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Biomedical subjects

K W Sniderman

Publications and source records attributed to K W Sniderman.

At least 73 records · Page 4Linked to original sources
PubMed1980

Popliteal artery branches: percutaneous transluminal angioplasty.

Percutaneous transluminal angioplasty of the branches of the popliteal artery was performed in six patients, two of whom also had femoropopliteal angioplasty. Dilatation was performed with catheters ranging from 5.5 to 7 French. None of the popliteal branch dilatations was performed with an inflated balloon. Excellent dilatation, as documented by angiography and Doppler ultrasound pressure recordings, was obtained in four cases and moderate and slight improvement in one case each. Two of the four patients with excellent results had prompt healing of toe amputations and are doing well at 19 and 22 months after angioplasty. In the other two patients with excellent results, below-knee amputation was necessary despite patency of the dilated segment in one. In the other patient with initially excellent results, reocclusion occurred 4 months after angioplasty. In the patients who had moderate and slight improvement on angiography and in distal pressures, no significant clinical course change occurred. No patient had clinical deterioration after angioplasty and no significant complications occurred.

Aged↗
PubMed1980

Percutaneous transluminal angioplasty of nonatherosclerotic lesions.

Percutaneous transluminal angioplasty (PTA) was attempted on 16 nonatherosclerotic lesions in 14 patients. Dilatation was initially successful in 4/4 cases with renal artery stenosis due to fibromuscular dysplasia (three) and Takayasu arteritis (one); all patients became normotensive and remain normotensive on no antihypertensive medications, at up to 12 months follow-up. PTA was technically successful in 4/5 transplant renal artery stenosis; these four patients remain normotensive or almost normotensive on no or markedly reduced antihypertensive medications, at up to 14 months followup. Initial success was obtained in 3/3 lesions involving vascular grafts; in one, the patient became and remained asymptomatic for the remaining 5 months he lived; in another, occlusion of the dilated segment and the graft occurred 8 months after PTA; and in the third, symptoms and signs of the limb ischemia returned within 24 hr of PTA. PTA was initially successful in a patient with recurrent celiac artery stenosis after surgery for median arcuate ligament syndrome; she has remained free of symptoms for 18 months. In a patient with three radiation-induced stenoses, PTA was initially successful; this patient is asymptomatic at 20 months follow-up. The medial type of fibromuscular dysplasia dilates most easily, suggesting a concentric stretching and some shearing of the fibrous tissue, which then heals in its dilated state. Intimal fibroplasia may be eccentric, and concentric stretching during dilatation may not be possible, leading to less satisfactory results. Radiation-induced stenosis involves periarterial fibrosis and arterial wall thickening, and the results in PTA of many of these lesions may be less satisfactory than reported here. The responsiveness of graft stenoses will vary with the cause; anastomotic stenoses will probably dilate easily, for they involve either concentric intimal proliferation, or a small degree of periarterial fibrosis; graft stenoses surrounded by dense fibrous tissue may respond initially to PTA, but the long-term results will probably be poor due to recurrent graft constriction.

Adult↗
PubMed1979

Pitfalls in the plain film evaluation of the thoracic aorta: the mimicry of aneurysms and adjacent masses and the value of aortography. Part II. Descending thoracic aorta.

Distinguishing posterior mediastinal and pulmonary masses from aneurysms and tortuosity of the descending thoracic aorta may be difficult, as five such cases illustrate. Both the neoplasms and the aortic aneurysms or tortuosity can compress the same vital mediastinal structures; thus, they may give rise to the same symptoms. Because the plain film findings may also be similar, aortography is essential to their diagnosis.

Aged↗
PubMed1979

Calcified renal cell carcinoma: a clinical, radiographic and pathologic study.

A retrospective review from 1954 to 1977 revealed 17 patients with radiographically calcified renal cell carcinoma. Any calcified renal lesion, regardless of the characteristics of the calcification, must be regarded as suspicious for a malignant neoplasm. Calcified renal cell carcinoma appears to be a biologically distinct subgroup of renal parenchymal tumors. The angiographic diagnosis of these tumors often was difficult since most were either hypovascular or avascular. Most calcified renal parenchymal tumors were relatively large but tended to be localized and histologically well differentiated. These tumors were associated with a predicted 5-year survival rate of 77 per cent.

