Julius H. Grollman

Arteriography in the Diagnosis of Islet-Cell Tumors

The results of arteriography in 8 patients with islet-cell tumors of the pancreas, combined with findings in the literature, serve as a basis for evaluation of the accuracy of the procedure in diagnosing these tumors. Arteriographic findings were positive in 80% of all patients with proved tumors. By excluding individually reported positive and negative cases, a more realistic figure of 63% was obtained. Techniques for improving diagnostic accuracy are discussed.

Transbrachial arteriography: techniques and complications

A study of 72 patients angiographically examined by the percutaneous transbrachial technique with 4–5F catheters is reported. Even though the patients were preselected to reduce the risk of the technique, an unacceptably high incidence (7%) of major complications, including 3 patients requiring surgery for brachial thrombosis, was encountered. Although transbrachial catheterization with single 4F catheter midstream injections as reported in the literature may be safe, this technique is unwarranted when selective studies are planned and the alternative transfemoral approach is available.

Acute Lower Gastrointestinal Bleeding Secondary to Varices of the Superior Mesenteric Venous System

Varices of the superior mesenteric vein were demonstrated angiographically in 2 patients with portal hypertension and lower gastrointestinal bleeding. Such a collateral route between the superior mesenteric vein and the inferior vena cava via the right ovarian vein has been described in occlusion of the inferior vena cava but not in portal hypertension. The importance of visualizing the entire superior mesenteric venous drainage in patients with portal hypertension and lower gastrointestinal bleeding is emphasized.

Thrombosis detection by radionuclide particle (MAA) entrapment: correlation with fibrinogen uptake and venography

Macroaggregated albumin (MAA) entrapment in areas of fibrin deposits has been used to detect intravenous thrombosis in the lower extremities. This study reports the correlation of MAA uptake in thrombosis with venography and autologous 125I-labeled fibrinogen uptake in approximately 30 cases. Correlation was good in most patients who underwent at least two of these procedures. The MAA thrombosis scan appears especially accurate in locating thrombosis in the upper thigh or pelvis where fibrinogen uptake is less helpful. The correlation suggests that the MAA scan has very few false negative results. The procedure is easily performed in conjunction with a perfusion lung scan.

Abnormal Vascularity in Left Ventricular Mural Thrombus Demonstrated by Selective Coronary Arteriography

Abnormal vascularity in left ventricular mural thrombus with washout into the left ventricular chamber was demonstrated during selective coronary arteriography. The abnormal vascular blush is caused by neovascularization extending into the thrombus from the myocardium. Abnormal vascularity in the left ventricle demonstrated during coronary arteriography does not necessarily mean tumor, but suggests mural thrombus.

Arteriography inthe diagnosis of gallbladder disease.

The Gallbladder is often visualized by arteriography, especially with the use of superselective methods. Several cases of gallbladder or bile duct disease have been included in reported series of celiac and superior mesenteric arteriography (1, 2, 6). Deutsch recently gave in detail his experience with various pathologic lesions of the gallbladder (3). In our article we will evaluate our experience by retrospective correlation of angiographic findings with proved pathologic conditions. From 1,000 celiac and superior mesenteric arterio-graphic examinations, we have selected for review 56 patients with primary or secondary gallbladder disease confirmed by surgery or autopsy. The detailed distribution of disease is shown in TABLE I. Fifty patients without gallbladder disease and good visualization of the gallbladder were selected for control and evaluation of the normal angiographic findings. Technic The femoral approach and a red, thin-wall Kifa catheter (I.D. = 1.4 mm and O.D. = 2.2 mm) have been used in m...

Arteriography in the Diagnosis of Gallbladder Disease1

The Gallbladder is often visualized by arteriography, especially with the use of superselective methods. Several cases of gallbladder or bile duct disease have been included in reported series of celiac and superior mesenteric arteriography (1, 2, 6). Deutsch recently gave in detail his experience with various pathologic lesions of the gallbladder (3). In our article we will evaluate our experience by retrospective correlation of angiographic findings with proved pathologic conditions. From 1,000 celiac and superior mesenteric arterio-graphic examinations, we have selected for review 56 patients with primary or secondary gallbladder disease confirmed by surgery or autopsy. The detailed distribution of disease is shown in TABLE I. Fifty patients without gallbladder disease and good visualization of the gallbladder were selected for control and evaluation of the normal angiographic findings. Technic The femoral approach and a red, thin-wall Kifa catheter (I.D. = 1.4 mm and O.D. = 2.2 mm) have been used in m...

The aortic diverticulum: a remnant of the partially involuted dorsal aortic root.

The aortic diverticulum, a large bulge on the lesser curvature of the aortic isthums, is an occasional variation found during thoracic aortography in patients with a left aortic arch and normal origin of the brachiocephalic arteries. Although it is commonly thought to be a remnant of the closed ductus arteriosus, the results of this study support the hypothesis that it is a remnant of the right dorsal aortic root.The aortic diverticulum, a large bulge on the lesser curvature of the aortic isthums, is an occasional variation found during thoracic aortography in patients with a left aortic arch and normal origin of the brachiocephalic arteries. Although it is commonly thought to be a remnant of the closed ductus arteriosus, the results of this study support the hypothesis that it is a remnant of the right dorsal aortic root.The aortic diverticulum, a large bulge on the lesser curvature of the aortic isthums, is an occasional variation found during thoracic aortography in patients with a left aortic arch and normal origin of the brachiocephalic arteries. Although it is commonly thought to be a remnant of the closed ductus arteriosus, the results of this study support the hypothesis that it is a remnant of the right dorsal aortic root.

A Potent Drug Combination for Producing Constriction of the Superior Mesenteric Artery and its Branches

The use of epinephrine in renal arteriography to bring about constriction of the normal renal vessels and relative enhancement of tumor vascularity is now an accepted technic (1, 6). On the other hand, epinephrine injected into the superior mesenteric artery fails to produce consistent vasoconstriction and is of uncertain value in improving visualization of pathologic vessels in the bowel and mesenteric bed (5, 7). It has recently been shown by one of us that infusions of epinephrine into the superior mesenteric artery of anesthetized cats may actually increase mesenteric blood flow, after a brief period of reduced flow (11). After induction of “beta-adrenergic blockade” of the animal with intravenous propranolol, however, an epinephrine infusion into the superior mesenteric artery causes a sustained reduction in mesenteric blood flow throughout the period of the infusion. These observations suggested that administration of epinephrine clinically into the superior mesenteric artery in the presence of beta...

Superselective Arteriography in the Diagnosis of Abdominal Pathology: Technical Considerations

Selective arteriography of the major visceral branches—celiac, superior, and inferior mesenteric arteries—has come to be accepted as one of the most important special technics in abdominal diagnosis. Diagnosis of pathological processes of parenchymatous organs is substantially improved, and important information may be obtained about abnormalities of hollow organs. This technic, however, has its disadvantages. Overlapping vessels frequently make evaluation difficult, especially in the region of the pancreas, stomach, and upper pole of the spleen and occasionally in the left lobe of the liver and mid transverse colon. Selective arteriography also does not guarantee the optimal filling of small pancreatic, duodenal, and gastric vessels supplied by more than one arterial trunk. Early pathologic processes can therefore escape detection. Superselective arteriography, when the catheter is introduced further into the branches of the main trunks and contrast medium is injected only into the artery supplying the o...