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Bonafe A, Perez MA, Henkes H, Lylyk P, Bleise C, Gascou G, Sirakov S, Sirakov A, Stockx L, Turjman F, Petrov A, Roth C, Narata AP, Barreau X, Loehr C, Berlis A, Pierot L, Miś M, Goddard T, Clifton A, Klisch J, Wałęsa C, Dall'Olio M, Spelle L, Clarencon F, Yakovlev S, Keston P, Nuzzi NP, Dima S, Wendl C, Willems T, Schramm P. Diversion-p64: results from an international, prospective, multicenter, single-arm post-market study to assess the safety and effectiveness of the p64 flow modulation device. J Neurointerv Surg 2021; 14:898-903. [PMID: 34782399 PMCID: PMC9380510 DOI: 10.1136/neurintsurg-2021-017809] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/21/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The use of flow diversion to treat intracranial aneurysms has increased in recent years. OBJECTIVE To assess the safety and angiographic efficacy of the p64 flow modulation device. METHODS Diversion-p64 is an international, prospective, multicenter, single-arm, study conducted at 26 centers. The p64 flow modulation device was used to treat anterior circulation aneurysms between December 2015 and January 2019. The primary safety endpoint was the incidence of major stroke or neurologic death at 3-6 months, with the primary efficacy endpoint being complete aneurysm occlusion (Raymond-Roy Occlusion Classification 1) on follow-up angiography. RESULTS A total of 420 patients met the eligibility criteria and underwent treatment with the p64 flow modulation device (mean age 55±12.0 years, 86.2% female). Mean aneurysm dome width was 6.99±5.28 mm and neck width 4.47±2.28 mm. Mean number of devices implanted per patient was 1.06±0.47, with adjunctive coiling performed in 14.0% of the cases. At the second angiographic follow-up (mean 375±73 days), available for 343 patients (81.7%), complete aneurysm occlusion was seen in 287 (83.7%) patients. Safety data were available for 413 patients (98.3%) at the first follow-up (mean 145±43 days) with a composite morbidity/mortality rate of 2.42% (n=10). CONCLUSIONS Diversion-p64 is the largest prospective study using the p64 flow modulation device. The results of this study demonstrate that the device has a high efficacy and carries a low rate of mortality and permanent morbidity.
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Affiliation(s)
- Alain Bonafe
- Department of Neuroradiology, Hopital Gui de Chauliac, Montpellier, France
| | - Marta Aguilar Perez
- Neuroradiologische Klinik, Klinikum Stuttgart, Stuttgart, Baden-Württemberg, Germany
| | - Hans Henkes
- Neuroradiologische Klinik, Klinikum Stuttgart, Stuttgart, Baden-Württemberg, Germany
| | - Pedro Lylyk
- Departamento de Neurociencias, ENERI, Clínica La Sagrada Familia, Buenos Aires, Argentina
| | - Carlos Bleise
- Departamento de Neurociencias, ENERI, Clínica La Sagrada Familia, Buenos Aires, Argentina
| | - Gregory Gascou
- Department of Neuroradiology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Stanimir Sirakov
- Department of Radiology, University Hospital St Ivan Rilski, Sofia, Bulgaria
| | - Alexander Sirakov
- Department of Radiology, University Hospital St Ivan Rilski, Sofia, Bulgaria
| | - Luc Stockx
- Neuroradiology, Ziekenhuis Oost-Limburg - Campus Sint Jan, Genk, Belgium
| | - Francis Turjman
- Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Lyon, France
| | - Andrey Petrov
- Department of Vascular Neurosurgery, Russian Polenov Neurosurgical Institute, Federal Almazov North West Medical Research Centre, St Petersburg, Russian Federation
| | - Christian Roth
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Bremen-Mitte gGmbH, Bremen, Germany
| | - Ana-Paula Narata
- Department of Interventional Neuroradiology, Regional University Hospital, Tours, France
| | - Xavier Barreau
- Department of Neuroradiology, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, France
| | - Christian Loehr
- Department of Radiology and Neuroradiology, Klinikum Vest GmbH Behandlungszentrum Knappschaftskrankenhaus Recklinghausen, Recklinghausen, Nordrhein-Westfalen, Germany
| | - Ansgar Berlis
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Augsburg, Augsburg, Bayern, Germany
| | - Laurent Pierot
