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Biomedical subjects

R F Colapinto

Publications and source records attributed to R F Colapinto.

At least 37 records · Page 2Linked to original sources
PubMed1981

Difficulty in assessing the severity of aorto-iliac disease by clinical and arteriographic methods.

Accurate hemodynamic assessment of the severity of aorto-iliac disease has important implications in the management of patients with symptomatic peripheral arterial occlusive disease. This study has documented that history, clinical examination, and single-plane angiography are often unsatisfactory for assessing the hemodynamic significance of an aorto-iliac lesion. The use of oblique angiographic views, certain noninvasive methods, such as quantitative Doppler waveform analysis, and direct pressure measurements will be of benefit in difficult cases and lead to a more accurate diagnosis.

Aortic Diseases↗
PubMed1981

Renal and hemodynamic effects of the peritoneovenous shunt. II. Long-term effects.

The long-term renal and hemodynamic effects of the peritoneovenous shunt for intractable ascites were studied in 11 patients to elucidate the mechanism of its persistent beneficial effect. Sodium balance studies were performed in 7 patients. All had patent shunts and no clinically detectable ascites. On a 20-mEq sodium diet, the mean sodium excretion was 17.2 +/- 5.3 mEq/day which was increased over the preoperative mean of 2.4 +/- 0.4 (p < 0.025) on the same diet. There was a 100% increase in creatinine clearance over the preoperative level (p < 0.0005). The mean plasma renin activity and serum aldosterone levels were within normal limits in most patients, and the sodium excretion correlated inversely with the levels of each. During 100-mEq sodium challenge diet, the sodium excretion ranged from 4 to 130 mEq/day with a mean of 56.1 +/- 16.5 and with 6 of the 7 patients displaying sodium retention. On this diet the mean creatinine clearance was 104.3 +/- 6.4 ml/min, and the mean plasma renin activity and serum aldosterone levels had decreased physiologically with the higher sodium intake. Again the sodium excretion correlated inversely with the serum aldosterone on the 100-mEq sodium diet. In 8 patients, the portal pressure, as reflected by the wedge hepatic vein pressure, had decreased by a mean of 37% (p < 0.0005). But, despite this, 2 of the 8 patients had major variceal hemorrhages postoperatively. There was a significant inverse correlation between the increase in sodium excretion and the fall in portal pressure in 4 patients. Thus, sodium retention in cirrhosis is multifactorial with the reninaldosterone system and, possibly, portal hypertension per se both playing a role. Peritoneovenous shunting in carefully selected patients partially reverses the sodium retention and renders patients more manageable over the long term.

Aldosterone↗
PubMed1980

Percutaneous transluminal angioplasty of peripheral vascular disease: a two-year experience.

Over a 23-month period, 172 successful peripheral angioplasties were performed. Life-table analysis gave a two-year patency rate for the total series of 80%. The patency rate for aorto-iliac and femoral-popliteal lesions was 86% and 70%, respectively. Only one late failure occurred in the group of 44 arteries followed for longer than eight months.

Arterial Occlusive Diseases↗
PubMed1980

Percutaneous transluminal dilatation and recanalization in the treatment of peripheral vascular disease.

Ninety-four successful transluminal angioplasties were followed up for as long as 15 months, during which time 15 failures occurred. Life-table analysis of this series gave a cumulative patency rate of 64%. The patency rate of 70% for iliac lesions, compared to 50% for the femoral-popliteal group, suggests that the former are likely to have a better long-term prognosis. In selected cases, transluminal angioplasty is a viable alternative to surgery that should be available to both patient and physician.

Adult↗
PubMed1980

Inadvertent percutaneous transluminal dilatation of a renal artery with a four-year follow-up.

The author presents a case of severe stenosis of the left renal artery with poststenotic dilatation. While performing a left arteriogram, a catheter was passed inadvertently through the stenosis, which resulted in the angiographic disappearance of the stenosis and the disappearance of an accompanying abdominal bruit. Dilatation was maintained when he returned four years later with hypertension and stenosis of the right renal artery. A left renal angiogram showed no stenosis. The long term result of this case suggests that deliberate dilatation of renal arteries may last for several years.

Catheterization↗
PubMed1980

A prospective randomized trial of the selective distal splenorenal shunt.

