Iliac artery stenosis and occlusion: preliminary results of treatment with Gianturco expandable metallic stents

Article Abstract:

Percutaneous transluminal angioplasty (PTA) is a surgical method of opening blocked blood vessels by inflating a tiny balloon at the end of a catheter inserted into the vessel. Improvements in its success rate have been made although the long-term ability to keep the vessels open is not always high in certain types of cases. This study examined the use of Gianturco expandable metallic stents (artificial passages to keep blood vessels open) inserted in iliac arteries immediately after PTA, to increase the immediate and long-term success of the procedure. Ten patients with narrowing or occlusion in the iliac artery underwent PTA. Five of the patients had occluded arteries and were given infusions of urokinase (an enzyme used to break up clots) prior to the procedures. Stents were placed in the arteries immediately after PTA. The patients were then followed for 2 to 18 months with regular clinical examinations and Doppler studies to measure the flow rate of blood in the vessels. The results showed successful placement of the stents in all 10 patients. Flow rates increased and clinical symptoms improved in all the patients. Follow-up exams showed no movement of the stents and no recurrence of narrowing or occlusion in the treated arteries. Flow rates remained higher than pre-treatment levels. Although the results are based on a small sample covering a relatively short period of time, they indicate that expandable metallic stents may be very valuable in the treatment of narrow or occluded blood vessels. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Surgery, Transluminal angioplasty, Balloon angioplasty, Arteries, Stent (Surgery), Stents, Arterial occlusions, Arterial occlusive diseases, Arterial stenosis

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Tumors of the bronchi: role of evaluation with CT

Article Abstract:

Computed tomography (CT) scanning was performed on 142 patients suspected of having an endobronchial tumor (tumor of the smaller bronchi of the lungs) to evaluate the accuracy and effectiveness of CT. All of the patients had undergone CT and bronchoscopy; diagnoses were confirmed by bronchoscopy in 110 patients and by bronchoscopy and surgery in the remaining 32. The CT scans were interpreted by two experienced radiologists. The results of this study demonstrate that CT is effective in showing the correct location and extension of a bronchial mass. CT was also able to locate tumors of a size less than one centimeter. It was noted that CT may overlook small tumors growing in the bronchial wall that do not cause narrowing or thickening of the wall. Tumors associated with local inflammation and swelling may also be overlooked or misdiagnosed with CT. These two types of tumors can be diagnosed by bronchoscopy and tissue biopsy. The researchers recommend CT as the first method of choice to visualize the endobronchial and extrabronchial parts of a mass or lesion. However, they emphasize that CT cannot replace bronchoscopy or tissue biopsy. It is their conclusion that CT and bronchoscopy should be applied as complementary diagnostic methods. CT can be most effectively used in cases where a tumor is suspected and a chest image is needed to guide bronchoscopy, or in those patients with normal chest radiographs who, despite normal or inconclusive bronchoscopy, are still suspected of having a bronchial mass.

Methods, Diagnosis, Tomography, Lung tumors, Bronchoscopy

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Right upper lobe versus right middle lobe: differentiation with thin-section, high-resolution CT

Article Abstract:

In evaluating lobar volume loss differentiation between the upper and middle lobes of the lung may be difficult with conventional computed tomography (CT) scanning or by using bronchography (a method for imaging lungs following the injection of a dye). A new method using thin-section, high-resolution CT was employed by researchers to obtain an accurate evaluation of lobar volume loss. Using this new method researchers evaluated the CT scans of 117 patients, including 54 with lobar volume loss. The new method is capable of evaluating subsegmental (i.e., much greater anatomical specificity) portions of the lung bronchi and differentiating between upper and middle lobes more accurately than is permitted by conventional CT imaging techniques.

Bronchi

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