- Department of Neuroradiology, Hôpital Maison Blanche, Reims, France
| | - Marcin Miś
- Department of General Radiology, Interventional Radiology, and Neuroradiology, Wroclaw Medical University, Wroclaw, Dolnoslaskie, Poland
| | - Tony Goddard
- Department of Neuroradiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Andy Clifton
- Department of Neuroradiology, St George's Hospital, London, UK
| | - Joachim Klisch
- Department of Neuroradiology, HELIOS Klinikum Erfurt, Erfurt, Thüringen, Germany
| | - Cezary Wałęsa
- Neuroradiology, Regionalny Szpital Specjalistyczny im dr Wl Bieganskiego, Grudziadz, Poland
| | - Massimo Dall'Olio
- Neuroradiology, Ospedale Bellaria Carlo Alberto Pizzardi, Bologna, Italy
| | - Laurent Spelle
- Department of Interventional Neuroradiology, BICETRE HOSPITAL - APHP, Le Kremlin-Bicetre, France.,Faculty of Medicine, Paris-Saclay University, Le Kremlin-Bicetre, France
| | - Frédéric Clarencon
- Department of Neuroradiology, Hôpital Universitaire Pitié Salpêtrière Service de Neuroradiologie Interventionnelle, Paris, Île-de-France, France
| | - Sergey Yakovlev
- Neuroradiology, Burdenko Neurosurgical Clinic, Moskva, Russian Federation
| | - Peter Keston
- Department of Clinical Neuroscience, NHS Lothian, Edinburgh, UK
| | - Nunzio Paolo Nuzzi
- Neuroradiologia Interventistica, IRCCS Istituto Clinico Humanitas, Rozzano, Lombardia, Italy
| | - Stefanita Dima
- Clinica de Neurochirurgie si Terapie Endovasculara Neurolife, Life Memorial Hospital, Bucharest, Romania
| | - Christina Wendl
- Institut für Röntgendiagnostik, Universitatsklinikum Regensburg, Regensburg, Bayern, Germany
| | | | - Peter Schramm
- Department of Neuroradiology, Universitätsklinikum Schleswig-Holstein Campus Lübeck, Lubeck, Schleswig-Holstein, Germany
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Miśkiewicz-Bujna J, Miśkiewicz-Migoń I, Panasiuk A, Kubica-Cielińska A, Zielińska M, Waszczuk Ł, Bladowska J, Miś M, Bąbol-Pokora K, Młynarski W, Ociepa T, Kałwak K, Gorczyńska E, Ussowicz M. Severe and fatal toxicity after hematopoietic stem cell transplantation in GNE defect-associated thrombocytopenia. Bone Marrow Transplant 2021; 56:1714-1716. [PMID: 33637881 DOI: 10.1038/s41409-021-01235-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/18/2021] [Accepted: 02/01/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Justyna Miśkiewicz-Bujna
- Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland
| | - Izabella Miśkiewicz-Migoń
- Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Panasiuk
- Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Kubica-Cielińska
- Department of Paediatric Anaesthesiology and Intensive Care, Wroclaw Medical University, Wroclaw, Poland
| | - Marzena Zielińska
- Department of Paediatric Anaesthesiology and Intensive Care, Wroclaw Medical University, Wroclaw, Poland
| | - Łukasz Waszczuk
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Joanna Bladowska
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Marcin Miś
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Bąbol-Pokora
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Łódź, Poland
| | - Wojciech Młynarski
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Łódź, Poland
| | - Tomasz Ociepa
- Department of Pediatrics, Hemato-Oncology and Gastroenterology, Pomeranian Medical University, Szczecin, Poland
| | - Krzysztof Kałwak
- Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland
| | - Ewa Gorczyńska
- Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland
| | - Marek Ussowicz
- Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland.
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Letachowicz K, Gołębiowski T, Miś M, Wolańczyk M, Zmonarski S, Krajewska M. Partial breakage of a tunneled dialysis catheter: An uncommon finding. Hemodial Int 2020; 25:E15-E17. [PMID: 33073510 DOI: 10.1111/hdi.12894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 09/25/2020] [Indexed: 12/14/2022]
Abstract
Infections and dysfunction are the most common complications related to catheter use. Here we describe a case of catheter rupture on the course of subcutaneous channel. Catheter fractures are relatively rare, but potentially hazardous complications. In case of partial breakage, a catheter exchange should be a simple solution.
