R E Lambiase's research while affiliated with Rhode Island Hospital and other places

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Publications (28)


Fig. 1-9-year-old boy with acute ataxia and progressive loss of consciousness after trauma. Initial head CT scan (not shown) had negative findings. A and B, Diagnostic angiograms obtained approximately 5 hr after onset of symptoms with 5-French Davis catheters (cook, Bloomington, IN) placed in left (A) and right (B) vertebral arteries reveal stenosis of basilar artery at distal third (arrow, A) and complete occlusion of right vertebral artery at level of C2 (arrow, B). Note sharp taper at level of vertebral artery occlusion consistent with dissection and thrombosis. C, Angiogram obtained after thrombolysis with infusion of 1.5 million units of urokinase over 90 mm reveals small filling defect in distal basilar artery (arrow) consistent with minimal residual thrombus. Thrombolysis of basilar artery was performed via left vertebral artery approach. catheter manipulation in right vertebral artery was avoided to reduce chance of extending presumed dissection. D and E, Axial T2-weighted turbo spin-echo MR images (TRITE, 5637/1 12) obtained 3 days afterA-C reveal high-signal-intensityfoci in pons (white arrow, D) and cerebellum 
Acute vertebrobasilar occlusion: Treatment with high-dose intraarterial urokinase
  • Article
  • Full-text available

April 1999

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24 Reads

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14 Citations

American Journal of Roentgenology

A I Hoffman

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R E Lambiase

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Objective: The purpose of this study was to describe our successful experience with high-dose intraarterial urokinase therapy in treating acute, life-threatening vertebrobasilar occlusion. Conclusion: We successfully treated five patients with acute vertebrobasilar occlusion who presented up to 24 hr after the onset of symptoms. Higher doses of urokinase than are commonly reported in the literature were used in this series at a rapid infusion rate with a "pulse-spray" technique. The result was prompt thrombolysis and good clinical outcome.

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Long bone surface osteomas: Imaging features that may help avoid unnecessary biopsies

October 1998

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23 Reads

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18 Citations

American Journal of Roentgenology

Objective: Our purpose is to show that a combination of imaging techniques and periodic radiologic follow-up offers an alternative to biopsy in certain patients with long bone surface osteomas. Conclusion: Asymptomatic lesions that are consistent with osteoma on a combination of imaging studies can be followed up clinically and radiographically, allowing patients to avoid unnecessary biopsies.



Percutaneous Revascularization of Complex Iliac Artery Stenoses and Occlusions with Use of Wallstents: Three-year Experience

January 1996

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24 Reads

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105 Citations

Journal of Vascular and Interventional Radiology

To assess the outcome of percutaneous placement of Wallstents for treatment of hemodynamically significant diffuse stenoses (> 3 cm in length), chronic occlusions, failed angioplasty procedures, and flow-limiting dissection in the iliac arteries. Lesions in 94 iliac limbs were treated in 66 patients. Indications for stent placement included claudication in 49 limbs and limb-threatening ischemia in 45. Forty-two limbs were treated for diffuse disease, 39 for chronic occlusion, nine for failed angioplasty, and four for flow-limiting dissection. Technical success was achieved in 86 of 94 limbs (91%), with major complications in 9% of patients. One death occurred within 30 days (not procedure-related). Ankle-brachial indexes improved from 0.51 +/- 0.24 to 0.76 +/- 0.22 (P < .001). Eighty-five percent demonstrated improvement under Rutherford criteria. Follow-up was obtained up to 38 months (mean, 14 months +/- 8). Cumulative primary patency rates were 78% at 1 year and 53% at 2 and 3 years (standard error 10%). Secondary patency rates were 86% at 1 year and 82% up to 32 months (standard error > 10% after 32 months). No significant decrease in mean ankle-brachial index was observed during follow up. No difference in primary patency was observed based on lesion type, symptom severity, lesion location, or runoff status. The limb salvage rate for patients with limb-threatening ischemia was 98% at a mean follow-up of 14 months +/- 7. Technical success and complication rates for percutaneous iliac artery revascularization with use of Wallstents are favorable, symptoms improved in the majority of patients, and excellent secondary patency can be achieved. With use of Wallstents, most patients with iliac artery insufficiency as a result of long-segment disease or chronic occlusions can be treated percutaneously.



Tc-99m MDP uptake in osteopoikilosis

February 1994

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19 Reads

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37 Citations

Clinical Nuclear Medicine

A Tc-99m bone scan of a patient with classic roentgenographic findings of osteopoikilosis revealed multiple foci of increased activity that corresponded to many of the sclerotic foci on the roentgenograms. The authors presume that the abnormal bone scan in this patient reflects active osseous remodeling, similar to what has been observed in bone islands. Previous reports have emphasized the critical role of the radionuclide bone scan for distinguishing osteopoikilosis from osteoblastic bone metastases in patients with a known or suspected primary malignancy. In a young patient, an abnormal bone scan does not exclude the diagnosis of osteopoikilosis if the roentgenographic findings are characteristic of that entity.


