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A M Belli

Publications and source records attributed to A M Belli.

79 records · Page 5Linked to original sources
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The role of transradial diagnostic angiography.

PURPOSE: To evaluate the use of 4 Fr radial artery catheters as an alternative to both transbrachial and transfemoral approaches. METHODS: Seventy examinations were performed via the transradial route using 4 Fr 130-cm-long pigtail catheters. Prior to puncture the radial artery was assessed with pulse oximetry to ensure that it did not contribute the dominant blood supply to the hand. Patients were reassessed for complications within 24 hr of the procedure. RESULTS: Acceptable images were obtained in femoral arteriography, arch aortography, and selective carotid studies. In three of six renal arteriograms, images were suboptimal. There was a total technical failure rate of 5.7%. Significant complications were encountered in 4.3%, but no hand ischemia occurred. CONCLUSION: The transradial route for arteriography is easy to learn and has a low complication rate. It is a reasonable alternative approach to transfemoral arteriography for true outpatient peripheral angiography and in cases where the transfemoral route is not feasible, though it did not prove satisfactory for renal arteriography in hypertensive patients.

Adult↗
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Distal venous arterialization for lower limb salvage: angiographic appearances and interventional procedures.

Approximately 14%-20% of patients with critical lower limb ischemia are unsuited for distal arterial reconstruction and face major distal amputation. Distal venous arterialization is a unique procedure in which the venous bed is used as an alternative conduit for perfusion of peripheral tissues. Eighteen patients with stage IV Fontaine critical lower limb ischemia underwent venous arterialization. Preoperative angiographic findings confirmed the absence of any below-knee continuous arterial vessels. The most distal satisfactory artery was used for proximal bypass anastomosis, and venous valves were destroyed with Parsonnet probes, cutting balloons, Fogarty catheters, and valvulotomes under radiologic guidance. All patients underwent intra- and postoperative angiography of the venous grafts and the distal venous bed. Primary and secondary graft patencies were 66% and 72%, respectively, at a mean follow-up of 25 months. The limb salvage rate was 83% overall and 75% at 2-year follow-up. Vascular imaging is essential in selecting and following up patients and in determining the appropriate intraoperative procedure.

Aged↗
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Evaluation of the pullback atherectomy catheter in the treatment of lower limb vascular disease.

PURPOSE: To evaluate prospectively the Pullback Atherectomy Catheter (PAC) in terms of its technical success and 1-year patency in the treatment of lower limb vascular disease.M ETHODS: Thirty-nine PAC procedures were performed in 34 patients to treat atherosclerotic disease (occlusive in 51%) of the femoropopliteal arteries, including four cases of graft neointimal hyperplasia and three dissection flaps. Follow-up was by ankle-brachial indices at 24 hr and 1 month, and arteriography at 6 and 12 months. RESULTS: Technical success was achieved in 38 of 39 procedures (97.4%). There was a reduction in mean stenosis from 89.4% to 12.1%, but 69.2% of procedures required additional balloon dilatation to achieve an adequate arterial lumen. Complications followed 15.4% of procedures, a third of which required surgery. CONCLUSION: The PAC is an easy and relatively safe catheter to use, but does not provide a satisfactory arterial lumen without additional percutaneous transluminal angioplasty (PTA). It proved to be effective, however, in the treatment of graft neointimal hyperplasia and in the resection of obstructive intimal flaps following PTA.

Aged↗