Improved patient selection for angioplasty utilizing color Doppler imaging.

Abstract:

:The accepted approach to patients with intermittent calf claudication is nonoperative unless the symptoms are truly incapacitating, in which case arteriography and either percutaneous angioplasty or operation is indicated. Arteriography is considered a preoperative procedure. However, with improvements in percutaneous angioplasty, we have altered our approach to those patients with limiting, but not incapacitating, claudication. These patients are given the choice of conservative treatment or percutaneous angioplasty, but not operation. In an attempt to limit arteriography to only those patients who would benefit from angioplasty, we have employed color Doppler imaging as a screening technique. Over a 2-year period, 62 patients with limiting claudication were evaluated with color Doppler imaging. Thirty-six patients had long occlusions and did not undergo arteriography since they were not believed to be candidates for percutaneous angioplasty. Three short (less than 5 cm) occlusions and 23 localized stenoses were identified in the superficial femoral and popliteal arteries. Angiography confirmed the Doppler findings in all 26 cases. In 24 patients, dilatation was successful, whereas 2 patients' arteries could not be dilated. Two stenoses recurred early and were redilated. There were no complications from the angioplasties. We conclude that in the subset of patients with limiting, but not incapacitating, claudication, color Doppler imaging can accurately select those patients who will benefit from angioplasty. In this way, patients can be spared unnecessary angiograms.

journal_name

Am J Surg

authors

Collier P,Wilcox G,Brooks D,Laffey S,Dalton T

doi

10.1016/s0002-9610(05)80300-9

subject

Has Abstract

pub_date

1990-08-01 00:00:00

pages

171-4

issue

2

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(05)80300-9

journal_volume

160

pub_type

杂志文章
  • Jejunoileal bypass. Late metabolic sequelae and weight gain.

    abstract::Of 101 patients originally operated on, the status of 98 is known. Given the mortality and reanastomosis rates, the operation must be considered an absolute failure in 28 percent of the patients. Given the other complications that appear (or persist) late postoperatively, only 18 percent of the entire series of patien...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(80)90165-8

    authors: Halverson JD,Scheff RJ,Gentry K,Alpers DH

    更新日期:1980-09-01 00:00:00

  • Pyogenic hepatic abscess with biliary communication.

    abstract:BACKGROUND:The aims of this study were to compare the effectiveness of percutaneous drainage between pyogenic hepatic abscesses with and those without biliary communication and to evaluate the role of endoscopic biliary stent placement in the treatment of communicating abscesses. METHODS:Sixty-one patients with hepati...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(01)00869-8

    authors: Sugiyama M,Atomi Y

    更新日期:2002-02-01 00:00:00

  • Efficacy of femorofemoral bypass for intermittent claudication. Clinical and hemodynamic assessment.

    abstract::Twenty patients treated by femorofemoral bypass were retrospectively reviewed to determine if femorofemoral bypass was efficacious in the treatment of disabling claudication. The data have clearly demonstrated that two criteria are necessary for the successful outcome of femorofemoral bypass. First, the donor artery s...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(86)90245-x

    authors: Buchbinder D,Pasch AR,Schuler JJ,Meyer JP,Dillon BC,Rollins DL,Flanigan DP

    更新日期:1986-08-01 00:00:00

  • George Peters Award: How does breast-specific gamma imaging affect the management of patients with newly diagnosed breast cancer?

    abstract:BACKGROUND:We sought to determine the number of patients with known breast cancer who were found to have an additional, mammographically occult lesion detected on breast-specific gamma imaging (BSGI). METHODS:An institutional review board-approved review of all patients who underwent BSGI at Beth Israel Medical Center...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2009.06.016

    authors: Killelea BK,Gillego A,Kirstein LJ,Asad J,Shpilko M,Shah A,Feldman S,Boolbol SK

    更新日期:2009-10-01 00:00:00

  • Management of vascular soft tissue neoplasms using transcatheter embolization and surgical excision.

    abstract::Preoperative embolization of highly vascular soft tissue tumors was performed in four patients. Selective catheterization of branch vessels supplying the tumors successfully avoided inadvertent embolization of adjacent normal tissue. Operative blood loss was significantly less than anticipated, permitting an easier, m...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(83)90429-4

    authors: Kadir S,Ernst CB,Hamper U,White RI Jr

    更新日期:1983-09-01 00:00:00

  • Single dose prophylaxis in elective cholecystectomy. A prospective, double-blind randomized study.

