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Biomedical subjects

R R Murray

Publications and source records attributed to R R Murray.

13 recordsLinked to original sources
PubMed1988

Congenital arteriovenous malformations: tailored embolotherapy.

Congenital arteriovenous malformations (AVMs) involving the pelvis or an extremity were occluded in 16 symptomatic patients, who subsequently underwent tailored embolotherapy. An additional 11 patients did not undergo embolization due to unfavorable vascular anatomy or lack of significant symptoms. Permanent occlusive agents including isobutyl cyanoacrylate, particles of polyvinyl alcohol foam, and coils were used to embolize the multiple feeding vessels and, when possible, the nidus of the AVM. All patients experienced dramatic reduction in pain and resolution of ulceration and bleeding, with a mean follow-up period of 41 months. Symptoms recurred in four patients but again resolved with repeat embolization. The authors conclude that selective and repetitive embolization is highly effective in palliation of symptomatic congenital AVMs.

Adult↗
PubMed1987

Long-segment femoropopliteal stenoses: is angioplasty a boon or a bust?

Analysis of 193 femoropopliteal angioplasties demonstrated patency rates in the stenotic group of 75.5% at 6 months and 54.4% at 54 months. The patency rates for the occlusive group were 93.7% at 6 months and 72.9% at 54 months; these rates were significantly better than those in patients with stenoses. A group of 14 patients with long-segment (greater than 7 cm) stenosis had the highest risk of early failure, with a 6-month patency of 23.1%. After removal of the long-segment stenosis group from the results, there were no significant differences between the long-term patencies for stenotic and occlusive lesions. If angioplasty of long stenoses is attempted, a high initial success rate but early failure should be anticipated.

Angioplasty, Balloon↗
PubMed1986

Comparison of recurrent varicocele anatomy following surgery and percutaneous balloon occlusion.

Venography of 44 recurrent varicoceles in 37 patients demonstrated different anatomical patterns of recurrence in surgical patients (26) compared to those treated by percutaneous balloon occlusion (18). The 3 types of patterns identified included parallel, renal vein and transcrotal collateral pathways. Virtually all surgical recurrences were owing to mid retroperitoneal (27 per cent) or low (inguinal) parallel collaterals (58 per cent). The majority of post-balloon occlusion recurrences were due to either high retroperitoneal parallel (44 per cent) or renal vein collaterals (28 per cent). Surgical recurrences were treated easily with percutaneous balloon occlusion. However, 39 per cent of the patients with recurrences following balloon embolization were not anatomical candidates for repeat percutaneous occlusion. We conclude that venous collaterals are identified easily by renal venography, and knowledge of these collaterals is helpful in planning further surgical or radiological treatment.

Embolization, Therapeutic↗
PubMed1986

Long-term results of superficial femoral artery angioplasty.

Short-term results of superficial femoral artery and popliteal percutaneous transluminal angioplasty have been good, but long-term results and factors influencing long-term patency are less commonly reported. One hundred thirty-seven superficial femoral artery angioplasties with follow-up for 54 months were reviewed. The 4-year patency for stenoses was 61% and for occlusions was 68%. If the initial result was clinically successful, the 4-year patency was not influenced by the quality or patency of runoff or by the length of the occlusion. Nineteen patients returned for redilatation, eight of whom had developed new lesions. Patency was adversely affected in patients with diabetes or with long-segment stenoses. Modifications of equipment and technique that may improve long-term patency rates are discussed.

Angioplasty, Balloon↗
PubMed1980

Operative intervention in normal labor and delivery.

Since the intent of this chapter is to discuss the operative intervention in a normal labor and delivery, there has been no discussion of such operative obstetrical procedures as midforceps delivery, breech presentation and delivery, management of multiple pregnancy, or cesarean section. The person who performs normal obstetrics, but without special training for complicated obstetrics, must be able to diagnose a breech presentation or a multiple pregnancy and to know when a midforceps delivery or a cesarean section is indicated, and obtain appropriate consultation.

Delivery, Obstetric↗
PubMedDate not supplied

Digital subtraction spinal cord angiography in patients undergoing thoracic aneurysm surgery.

Thoraco-abdominal aortic replacement can be associated with a high incidence of paraplegia. Because the major source of blood supply to the thoraco-abdominal spinal cord is through the anterior spinal artery of Adamkiewicz, reimplantation of intercostal and lumbar arteries could reduce the risk of this operation. We used intraarterial digital subtraction angiography (DSA) for preoperative localization of the anterior spinal artery in 12 patients. This vessel was successfully located in 9 patients, with DSA providing good quality images in all patients. Preoperative knowledge of the origin of this vessel was helpful in the planning of the operation in all patients, but its efficacy as a routine procedure was not established.

Adult↗
PubMedDate not supplied

Bleeding following endoscopic sphincterotomy: angiographic management by transcatheter embolization.

Transcatheter embolization is a well-established and effective method for the control of bleeding from the upper gastrointestinal tract and often represents the preferred alternative to more invasive surgical management. The applications of this technique for the management of bleeding following endoscopic sphincterotomy have not been reported previously. Of five patients referred for arteriography with life-threatening postsphincterotomy bleeding, active bleeding from branches of the gastroduodenal artery was demonstrated in four. Embolization of this vessel with Gelfoam controlled the bleeding in all three patients in whom it was attempted. Arterial stenosis and spasm precluded such treatment in one patient. The fifth patient was not bleeding at the time of arteriography. There were no complications from these procedures. Our experience shows that postsphincterotomy bleeding can be safely and effectively controlled by transcatheter embolization, thereby avoiding surgery which is associated with significant morbidity and mortality in this setting.

Adult↗
PubMedDate not supplied

Cerebral computed tomography in drowning victims.

Computed tomography in two patients who had drowned revealed bilateral basal ganglia and medial temporal lobe low densities. Postmortem examination in one case showed these areas to be necrotic, probably secondary to the hypoxia and hypotension associated with drowning.

Basal Ganglia↗