Tc99m MDP Uptake in Osteopoikilosis

January 1994

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10 Reads

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30 Citations

Clinical Nuclear Medicine

A Tc-99m bone scan of a patient with classic roentgenographic findings of osteopoikilosis revealed multiple foci of increased activity that corresponded to many of the sclerotic foci on the roentgenograms. The authors presume that the abnormal bone scan in this patient reflects active osseous remodeling, similar to what has been observed in bone islands. Previous reports have emphasized the critical role of the radionuclide bone scan for distinguishing osteopoikilosis from osteoblastic bone metastases in patients with a known or suspected primary malignancy. In a young patient, an abnormal bone scan does not exclude the diagnosis of osteopoikilosis if the roentgenographic findings are characteristic of that entity.


Citations (21)


... In the bone scan, due to active osseous remodeling, slightly increased activity is present [9]. However, an abnormal bone scan doesn't exclude osteopoikilosis if typical radiologic indings are present [11]. ...

Reference:

Osteopoikilosis: a rare case with interesting imaging
Tc99m MDP Uptake in Osteopoikilosis
  • Citing Article
  • January 1994

Clinical Nuclear Medicine

... In recent times with the development of intervention radiology as a subspecialty, the management of liver abscess has completely evolved from medicine-centric disease to minimally invasive image-guided treatment-centric disease. Percutaneous drainage (either needle aspiration or catheter drainage) along with systemic antibiotics has become the core method of treatment of LA [5][6][7][8]. The role of the intervention radiologist is therefore of prime importance from diagnosis to followup of the patients. ...

Percutaneous drainage of 335 consecutive abscesses: Results of primary drainage with 1-year follow-up
  • Citing Article
  • August 1992

Radiology

... Furthermore, the development of fistulas connecting the abscesses to the bronchial or biliary system may manifest [10]. The development of a fistula between a liver abscess and intrahepatic bile ducts is a very uncommon complication of PLA and an infrequent cause of bile leakage [2][3][4][5][6][7][8][9]11]; the infrequent occurrence of this complication is likely a result of the vasculobiliary sheath's resistance, a tough layer of fibrous tissue that encircles the segmental portal systems (bile duct, hepatic artery, and portal vein) [12]; also, the presence of biliary communication has the potential to impede the resolution of an abscess following percutaneous drainage and necessitate an extended duration of drainage compared to patients whose abscesses do not have a fistula [13,14]. ...

Percutaneous Drainage of Hepatic Abscesses: Comparison of Results in Abscesses With and Without Intrahepatic Biliary Communication

American Journal of Roentgenology

... Reported series range from 1 to 16 patients being treated for distal arm and hand arterial occlusive disease with thrombolytic therapy. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Objective description of the level of ischemia, original and completion angiographic findings, and long-term clinical outcomes are variable, making firm conclusions difficult. ...

Extensive Thromboembolic Disease of the Hand and Forearm: Treatment with Thrombolytic Therapy
  • Citing Article
  • June 1991

Journal of Vascular and Interventional Radiology

... PTBT is with relatively low risk and a considerably positive result. The procedure has proven to be less intricate in dilated than in nondilated ducts [52,[82][83][84][85]. The reason for absence of dilatation is the presence of leak, despite the distal stenosis. ...

Treatment of biliary leaks and fistulae by simultaneous percutaneous drainage and diversion
  • Citing Article
  • March 1991

CardioVascular and Interventional Radiology

... Due to the infection the duration of the hospital stay, use of antibiotics are increased. [16] reported 12% complication rate in series of catheter drainage. Baek et al [17] reported 4% complication rate in series of percutaneous needle aspiration. ...

Percutaneous abscess and fluid drainage: A critical review
  • Citing Article
  • May 1991

CardioVascular and Interventional Radiology

... Nonbifurcating carotid artery (NBCA) is an exceptionally rare vascular anomaly with only a handful of evidence in the literature. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The development of the carotid arteries is quite complex, and explaining the embryological basis behind its variants is daunting. Various authors have tried to ascertain the embryological anomaly behind the variants, but could not conclusively give a theory that could fully encompass it. ...

Anomalous branching of the left common carotid artery with associated atherosclerotic changes: A case report
  • Citing Article
  • January 1991

American Journal of Neuroradiology

... Usually, abscess size less than 3 cm are treated solely with antibiotics and drainage is warranted for larger abscesses. 16 A few predictive factors which may determine poor outcomes include obstructive uropathy, diabetes and old age. In our patient, obstructive uropathy and type 2 diabetes were both present leading to a prolonged hospital stay and course of antibiotics. ...

Percutaneous drainage of renal and perirenal abscesses: Results in 30 patients

American Journal of Roentgenology

... A common early post-procedure complication of filter placement is insertion site thrombosis (IST). (Table 1) 27,[57][58][59][60][61][62] IST is a deep venous thrombosis that develops at the venous insertion site. Given the process of filter insertion and the patient population, it is not surprising that non-occlusive and occasionally occlusive thrombi develop at the site of venous access. ...

Iatrogenic changes at the venotomy site after percutaneous placement of the Greenfield filter
  • Citing Article
  • November 1989

Radiology

... Image-guided catheter drainage of abscesses caused by fistulae involves evacuating the abscess and, in select patients, catheter cannulation of the tract. The success rates of techniques to resolve postoperative abscess-fistula complexes range from 57% to 100% (2,(8)(9)(10)(11)(12)(13)(14). The reported techniques, cannulation of the fistula tract or not, and timing of cannulation vary considerably in previous series. ...

Postoperative abscesses with enteric communication: Percutaneous treatment
  • Citing Article
  • June 1989

Radiology