Distal splenorenal shunt has been compared in a prospective randomized way with end-to-side portacaval shunt in patients who have survived a major hemorrhage from esophageal varices. The operative mortality was higher after the elective shunt than after the portacaval shunt. However, most of these deaths occurred in the early phases of the study. Postoperative encephalopathy was significantly lower after the selective shunt than after the portacaval shunt. Follow-up studies to date show no significant difference in late survival.

Adult↗
PubMed1980

Preliminary results of transluminal dilation in the treatment of peripheral arterial occlusive disease.

The results of our pathologic studies demonstrated that a Grüntzig catheter does not damage arteries in vitro, and our clinical results confirm the observations made by Grüntzig and indicate that this technique has a role in management of certain patients with peripheral arterial occlusive disease. Although long term results are not available, we believe that this technique widens the scope of management for certain patients with peripheral vascular disease but will not replace conservative medical management or surgical treatment. At present, it probably has an intermediate role between the two and replaces neither.

Arterial Occlusive Diseases↗
PubMed1980

Transluminal dilatation in the treatment of peripheral arterial occlusive disease.

The authors review their experience over a 2-year period with transluminal arterial dilatation using the Grüntzig catheter. In 96 patients 136 aortoiliac or femoropopliteal arterial segments were dilated. The success rates at 1 year were 76% and 70%, respectively, for aortoiliac and femoropopliteal dilatations. The early and late results indicate that this procedure is useful in managing peripheral arterial occlusive disease in certain patients and that there are few complications when the procedure is carried out by a skilled angiographer.

Aortic Diseases↗
PubMed1979

Thrombosis of the portal vein following distal splenorenal shunt.

Portal vein thrombosis with a patent shunt is a distinct clinical entity which can follow selective distal splenorenal shunt and should be looked for in patients in whom ascites and abdominal pain develop postoperatively. Possible mechanisms include an increase in blood viscosity and a decrease in portal flow which may be aggravated by inadequate devascularization.

Adult↗
PubMed1978

Selection of operation in patients with bleeding esophageal varices.

The results of surgical treatment of bleeding esophageal varices over an 8-year period in 155 patients are reviewed. Primary treatment of bleeding was conservative, with intravenous administration of vasopressin and balloon tamponade. Emergency operations were carried out after 48 hours in persons with persistent bleeding who were surgical candidates. Operative mortality was higher in this group (40%) than in those undergoing elective or urgent operations (each 10%). Postoperative encephalopathy occurred in 35% of patients and was correlated closely to late death after establishment of a shunt. The mesocaval shunt is no better than the portacaval but appears to be a good alternative in an emergency. In a controlled trial the distal splenorenal shunt was found to be associated with a lower rate of postoperative encephalopathy than the portacaval shunt, but thus far the long-term survival rates have not differed.

Blood Vessel Prosthesis↗
PubMed1978

Pheochromocytoma in the modern context.

The hypertensive patient faces an uncertain future. Therefore a search for those cases in which the condition is potentially curable is eminently worth while and has become increasingly productive because of the specific diagnostic aids now available and because of the present safety of surgical intervention. Detection and localization of a pheochromocytoma allows a planned surgical approach. Correction of hypovolemia preoperatively ensures a safe course postoperatively. The use of blocking agents pre- and peroperatively prevents the hazardous hypertensive crises and arrhythmias that were a part of early surgical experience. Monitoring of central venous and arterial pressures as well as the electrocardiographic tracing during the operation permits prophylactic therapy when necessary. On the basis of a series of 31 patients the authors compare many aspects of the current management with earlier experience of pheochromocytoma in the same institution. The incidence of extra-adrenal lesions (3.8%), multicentric tumours (3.8%) and malignant change (11.5%) was lower in this group of patients than that usually reported. Abdominal exploration remains the approach of choice in most cases. Treatment of the solitary pheochromocytoma has become straightforward. However, management of the familial syndromes and the malignant from of the disease still requires careful scrutiny.

Adrenal Gland Neoplasms↗
PubMed1971

Scintigraphy and arteriography in the diagnosis of diseases of the liver.

Arteriograms and scans performed over a five-year period on 60 patients with suspect hepatic disease have been reviewed. The diagnosis was proved in every case by biopsy, autopsy or laparotomy. Scintigraphy correctly predicted the presence or absence of disease in 75% and arteriography in 75% of cases. Fifty-four of the patients had hepatic disease. In 81% of these the accurate diagnosis of diffuse or localized disease was made by one or both techniques. Arteriography is preferred for the detection of localized lesions, but diffuse processes are more readily demonstrated by scintigraphy.

Angiography↗