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Biomedical subjects

F W Sanchez

Publications and source records attributed to F W Sanchez.

12 recordsLinked to original sources
PubMed1986

Transcatheter control of postpolypectomy hemorrhage.

Intraarterial vasopressin infusion of the inferior mesenteric artery was used in the treatment of 2 patients with massive hemorrhage following colonoscopic polypectomy. Both patients had multiple medical problems and were considered to be very-high-risk candidates for emergency surgery. Arteriography readily demonstrated the site of bleeding, and vasopressin infusion effectively controlled the hemorrhage in both patients without complication. Angiographic management allowed elective colonic resection 1 month later in 1 patient and prevented surgery in the other who has not bled again in the 6 months following the procedure. The role of arteriography in the management of postpolypectomy hemorrhage is discussed.

Aged↗
PubMed1986

Transcatheter treatment of myelomatous AV shunting causing high-output failure.

Intraarterial digital subtraction arteriography (DSA) was performed in a 39-year-old man with multiple myeloma, high-output congestive heart failure unresponsive to correction of anemia, and a pelvic bruit suspicious for an arteriovenous malformation. DSA revealed extensive neovascularity of all the visualized skeletal structures with rapid arteriovenous shunting in the pelvis. Temporary embolization of both hypogastric arteries with Gelfoam and autologous clot produced immediate and dramatic clinical relief of the shortness of breath, orthopnea, and hyperdynamic circulation. Following return of symptoms, repeat permanent occlusion with Ivalon and Gianturco coils produced minimal clinical response, but a decrease in cardiac output from approximately 23 L/min to 19 L/min. The etiology of congestive heart failure in myeloma, the implications of the use of intraarterial DSA, and the arteriographic findings in myeloma are discussed.

Adult↗
PubMed1985

The distinctly visible right upper lobe bronchus on the lateral chest: a clue to adolescent cystic fibrosis.

Radiographic differentiation between cystic fibrosis and asthma presenting in teenagers and young adults can be difficult. Many patients with a late presentation of cystic fibrosis display minimal changes on a chest radiograph. However, a large majority (90%) of cystic fibrosis patients with an essentially normal PA chest radiograph will have a distinctly outlined orifice of right upper lobe bronchus on a lateral chest film as opposed to a small number of asthmatics (25%) or normal patients (18%). This observation correlates well with the pathologic finding that the initial pulmonary involvement in cystic fibrosis is typically in the right upper lobe in adolescents. Teenage or young adult patients presenting with a history of repeated respiratory infections, asthma-like symptoms and a distinctly visible right upper lobe bronchus on a lateral chest film should be sweat-tested to exclude cystic fibrosis.

Adolescent↗
PubMed1985

Hemorrhagic renal angiomyolipoma: superselective renal arterial embolization for preservation of renal function.

A 35-year-old woman with tuberous sclerosis and known bilateral renal angiomyolipomas presented with shock due to massive hematuria arising from the left kidney. The cause of bleeding was diagnosed angiographically as arising from a left upper pole renal artery aneurysm within the tumor. Cessation of bleeding and clinical stabilization occurred without deterioration of renal function after superselective embolization of the dorsal segmental renal artery with a single 5-mm Gianturco coil.

Adult↗
PubMed1985

Embolotherapy of a mycotic pseudoaneurysm of the internal mammary artery in chronic granulomatous disease.

We report a case demonstrating an unusual and previously unpublished complication of chronic granulomatous disease (CGD), that is massive hemorrhage from a mycotic pseudoaneurysm of the left internal mammary due to invasive Aspergillus fumigatus of the anterior chest wall. This brief report further illustrates the angiographic diagnosis and embolotherapeutic control of a mycotic pseudoaneurysm of the internal mammary artery.

Adolescent↗
PubMed1985

Hemiazygous continuation of a left inferior vena cava: misleading radiographic findings in chest trauma.

A widened mediastinum was found on chest radiography following blunt chest trauma. Aortography alone could not adequately determine the etiology of the radiographic findings; on computed tomography (CT) benign mediastinal widening was confirmed owing to accessory hemiazygous continuation of a left inferior vena cava (IVC), with communication to the left brachiocephalic vein through an enlarged left superior (highest) intercostal vein. This unusual anatomic variant and its radiographic findings are reviewed, as well as the complementary role of CT in the evaluation of the traumatized thoracic aorta and mediastinum.

Aortography↗
PubMed1985

Hemodynamics of portal blood flow shown by CT portography. Work in progress.

Computed tomography and arterial portography were combined in 12 patients for studies of the anatomy and hemodynamics of the portal venous system. This technique was found to be more sensitive than conventional venous-phase angiograms of the superior mesenteric and splenic arteries for evaluation of the anatomy of the portal venous system and extent of thrombosis in patients with cavernous transformation and also facilitated recognition of subtle evidence of hepatofugal flow and portosystemic shunts. CT portography can be employed when conventional angiograms fail to show the portal vein adequately.

Adult↗
PubMedDate not supplied

Direct percutaneous embolization of a postembolectomy pseudoaneurysm.

A case of direct percutaneous embolization of a large pseudoaneurysm of the posterior tibial artery is presented. The pseudoaneurysm developed following thrombectomy of an occluded femoropopliteal bypass graft with a Fogarty balloon catheter. Two needles were used: a 19-gauge needle to perform embolization and a 22-gauge needle for contrast injection. The two-needle technique allowed rapid, safe embolization with precise angiographic control of the embolization procedure.

Aged↗