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OBJECTIVES The aims of this study were to determine if angiographic findings can be used to predict successful nonoperative therapy of splenic injury and to determine if coil embolization of the proximal splenic artery provides effective hemostasis. METHODS Splenic injuries detected by diagnostic imaging between 1981 and 1993 at a level I trauma center(More)
HYPOTHESIS Measurement of pelvic hemorrhage on computed tomographic (CT) scans can estimate the pelvic fracture component of total patient blood loss and predict the need for angiography. DESIGN Retrospective cohort study. SETTING Large level 1 trauma center. PATIENTS We examined data from 759 consecutive, nonreferral blunt trauma patients who(More)
PURPOSE To compare the efficacy of radiologic guided placement of percutaneous gastrojejunostomy (PGJ) and percutaneous endoscopic gastrostomy (PEG). MATERIALS AND METHODS Patients were randomized to PGJ (n = 66) or PEG (n = 69). Indications for gastrostomy were need for prolonged enteral nutrition (97%) or gastrointestinal decompression (3%), with(More)
BACKGROUND Endovascular stent grafts (EVSGs) offer an alternative in the management of traumatic rupture of the aorta, particularly in patients who are at prohibitive operative risk. METHODS We conducted a retrospective review of 11 cases managed by EVSGs over a 4-year period. EVSGs were defined as "noncommercial" (graft material hand sewn over metallic(More)
Advances in interventional angiography such as covered stent technology and adjunctive anticoagulation and antiplatelet therapy for arterial recanalization have reached the margins of percutaneous application. In these circumstances, compression methods of arterial closure require prolonged compression or long arterial sheath dwell times that increase(More)
BACKGROUND Pelvic fractures can be an important source of major hemorrhage in victims of blunt trauma. However, no rapid and reliable noninvasive method exists for predicting which subjects will have major hemorrhage. The objective of this study is to use information available upon presentation to the trauma center to develop a clinical prediction rule to(More)
Widening of the mediastinum on chest radiography is widely promoted as a useful criterion for detecting aortic injury. We sought to determine the reliability, sensitivity, and specificity of this sign. The initial chest radiographs from 30 subjects with aortic injury and 47 controls were independently reviewed by six radiologists, who were blinded to(More)
PURPOSE To describe the precise anatomical location and extent of injury (based on angiography) in a series of patients with blunt thoracic aortic injury (BTAI) and evaluate the findings relative to the potential for endograft repair. METHODS Thoracic aortograms from 50 trauma patients (37 men; mean age 37 years, range 13-87) with BTAI were(More)
PURPOSE To evaluate whether peripherally inserted central catheters (PICCs) with a proximal valve have any advantage compared to those with a distal valve in regard to the incidence of occlusion, infection, or malfunction. MATERIALS AND METHODS One hundred patients (mean age, 46 y) were randomized to receive either a distal-valved Bard Groshong catheter(More)
PURPOSE To examine prospectively the effects of balloon inflation time on the technical success of balloon angioplasty in dialysis access venous stenosis and on postintervention primary patency. MATERIALS AND METHODS The study design was approved by the institution's Committee for the Protection of Human Subjects, and informed consent was obtained.(More)