    abstract::We tested the effectiveness of a single dose of prophylactic antibiotic (gentamicin) in elective cholecystectomy in a double-blind, controlled randomized study. All patients recognized preoperatively as being at risk were excluded. The treatment group comprised of 102 patients received a single dose of gentamicin and ...

    journal_title:American journal of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/0002-9610(86)90218-7

    authors: Kaufman Z,Dinbar A

    更新日期:1986-11-01 00:00:00

  • Mucinous cystic neoplasms of the pancreas in the modern era. Experience with 707 patients.

    abstract:BACKGROUND:Mucinous Cystic Neoplasms are mucin producing cysts of the pancreas with malignant potential. The existing literature on treatment outcomes is limited to relatively small surgical series. METHODS:We reviewed the National Cancer Database assessing the outcomes of patients with mucinous cystic neoplasms betwe...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2020.09.006

    authors: Ahmad M,Maegawa FB,De La Rosa E,Davis B,Tyroch A,Konstantinidis IT

    更新日期:2020-12-01 00:00:00

  • A randomized, double-blind, placebo-controlled study to assess the effect of recombinant human erythropoietin on functional outcomes in anemic, critically ill, trauma subjects: the Long Term Trauma Outcomes Study.

    abstract:BACKGROUND:Achieving a higher hemoglobin (Hb) level might allow the anemic, critically ill, trauma patient to have an improved outcome during rehabilitation therapy. METHODS:Patients with major blunt trauma orthopedic injuries were administered epoetin alfa or placebo weekly both in hospital and for up to 12 weeks aft...

    journal_title:American journal of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.amjsurg.2011.08.006

    authors: Luchette FA,Pasquale MD,Fabian TC,Langholff WK,Wolfson M

    更新日期:2012-04-01 00:00:00

  • Laparoscopic cholecystectomy in geriatric patients.

    abstract:BACKGROUND:The results and advantages of laparoscopic cholecystectomy in the geriatric population have received minimal attention. Several early reports related high conversion rates complications and mortality. This case series review is focused on the results of laparoscopic cholecystectomy in the geriatric populatio...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2003.11.031

    authors: Majeski J

    更新日期:2004-06-01 00:00:00

  • Primary gastric lymphoma. Problems in staging and management.

    abstract::A retrospective review of 28 patients with primary gastric lymphoma was performed to determine the optimal treatment modality. The presenting signs and symptoms resembled peptic ulcer disease or gastric carcinomas. The majority of the lymphomas were of the diffuse histiocytic subtype. There was a 75 percent resectabil...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(88)80268-x

    authors: Jones RE,Willis S,Innes DJ,Wanebo HJ

    更新日期:1988-01-01 00:00:00

  • Results and prognostic factors in skull base surgery.

    abstract::The charts of 81 patients who underwent skull base surgery between 1982 and 1993 were reviewed retrospectively. Data relative to demographic aspects, clinical stage, previous treatment, surgical approach, type of reconstruction, histology, extent of disease, complications, and follow-up were analyzed. The craniofacial...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(05)80106-0

    authors: Dos Santos LR,Cernea CR,Brandao LG,Siqueira MG,Vellutini EA,Velazco OP,Cruz OL,Morais-Besteiro J,Freitas CA

    更新日期:1994-11-01 00:00:00

  • Pancreatic incidentalomas: clinical and pathologic spectrum.

    abstract:BACKGROUND:Incidental abnormalities are increasingly being detected. The pathology and clinical outcome of patients with pancreatic incidentalomas have not been well characterized. METHODS:We reviewed the records of 356 patients with pancreatic abnormalities from August 2001 to June 2007. Clinical and pathologic data ...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2007.12.027

    authors: Bruzoni M,Johnston E,Sasson AR

    更新日期:2008-03-01 00:00:00

  • Challenging abdominal wall defects.

    abstract:BACKGROUND:We propose a simple algorithm for management of patients with challenging abdominal fascial defects. METHODS:The medical records of 64 patients with complicated abdominal wall defects representing a consecutive series by a single surgeon over a 4-year period were reviewed. Group I patients presented with ma...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(00)00566-3

    authors: Sukkar SM,Dumanian GA,Szczerba SM,Tellez MG

    更新日期:2001-02-01 00:00:00

  • Carotid endarterectomy with an occluded contralateral carotid artery.

    abstract::Five hundred twenty-six patients who underwent carotid endarterectomy were separated by reviewing those 81 (15%) patients with an occluded contralateral carotid artery and those 445 (85%) with nonocclusion. The population characteristics and surgical indications were similar between the occluded and nonoccluded groups...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(05)81050-5

    authors: McCarthy WJ,Wang R,Pearce WH,Flinn WR,Yao JS

    更新日期:1993-08-01 00:00:00

  • Teaching and learning in the operating room is a two-way street: resident perceptions.