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Affiliation(s)
- Krzysztof Letachowicz
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Gołębiowski
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Marcin Miś
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Michał Wolańczyk
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Sławomir Zmonarski
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
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4
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Gołębiowski T, Poznański P, Kusztal M, Miś M, Szczurowska A, Letachowicz K, Konieczny A, Majchrzak K, Janczak D, Krajewska M. Carotid artery tortuosity may pose a problem during insertion of the tunneled catheter for hemodialysis. Artif Organs 2020; 45:303-308. [PMID: 32920839 DOI: 10.1111/aor.13817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/29/2020] [Accepted: 09/03/2020] [Indexed: 11/27/2022]
Abstract
Tortuosity of the carotid artery is usually an asymptomatic vascular abnormality and is discovered accidentally during cerebral angiography. These vascular changes may aggravate surgical procedures in the neck region. We described a technique of permanent catheter insertion in patients with renal graft failure in whom renal replacement therapy was necessary. Severe tortuosity of cervical arteries may make this procedure more difficult, necessitating a special technique, that is, full image monitoring.
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Affiliation(s)
- Tomasz Gołębiowski
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Paweł Poznański
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Mariusz Kusztal
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Marcin Miś
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Agata Szczurowska
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Letachowicz
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Andrzej Konieczny
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Konrad Majchrzak
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Dariusz Janczak
- Department of Vascular, General and Transplantation Surgery, Wroclaw Medical University, Wrocław, Poland
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
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5
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Banasik M, Dawiskiba T, Letachowicz K, Zmonarski S, Mazanowska O, Lipiak E, Miś M, Janczak D, Krajewska M. Pleural effusion with arm, breast, and face edema as a complication of subclavian vein catheterization and arteriovenous fistula in a patient after renal transplantation: A therapeutic approach. J Vasc Access 2020; 22:1017-1020. [PMID: 32985359 DOI: 10.1177/1129729820961959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A 52-year-old woman after renal transplantation developed unilateral pleural effusion as well as a massive edema of the upper limb, breast, and face as a complication of the subclavian vein catheterization and arteriovenous fistula for hemodialysis. We revealed that impaired venous drainage due to extensive vein occlusion after temporary catheter insertion, together with high venous flow from the arteriovenous fistula, were the explanation. Because of moderately impaired renal graft function and limited availability of vascular access in the patient, fistula ligation as a therapeutic method described in literature, was not an option in our case. The patient underwent an unsuccessful attempt of venous angioplasty, and eventually banding of the fistula and blood flow reduction resolved pleural effusions and edema. This is a reasonable approach to the problem of massive upper torso edema due to central vein occlusion with ipsilateral arteriovenous fistula.
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Affiliation(s)
- Mirosław Banasik
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Tomasz Dawiskiba
- Department of Vascular, General and Transplantation Surgery, Wroclaw Medical University, Wrocław, Poland
| | - Krzysztof Letachowicz
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Sławomir Zmonarski
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Oktawia Mazanowska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Edyta Lipiak
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Marcin Miś
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
| | - Dariusz Janczak
- Department of Vascular, General and Transplantation Surgery, Wroclaw Medical University, Wrocław, Poland
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland
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6
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Szczurowska A, Banasik M, Kurcz J, Miś M, Nowańska K, Madziarska K, Mazanowska O, Krajewska M, Garcarek J, Guziński M. Intra-arterial computed tomography angiography with ultra-low volume of iodine contrast and stent implantation in transplant renal artery stenosis in terms of contrast-induced kidney injury - a preliminary report. Pol J Radiol 2020; 85:e174-e177. [PMID: 32419881 PMCID: PMC7218445 DOI: 10.5114/pjr.2020.94364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 02/25/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Traditional digital subtraction angiography is still regarded as the gold standard in the diagnostics of transplant renal artery stenosis (TRAS). However, this procedure requires a high volume of iodine contrast medium for optimal visualisation of the renal artery. The aim of this study was to analyse both the usefulness and the safety of intra-arterial computed tomography angiography (IA-CTA) with ultra-low-volume iodine contrast administration in the diagnostic and therapeutic management of TRAS in patients with impaired renal transplant function. MATERIAL AND METHODS Thirty-three patients with a suspicion of TRAS based on Doppler-ultrasound and clinical setting underwent IA-CTA with ultra-low iodine contrast volume. A special, author-elaborated CTA protocol was used. The volume of 8-18 ml of diluted iodine contrast medium was administered through a catheter with the tip placed 2 cm below the aortic bifurcation. RESULTS In six patients the CTA examinations revealed TRAS in three configurations: in the anastomosis, in the trunk (critical and high-grade), or in both sections. Stenoses were treated with primary stenting obtaining favourable anatomical outcome. No intervention-related complications were observed. No contrast-induced acute kidney injury was diagnosed in this study. Mean serum creatinine concentration was 2.93 ± 0.89 mg/dl at the baseline and 2.89 ± 1.73 mg/dl and 2.17 ± 0.51 mg/dl after three and seven days from IA-CTA, respectively. CONCLUSIONS Intra-arterial CTA with ultra-low volume of iodine contrast seems to be a safe and reliable diagnostic tool to detect and assess TRAS in the aspect of stent implantation. Application of this imaging modality eliminates the need for a high volume of iodine contrast and thus does not adversely influence renal transplant function.
