Sixty central venous catheterizations in 53 patients were prospectively studied with respect to phlebographic findings after prolonged parenteral nutrition. Phlebography was performed by a special technique on completion of the intravenous therapy. Under fluoroscopic control, the central venous catheter was slowly removed, while simultaneously contrast medium was continuously injected through it. Two types of thrombosis were demonstrated--sleeve thrombosis, on 25 occasions (42%), and mural veno-occlusive thrombosis, on five occasions (8%). On removal of the catheter the sleeve thrombosis peeled off the catheter and in several cases it was noticed that parts of the sleeve thrombus or the entire sleeve became detached and were carried away with the blood flow. Although the sleeve thrombus seldom gave rise to any symptoms, this type of thrombosis is of great importance in view of the risk of pulmonary embolism, especially in connection with removal of the catheter. With use of the described phlebographic technique thrombi of this type can be visualized.
Serial graft angiographies and scintigraphies were obtained in 4 human pancreatic allograft recipients. Important information was obtained both of graft morphology and function. Graft rejection was accompanied by characteristic abnormalities, including arterial irregularities and prolonged contrast medium passage time. On scintigraphy, rejection was associated with reduced isotope uptake.
A method for the diagnosis of disc herniation and nerve root compression in the lower lumbar and upper sacral spine is presented. Computed tomography of the spine was carried out after injection of a positive contrast medium into the epidural space. Preliminary results indicate a high diagnostic accuracy.
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