    abstract:BACKGROUND:The transformation of a trainee into a surgeon is influenced strongly by communication patterns in the operating room (OR). In the current era of limited educational opportunities, elucidation of teaching and learning strategies in this environment is critical. The aim of this study was to further understand...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2008.01.004

    authors: Vikis EA,Mihalynuk TV,Pratt DD,Sidhu RS

    更新日期:2008-05-01 00:00:00

  • Placement of an implantable percutaneous permanent triple-lumen catheter.

    abstract::A new technique has been described for the placement of an implantable percutaneous triple-lumen catheter. This procedure eliminates the need for a large bore introducer. It also provides a mechanism to change these catheters over a wire if necessary. This cannot be accomplished with the Hickman or Broviac catheters. ...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(85)80116-1

    authors: Geiss AC,Montefusco PP

    更新日期:1985-03-01 00:00:00

  • Putative tumor-suppressor gene on chromosome 11 is important in sporadic endocrine tumor formation.

    abstract::Endocrine tumors arising sporadically or as a manifestation of the multiple endocrine neoplasia type I syndrome (MEN I) have been shown to have mutations on chromosome 11. These mutations can be detected at the molecular level by loss of heterozygosity (LOH) for DNA markers from chromosome 11. This study represents on...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(94)90071-x

    authors: Eubanks PJ,Sawicki MP,Samara GJ,Gatti R,Nakamura Y,Tsao D,Johnson C,Hurwitz M,Wan YJ,Passaro E Jr

    更新日期:1994-01-01 00:00:00

  • A method for safe pancreaticojejunostomy.

    abstract::We devised a new technique to increase the safety of pancreaticojejunostomy in patients with an extended operation for pancreatic cancer. This new pancreaticojejunostomy was created by end-to-side anastomosis with four layers about 7 cm distal to the jejunal stump. The cut surface of the pancreas was placed on the ser...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/s0002-9610(05)80524-0

    authors: Hiraoka T,Kanemitsu K,Tsuji T,Saitoh N,Takamori H,Akamine T,Miyauchi Y

    更新日期:1993-02-01 00:00:00

  • Relationship between pancreatic and serum amylase in basal conditions and during stimulation in man. Report of a new intraoperative technique.

    abstract::The correlation between serum amylase and pancreatic amylase secretion was studied in two patients. Both patients underwent sphincterotomy, and the pancreatic duct was cannulated with a polyethylene tube. The tube was left in place for 15 to 21 days. The rate of amylase secretion over 7 days was studied in response to...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(82)90178-7

    authors: Lezoche E,Carlei F,Vagni V,Rossini S,De Masi E,Passaro E Jr,Speranza V

    更新日期:1982-05-01 00:00:00

  • Fiberoptic intraoperative illumination of the stomach as an aid in the management of acute gastric hemorrhage.

    abstract::Intragastric illumination using a flexible light source is described as a technical aid in the management of gastric bleeding. The flexible light source can be recommended for illumination of the proximal intragastric area to facilitate surgical control of bleeding from Mallory-Weiss lacerations, ulcers, varices, and ...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(77)90173-8

    authors: Delany HM,Moss CM

    更新日期:1977-06-01 00:00:00

  • Stump pressure, electroencephalographic changes, and the contralateral carotid artery: another look at selective shunting.

    abstract:BACKGROUND:Selective shunting during carotid endarterectomy is associated with the lowest operative stroke rate; therefore, patient selection for carotid shunting is critical. Electroencephalography (EEG) can detect ischemic brain cell dysfunction before irreversible injury. The carotid stump back pressure (CSP) has be...

    journal_title:American journal of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0002-9610(99)80275-x

    authors: Harada RN,Comerota AJ,Good GM,Hashemi HA,Hulihan JF

    更新日期:1995-08-01 00:00:00

  • Chronic syphilitic aortic aneurysm complicated with chronic aortic dissection.

    abstract:BACKGROUND:Historically, tertiary syphilis infection has been the most common cause of thoracic aortic aneurysm, resulting in 5% to 10% of cardiovascular deaths until the era of antibiotics. METHODS:A 49-year-old Caucasian man presented to our institution with progressive dysphagia, weight loss, incomplete bladder emp...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2010.02.017

    authors: Cruz RP,Marrone LC,Marrone AC

    更新日期:2010-11-01 00:00:00

  • Do male chairs of surgery have implicit gender bias in the residency application process?