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Affiliation(s)
- Agata Szczurowska
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Mirosław Banasik
- Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Jacek Kurcz
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Marcin Miś
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Nowańska
- Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Madziarska
- Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Oktawia Mazanowska
- Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Magdalena Krajewska
- Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy Garcarek
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | - Maciej Guziński
- Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
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7
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Słowik A, Wnuk M, Brzegowy P, Chrzanowska-Waśko J, Golenia A, Łasocha B, Włoch-Kopeć D, Ferens A, Serednicki W, Jarocki P, Bartosik-Psujek H, Kaczorowski R, Filip E, Grzegorzak M, Homa J, Darocha J, Dudek D, Guz W, Rejdak K, Luchowski P, Wojczal J, Sojka M, Górnik M, Stachowicz S, Jaworski J, Buraczyńska K, Ficek R, Szczepańska-Szerej A, Jargiełło T, Szczerbo-Trojanowska M, Lasek-Bal A, Puz P, Warsz-Wianecka A, Stęposz A, Ziaja K, Kuczmik W, Urbanek T, Ziaja D, Tomalski W, Kobayashi A, Richter P, Płoński A, Kotkowski M, Czepiel W, Kurkowska-Jastrzębska I, Sienkiewicz-Jarosz H, Członkowska A, BłażejewskaHyżorek B, Ryglewicz D, Konopko M, Brelak E, Antecki J, Szydłowski I, Włosek M, Stępień A, Brzozowski K, Staszewski J, Piasecki P, Zięcina P, Wołoszyńska I, Kolmaga N, Narloch J, Hasiec T, Gawłowicz J, Pędracka M, Porębiak J, Grzechnik B, Matsibora V, Frąszczak M, Leus M, Mazgaj M, Palacz-Duda V, Meder G, Skura W, Płeszka P, Świtońska M, Słomiński K, Kościelniak J, Sobieszak-Skura P, Konieczna-Brazis M, Rowiński O, Opuchlik A, Mickielewicz A, Szyluk B, Szczudlik P, Kostera-Pruszczyk A, Jaworski M, Maciąg R, Żyłkowski J, Adamkiewicz B, Szubert W, Chrząstek J, Raźniewski M, Pawelec A, Wilimborek P, Wagner R, Pilarski P, Gierach P, Baron J, Gruszka W, Ochudło S, Krzak-Kubica A, Rudzińska-Bar M, Zbroszczyk M, Smulska K, Arkuszewski M, Różański D, Koziorowski D, Meisner-Kramarz I, Szlufik S, Zaczyński A, Kądziołka K, Kordecki K, Zawadzki M, Ząbek M, Karaszewski B, Gąsecki D, Łowiec P, Dorniak W, Gorycki T, Szurowska E, Wierzchowska-Cioch E, Smyk T, Szajnoga B, Bachta M, Mazurek K, Piwowarska M, Kociemba W, Drużdż A, Dąbrowski A, Glonek M, Wawrzyniak M, Kaźmierski R, Juszkat R, Tomalski W, Heliosz A, Ryszczyk A, Zwiernik J, Wasilewski G, Tutaj A, Dałek G, Nosek K, Bereza S, Lubkowska K, Kamienowski J, Sobolewski P, Bielecki A, Miś M, Miś M, Krużewska-Orłowska M, Kochanowicz J, Mariak Z, Jakoniuk M, Turek G, Łebkowska U, Lewszuk A, Kordecki K, Dziedzic T, Popiela T. Mechanical thrombectomy in acute stroke - Five years of experience in Poland. Neurol Neurochir Pol 2017; 51:339-346. [PMID: 28756015 DOI: 10.1016/j.pjnns.2017.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 05/13/2017] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. METHODS AND RESULTS We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. RESULTS Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% - emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b-TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization - in 30.7%, mRS of 0-2 - in 31.4% and mRS of 6 in 22% of cases. CONCLUSION Our results can help harmonize standards for MT in Poland according to international guidelines.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Edward Filip
- Clinical Voivodeship Hospital, No. 2, Rzeszów, Poland.
