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Biomedical subjects

J W Yedlicka

Publications and source records attributed to J W Yedlicka.

30 records · Page 2Linked to original sources

The inferior vena cava clip. The percutaneous approach.

Pulmonary embolism in high-risk patients may be minimized by surgical inferior vena cava (IVC) clipping or by the insertion of caval filters. A percutaneous clipping technique was developed that narrows the cava while allowing caval patency. The caval clip is inserted through a percutaneous translumbar approach under fluoroscopic control. Nine dogs underwent percutaneous translumbar caval clip placement without complications. Three of four dogs, followed-up for 5 to 19 weeks by angiography and caval pressure measurements, showed caval patency. This technique eliminates the risks of surgical IVC clip placement and risks from the insertion of intravascular foreign bodies such as filters.

Angiography↗

Therapeutic embolization: enhanced radiolabeled monitoring.

Radiolabeling of Ivalon (polyvinyl alcohol sponge) particles permits localization of injected particles during embolization through the use of a portable gamma camera and provides a means to prevent potentially fatal complications such as pulmonary embolization. A more efficient technique of labeling Ivalon particles with technetium-99m sulfur colloid was developed. An increase in labeling efficiency allowed more accurate determination of the distribution of injected Ivalon particles. Scanning electron microscopy demonstrated the stability of the Ivalon particles during this new labeling process. Two patients with arteriovenous malformations underwent therapeutic embolization with radiolabeled Ivalon particles; gamma camera imaging of the lesion and chest was performed throughout the procedure.

Adult↗

Retrograde left atrial catheterization.

Catheterization of the left atrium can provide valuable information about both congenital and acquired heart disease. The traditional approach to examination of the left atrium has been the transseptal route, which has occasionally been associated with serious complications. A method of retrograde left atrial catheterization has been developed that is performed with a modified standard catheter. The technique was tested in five dogs and was easy and safe to perform.

Animals↗

Computed tomography of superior vena cava obstruction.

Which imaging procedure is best for the diagnosis of the superior vena cava (SVC) syndrome is subject to considerable debate. Available imaging procedures include the plain chest film, SVC phlebography, scintiangiography, digital phlebography, CT digital phlebography, and CT. In our experience the combined technique of contrast enhanced CT axial images, followed by a CT digital phlebogram, is the most informative, cost-effective, and least invasive method available.

Humans↗

The biocompatibility of compressed collagen foam plugs.

The tissue reaction to reexpanded, purified bovine collagen sponge placed percutaneously into the lung, pleural space, liver, kidney, and muscle was studied in dogs and rabbits. In addition, the biocompatibility and radiopacity of tantalum-treated collagen foam plugs was examined. No adverse effects were found. We believe that collagen plugs may be of use in occluding needle tracts from biopsy sites to prevent complications such as bleeding or pneumothoraces.

Animals↗

The incidence of myocardial bridges in heart transplants.

Coronary angiograms of 64 heart transplant patients were reviewed to determine the incidence of myocardial bridges. In 33% of the patients, myocardial bridges were detected, almost exclusively across the midportion of the left anterior descending coronary artery. The incidence is higher than previously reported in the literature and is thought to be related to increased stiffness and hypertrophy of the myocardium, which facilitates angiographic detection of myocardial bridges in the transplanted heart.

Adult↗

Acute clot-trapping efficiency in dogs with compacted versus elongated wires in bird's nest filters.

PURPOSE: The clot-trapping efficiency of the Bird's Nest filter was studied in dogs with the stainless steel wires in a compacted versus fully elongated configuration. MATERIALS AND METHODS: Bird's Nest filters were placed infrarenally with the wires compacted in 10 dogs and with the wires elongated in an additional 10 dogs. The dogs were separated into two groups, five dogs with each wire configuration in each group. In group 1, 10 unlabeled 6 x 30-mm blood clots were injected into the inferior vena cava. In group 2, six 6 x 10-mm, four 6 x 15-mm, and four 6 x 30-mm labeled clots were introduced. RESULTS: In group 1, clot-trapping efficiencies were 82% for the compacted versus 86% for the elongated configuration, as seen on serial cavograms and pulmonary angiograms. In group 2, clot-trapping efficiencies were 90% for the compacted versus 97% for the elongated configuration, as seen at fluoroscopy. Clot size did not affect trapping efficiency. CONCLUSION: Acute clot-trapping efficiency of Bird's Nest filters did not differ when the wires were in a compacted versus elongated configuration. This study suggests that placement of a Bird's Nest filter in the elongated configuration may be satisfactory and may not indicate placement of a second filter.

Animals↗

Chronic iliac artery occlusions: primary recanalization with endovascular stents.

PURPOSE: The authors describe treatment of chronic iliac artery occlusions with primary stent placement without prior thrombolysis or angioplasty. PATIENTS AND METHODS: Eight patients with chronic iliac artery occlusions (six men and two women) underwent primary stent placement without prior use of thrombolytic agents or angioplasty. Palmaz stents were placed in seven patients and a Wallstent device was placed in one. RESULTS: In all patients, revascularization was successful without residual stenoses or pressure gradients. There was no angiographic evidence of distal embolization. CONCLUSION: Primary stent placement for chronic iliac artery occlusions without prior thrombolysis or angioplasty appears to be safe and efficacious and is potentially cost effective.

Adult↗