    abstract:INTRODUCTION:Medical students applying for general surgery residencies often require a letter of recommendation (LOR) from the Surgical Chair. However, LORs may reveal gender and ethnic bias. This study examines the presence of implicit bias in general surgery resident selection by evaluating chair LORs. METHODS:A ret...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2020.08.010

    authors: Dream S,Olivet MM,Tanner L,Chen H

    更新日期:2020-08-15 00:00:00

  • Intraplaque hemorrhage: its significance in cerebrovascular disease.

    abstract::Recently, carotid plaque factors, specifically intraplaque hemorrhage, have been studied with respect to the production of cerebrovascular symptoms. Ninety-five carotid endarterectomies were performed and the plaques that were removed were examined for intraplaque hemorrhage. Patients were separated into three groups:...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(84)90450-1

    authors: Ammar AD,Wilson RL,Travers H,Lin JJ,Farha SJ,Chang FC

    更新日期:1984-12-01 00:00:00

  • Bovine carotid heterograft for segmental ureteral substitution.

    abstract::Substitution of segments of traumatized or diseased ureter has been attempted often with little success. The ideal ureteral subsitute has yet to be found, and experiments with the newer biologically inert prosthetic materials such as the bovine carotid artery heterograft are warranted. ...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(76)90010-6

    authors: Albert PS,Vitolo RV,Friedenberg R,Davis JE

    更新日期:1976-05-01 00:00:00

  • Screening cervical spine MRI after normal cervical spine CT scans in patients in whom cervical spine injury cannot be excluded by physical examination.

    abstract:BACKGROUND:Cervical spine injuries can occur in as many as 10% of patients with blunt trauma with mental status changes from closed head injuries. Despite normal results on cervical spine computed tomography (CT), magnetic resonance imaging (MRI) is often recommended to exclude ligamentous or soft tissue injury. METHO...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2008.07.040

    authors: Steigelman M,Lopez P,Dent D,Myers J,Corneille M,Stewart R,Cohn S

    更新日期:2008-12-01 00:00:00

  • Indications and results for transduodenal sphincteroplasty in the era of endoscopic sphincterotomy.

    abstract:BACKGROUND:Transduodenal sphincterotomy (TS) has fallen into disuse since endoscopists developed techniques to treat sphincter problems nonsurgically. However, some patients experience recurrent sphincter strictures after endoscopic sphincterotomy (ES), with the ampulla endoscopically inaccessible, and pancreas divisum...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2009.08.048

    authors: Miccini M,Amore Bonapasta S,Gregori M,Bononi M,Fornasari V,Tocchi A

    更新日期:2010-08-01 00:00:00

  • The natural history of pancreatic pseudocysts: a unified concept of management.

    abstract::Between 1971 and 1976, ninety-three patients with a clinical diagnosis of pseudocyst confirmed by ultrasonography were identified from a group of 923 patients admitted for pancreatic disease. Uncertainties in diagnosis and/or rapid progression of underlying pancreatitis led to urgent laparotomy and drainage in eleven ...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/0002-9610(79)90024-2

    authors: Bradley EL,Clements JL Jr,Gonzalez AC

    更新日期:1979-01-01 00:00:00

  • The impact of race on outcomes following emergency surgery: an American College of Surgeons National Surgical Quality Improvement Program assessment.

    abstract:BACKGROUND:Despite significant evolutions in health care, outcome discrepancies exist among demographic cohorts. We sought to determine the impact of race on emergency surgery outcomes. METHODS:This is a retrospective review of the American College of Surgeons National Surgical Quality Improvement Program database (20...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2012.11.022

    authors: Causey MW,McVay D,Hatch Q,Johnson E,Maykel JA,Champagne B,Steele SR

    更新日期:2013-08-01 00:00:00

  • Adventitial contributions of the extracellular signal-regulated kinase and Akt pathways to neointimal hyperplasia.

    abstract:BACKGROUND:We recently reported that the efficacy of nitric oxide (NO) appears to be based on both sex and hormone status. The mechanism responsible for this differential efficacy is unknown. The aim of this study was to characterize the effect of sex, hormones, and NO on the extracellular signal-regulated kinase (ERK)...

    journal_title:American journal of surgery

    pub_type: 杂志文章

    doi:10.1016/j.amjsurg.2011.06.022

    authors: Havelka GE,Hogg ME,Martinez J,Banjeree MN,Jiang Q,Kibbe MR

    更新日期:2011-11-01 00:00:00