| | | | - Jarosław Homa
- Clinical Voivodeship Hospital, No. 2 Rzeszów, Poland.
| | | | - Daniel Dudek
- Clinical Voivodeship Hospital, No. 2 Rzeszów, Poland.
| | - Wiesław Guz
- Medical Faculty University of Rzeszów, Poland.
| | | | | | | | | | - Michał Górnik
- Independent Public Clinical Hospital, Lublin, Poland.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Adam Kobayashi
- Institute of Psychiatry and Neurology of Warsaw, Poland.
| | | | | | | | | | | | | | | | | | | | | | - Edyta Brelak
- Voivodeship Integrated Hospital in Kielce, Poland.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marcin Leus
- State Specialistic Hospital in Lublin, Poland.
| | | | - Violetta Palacz-Duda
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Grzegorz Meder
- Department of Interventional Radiology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Wojciech Skura
- Department of Interventional Radiology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Piotr Płeszka
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Milena Świtońska
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Krzysztof Słomiński
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Józef Kościelniak
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Paulina Sobieszak-Skura
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | - Magdalena Konieczna-Brazis
- Stroke Intervention Treatment Center, Department of Neurology, University Hospital, No 2, Bydgoszcz, Poland.
| | | | | | | | | | | | | | | | | | | | - Bożena Adamkiewicz
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Wojciech Szubert
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Jarosław Chrząstek
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Marek Raźniewski
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Agnieszka Pawelec
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Paweł Wilimborek
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Ryszard Wagner
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Paweł Pilarski
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Paweł Gierach
- Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Poland.
| | - Jan Baron
- Medical University of Silesia, Poland.
| | | | | | | | | | - Miłosz Zbroszczyk
- Department of Radiodiagnostic and Invasive Radiology, The University Clinical Centre, Medical University of Silesia, Poland.
| | - Kamila Smulska
- Department of Radiodiagnostic and Invasive Radiology, The University Clinical Centre, Medical University of Silesia, Poland.
| | | | - Dorota Różański
- Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Poland.
| | - Dariusz Koziorowski
- Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Poland.
| | | | - Stanisław Szlufik
- Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Poland.
| | - Artur Zaczyński
- Department of Neurosurgery, Centre of Postgaduate Medical Education, Warszawa, Poland.
| | - Krzysztof Kądziołka
- Department of Neurosurgery, Centre of Postgaduate Medical Education, Warszawa, Poland.
| | - Kazimierz Kordecki
- Department of Neurosurgery, Centre of Postgaduate Medical Education, Warszawa, Poland.
| | - Michał Zawadzki
- Department of Neurosurgery, Centre of Postgaduate Medical Education, Warszawa, Poland.
| | - Mirosław Ząbek
- Department of Neurosurgery, Centre of Postgaduate Medical Education, Warszawa, Poland.
| | - Bartosz Karaszewski
- Department of Adult Neurology, Medical University of Gdansk & University Clinical Centre in Gdansk, Poland.
| | - Dariusz Gąsecki
- Department of Adult Neurology, Medical University of Gdansk & University Clinical Centre in Gdansk, Poland.
| | - Paweł Łowiec
- Department of Adult Neurology, Medical University of Gdansk & University Clinical Centre in Gdansk, Poland.
| | - Waldemar Dorniak
- Department of Adult Neurology, Medical University of Gdansk & University Clinical Centre in Gdansk, Poland.
| | - Tomasz Gorycki
- Department of Radiology, Medical University of Gdansk, Poland.
| | - Edyta Szurowska
- 2 nd Department of Radiology, Medical University of Gdansk, Poland.
| | | | - Tomasz Smyk
- Voivodeship Public Hospital, Zamość, Poland.
| | | | | | | | | | - Wojciech Kociemba
- Neuroradiology, Department University of Medical Sciences in Poznan, Poland.
| | - Artur Drużdż
- Multidisciplinary Municipal Hospital, Poznań, Poland.
| | | | - Michał Glonek
- Voivodeship Specialistic Neuropsychiatric Complex, Opole, Poland.
| | | | - Radosław Kaźmierski
- Department of Neurology and Cerebrovascular Disorders, Poznan University of Medical Sciences, Poland.
| | - Robert Juszkat
- Department of General and Interventional Radiology, Poznan University of Medical Sciences, Poland.
| | | | - Adam Heliosz
- Voivodeship Hospital, No 2, Jastrzębie Zdrój, Poland.
| | - Adam Ryszczyk
- Voivodeship Hospital, No 2, Jastrzębie Zdrój, Poland.
| | - Jacek Zwiernik
- University of Warmia and Mazury in Olsztyn, Faculty of Medical Sciences, Department of Neurology and Neurosurgery, Poland.
