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Sridhar Shankar

Publications and source records attributed to Sridhar Shankar.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Interventional radiology strategies in the treatment of pseudomyxoma peritonei.

PURPOSE: To describe percutaneous maneuvers to treat the unusual entity symptomatic pseudomyxoma peritonei (PMP). METHODS: Four patients with PMP were treated by interventional radiology techniques that included large catheters (20-30 Fr) alone (n = 3), multiple catheters (n = 4), and dextran sulfate as a catalytic agent through smaller catheters (n = 1). The causes of the PMP were tumors in the ovary (2 patients), appendix (1 patient), and colon (1 patient). Each patient previously had undergone at least two operations to remove the PMP, and all patients had symptomatic recurrence. An in vitro analysis of catalytic agents also was performed. RESULTS: All four patients improved symptomatically. Follow-up CT scans demonstrated marked reduction of PMP material in all cases. One patient underwent another interventional radiology session 5 months after the first; the other three patients had no recurrence of symptoms. One patient had reversible hypotension 2 hr after the procedure. The amount of material removed varied from 3 to 6 L. CONCLUSION: These interventional radiology techniques were effective and safe for PMP and suggest options for this difficult medical and surgical problem.

Aged↗
PubMedDate not supplied

Brachial plexus injury from CT-guided RF ablation under general anesthesia.

Brachial plexus injury in a patient under general anesthesia (GA) is not uncommon, despite careful positioning and, particularly, awareness of the possibility. The mechanism of injury is stretching and compression of the brachial plexus over a prolonged period. Positioning the patient within the computed tomography (CT) gantry for abdominal or chest procedures can simulate a surgical procedure, particularly when GA is used. The potential for brachial plexus injury is increased if the case is prolonged and the patient's arms are raised above the head to avoid CT image degradation from streak artifacts. We report a case of profound brachial plexus palsy following a CT-guided radiofrequency ablation procedure under GA. Fortunately, the patient recovered completely. We emphasize the mechanism of injury and detail measures to combat this problem, such that radiologists are aware of this potentially serious complication.

Anesthesia, General↗
PubMedDate not supplied

Multidetector CT urography: comparison of two different scanning protocols for improved visualization of the urinary tract.

The goal of this study was to evaluate different CT scanning protocols on the depiction of the urinary tract by multidetector CT. The authors retrospectively reviewed 55 consecutive patients who underwent CT scanograms. Two groups of patients were included: renal donors (n=29) and hematuria patients (n=26). For the renal donor protocol, 120 mL of iodinated contrast was injected and a CT scanogram was obtained after a 5-minute delay. For the hematuria CT urography protocol, 100 mL of contrast was followed by a 250 mL normal saline drip and CT scanograms acquired after an 8-minute delay. Urinary tracts from both imaging protocols were then divided into four segments and evaluated by consensus reading of two experienced radiologists rated on a scale of 0 to 2. Complete visualization of the renal pelvis and the proximal, middle, and distal ureter for the renal donor protocol was noted to be 86%, 57%, 45%, and 52% and for that of the CT urography protocol to be 75%, 65%, 40%, and 44%, respectively. Comparing scanograms of the renal donor protocol and the CT urography protocol, there was no statistically significant difference in the depiction of renal pelvis or the proximal, middle or distal ureteral region (P=0.1625, 0.3226, 0.8636, and 0.6145, respectively). The study demonstrates that there is no significant difference between the CT urography protocol and the renal donor protocol in the depiction of the urinary tract.

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