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Biomedical subjects

M Unni

Publications and source records attributed to M Unni.

12 recordsLinked to original sources
PubMed2005

Mycobacterium fortuitum bacteraemia in an immunocompromised patient.

A case of Mycobacterium fortuitum bacteraemia in an immunocompromised patient confirmed by four positive serial blood cultures is reported here. The patient was a known case of acute lymphoblastic leukemia (ALL) on intensive chemotherapy. The source of bacteraemia was most probably a peripherally inserted vascular catheter. After initiation, of treatment with amikacin to which the strain was sensitive and clarithromycin and removal of the central line the patient's fever defervesced and repeat blood cultures were negative. This is the first time we have encountered an immunocompromised patient with M. fortuitum septicaemia in our hospital. The possibility of an infection with rapidly growing mycobacteria is important to consider when conventional organisms are not isolated in culture especially in the context of patients with malignancy.

Adult↗
PubMed1994

Angiographic analysis and results of endovascular therapy of aneurysm of vein of Galen.

Angioarchitecture of the aneurysmal malformation of the vein of Galen in 9 patients is analysed. An arterial maze arborised directly into the vein of Galen in 6 patients. Direct fistulous communication from one or two pedicles was noted in three children. Unilateral choroidal arterial contribution via an eccentric cul-de-sac in two infants suggested embryonic involvement of the ipsilateral internal cerebral vein along with the median prosencephalic vein of Markowski. Unusually, a sylvian branch of the middle cerebral artery drained directly into the basal vein of Rosenthal which in turn communicated to the aneurysm of vein of Galen in another patient. Two adult patients had curvilinear rim calcification of the venous sac with rapid circulation. All but two showed venous sinus anomalies. Two children had prior shunt surgery at the referring hospitals. The pathophysiology of hydrocephalus and the possible consequences of shunt, question the need for CSF diversion as a routine in these patients. Percutaneous trans-arterial embolotherapy, in five patients achieved complete obliteration of the malformation in four patients and partial reduction of flow in another. While transvenous/trans-torcular approach is reserved for selected patients and direct surgery carries high morbidity, this report emphasises the efficacy of trans-arterial embolotherapy.

Adult↗
PubMed1993

Arteriovenous aneurysm of the occipital artery.

We report an unique case of a giant aneurysm of the occipital artery, with a venous connection to the transverse sinus via an emissary vein. Because of this connection, the term arteriovenous aneurysm is used.

Catheterization↗
PubMed1993

Multiple pulmonary-artery aneurysms due to mucoid vasculopathy--angiographic and histological observations.

Multiple peripheral pulmonary artery aneurysms were diagnosed by computed tomography and confirmed angiographically in a 7-year-old boy. On histological examination unusual mucoid vasculopathic changes were noted in the pulmonary artery aneurysms and pulmonary vasculature as a part of systemic vascular involvement. This case demonstrates a new association between mucoid vasculopathic changes and pulmonary aneurysms. Mucoid vasculopathy could represent one more disorder having a causative role in the etiology of intrapulmonary arterial aneurysms.

Aneurysm↗
PubMed1991

Obstruction of the infrarenal portion of the abdominal aorta: results of treatment with balloon angioplasty.

Our experience in the treatment of stenoses of the infrarenal portion of the abdominal aorta with balloon angioplasty in 27 patients is reported. Clinical findings were lower limb claudication (all patients), impotence (eight patients), and blue-toe syndrome (two patients). The underlying disease was atherosclerosis in 24 patients and nonspecific aortoarteritis in three patients. Dilatation was successful in all patients. Embolic occlusions of the left common iliac artery (one patient) and left superficial femoral artery (one patient) were the only major complications. Claudication in the affected limb continued in the first patient; the second died when diagnostic angiography, performed 3 months after angioplasty, caused a severe atheroembolus. Of the other 25 patients, nine of the 10 followed up for 13-48 months and all seven followed up for 3-8 months were free of symptoms. Six of eight patients with sexual dysfunction had normal function after angioplasty. Seven patients still awaited follow-up and one was lost to follow-up. Our experience suggests that balloon angioplasty is an effective treatment of stenoses of the infrarenal portion of the abdominal aorta.

Adult↗
PubMed1991

Hydrolysed microspheres from cross-linked polymethyl methacrylate (Hydrogel). A new embolic material for interventional neuroradiology.