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Bhogal P, Aguilar Pérez M, Martinez Moreno R, Miś M, Miś M, Henkes H. Combined use of a pCONus and a Solitaire stent: Report of two cases. Interv Neuroradiol 2016; 23:123-128. [PMID: 27913802 DOI: 10.1177/1591019916680571] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective The aim of this study was to report our initial experience of the use of the pCONus neck protection device in conjunction with the Solitaire AB stent to assist in the endovascular management of complex intracranial aneurysms with arteries arising from both the neck and the dome of the aneurysm. Methods Two patients with unruptured aneurysms underwent elective endovascular management of their aneurysms, one arising from the middle cerebral artery bifurcation and one from the anterior communicating artery. Both aneurysms had vessels arising from the neck and dome of the aneurysm. We present the strategy involved to protect all the arterial branches and coil occlude the aneurysm, the angiographic appearances and clinical status of the patients. Results Both cases involved the combined use of a pCONus and Solitaire stent. The parent vessel and efferent branches were all preserved with exclusion of the aneurysm from the circulation. There were no intraoperative complications. One patient developed mild transient symptoms 24 hours post procedure, which had resolved completely on discharge. Conclusion The use of the pCONus in conjunction with the Solitaire stent is a useful combination when dealing with complex wide-necked aneurysms with arteries derived from the fundus of the aneurysm.
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Affiliation(s)
- Pervinder Bhogal
- 1 Neuroradiological Clinic, Neurocenter, Klinikum Stuttgart, Germany
| | | | | | - Marcin Miś
- 2 Department of Neurosurgery, Specialized Hospital, Poland.,3 Department of General Radiology, Interventional Radiology and Neuroradiology, Clinical University Hospital, Poland
| | - Maciej Miś
- 2 Department of Neurosurgery, Specialized Hospital, Poland.,3 Department of General Radiology, Interventional Radiology and Neuroradiology, Clinical University Hospital, Poland
| | - Hans Henkes
- 1 Neuroradiological Clinic, Neurocenter, Klinikum Stuttgart, Germany.,4 Medical Faculty, University Duisburg-Essen, Germany
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Garcarek J, Kurcz J, Guziński M, Banasik M, Miś M, Gołębiowski T. Intraarterial CT Angiography Using Ultra Low Volume of Iodine Contrast - Own Experiences. Pol J Radiol 2015; 80:344-9. [PMID: 26191113 PMCID: PMC4497469 DOI: 10.12659/pjr.894050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 04/09/2015] [Indexed: 11/09/2022] Open
Abstract
Background High volume of intravenous contrast in CT-angiography may result in contrast-induced nephropathy. Intraarterial ultra-low volume of contrast medium results in its satisfactory blood concentration with potentially good image quality. The first main purpose was to assess the influence of the method on function of transplanted kidney in patients with impaired graft function. The second main purpose of the study was to evaluate the usefulness of this method for detection of gastrointestinal and head-and-neck haemorrhages. Material/Methods Between 2010 and 2013 intraarterial CT-angiography was performed in 56 patients, including 28 with chronic kidney disease (CKD). There were three main subgroups: 18 patients after kidney transplantation, 10 patients with gastrointestinal hemorrhage, 8 patients with head-and-neck hemorrhage. Contralateral or ipsilateral inguinal arterial approach was performed. The 4-French vascular sheaths and 4F-catheters were introduced under fluoroscopy. Intraarterial CT was performed using 64-slice scanner. The scanning protocol was as follows: slice thickness 0.625 mm, pitch 1.3, gantry rotation 0.6 sec., scanning delay 1–2 sec. The extent of the study was established on the basis of scout image. In patients with CKD 6–8 mL of Iodixanol (320 mg/mL) diluted with saline to 18–24 mL was administered at a speed of 4–5 mL/s. Results Vasculature was properly visualized in all patients. In patients with impaired renal function creatinine/eGFR levels remained stable in all but one case. Traditional arteriography failed and CT-angiography demonstrated the site of bleeding in 3 of 10 patients with symptoms of gastrointestinal bleeding (30%). In 8 patients with head-and-neck bleeding CT-angiography did not prove beneficial when compared to traditional arteriography. Conclusions 1. Ultra-low contrast intraarterial CT-angiography does not deteriorate the function of transplanted kidneys in patients with impaired graft function. 2. 3D reconstructions allow for excellent visualization of vascular anatomy of renal transplants. 3. Intraarterial CT-angiography is useful for detection of the bleeding site.
