in seven patients. A high technical success rate may be expected and further long-term studies of this mode of treatment are indicated.

Aged↗
PubMed1991

Malignant 'angiodysplasia'.

Four patients with chronic gastrointestinal blood loss of obscure aetiology were investigated by visceral angiography. All showed angiographic abnormalities in the caecum with characteristic features seen in angiodysplasia as well as other conditions such as inflammatory bowel disease, carcinoma. All four patients had a malignant cause for their angiographic appearance. This paper stresses the importance of reviewing previous examinations before accepting a diagnosis of angiodysplasia. The angiographic features of contrast pooling on the anti-mesenteric border of the caecum or ascending colon, a dilated intramural vein and early filling of a draining vein imply that serious pathology is present.

Adult↗
PubMed1991

Follow-up of conventional angioplasty versus laser thermal angioplasty for total femoropopliteal artery occlusions: results of a randomized trial.

Sixty-eight patients with 68 femoropopliteal occlusions were entered into a randomized trial of conventional guide-wire and catheter percutaneous angioplasty versus laser thermal angioplasty. Thirty-four occlusions were randomized to conventional angioplasty and 34 to laser thermal angioplasty. After successful recanalization and balloon dilation, the patients were followed up for 1 year. Follow-up consisted of obtaining measurements of the ankle-arm indexes at 1, 3, 6, and 12 months. The increase in the mean resting ankle-arm index 1 year after conventional angioplasty (0.26) was greater than that after laser angioplasty (0.12). At 1-year follow-up, the cumulative success rate was 47% for patients treated with conventional angioplasty versus 39% for those treated with laser angioplasty. Statistical analysis showed no significant difference in clinical success between the two treatment groups.

Angioplasty, Balloon↗
PubMed1991

Total peripheral artery occlusions: conventional versus laser thermal recanalization with a hybrid probe in percutaneous angioplasty--results of a randomized trial.

Increasing the primary success rate in recanalization of peripheral vascular occlusions is one aim of using laser techniques in the treatment of peripheral vascular disease. Although reports of lasers enabling recanalization after failure of guide wires have been numerous, direct comparisons of the success of the two techniques in a randomized trial have been few. The results of a randomized trial showed no statistical difference in recanalization of femoropopliteal occlusions between the conventional guide wire and hybrid laser probe. The number of patients with iliac occlusions was small and comparisons are difficult to make, but the findings suggest that the hybrid laser probe has little to offer. Immediate crossover to the alternative method allowed investigation of the relationship between the two methods in practice. Combining the two methods improved the primary success rate from 82% to 91% for femoropopliteal occlusions randomized to laser thermal recanalization and from 74% to 91% for those randomized to conventional recanalization.

Angioplasty, Balloon↗
PubMed1990

Lasers in radiology.

Explore the source record for details and available documents.

Angioplasty, Balloon↗
PubMed1990

The complication rate of percutaneous peripheral balloon angioplasty.

One thousand six hundred and forty-two vessel segments (46% iliac, 54% femoro-distal) in 1141 patients have undergone percutaneous peripheral balloon dilatation at the Northern General Hospital, Sheffield over a 9 year period. Forty-two significant complications were encountered in all; 28 of these were occlusive and half of these were treated by angioplasty itself, either by thrombolysis or catheter suction. There was one case of distal ischaemia attributed to cholesterol embolisation which led to death (Gaines et al., 1988). There were two cases of perforation and haematoma requiring surgery, one retroperitoneal haemorrhage and one false aneurysm. One diabetic patient developed septicaemia following successful PTA for an ischaemic foot and died. One case each of bowel ischaemia, cerebrovascular accident and myocardial infarction occurred within 24 h of the angioplasty procedure, but there was no clear causal relationship. Arterial wall dissection or perforation per se was not considered a complication unless it progressed to haemorrhage or vessel occlusion. There were three cases of femoral nerve damage causing sensory loss in the thigh, two of which were permanent. Four hundred and thirty-five procedures were performed in patients with rest ischaemia. Of these, 2.8% developed complications requiring surgery, but only 0.9% required reconstructive bypass surgery. For intermittent claudication 1207 procedures were performed, 0.7% of these developed complications requiring surgery but only 0.5% required reconstructive surgery. These results justify the use of angioplasty in the treatment of intermittent claudication and in poor risk patients with threatened limb loss.

Angioplasty, Balloon↗