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Biomedical subjects

J E Wiedeman

Publications and source records attributed to J E Wiedeman.

6 recordsLinked to original sources
PubMed1988

Special problems after iatrogenic vascular injuries.

Iatrogenic vascular injuries occurring at our institution were reviewed and several special problems not previously well described were found. These include carotid and femoral pseudoaneurysms, occult hemorrhage and knotting of the angiographic catheter. These problems are exemplified in four patient reports to illustrate how appropriate planning of operative approach and adherence to vascular surgical principles can optimize results.

Aged↗
PubMed1986

Minimizing mortality and morbidity from iatrogenic arterial injuries: the need for early recognition and prompt repair.

Seventy-one cases of iatrogenic arterial injury requiring repair at our institution from 1972 through 1984 were retrospectively analyzed. Cardiac catheterization accounted for most of the injuries (62%). Ten injuries (14%) resulted from angiography or percutaneous transluminal angioplasty; four injuries (5.6%) occurred after invasive monitoring devices were inserted. Six injuries (8.45%) stemmed from complications of intra-aortic balloon pump insertion, whereas the remainder occurred during various surgical procedures. Most injuries were in the femoral (42.3%) and brachial (38.1%) locations. Thrombectomy (23.9%) and resection with end-to-end anastomosis (35.2%) were the repairs most commonly performed. Morbidity and mortality were low; only one case resulted in limb loss, and neither of the two deaths resulted from the vascular repair itself. On the basis of our experience, we can make certain recommendations with regard to specific injuries. First, the conservative approach to brachial artery thrombosis occurring after catheterization is early exploration and repair. Second, although most injuries can be managed simply with thrombectomy and primary repair, iliofemoral injuries are more likely to require complex reconstructive techniques. Third, large-bore catheter injuries to the carotid artery require immediate exploration and repair to prevent thrombosis, pseudoaneurysm, and cerebral embolism. Fourth, symptoms of nerve compression after transaxillary arteriography require prompt exploration. Our results indicate that, depending on the site of injury, individualized techniques of varying complexity are required for repair. In general, serious sequelae can be minimized by early recognition, prompt operation, and adherence to sound vascular surgical principles.

Adult↗
PubMed1986

Use of the Hickman catheter for jejunal feedings in children.

A simple, safe method for creating a long term jejunal feeding route using the standard Hickman catheter is described herein. The positive results in pediatric patients suggest that this method would be suitable in selected adult instances.

Abdominal Muscles↗