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Biomedical subjects

G L Pride

Publications and source records attributed to G L Pride.

13 recordsLinked to original sources
PubMed2001

Transluminal stent-assisted angiplasty of the intracranial vertebrobasilar system for medically refractory, posterior circulation ischemia: early results.

OBJECTIVE: Symptomatic vertebrobasilar artery stenosis portends a poor prognosis, even with medical therapy. Surgical intervention is associated with considerable morbidity, and percutaneous angioplasty alone has demonstrated mixed results, with significant complications. Recent advances in stent technology have allowed for a novel treatment of symptomatic, medically refractory, vertebrobasilar artery stenosis. We report on a series of patients with medically refractory, posterior circulation stenosis who were treated with transluminal angioplasty and stenting at two medical centers in the United States. METHODS: A retrospective analysis of data for 11 consecutive patients with symptomatic, medically refractory, intracranial, vertebral or basilar artery stenosis was performed. All patients were treated with percutaneous transluminal angioplasty and stenting. Short-term clinical and angiographic follow-up data were obtained. RESULTS: Among 11 patients who were treated with stent-assisted angioplasty of the basilar or vertebral arteries, there were three periprocedural deaths and one delayed death after a pontine stroke. Other complications included a second pontine infarction, with subsequent residual diplopia. The remaining seven patients (64%) experienced symptom resolution and have resumed their preprocedural activities of daily living. Angiographic follow-up examinations demonstrated good patency of the stented lesions for five of seven survivors (71%); one patient exhibited minimal intrastent intimal hyperplasia, and another patient developed new stenosis proximal to the stent and also developed an aneurysm within the stented portion of the basilar artery. The last patient exhibited 40% narrowing of the treated portion of the vessel lumen. CONCLUSION: Recent advances in stent technology allow negotiation of the proximal posterior circulation vasculature. Although the treatment of vertebrobasilar artery stenosis with angioplasty and stenting is promising, long-term angiographic and clinical follow-up monitoring of a larger patient population is needed.

Adult↗
PubMed2001

Rupture of intracranial aneurysms during endovascular coiling: management and outcomes.

OBJECTIVE: In this study, the incidence, etiologies, and management with respect to clinical outcome of patients with iatrogenic aneurysmal rupture during attempted coil embolization of intracranial aneurysms are reviewed. METHODS: A retrospective analysis was conducted of 274 patients with intracranial aneurysms treated with Guglielmi detachable coils over a 6-year period from 1994 to 2000. Patient medical records were examined for demographic data, aneurysm location, the number of coils deployed preceding and after aneurysmal rupture, the etiology of the rupture, and the clinical status on admission and at the time of discharge. RESULTS: Of 274 patients with intracranial aneurysms treated with coil embolization, six (2%) had an intraprocedural rupture. Of these six, two were women and four were men. The mean age was 67 years (range, 52-85 yr). Mean follow-up time was 8 months (range, 0-25 mo). Aneurysmal rupture resulted from detachment of the last coil in three patients, detachment of the third coil (of four) in one patient, and insertion of the first coil in another patient. In one patient, the aneurysmal rupture was a result of catheter advancement before detachment of the last coil. The Glasgow Outcome Scale score at last follow-up examination was 1 in two patients, 2 in two patients, and 5 in two patients. CONCLUSION: The rate of rupture of aneurysms during coil embolization is approximately 2 to 4%. The clinical outcome may be related to the timing of the rupture and the number of coils placed before rupture. If extravasation of contrast agent is seen, which suggests intraprocedural rupture, further coil deposition should be attempted if safely possible.

Aged↗
PubMed2000

Safety of MR scanning in patients with nonferromagnetic aneurysm clips.

The purpose of this study was to report our surveillance of patients with nonferromagnetic aneurysm clips (NFAC) who have undergone magnetic resonance imaging (MRI). Forty-six patients with NFAC underwent MRI over a 7-year period. Medical records were studied for evidence of subjective or objective clinical findings as a result of the MRI scan. In two patients with subjective complaints, computed tomograms (CT) were reviewed and patient interviews conducted. No significant neurologic signs or longterm symptoms were experienced. Two patients did not complete their MRI scans due to transient unilateral head pain in one and head "pressure" in another. CT scans in these patients demonstrated no evidence for hemorrhage or visible change in clip position. We documented no objective adverse outcome of patients undergoing MRI with NFAC, confirming that MRI can be performed safely in patients with nonferromagnetic aneurysm clips. The cause of subjective complaints in two of our patients is unknown.

Adult↗
PubMed2000

Endovascular problem solving with intravascular stents.

BACKGROUND AND PURPOSE: Intravascular stents are being used with increasing frequency in interventional neuroradiology. They provide the potential to expand the therapeutic capabilities of the endovascular therapist and stand to revolutionize endovascular intervention within both the intracranial and extracranial vessels. We present our application of stent technology to further the understanding of endovascular rescue from procedural complications and the solving of complex clinical problems. METHODS: Three patients underwent unplanned placement of intravascular stents. In two patients a stent was used to provide stabilization of an irretrievable intravascular device; in the third patient a stent was used to provide a scaffolding for proximal external carotid sacrifice. RESULTS: Stent deployment was successful in all patients. The intravascular devices stabilized by stent placement included unraveled fragments of a Guglielmi detachable coil (GDC) and a partially deployed coronary stent. Proximal external carotid sacrifice was achieved with the aid of a stent in one patient to control hemorrhage from recurrence of laryngeal cancer. No periprocedural neurologic complications were encountered. Six-month follow-up angiography in one patient showed only minimal myointimal hyperplasia induced by stent-stabilized GDC fragments adjacent to the internal carotid vessel wall. CONCLUSION: Stents can be used to provide stabilization of irretrievable intravascular devices or as a scaffolding for proximal vessel sacrifice. These applications may allow endovascular rescue of procedural complications and solve unique clinical problems.