Adenocarcinoma↗
PubMed1979

The radiologic and clinical aspects of calcified hypernephroma.

The radiologic, pathologic, and clinical findings were reviewed in 18 patients with calcified hypernephroma and 6 with calcified benign renal lesions. Our results suggest: (a) that the pattern of calcification in a renal parenchymal lesion is of little assistance in diagnosis; in this series, many hypernephromas had peripheral curvilinear calcifications, and most benign renal lesions had internal amorphous calcifications; (b) that no distinct angiographic pattern exists in calcified hypernephroma, and a spectrum ranging from avascular to hypervascular may be identified; and (c) that these tumors may behave more benignly than uncalcified hypernephroma (5-year survival 78%).

Abscess↗
PubMed1979

A modified technique for percutaneous insertion of biliary T-tube.

Following percutaneous removal of retained biliary calculi through a t-tube tract, a tube should be reinserted over a guide wire. Reinsertion usually is easy; however, if buckling occurs, a coaxial system consisting of a t-tube over a teflon dilator will give added stiffness, and the t-tube will advance easily into the common bile duct.

Aged↗
PubMed1979

Cinefluoroscopy in evaluating left ventricular contractility and aneurysms.

Cardiac cinefluoroscopy was performed immediately prior to biplane left ventriculography in 113 patients and the findings of two independent observers compared to the angiographically documented state of the left ventricle. The observers' interpretations were correct in 44% and 46% of studies, respectively; there were 41% and 24% false negatives and 24% and 29% false positives. The observers agreed in only 59% of cases. The results show that cinefluoroscopy for evaluation of left ventricular contractility is grossly inaccurate and should not be performed.

Cineradiography↗
PubMed1979

Arteriographic demonstration of spontaneous right coronary artery spasm in a patient with Prinzmetal's angina.

Coronary artery spasm may occur spontaneously during coronary angiography in patients with clinically documented or suspected Prinzmetal's angina. In other patients with Prinzmetal's angina, the spasm can be provoked by the administration of ergonovine. A patient with spontaneous spasm of the right coronary artery during coronary angiography is reported and some considerations for diagnosis and therapy of this entity is offered. Although intraoperative spasm has been reported in the cardiology literature, no such case has been described in the radiology literature.

Angina Pectoris↗
PubMed1978

Treatment of massive hemoptysis by combined occlusion of pulmonary and bronchial arteries.

Massive, life-threatening hemoptysis occurred in a patient with left upper lobe bronchiectasis secondary to old tuberculosis. Selective left bronchial arteriography showed extravasation of contrast medium in the bronchiectatic area. A marked decrease in hemoptysis occurred after selective left bronchial arterial embolization. Complete cessation of bleeding followed the inflation of a Swan-Ganz balloon catheter that had been placed in the left main pulmonary artery.

Aged↗
PubMed1978

Aortic dissection beginning in the abdomen.

Two cases of aortic dissection beginning in the abdominal aorta are presented, and the angiographic and surgical principles are discussed. Every effort must be made to identify the sites of all intimal tears at aortography and to excise or oversew these sites at surgery; otherwise, dissection may continue. If an intimal tear cannot be identified at aortography, we recommend initial conservative therapy unless the patient's clinical condition forces emergency surgery.

Aged↗
PubMed1976

Urethral diverticula in the adult female.

Urethral diverticulum in the adult female is an uncommon lesion which is practically ignored in the radiologic literature. The important symptom is incontinence. Because there is such poor clinical differentiation between stress incontinence, urgency incontinence, and post-void dribbling incontinence, we feel that any patient with incontinence that is not classical stress incontinence or of a neurologic cause should be investigated for urethral diverticulum. Six such patients plus one patient with a false positive panendoscopic examination are presented. Our method of examination with cinefluorography and conventional spot filming is explained. The urethrographic examination was found to be more reliable than the panendoscopic examination. When a discrepancy occurs, further studies are indicated.

Adult↗