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Affiliation(s)
- Jerzy Garcarek
- Department of General Radiology, Interventional Radiology ang Neuroradiology, Wrocław Medical University, Wrocław, Poland
| | - Jacek Kurcz
- Department of General Radiology, Interventional Radiology ang Neuroradiology, Wrocław Medical University, Wrocław, Poland
| | - Maciej Guziński
- Department of General Radiology, Interventional Radiology ang Neuroradiology, Wrocław Medical University, Wrocław, Poland
| | - Mirosław Banasik
- Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland
| | - Marcin Miś
- Department of General Radiology, Interventional Radiology ang Neuroradiology, Wrocław Medical University, Wrocław, Poland
| | - Tomasz Gołębiowski
- Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland
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Czyż M, Tabakow P, Gheek D, Miś M, Jarmundowicz W, Raisman G. The supraorbital keyhole approach via an eyebrow incision applied to obtain the olfactory bulb as a source of olfactory ensheathing cells – radiological feasibility study. Br J Neurosurg 2013; 28:234-40. [DOI: 10.3109/02688697.2013.817534] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kołtowska A, Hendrich B, Knysz B, Sokolska V, Miś M, Lubkowska K, Furdal M, Szewczyk P, Gąsiorowski J, Gładysz A, Sąsiadek M. Analysis of metabolic changes of brain in HIV-1 seropositive patients with proton magnetic resonance spectroscopy. Pol J Radiol 2010; 75:27-32. [PMID: 22802773 PMCID: PMC3389870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Accepted: 04/06/2010] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Asymptomatic central nervous system involvement may occur in the early stages of the HIV infection. The aim of the study was to evaluate early brain metabolic changes by means of proton MR spectroscopy (H1MRS) in the HIV-1 seropositive patients without neurological deficits or significant abnormalities in the plain MR study. MATERIAL/METHODS The H1MRS examinations were performed with the use of a MR GE Signa 1,5T system. There were 39 subjects examined, aged 21 to 57 years (mean age 35 years) were examined, including 25 patients infected with HIV-1 and 14 healthy volunteers who constituted a control group. The examinations were performed using the Single Voxel Spectroscopy technique with the PRESS sequence, with following parameters: TR=1500 ms, TE=35 ms, number of acquisitions =128, time of acquisition =3 min. 43 sec. Voxels of 8 cm(3) (20×20×20 mm) in size were located in the following 5 regions: posterior cingulate gyrus, grey matter of the frontal area, left basal ganglia, white matter of the left parietal area and white matter of the frontal area. The NAA/Cr, Cho/Cr, mI/Cr ratios in the defined regions of interest were statistically analyzed. RESULTS There was a statistically significant decrease (p<0.05) in the NAA/Cr ratios in the posterior cingulate area and white matter of the left parietal area in HIV-1 seropositive patients, as compared to the control group. Other metabolite ratios in all the above mentioned locations showed no statistically significant differences, as was also the case for NAA/Cr ratios in grey matter of the frontal area, left basal ganglia and white matter of the frontal area. CONCLUSIONS The reduction of NAA/Cr values revealed in H1MRS studies suggests loss of neurons/neuronal activity in the posterior cingulate area and white matter of the left parietal area, in patients with HIV-1 at the stage before clinical manifestations of retroviral infection and structural changes in the plain MR study. This may reflect a direct neurotropic activity of HIV.
