Angiosarcoma presenting as an occluded popliteal artery pseudoaneurysm.
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Aged↗
Biomedical subjects
M Dalsing
Publications and source records attributed to M Dalsing.
Carotid body tumors, inheritance, and a high incidence of associated cervical paragangliomas.
BACKGROUND: Current experience with carotid body tumors suggesting a high prevalence of associated cervical paragangliomas prompted this review. PATIENTS AND METHODS: An 8-year retrospective study of patients with carotid body tumors was undertaken, detailing presentation, diagnosis, and treatment. RESULTS: Eleven patients harboring 17 carotid body tumors were discovered. All patients had a neck mass. Seven patients (64%) had bilateral carotid body tumors. Six (55%) reported a positive family history-4 were first-generation relatives, 5 had bilateral tumors, and 3 had other head and neck paragangliomas. Angiography documented 4 associated vagal and 2 glomus jugulare paragangliomas in addition to the carotid body tumors. Precise surgical care limited blood loss to an average of 590 cc. The carotid artery was repaired during 5 resections (29%). Cranial nerve injury occurred in 3 cases, all following vagal body or glomus jugulare resection. Every patient is currently alive, stroke free, and functioning without major disability. CONCLUSIONS: Patients with carotid body tumors have a propensity for multiple head and neck paragangliomas. Angiography is diagnostic. The need for associated paraganglioma resection dramatically increases the risk of cranial nerve injury.
Adult↗
Endothelial seeding of polytetrafluoroethylene femoral popliteal bypasses: the failure of low-density seeding to improve patency.
PURPOSE: We compared 66 seeded polytetrafluoroethylene and 53 autologous vein grafts to determine whether endothelial seeding could improve the patency of polytetrafluoroethylene femoral popliteal bypass grafts and to determine whether endothelial seeding could be performed consistently in multiple institutions. METHODS: Nine surgeons at four hospitals randomized patients to receive either a seeded polytetrafluoroethylene or a vein graft, but if no satisfactory vein (n = 26) existed, an "obligatory" seeded polytetrafluoroethylene graft was used. RESULTS: Scanning electron microscopy confirmed satisfactory initial attachment of endothelium on the discarded ends of the grafts. Patency was compared with the use of log rank analysis and revealed better patency in vein grafts at 30 months (vein = 91.6% +/- 4.1%; seeded polytetrafluoroethylene = 37.8% +/- 9.4%; p = 0.006). Failed grafts revealed anastomotic hyperplasia. CONCLUSIONS: (1) Vein graft patency was better than seeded polytetrafluoroethylene grafts; (2) seeding did not improve patency in below-the-knee bypasses as suggested by pilot studies; (3) the failure of seeded grafts was associated with anastomotic hyperplasia but not with the failure of initial endothelial attachment; and (4) each institution reported similar results.
Blood Vessel Prosthesis↗
Peripheral cardiopulmonary support during high-risk angioplasty.
We report the safety and feasibility of the first three patients using cardiopulmonary bypass support at the Indiana University Medical Center during PTCA. All patients had severe left ventricular dysfunction. Cannulation was performed using 18- or 20-French cannulae of the femoral vessels, either surgically or percutaneously. After heparinization with an activated clotting time of greater than 450 seconds, cardiopulmonary bypass was instituted using the Bard CPS system. Flows ranged from 3.0 to 4.3 L/min. Normasol was used to prime the pump. Blood was retransfused back into the patient at the end of the procedure. Bleeding was a problem in case 1 at the arterial cannulation site and subsequently was corrected for cases 2 and 3. Coronary angioplasties were deemed technically successful. We conclude that high-risk angioplasty can be performed in patients with poor left ventricular function using cardiopulmonary bypass support in the cardiac catheterization laboratory. Further study is indicated.
Aged↗
Recent subsegmental splenic infarction: hypervascular appearance on angiography.
The authors describe a case of a focal splenic infarction with a hypervascular appearance on selective splenic arteriography. This appearance of splenic infarction has never before been reported. Angiographers should be aware of this unusual presentation of splenic infarction when they encounter an unexplained focal hypervascular area.
Angiography↗
Superoxide: a critical oxygen-free radical in ischemic bowel injury.
The radical anions of molecular oxygen reduction, superoxide (O2), hydrogen peroxide (H2O2), and hydroxyl radical (OH), have been implicated in a number of disease processes, including ischemic bowel injury. This report evaluates the effect of superoxide dismutase (SOD), catalase (CAT), dimethyl sulfoxide (DMSO), selenium treatment, and selenium deficiency on bowel integrity and survival in experimental intestinal ischemia in rats. Ischemic bowel injury was produced in 204 male Sprague-Dawley rats (wt 90 to 100 g) by a one-minute occlusion of the superior mesenteric artery (SMA) with a microaneurysm clip. Experiment I treatment animals (n = 20) received 2.5 mg/kg SOD dissolved in Ringer's lactate, and control animals (n = 71) received Ringer's lactate alone. Experiment II treatment animals (n = 16) received 1 cc of 100% DMSO gavage, and control animals (n = 11) received no treatment. Experiment III treatment animals (n = 17) received 25 mg/kg CAT dissolved in phosphate buffered saline, and control animals (n = 11) received nothing. Experiment IV treatment animals (n = 14) received 300 micrograms of sodium selenate by gavage dissolved in deionized water, and control animals (n = 15) receiving nothing. Experiment V treatment animals (n = 20) were raised from 35 to 50 g size on a selenium deficient diet, and control animals were raised (n = 20) on a normal rat chow diet, until they weighed 100 g when ischemia was induced. At seven days, survival, incidence of bowel perforation or necrosis, and length of survival were compared in each experiment between control and treatment groups using chi 2 analysis.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Distal embolization from an unsuspected external iliac artery pseudoaneurysm: diagnosis during urokinase infusion.
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