Biomedical subjects

B L McCroskey

Publications and source records attributed to B L McCroskey.

23 records · Page 2Linked to original sources

PubMed1987

Intraoperative hypogastric artery embolization for life-threatening pelvic hemorrhage: a preliminary report.

Percutaneous pelvic embolization has become a useful adjunct in the management of life-threatening hemorrhage from pelvic trauma. However, this approach may be preempted by the need for emergency laparotomy. The surgeon is then confronted with a hemodynamically unstable patient with an expanding hematoma in the face of other life-threatening injuries. Bilateral hypogastric artery ligation has failed in this scenario due to extensive collateralization of the pelvic circulation. We present our experience with intraoperative hypogastric artery embolization used in the management of four patients, and review the available literature on the subject.

Embolization, Therapeutic↗

PubMed1987

Venous bullet embolism: rationale for mandatory extraction.

Venous missile embolism is a rare complication of penetrating trauma which poses controversial management options. We report a case of hepatic vein bullet embolism treated by percutaneous transvenous basket relocation and extraction via femoral vein cutdown. A review of 102 reported bullet emboli since 1930 indicates that the morbidity of a retained projectile is substantial (25%), while removal using modern techniques has few complications. Salient features of early extraction include: 1) prevention of proximal migration, 2) transvenous relocation of the missile to an accessible vein, and 3) peripheral surgical removal. Delayed recognition of an asymptomatic bullet embolus demands further judgment in guiding selective operative removal. A management scheme based on time of recognition, patient status, and embolus characteristics is presented for this unusual problem.

Adult↗

PubMed1985

Success of profundoplasty: the role of the extent of deep femoral artery disease.

A review of 64 profundoplasties performed in conjunction with inflow procedures for multilevel vascular occlusive disease of the lower extremity revealed that the extent of deep femoral artery disease had a strong influence on results. Profundoplasty for proximal deep femoral artery disease resulted in an 80 percent success rate when carried out for claudication, and an approximately 65 percent success rate for limb salvage and in limbs with poor runoff. In contrast, profundoplasty for diffuse or distal deep femoral artery diseases resulted in a 62 percent success rate for claudication and decreased to approximately 20 percent for limb salvage or in extremities with poor runoff.

Adult↗

PubMed1985

Ultrasonographic and angiographic evaluation of polytetrafluoroethylene aortic bifurcation grafts.

Arterial reconstruction in 50 consecutive male patients with aortoiliac aneurysmal or occlusive disease was performed with PTFE bifurcation grafts. Follow-up intervals ranged from 1 to 39 months. All patients were evaluated by physical examination at 19.5 +/- 1.3 months. In addition, 46 patients were evaluated by ultrasonography at 18.2 +/- 1.2 months, 19 by angiography at 19.8 +/- 2.2 months, and 4 by computerized axial tomography at 21.5 +/- 5.2 months. Intraluminal thrombus or pannus was found in one graft in a patient with compromised outflow, but all graft limbs were patent. There were no accumulations of perigraft fluid, graft dilatations, or anastomotic aneurysms. The results of this study provide support for the continued use of PTFE bifurcation grafts for aortic reconstruction.

Aneurysm↗

PubMed1983

Aortoiliac reconstruction combined with nonvascular operations.

Seventy-six patients with aortoiliac reconstruction and associated intraabdominal procedures were compared with 445 patients with aortoiliac revascularization alone to provide information about the associated morbidity and mortality of adding a nonvascular procedure to aortic reconstruction. Patients with aortoiliac reconstruction for limb salvage had a significant increase in complications when an abdominal procedure was performed in association with aortoiliac reconstruction (66 percent versus 14 percent, p less than 0.01). Additionally, patients with elective aortoiliac reconstruction had a significant increase in mortality when an abdominal procedure was performed in addition to aortoiliac reconstruction (9 percent versus 3 percent, p less than 0.01). A small bowel obstruction and a pancreatic pseudocyst occurred as a direct result of the associated abdominal procedure. None of the deaths could be directly attributed to a concomitant abdominal procedure. The demonstration of an increase in morbidity and mortality with the addition of nonvascular procedures to aortoiliac reconstruction, even though certain subgroups of patients underwent aortic revascularization, suggest that the surgeon must carefully weigh the benefits and risks before combining vascular and nonvascular operations.

Adult↗