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Biomedical subjects

T Riles

Publications and source records attributed to T Riles.

9 recordsLinked to original sources
PubMed2001

Transesophageal echocardiography in intimal flap fenestration.

In selected patients with descending aortic dissection, percutaneous intimal flap fenestration is a less-invasive alternative to surgery. We describe a patient with decreased renal and mesenteric blood flow as a result of descending aortic dissection. Percutaneous balloon intimal fenestration was performed under guidance of transesophageal echocardiography. Transesophageal echocardiography provided crucial information about the intimal flap puncture site and true- and false-lumen blood flow. After the flap fenestration, false-lumen blood flow increased, and the patient improved clinically.

Aortic Dissection↗
PubMed1998

Ultrasound evaluation of endovascular repair of abdominal aortic aneurysms.

UNLABELLED: Endovascular repair of an abdominal aortic aneurysm (AAA) offers a minimally invasive alternative to an open surgical procedure in selected patients. The purpose of this study was to examine the usefulness of ultrasonography for evaluating the results of endovascular repair. METHODS: We studied 17 patients who underwent endovascular repair. In 10 patients a bifurcated prosthesis was positioned below the renal arteries with the bifurcated branches in the iliac arteries. The other 7 patients had a nonbifurcated infrarenal prosthesis. RESULTS: In each patient the AAA and the entire prosthesis, including its bifurcated branches, were visualized. The mean AAA diameter was 5.0 +/- 0.6 cm. The mean prosthesis body diameter was 2.2 +/- 0.3 cm, and the diameters of the bifurcated limbs were 1.0 to 1.2 cm. Color Doppler studies revealed blood flow limited to the prosthetic lumen and its bifurcation in 16 patients; the space between the prosthesis and the AAA wall was clotted in these patients. In 1 patient a communication was seen between the prosthesis and the AAA lumen through a dehiscence in the distal attachment. CONCLUSION: Ultrasonography is a simple, noninvasive tool for the evaluation of the results of endovascular repair of AAA and can detect complications of this procedure.

Aged↗
PubMed1990

Comparison of hetastarch to albumin for perioperative bleeding in patients undergoing abdominal aortic aneurysm surgery. A prospective, randomized study.

The effects of hetastarch and human albumin solutions on perioperative bleeding and coagulation parameters during abdominal aortic aneurysm repair were compared. In two randomized groups of 20 patients, albumin 5% (group 1) or hetastarch 6% (group 2) 1 g/kg was given during surgery. The remaining perioperative fluids consisted of lactated ringers and packed red blood cells. Perioperative coagulation measurements included partial thromboplastin time, prothrombin time, activated clotting time, platelet count, and bleeding time. Estimated blood loss and the total amount of crystalloid and blood infused were also measured. The surgeon, blind to the colloid used, subjectively rated bleeding on a scale of 1 to 10. There was no significant difference between groups for any measured parameter at any time. Measurements of coagulation function were within normal limits for both groups. Hetastarch does not cause clotting disorders in patients undergoing abdominal aortic aneurysm repair, at least if the quantities used in this study are not exceeded.

Aged↗
PubMed1984

Deep venous thrombosis: detection by high-resolution real-time ultrasonography.

High-resolution real-time ultrasonography was performed in 11 patients with clinically suspected deep venous thrombosis (DVT) of the lower extremity. Contrast venography was performed in all patients within 24 hours of sonographic examination. The common femoral vein at the groin and the popliteal vein in the popliteal fossa were evaluated for presence or absence of intraluminal soft-tissue mass (thrombi), compressibility of the veins, and response to performance of the Valsalva maneuver. Of the 11 patients, six were shown to have DVT by contrast venography. In all six cases there was complete agreement between sonography and contrast venography as to the presence or absence of thrombi in the common femoral vein or the popliteal vein.

Adolescent↗
PubMed1982

Cerebral protection in carotid surgery.

We performed 956 carotid endarterectomies in 661 conscious patients who were under cervical block anesthesia and in whom the stroke rate was 2.5%. They were analyzed to determine the mechanisms of strokes and the risk factor for perioperative stroke. Twenty-three patients with perioperative strokes, regardless of severity, were analyzed as to the mechanism of cause. One half were due to technical problems, one quarter to intraoperative embolization, one sixth to intracerebral hemorrhage, and the remainder were not directly related to the operative procedures. Perioperative stroke rate varied by group from 0.6% to 28.4%, highest when the contralateral carotid was occluded, where there was a preoperative persistent neurologic deficit, and when the patient failed to tolerate carotid clamping. Regional block monitoring was accurate and no stroke could be ascribed to anesthetic technique. Standard reporting techniques should be used in classifying patients into appropriate risk groups to permit meaningful comparisons among groups using different techniques for cerebral protection.

Anesthesia, Conduction↗
PubMed1979

Angiographically undetected ulceration of the carotid bifurcation as a cause of embolic stroke.

The accuracy of angiographic diagnosis of carotid artery ulceration was evaluated. Of those carotid bifurcations showing ulceration at surgery, 60% were diagnosed as having ulcers at angiography. Half of the remaining ulcers occurred in smooth, benign-appearing plaques and were too small to be seen at angiography. An incorrect angiographic diagnosis of ulceration was made in 17 of 50 carotid arteries; in most cases this was due to the presence of a subintimal hematoma in the wall of the artery.

Carotid Artery Diseases↗
PubMed1979

Atherosclerotic subintimal hematoma of the carotid artery.

A presumed new radiological-pathological entity of atherosclerotic subintimal of the carotid artery is described. Subintimal hematomas were found in 12 of 50 (24%) carotid bifurcations during surgery for repeated transient ischemic attacks in a single hemispheric distribution; only 33% were associated with ulcerations. The typical angiographic appearance was a sharply marginated, rounded, eccentric filling defect located near the extracranial carotid bifurcation, although occasionally it may simulate a typical smooth or even ulcerated atherosclerotic plaque. Pathological mechanisms responsible for the hemorrhage into the atherosclerotic plaque resulting in the hematoma are discussed.

Arteriosclerosis↗