Highly hydrophilic, perfectly smooth and spherical microspheres have been synthetized. These non-biodegradable microspheres absorb water in varying degrees and can be injected easily through microcatheters due to their slippery and compressible characteristics. The material was successfully used for embolization of 4 vascular intracranial tumours and 2 spinal vascular lesions in the cervical region, by superselective delivery. Histopathology confirmed absolute inertness of the microspheres.

Adult↗
PubMed1990

Corpus callosum lipoma with frontal encephalocele.

Computed tomographic and plain X-ray observations in a patient with corpus callosum lipoma associated with frontal encephalocele are reported. The rarity of the lesion and the specific diagnostic criteria on CT are emphasised.

Brain Neoplasms↗
PubMedDate not supplied

Modified crossover and guidewire loop technique for double-balloon angioplasty of the aortic bifurcation.

A modified form of crossover railroad technique is described for iliac and aortic bifurcation obstructions in which the iliac occlusion is crossed from the opposite side by a guidewire which is brought out through the ipsilateral puncture site. After forming a loop in the abdominal aorta, dilatation with two balloons is performed. This procedure was successfully performed in 2 patients having iliac artery occlusions and aortic bifurcation obstruction.

Angioplasty, Balloon↗
PubMedDate not supplied

Percutaneous transluminal angioplasty in nonspecific aortoarteritis (Takayasu's disease): experience of 16 cases.

Sixteen patients with aortoarteritis underwent percutaneous transluminal angioplasty for dilatation of 19 stenotic arteries. Sites included renal arteries (9), subclavian arteries (5), innominate artery (1), abdominal aorta (2), and descending thoracic aorta (2). Angiographic success was obtained in 14 lesions (74%) and partial success in 1 stenosis. The procedure was unsuccessful in 3 renal and 1 subclavian stenoses (21%). There were three complications. Clinically, there was cure of hypertension in three patients and improvement in six patients who had hypertension. Relief of claudication or return of pulsations was observed in seven patients. There was no evidence of any recurrence in the follow-up period (2-33 months). We conclude that percutaneous transluminal angioplasty is a safe and effective procedure for treating symptomatic stenotic lesions in aortoarteritis.

Adolescent↗
PubMedDate not supplied

Left cervical arch and associated abnormalities.

Cervical aortic arch is a rare congenital anomaly. Occasionally it is associated with other cardiac and aortic abnormalities. This paper describes the association of a left cervical aortic arch with a fusiform aneurysm of the arch in one patient and with multiple coarctations in another.

Adolescent↗
PubMedDate not supplied

Total occlusion of iliac arteries: results of balloon angioplasty.

Fifty-six occluded iliac arteries (mean length 6.1 cm; range 1-17 cm) in 50 patients were treated by percutaneous transluminal angioplasty (PTA) or laser-assisted PTA (bilateral lesions in 6 patients). Twenty-seven patients (54%) were at high risk for surgery. Patients were followed for a maximum period of 72 months (mean 23.12 months; median 20 months). The initial success rate was 78.57% for arteries and 82% for patients. Laser-assisted PTA was attempted in 11 occluded arteries (19.64%) and was successful in 4 arteries (7.14%). Conventional PTA was successful in 71.4% of arteries including all 7 arteries for which laser-assisted PTA failed (76% of patients). PTA was unsuccessful in 12 arteries (21.43%). Urokinase was used before PTA in 1 artery. The effect of PTA was evident clinically by relief of rest pain (66.66%), healing of ulcer (57%), increased claudication distance or no claudication (79%) in limbs, and objectively, by improvement in ankle/arm index (AAI) (an increase of 0.16 to 0.91) and increased exercise tolerance. Continuous improvement in AAI was observed after PTA on follow-up in 9 limbs. One patient died during follow-up. On follow-up, 3 arteries were occluded, 6 showed evidence of stenosis, and 1 showed fusiform dilatation at the PTA site. The long-term results using the life-table method determined a 76% primary patency rate and 81% secondary patency rate for 72 months. The overall patency including failures was 63%. Age of the patients (p = 0.0169) and hypertension (p = 0.0015) significantly affected the long-term patency of the artery but not the initial success. The major complications were arterial rupture in a repeat procedure in 1 artery, axillary artery thrombosis in 1, and distal thromboembolic occlusion during PTA in 4. The long-term patency rates suggest that PTA of totally occluded iliac arteries is a safe and effective procedure and provides a long-term benefit.

Adult↗