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Biomedical subjects

C D Kellum

Publications and source records attributed to C D Kellum.

8 recordsLinked to original sources
PubMed1987

The role of radiology in extracorporeal shock wave therapy.

Extracorporeal shock wave lithotripsy was used for the treatment of 1,252 kidneys and ureters with calculi during a 10-month period at the authors' medical center. Before lithotripsy was performed, excretory urography, radiography, renography, computed tomography, and ultrasound studies were done, when necessary, to locate the calculi. Nine calculi in five kidneys could not be fragmented with lithotripsy. Of 895 patients with calculi less than 2.5 cm in diameter, only 13 (1.5%) required interventional procedures to clear the calculi, whereas of 161 patients with calculi greater than or equal to 2.5 cm, 36 (22.4%) required nephrostomies. A column of calculous debris in the mid and distal portions of the ureter (steinstrasse) was seen in 171 instances (13.6%) after lithotripsy; 62% required interventions. The most common intervention required for successful lithotripsy was retrograde ureteral catheterization. Evaluation and treatment of patients with urolithiasis were largely dependent on radiography and excretory urography.

Endoscopy↗
PubMed1986

Isolated injury of the proximal vertebral artery associated with blunt chest trauma.

A patient who had sustained blunt trauma of the chest was admitted for evaluation and treatment. A thoracic aortogram was obtained to exclude mediastinal vascular injury, and an incomplete intimal disruption of the proximal left vertebral artery was found. Transient visual disturbances developed after admission, and the patient was treated by operation and vein patch angioplasty. He recovered without additional neurologic symptoms. The vertebral artery can be divided descriptively into four sections, and each section is commonly associated with particular types of injuries. This is the first reported case of an isolated injury to the proximal extraosseous portion of the vertebral artery caused by distant blunt trauma.

Adult↗
PubMed1986

Pseudoaneurysms complicating pancreatitis: detection by CT.

Complications of pancreatitis such as pseudocyst formation and abscess are well known to radiologists. Secondary formation of pseudoaneurysms has not been emphasized in the radiologic literature. The great morbidity and mortality associated with pseudoaneurysms emphasize the importance of early detection. Three patients are described whose angiographically proved pseudoaneurysms were demonstrated on contrast material-enhanced abdominal CT scans obtained for evaluation of pancreatitis. A homogeneously enhancing structure within or adjacent to a pancreatic pseudocyst or contiguous with a vascular structure should be considered highly suspicious for an associated pseudoaneurysm.

Aneurysm↗
PubMed1986

Extracorporeal shock wave lithotripsy: interventional radiologic solutions to associated problems.

Among 1,500 patients treated with extracorporeal shock wave lithotripsy, 1,300 had calculi less than 2.5 cm in diameter and 200 had calculi of 2.5 cm or larger. Although most patients did well and required no further radiologic intervention, 178 interventional radiologic procedures were performed. Urinary tract obstruction often developed in patients with large stones when the collecting system filled with stone fragments (steinstrasse). Nephrostomy was performed in 5.3% of the total patient population and in 29% of the patients with stones measuring 2.5 cm or more. Only 1.8% of the patients with calculi smaller than 2.5 cm required radiologic intervention. When the obstructed collecting system could not be crossed with conventional angiographic techniques, the stone fragments were removed through a percutaneous nephrostomy tract either by flushing or by suctioning with a pulsating water jet.

Humans↗
PubMed1985

Percutaneous transluminal angioplasty in the region of the aortic bifurcation. The two-balloon technique with results and long-term follow-up study.

Percutaneous transluminal angioplasty of lesions located at the bifurcation of vessels, especially the aortic bifurcation, has been considered contraindicated because of possible occlusion or embolization of the contralateral vessel. With the evolution of angioplasty techniques and the development of new balloon catheters, these lesions can now be successfully treated with the kissing balloon technique. This technique was used to dilate 61 atherosclerotic vascular lesions in 32 patients with vascular insufficiency. The procedure was successful in 58 atherosclerotic stenoses in 30 patients. Because of the high blood flow and large size of these vessels, beneficial clinical results can be anticipated following successful dilatation. Follow-up study, extending for as long as 53 months, suggests the durability of the procedure and that the kissing balloon technique should be considered as a viable alternative to surgery in dilatable lesions of the aortic bifurcation.

Adult↗
PubMed1984

Percutaneous transluminal angioplasty of the renal artery. Results and long-term follow-up.

Percutaneous transluminal angioplasty (PTA) was used to treat 109 patients with 141 renal artery stenoses, including 58 patients in whom medical management was unsuccessful. The initial success rate was 94%. Fifty-five patients had severe diffuse atherosclerosis and 40 had renal insufficiency. Thus far, 36 patients (50 stenoses) have undergone a total of 52 follow-up angiographic studies. Clinical data, including blood pressure response, were obtained in all cases. Only 7 of the 98 hypertensive patients failed to respond to PTA. Of the 11 patients treated primarily for renal insufficiency, 5 improved. Of the 29 hypertensive patients who also had elevated BUN and creatinine, renal function improved in 13. Altogether, 96 patients (88%) benefited from the procedure. Analysis of long-term results suggests that PTA should be the treatment of choice for fibromuscular dysplasia and short, segmental atherosclerotic lesions and could also prove helpful in improving renal insufficiency.

Adolescent↗
PubMed1983

Iopamidol and meglumine diatrizoate: comparison of effects on patient discomfort during aortofemoral arteriography.

Iopamidol was compared with Renografin-60 (meglumine diatrizoate, Squibb) in a controlled, randomized double-blind study of 40 patients undergoing peripheral arteriography for arteriosclerotic occlusive disease to determine which agent caused less discomfort. Each patient was evaluated for objective signs of discomfort and subjective feelings of pain and heat. Monitoring was achieved by multiple physical examinations, chemical tests, electrocardiograms, and intra-arterial pressure recordings. It is concluded that iopamidol is safe and causes significantly less patient discomfort than Renografin-60.

Angiography↗