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Biomedical subjects

C Kerber

Publications and source records attributed to C Kerber.

36 records · Page 2Linked to original sources
PubMed1977

Asymptomatic angiographic occlusion of the internal carotid artery: an indication for emergency endarterectomy.

A 56-year-old man had retinal artery embolization from a carotid artery atheroma. Complete occlusion of the internal carotid artery occurred during cerebral angiography, but the patient developed no acute symptoms of cerebral ischemia. The patient immediately underwent emergency carotid endarterectomy which he tolerated well, and follow-up angiography nine days later demonstrated continued patency. The patient has remained neurologically unchanged.

Arterial Occlusive Diseases↗
PubMed1976

Balloon catheter with a calibrated leak. A new system for superselective angiography and occlusive catheter therapy.

Problems with the use of the diagnostic angiography catheter as a therapeutic tool relate to difficulty in placing the catheter precisely in the desired area and controlling the infusion of the occluding agent. The author describes a soft microcatheter which has been developed to overcome these problems. The catheter ends in a balloon tip and thus can be flow-directed. To overcome the traditional difficulties of flow-guided catheters and the need for a double lumen, a calibrated leak in the balloon allows distal fluid delivery while the balloon remains inflated.

Aged↗
PubMed1976

Pediatric pneumoencephalography with nitrous oxide.

The recent advances in neurodiagnostic procedures have changed pneumoencephalography. Now we must find the smallest lesions and demonstrate accurately their relationships to the ventricular system cisterns and surrounding structures. Complex blurring motion tomography gives this detail, but the pediatric patients are difficult to examine and immobilization during the long exposure needed for tomography frequently compromises the airway. Hypoventilation from sedation and from the radiographic positioning may lead to increased intracranial pressure. By performing pediatric pneumoencephalography under general anesthesia, with nitrous oxide as both an anesthetic agent and as the contrast material, we are able to control patient motion, preserve the child's airway, and prevent hypoventilation. The nitrous oxide, rapidly diffusible, is a good contrast agent, as large volumes can be used and the gas leaves the ventricular system quickly after the discontinuation of the anesthetic. This rapid reabsorption and elimination of the subarachnoid gas may decrease pneumoencephalographic morbidity.

Adolescent↗
PubMed1975

Selective cerebral angiography through the axillary artery.

The femoral artery approach to cerebral angiography has become well accepted. Some patients, however, are not candidates for femoral catheterization because of severe arteriosclerosis. One hundred cerebral angiograms were performed in 88 severely arteriosclerotic patients, using No. 5 French polyethylene catheters and the axillary approach. The technique, degree of success, patient population, and their complications are described. This approach allows selective vertebral and internal carotid artery injections. Only one serious complication occurred, thrombosis of the axillary artery. Because of the time saved, this technique is often preferable to the femoral approach in severely arteriosclerotic patients.

Axillary Artery↗
PubMed1975

Selective carotid angiography in the diagnosis of fibrous histiocytoma. A case report.

Selective carotid angiography is of value in the diagnosis of an orbital fibrous histiocytoma, an uncommon tumor with a high local recurrence rate and frequent distant metastases. The angiogram shows the physical extent of the tumor and also suggests its general microscopic anatomy. Comparison is made with similar angiographic presentations seen in cerebellar hemangioblastomas, glomus tumors, meningiomas, and hemangiopericytomas.

Adult↗
PubMed1975

Presurgical embolization of neurogenic hamartoma in an infant. A case report.

The vessels supplying a rare congenital tumor (neurogenic hamartoma) were deliberately occluded by emboli. This extensive tumor presented both in the oropharynx and in the left middle cranial fossa. Using a 3.7 French catheter, Gelfoam emboli suspended in contrast medium were injected into the vessels of the tumor under fluoroscopic visualization. The once vacular tumor was then removed in two stages with little blood loss.

Brain Neoplasms↗
PubMedDate not supplied

Rapid superselective high-dose cisplatin infusion for advanced head and neck malignancies.

Advances in vascular radiology techniques for superselective arterial infusions and methods to overcome systemic toxicity from high-dose cisplatin chemotherapy encouraged us to reevaluate the effects of rapid regional cisplatin infusion for patients with head and neck malignancies. Twenty patients (17 carcinomas, three sarcomas) received high-dose cisplatin (100-200 mg/m2) by this method. Fifteen of the 17 patients with upper aerodigestive tract carcinoma are part of an ongoing phase I dose escalation of cisplatin with sodium thiosulfate neutralization. Three additional patients with sarcomas were treated with intra-arterial (IA) cisplatin and systemic Adriamycin. Fifty-three IA infusions were performed without any complications. Only minimal toxicity related to the chemotherapy was observed. The overall response rate for previously untreated patients was nine of 10 (90%) [complete response (CR) 67%; partial response (PR) 33%]. The response rate for patients with recurrent disease was five of eight (63%) (CR 20%, PR 80%). The average length of follow-up is 9.5 months and the actuarial survival rate is 56%. Superselective rapid infusion of high-dose cisplatin for patients with advanced head and neck malignancies is feasible, relatively nontoxic, and may have important applications in multimodality therapy, particularly for patients with bulky primary disease.

Antidotes↗
PubMedDate not supplied

Program requirements for residency/fellowship education in neuroendovascular surgery/interventional neuroradiology: a special report on graduate medical education.

BACKGROUND AND PURPOSE: Neuroendovascular surgery/interventional neuroradiology is a relatively new subspecialty that has been evolving since the mid-1970s. During the past 2 decades, significant advances have been made in this field of minimally invasive therapy for the treatment of intracranial cerebral aneurysms; acute stroke therapy intervention; cerebral arteriovenous malformations; carotid cavernous sinus fistulas; head, neck, and spinal cord vascular lesions; and other complex cerebrovascular diseases. Advanced postresidency fellowship programs have now been established in North America, Europe, and Japan, specifically for training in this new subspecialty. METHODS: From 1986 to the present, an ad hoc committee of senior executive committee members from the American Society of Interventional and Therapeutic Neuroradiology, the Joint Section of Cerebrovascular Neurosurgery, and the American Society of Neuroradiology met to establish, by consensus, general guidelines for training physicians in this field. RESULTS: In April 1999, the Executive Committee of the Joint Section of Cerebrovascular Neurosurgery voted unanimously to endorse these training standard guidelines. In May 1999, the Executive Committee of the American Society of Interventional and Therapeutic Neuroradiology and the American Society of Neuroradiology also unanimously voted to endorse these guidelines. In June 1999, the Executive Council of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons unanimously voted to endorse these guidelines. CONCLUSION: The following guidelines for residency/fellowship education have now been endorsed by the parent organization of both the interventional and diagnostic neuroradiology community, as well as both senior organizations representing neurosurgery in North America. These guidelines for training should be used as a reference and guide to any institution establishing a training program in neuroendovascular surgery/interventional neuroradiology.

Curriculum↗
PubMedDate not supplied

Experimental arteriovenous fistula. Creation and percutaneous catherter obstruction with cyanoacrylate.

Arteriovenous fistula models were created of plastic and in dogs, allowing exploration of the intraarterial use of tissue adhesive, isobutyl cyanoacrylate. A delivery system utilizing superselective coaxial catheterization was developed on the model. Carotid artery to external jugular vein shunts constructed in 19 dogs provided a suitable in vivo model. Using varied injection techniques, the shunts were occluded in 17 of 17 treated animals. Three dogs subsequently died because of embolization to the lungs and one carotid artery was occluded. Techniques to avoid these complications were devised. Refinement of the intraarterial use of these adhesives will offer us another mode of treatment of vascular abnormalities.

Angiography↗