Biomedical subjects

C W Pulliam

Publications and source records attributed to C W Pulliam.

3 recordsLinked to original sources

PubMed1991

Venous duplex scanning in the diagnosis and treatment of progressive superficial thrombophlebitis.

Venous duplex scanning, employing both B-Mode imaging and Doppler waveform analysis, is a valuable noninvasive technique for the evaluation of venous disorders of the lower extremities. During the past three years, 442 venous duplex scans were performed in our laboratory, evaluating both the deep and superficial venous systems. Sixty-four scans revealed deep venous thrombosis; twenty studies revealed superficial thrombophlebitis. A subgroup of six studies revealed progressive thrombophlebitis approaching or involving the deep venous system. Three of these six studies documented progression of superficial thrombophlebitis extending into the deep venous system, producing limited deep venous thrombosis. All six patients were treated with venous excision and local venous thrombectomy. None of the patients developed deep venous thrombosis on follow-up venous duplex scans. We conclude that venous duplex scanning is a valuable noninvasive method in the detection of progressive superficial thrombophlebitis. Therefore, prompt therapy may prevent the development of deep venous thrombosis and its sequelae. Additionally, venous duplex scanning provides a method for noninvasive follow-up of the results of therapy.

Adult↗

PubMed1988

Reoperative carotid surgery.

Fourteen patients underwent carotid reoperation for symptomatic recurrent carotid stenosis after previous ipsilateral carotid endarterectomy. Eight of these patients presented with focal transient ischemic attacks, two with strokes, and four with vertebrobasilar insufficiency. Recurrent symptoms in eight patients were similar to those prompting the initial carotid endarterectomy. Symptoms recurred early after previous carotid endarterectomy in 2 patients and late in 12 patients. Eleven patients underwent repeat endarterectomy and carotid patch angioplasty, two patients underwent patch angioplasty alone, and one patient underwent carotid artery replacement with a vein graft. Persistent or recurrent focal symptoms referable to the reoperated carotid artery were not present during follow-up (mean 27.4 months, range 4 to 79 months). Vertebrobasilar symptoms were relieved by carotid reoperation in each patient. Although the natural history of asymptomatic postoperative carotid restenosis is unknown, reluctance to reoperate on symptomatic patients is unwarranted, since carotid reoperation can be performed safely with the expectation that recurrent focal and nonfocal vertebrobasilar symptoms will be relieved.

Aged↗

PubMed1985

Subclavian vein catheterization.

Massive fluid replacement is occasionally useful for resuscitation of severely injured patients. The use of MAST garment and the inability to obtain peripheral intravenous access may necessitate the use of infraclavicular subclavian cannulation. Two modifications of the standard subclavian technique have been described which enable quick access for infusion of large fluid volume and autotransfusion. The first involves the placement of multiple catheters in the same vein. The second method utilizes a modified Seldinger technique to place an 8 F. Swan-Ganz introducer into the subclavian vein. Complications are similar to those encountered when the standard subclavian technique is utilized.

Abdominal Injuries↗