Biomedical subjects
Publications and source records attributed to J W Husted.
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The use of multihole catheters to achieve longterm antegrade biliary drainage in 43 patients with obstructive jaundice is described. Catheters were positioned with sideholes both above and below an obstruction and continued patency maintained. Better results were obtained using larger diameters and larger sideholes.
Renal venography may be an extremely useful adjunctive diagnostic procedure in selected cases of renal disease. The techniques utilized in renal phlebography are described, and the newer applications of this technique are discussed and illustrated.
Percutaneous transhepatic catheterization of the biliary tree was performed in 23 patients. In 21 the catheter was advanced past an obstructing lesion into the distal common bile duct and duodenum to establish antegrade biliary drainage. The catheter was left permanently in place as a form of endoprosthesis in 5 patients.
A total of 33 renal venograms were reviewed to determine the incidence of radiographically demonstrable valves. Valves were identified in five of 22 left renal venograms and two of 11 right renal venograms. On the right side in both patients the valve was located at the junction of the renal vein with the inferior vena cava. On the left, valves were located in the main renal vein proximal or distal to the gonadal vein and in one patient in a segmental upper pole tributary. These valves are significant because of the technical difficulties they can create during renal venography and their possible usefulness in selecting the site of anastomosis in patients undergoing distal splenorenal shunts.
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Selective arterial infusions of vasopressin have often been successful in controlling arterial bleeding. When bleeding occurs in an area with a dual blood supply through a vascular arcade, situations may arise which can compromise angiographic management. These include: (1) artifacts caused by pressure injections of contrast material inaccurately depicting the usual distribution of blood flow in the arcade; (2) catheter-induced vasospasm altering the flow dynamics through the arcade; (3) vasopressin-induced constriction of the proximal portion of an arcade changing the origin of blood flow to the distal arcade; and (4) proximal occlusion of one limb of an arcade permitting continuation of bleeding through collateral channels. When angiographic techniques fail to control bleeding because of these circumstances, hemostasis may be achieved by treating both limbs of the vascular arcade.
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