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Affiliation(s)
- Anna Kołtowska
- Department of General, Interventional and Neuroradiology, Department of Radiology, Wrocław Medical University, Wrocław, Poland
| | - Barbara Hendrich
- Department of General, Interventional and Neuroradiology, Department of Radiology, Wrocław Medical University, Wrocław, Poland
| | - Brygida Knysz
- Department and Clinic of Infectious Diseases, Liver Diseases and Acquired Immune Deficiency, Wroclaw Medical University, Wrocław, Poland
| | - Violetta Sokolska
- Department of General, Interventional and Neuroradiology, Department of Radiology, Wrocław Medical University, Wrocław, Poland
| | - Marcin Miś
- Department of General, Interventional and Neuroradiology, Department of Radiology, Wrocław Medical University, Wrocław, Poland
| | - Katarzyna Lubkowska
- Department of General, Interventional and Neuroradiology, Department of Radiology, Wrocław Medical University, Wrocław, Poland
| | - Michał Furdal
- Department and Clinic of Infectious Diseases, Liver Diseases and Acquired Immune Deficiency, Wroclaw Medical University, Wrocław, Poland
| | - Paweł Szewczyk
- Department of General, Interventional and Neuroradiology, Department of Radiology, Wrocław Medical University, Wrocław, Poland
| | - Jacek Gąsiorowski
- Department and Clinic of Infectious Diseases, Liver Diseases and Acquired Immune Deficiency, Wroclaw Medical University, Wrocław, Poland
| | - Andrzej Gładysz
- Department and Clinic of Infectious Diseases, Liver Diseases and Acquired Immune Deficiency, Wroclaw Medical University, Wrocław, Poland
| | - Marek Sąsiadek
- Department of General, Interventional and Neuroradiology, Department of Radiology, Wrocław Medical University, Wrocław, Poland
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Woszczek G, Borowiec M, Miś M, Górska M, Kowalski ML. Comparison of serological and molecular (PCR-SSP) techniques of HLA-DR typing in clinical laboratory routine. Ann Transplant 1998; 2:39-42. [PMID: 9869840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Advances in molecular biology techniques allowed for introduction of PCR-based methods for HLA typing. In routine HLA typing for organ transplantation serological method is still being used as a standard, although molecular techniques are applied more and more often. The aim of our study was to compare HLA-DR typing using traditional serological method and PCR-SSP methodology in routine clinical laboratory. HLA-DR typing was performed using standard microcytotoxicity assay and PCR-SSP method in 28 patients referred to our Transplantation Immunology Unit for HLA typing. Comparison of results obtained by both methods revealed no discrepancies in 5 patients, in 12 patients the PCR-SSP typing showed additional DR antigens or splits of antigens. In 11 patients serological typing turned out to be impossible because of technical problems. Molecular PCR typing allowed for precise antigen determination in all the patients. Comparing both methods we found PCR-SSP HLA typing method very useful in routine HLA-DR determination, especially valuable in patients, in whom some problems in serological testing are expected.
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Affiliation(s)
- G Woszczek
- Department of Clinical Immunology and Allergy, Medical University of Lódź, Poland.
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Miś M, Wilczak K. [Prismatic system for measuring the anterior segment of the eyeball]. Klin Oczna 1982; 84:237-238. [PMID: 7154605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Miś M, Wilczak K. [Milimeter ruler - projector]. Klin Oczna 1982; 84:239. [PMID: 7154606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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15
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Miś M. [Oculocentrometer (author's transl)]. Klin Oczna 1981; 83:185-6. [PMID: 7265785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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16
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Miś M. [Chromogradometer (author's transl)]. Klin Oczna 1979; 81:488. [PMID: 491483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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17
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Miś M. [Mesophotometer (author's transl)]. Klin Oczna 1979; 81:487. [PMID: 491482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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18
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Miś M. [Electrical hand keratoscope (author's transl)]. Klin Oczna 1979; 81:295. [PMID: 439756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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19
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Miś M. [The modified lamp of Wilczek (author's transl)]. Klin Oczna 1979; 81:297. [PMID: 439757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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20
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Miś M. [A trephine for removing rust from the cornea (author's transl)]. Klin Oczna 1979; 81:293. [PMID: 439755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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21
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Miś M. [Plate photometer]. Klin Oczna 1979; 81:239. [PMID: 439740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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22
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Miś M. [Magnifying glass-reflector]. Klin Oczna 1979; 81:241. [PMID: 439741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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23
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Miś M. [Forceps for peripheral iridectomy]. Klin Oczna 1973; 43:1379. [PMID: 4769387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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24
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Miś M. [Magnetic cryoapplicator]. Klin Oczna 1973; 43:1039-40. [PMID: 4756270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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25
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Miś M. [Iris retractor]. Klin Oczna 1973; 43:1041-2. [PMID: 4756271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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26
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Miś M. [Dynamic stereoscope]. Klin Oczna 1973; 43:937-9. [PMID: 4795444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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