Emerging from the shadows.
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History, 20th Century↗
Biomedical subjects
S G Miles
Publications and source records attributed to S G Miles.
Dynamic CT of hepatic masses using intraarterial enhancement: advantages and pitfalls.
Forty-two patients were evaluated by dynamic incremental computed tomography (CT) following transcatheter infusion of contrast material into the celiac and hepatic arteries. Most of these patients had liver metastases from colorectal carcinoma, but the series also included two cases of hepatic hemangiomas, one case of granulomas due to atypical mycobacterium, and two cases of retroperitoneal tumors involving the liver. Several distinct patterns of liver opacification were recognized, reflecting differential perfusion of hepatic lobes during selective intraarterial contrast enhancement. The spectrum of observed findings, as well as the advantage or limitations of this technique, are described.
Colorectal Neoplasms↗
Guide-wire reinforcement and lengthening with coaxial locking guide wires: the crimping technique.
The authors developed a technique to increase the size of a guide wire and permit single-step placement of catheters and large sheath systems over previously inserted small-caliber guide wires. The technique involves compression of metal cannula against a smaller in-dwelling wire or inner cannula. It has been used successfully during laser-assisted balloon angioplasty and percutaneous nephrolithotomy.
Angiography↗
Safe use of an intravenous power injector for CT: experience and protocol.
Use of a power injector to deliver contrast material intravenously for computed tomography is a safe alternative to a bolus or drip infusion technique. The authors performed 5,280 injections at rates of 0.5-5.0 mL/sec. Six extravasations occurred, and none resulted in long-term sequelae. This complication rate is 0.1%.
Contrast Media↗
New high-flow "cloud" catheter for safer delivery of contrast material.
The authors describe a new angiographic catheter, which delivers equal flow rates through the side holes and reduced flow through the end hole compared with conventional catheters. Computer analysis of catheter-flow models revealed that placement of larger side holes proximally and smaller side holes distally produces more uniform flow rates out of the holes. This decreases the risk of potentially hazardous delivery of high-pressure jets of contrast material from the end hole. The flow pattern is so uniform that it resembles a cloud of contrast material on injection. This catheter design is particularly applicable for 3-5-F catheters, which require high-pressure injections. Clinical testing in 50 cases revealed no extravasations or unintentional selective injections with use of this catheter.
Angiography↗
Pneumatic reduction of ileocolic intussusception in children.
Pneumatic reduction of ileocolic intussusception in children has been used in Argentina and in China for more than 25 years but has only recently been attempted in North America. It is reported to be safer and more effective than reduction by the hydrostatic pressure of a barium suspension. Our preliminary experience with four patients has been rewarding and we believe it may become the method of choice.
Air↗
Directional needle for antegrade guide wire placement with vertical arterial puncture.
A directional needle with a closed pencil-point tip and a distal side hole was developed to permit antegrade guide wire placement by way of a 90 degrees puncture angle. It has been used in over 25 patients without technical difficulties or complications. It has been very effective for catheterization of the superficial femoral artery for angioplasty, diagnostic studies, and chemotherapy infusion, providing easy antegrade access in patients in whom the traditional antegrade approach may be difficult.
Catheterization, Peripheral↗
Extracorporeal shock-wave lithotripsy: prevalence of renal stones 3-21 months after treatment.
One hundred and four (70%) of the first 148 patients who underwent extracorporeal shock-wave lithotripsy (ESWL) at the University of Florida were evaluated for persistent or recurrent renal stone disease. Radiographs obtained 3-21 months after treatment showed that 53 (50%) of 106 treated kidneys were free of stones. In 48 of the 53 kidneys that contained stones, the stones were residual fragments dating from the period immediately after ESWL. New stones had developed in only five kidneys. The 50% incidence of stone-free kidneys 3-21 months after ESWL is less than the 65-90% rate reported by other institutions in the United States and Europe. After stone removal by ESWL, new stone formation occurs at a rate of 5%, which is much lower than the expected recurrence rate of 37-50%.
Follow-Up Studies↗
New directional accordion catheter for converting a retrograde puncture into an antegrade catheter placement.
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Arteries↗