Aged↗
PubMed1999

Percutaneous transluminal angioplasty and stenting of midbasilar stenoses: three technical case reports and literature review.

OBJECTIVE AND IMPORTANCE: Symptomatic basilar artery stenosis is a highly morbid disease process. Recent technological and pharmaceutical advances make endovascular treatment of this disease process possible. CLINICAL PRESENTATION: We report three cases of patients with a symptomatic basilar artery stenosis despite anticoagulation. INTERVENTION: All patients were successfully treated with a flexible coronary stent and perioperative antiplatelet medications without incident. Poststenting angiography demonstrated a normal-caliber artery with patent perforators. In one case, a poststenting cerebral blood flow study revealed improved perfusion. CONCLUSION: A new generation of stents and balloons makes access to intracranial intradural arterial pathological abnormalities possible. Such devices may well revolutionize the management of ischemic and hemorrhagic intracranial cerebrovascular disease.

Aged↗
PubMed1990

Treatment of large lower genital tract condylomata acuminata with topical 5-fluorouracil.

Nineteen women with extensive condyloma acuminatum involvement of the lower female genital tract were treated with seven-day courses of topical 5-fluorouracil. The complete response rate was 68.4%. One patient completed only two courses; she underwent vaginal delivery after cryosurgical destruction of the remaining lesions. Her recurrent lesions in the immediate postpartum period were controlled with additional courses of topical 5-fluorouracil. Only one patient was totally unresponsive to treatment with topical 5-fluorouracil.

Administration, Topical↗
PubMed1982

Topical 5-fluorouracil treatment of transformation zone intraepithelial neoplasia of cervix and vagina.

The authors present preliminary findings in 11 unselected patients with upper vaginal and/or cervical transformation zone intraepithelial neoplasia treated with a 5% topical 5-fluorouracil (5-FU) cream. Only 6 of 11 patients were found to be cured of disease when subsequently evaluated histologically by conization biopsy and/or hysterectomy. Although further clinical trials using differing concentrations and/or more prolonged exposure to the drug may be warranted, the authors cannot recommend topical 5-FU as a replacement for standard outpatient therapy for upper vaginal and/or cervical intraepithelial neoplasia.

Administration, Topical↗
PubMed1979

Primary invasive squamous carcinoma of the vagina.

Forty-three cases of primary vaginal squamous cell cancer were treated at the University of Wisconsin Hospital between 1956 and 1971. These cases comprised 1.2% of patients admitted to the University Hospital with female genital tract cancer. Evidence is presented to support a modification of the currently accepted FIGO staging system for vaginal carcinoma (Stage II disease). Radiation therapy using both external beam and brachyradium equivalents or interstitial implantation of suitable isotopes was an effective method for the treatment of patients having early and locally advanced invasive vaginal cancer. The 5-year absolute survival rate for the entire series was 37.2%. Absolute survival rate by modified FIGO clinical staging was 66% for Stages I and IIA, 31% for Stage IIB, 25% for Stage III, and 0% for Stage IV.

Adult↗
PubMed1977

Carcinoma of vagina 10 or more years following pelvic irradiation therapy.

Gynecologic cancer records of 4,238 patients treated between 1956 and 1974 were reviewed. Sixteen patients developed noeplasia in the cervix or vagina 10 or more years following pelvic irradiation. Three patients had squamous carcinoma in situ; the other 13 patients had invasive squamous cancer involving the upper vagina. Only 1.26 per cent of invasive carcinoma of the cervix treated by radiation therapy from 1956 to 1966 presented with a late or recurrent or new primary tumor involving the vagina or cervix 10 or more years after primary treatment. The authors conclude that the risk of developing radiation-induced carcinoma in the upper vagina or cervix following pelvic irradiation is low. Follow-up Pap smears are indicated for all patients treated for cervical or vaginal malignancies by radiation therapy in order to detect vaginal neoplasia as well as recurrent carcinoma of the cervix.

Adult↗
PubMed1977

Nonpuerperal uterine inversion. Report of an unusual case.

Total nonpuerperal inversion of the uterus is rare. A case caused by a fundal leiomyoma is presented. It is the first reported case that included the complications of acute obstruction of the urethra from upper vaginal inversion and bilateral hydronephrosis from traction of the prolapsed inverted uterus on the distal ureters. The various complications and the management of the condition are discussed.

Female↗
PubMed1976

Müllerian adenosarcoma of the uterine cervix with heterologous elements: a light and electron microscopic study.

A müllerian adenosarcoma with heterologous elements having the gross appearance of a sarcoma botryoides occurred in the uterine cervix of a 14-year-old girl. Histologically, the tumor was composed of an admixture of benign-appearing glands and a sarcomatous stroma, the latter containing areas of undifferentiated sarcoma and endometrial stromal sarcoma, as well as heterologous elements consisting of rhabdomyosarcoma and hyaline cartilage. No malignant epithelial component was observed. The distribution of benign müllerian-type glands throughout the tumor simulated a malignant mixed müllerian tumor in appearance. Ultrastructural studies of the stromal elements of the neoplasm suggest origin from primitive müllerian stroma, and the glands have features of primitive müllerian epithelium. This study supports the concept that the malignant mixed müllerian tumor and related müllerian sarcomas originate from a common undifferentiated multipotential müllerian stem cell.

Adolescent↗