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Biomedical subjects

D M Coldwell

Publications and source records attributed to D M Coldwell.

48 records · Page 3Linked to original sources
PubMed1988

Superselective embolization for renal hemorrhage with a new coaxial catheter and steerable guidewire.

We utilized a new commercially available 2.2 French coaxial catheter and steerable guidewire to superselectively catheterize and embolize a small renal artery branch to abolish hemorrhage which was a complication of percutaneous nephrostomy. Because of the superselective technique and small caliber of the vessel occluded, there was no demonstrable loss of global renal function or evidence of significant cortical infarction by laboratory and radionuclide scintigraphic studies.

Aged↗
PubMed1987

Hepatic embolization with an open-ended guide wire.

Experience in four patients indicates the recently developed open-ended guide wire with the steerable mandril is invaluable in the catheterization of tortuous vessels and can be used without a catheter in the embolization of hepatic arteries. A much more dilute suspension of polyvinyl alcohol foam powder was found to be necessary with this wire so that the wire did not become occluded. A suspension of 0.6 mg polyvinyl alcohol foam powder per milliliter of normal saline was found to be optimum.

Adenocarcinoma↗
PubMed1985

Emphysematous cholecystitis as a complication of hepatic arterial embolization.

We describe a case of emphysematous cholecystitis that developed 2 weeks after hepatic arterial embolization. Angiographers should be alert to the possibility of this complication developing under conditions when the cystic artery is not visualized on the post embolization arteriogram while present on the diagnostic study before embolization.

Adenocarcinoma↗
PubMedDate not supplied

Embolization of paraspinal masses.

Arterial embolization is a method of palliative therapy for both primary and metastatic tumors. This treatment is frequently used in the liver and kidney, but has not been previously extended to paraspinal masses. Five patients with recurrent renal cell carcinoma or neurofibrosarcoma underwent palliative embolization for pain or mass effect. All had relief of pain after embolization. Four patients showed change in the mass on follow-up computed tomography scan with one demonstrating tumor shrinkage. Arterial embolization can be an effective method for palliation of pain and mass effect caused by paraspinal masses.

Adult↗
PubMedDate not supplied

Hepatic arterial embolization utilizing a coaxial catheter system: technical note.

A coaxial catheter system using the Tracker Hi-Flow catheter was utilized to perform 38 hepatic arterial embolizations in 20 patients. These embolizations would not have been feasible if the ability to superselectively catheterize the segmental arteries and negotiate tortuous vessels had not been available. This is a valuable technique for use in superselective hepatic arterial embolizations.

Carcinoma↗
PubMedDate not supplied

Internal mammary artery embolization for hepatic tumors.

PURPOSE: To prospectively identify patients with collateral internal mammary artery (IMA) supply to hepatic tumors, and to embolize the IMA as part of palliative hepatic artery embolization (HAE). METHODS: Over a 4-year period, 222 patients were enrolled in an HAE protocol for inoperable liver tumors. All underwent abdominal computed tomography (CT) prior to preembolization diagnostic hepatic arteriography. When anterior subcapsular hepatic tumor was seen on the CT scan, patients underwent IMA arteriography as well. All arteries supplying tumor were embolized. RESULTS: Six patients had anterior subcapsular lesions identified on CT. IMA catheterization revealed that these lesions drew blood supply directly or indirectly from one or both IMAs in all six patients. All IMAs were embolized. CONCLUSION: When an hepatic tumor is identified in an anterior subcapsular location prior to HAE, the IMA should be examined and, if significant tumor supply is demonstrated, these branches should be embolized.

Adult↗
PubMedDate not supplied

Effects of transjugular intrahepatic portosystemic shunts on hepatic metabolic function determined with serial monitoring of arterial ketone bodies.

PURPOSE: To investigate the effects of transjugular intrahepatic portosystemic shunt (TIPS) on hepatic metabolic function by measuring serial arterial ketone body ratio (acetoacetate/-hydroxybutyrate; AKBR). MATERIAL AND METHODS: The arterial blood of 30 TIPS patients was assayed before TIPS, 30 minutes after TIPS, and 24 hours after TIPS for acetoacetate, beta-hydroxybutyrate, and glucose. The authors compared the AKBR values to clinical outcome stratified by Child class, emergent versus elective TIPS, and before-TIPS AKBR value < or = 0.5 versus before-TIPS AKBR value > 0.5. RESULTS: A significant change was noted between the AKBR values obtained before TIPS and values 30 minutes after TIPS (0.76 +/- 0.09 vs 0.61 +/- 0.05, P < .05) and between 30 minutes and 24 hours after TIPS (0.81 +/- 0.10, P < .001), but not between the value obtained before TIPS and that obtained 24 hours after TIPS. The 30-day mortality rate in emergency TIPS patients was 50% compared to 7% in the elective TIPS patients (P < .01). The pre-TIPS AKBR values were significantly suppressed in the emergency TIPS patients compared to the elective TIPS patients (0.56 +/- 0.04 vs 0.99 +/- 0.17, P < .005). The 30-day mortality rate in patients with a pre-TIPS AKBR value < or = 0.5 was 75%, which was significantly higher than the 14% rate in patients with a pre-TIPS AKBR value > 0.5 (P < .01). CONCLUSION: A low pre-TIPS AKBR may be predictive of poor outcome after TIPS. Furthermore, AKBR may be of value in determining the timing for performing an elective TIPS.

Adolescent↗
PubMedDate not supplied

Angiosarcoma. Diagnosis and clinical course.

The findings at radiography, computed tomography and angiography and the clinical course of 30 cases of angiosarcoma were reviewed. The variety of primary sites results in a multitude of findings but the most common finding was that of a hypervascular soft tissue mass seen on CT and angiography. Additional findings of well demarcated cortical defects in long bones were also frequently noted. The general clinical behavior of these aggressive malignant tumors was also reviewed and it was noted that they had a deceptively benign presentation.

Adult↗