1
|
Iaccarino C, Kolias A, Adelson PD, Rubiano AM, Viaroli E, Buki A, Cinalli G, Fountas K, Khan T, Signoretti S, Waran V, Adeleye AO, Amorim R, Bertuccio A, Cama A, Chesnut RM, De Bonis P, Estraneo A, Figaji A, Florian SI, Formisano R, Frassanito P, Gatos C, Germanò A, Giussani C, Hossain I, Kasprzak P, La Porta F, Lindner D, Maas AIR, Paiva W, Palma P, Park KB, Peretta P, Pompucci A, Posti J, Sengupta SK, Sinha A, Sinha V, Stefini R, Talamonti G, Tasiou A, Zona G, Zucchelli M, Hutchinson PJ, Servadei F. Consensus statement from the international consensus meeting on post-traumatic cranioplasty. Acta Neurochir (Wien) 2021; 163:423-440. [PMID: 33354733 PMCID: PMC7815592 DOI: 10.1007/s00701-020-04663-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/28/2020] [Indexed: 12/26/2022]
Abstract
Background Due to the lack of high-quality evidence which has hindered the development of evidence-based guidelines, there is a need to provide general guidance on cranioplasty (CP) following traumatic brain injury (TBI), as well as identify areas of ongoing uncertainty via a consensus-based approach. Methods The international consensus meeting on post-traumatic CP was held during the International Conference on Recent Advances in Neurotraumatology (ICRAN), in Naples, Italy, in June 2018. This meeting was endorsed by the Neurotrauma Committee of the World Federation of Neurosurgical Societies (WFNS), the NIHR Global Health Research Group on Neurotrauma, and several other neurotrauma organizations. Discussions and voting were organized around 5 pre-specified themes: (1) indications and technique, (2) materials, (3) timing, (4) hydrocephalus, and (5) paediatric CP. Results The participants discussed published evidence on each topic and proposed consensus statements, which were subject to ratification using anonymous real-time voting. Statements required an agreement threshold of more than 70% for inclusion in the final recommendations. Conclusions This document is the first set of practical consensus-based clinical recommendations on post-traumatic CP, focusing on timing, materials, complications, and surgical procedures. Future research directions are also presented.
Collapse
|
2
|
Szynglarewicz B, Kasprzak P, Kowalska E, Blaszczyk D, Maciejczyk A, Matkowski R. Predictive value of short-term follow-up in a breast cancer screening program. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
3
|
Szynglarewicz B, Maciejczyk A, Michalik T, Oleszkiewicz B, Kasprzak P, Matkowski R. 680. Surgical service in a newly formed breast unit in the regional comprehensive cancer centre – Quality assessment using early performance indicators. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
4
|
Szynglarewicz B, Kasprzak P, Maciejczyk A, Kowalska E, Matkowski R. 679. Non-operative diagnostic service in a newly formed breast unit in the regional comprehensive cancer centre – Quality assessment using key performance indicators. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
5
|
Szynglarewicz B, Oleszkiewicz B, Kasprzak P, Maciejczyk A, Michalik T, Strychalska M, Halon L, Wojnar A, Matkowski R. 208. Imaging-histologic concordant breast papillomas without atypia and radiologically visible residual lesions after image-guided biopsy: A voice against the subsequent surgical excision. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
6
|
Szynglarewicz B, Maciejczyk A, Kasprzak P, Michalik T, Oleszkiewicz B, Matkowski R. 678. Time to surgery before and after the implementation of breast cancer rapid management policy. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
7
|
Szynglarewicz B, Kasprzak P, Maciejczyk A, Matkowski R. 213. Short-term follow-up (early recall) in breast cancer screening programs should be avoided due to very low predictive value for malignancy. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
8
|
Szynglarewicz B, Blaszczyk D, Maciejczyk A, Kasprzak P, Matkowski R. 676. Quality assessment of population-based mammographic screening program. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
9
|
Müller-Wille R, Güntner O, Zeman F, Dollinger M, Hälg C, Beyer LP, Pfister K, Kasprzak P, Stroszczynski C, Wohlgemuth WA. The Influence of Preoperative Aneurysmal Thrombus Quantity and Distribution on the Development of Type II Endoleaks with Aneurysm Sac Enlargement After EVAR of AAA. Cardiovasc Intervent Radiol 2016; 39:1099-109. [PMID: 27307180 DOI: 10.1007/s00270-016-1386-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/23/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To determine the influence of preoperative aneurysmal thrombus quantity and distribution on the development of type II endoleak with aneurysm sac enlargement after endovascular aneurysm repair (EVAR). MATERIALS AND METHODS We retrospectively analyzed the pre- and postoperatively performed CT scans of 118 patients who had follow-up imaging for at least 1 year after EVAR available. We assessed preoperative thrombus perimeter (T Peri), diameter (T Dia), cross-sectional area (T CSA), and volume (T Vol). The preoperative thrombus distribution was classified into no thrombus, semilunar-shaped (anterior, right side, left side, posterior) thrombus, and circumferential type thrombus. The number of preoperative patent aortic side branches (ASB) was identified. Endpoint was type II endoleak with aneurysm volume (A Vol) increase of ≥5 % during follow-up. RESULTS During follow-up (2 years, range 1-9 years), 17 patients with type II endoleak had significant A Vol increase. Less preoperative T Peri, T Dia, T CSA, and T Vol were associated with A Vol increase. A circumferential thrombus distribution significantly protected against aneurysm enlargement (p = 0.028). The variables with the strongest significance for A Vol increase were preoperative T Vol/A Vol ratio (OR 0.95; p = 0.037) and number of patent ASB (OR 3.52; p < 0.001). CONCLUSION A low preoperative T Vol/A Vol ratio and a high number of patent ASB were associated with aneurysm sac enlargement after EVAR.
Collapse
Affiliation(s)
- R Müller-Wille
- Department of Radiology, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
| | - O Güntner
- Dr. Neumaier MVZ GmBH Castra Regina Center, Bahnhofstraße 24, 93047, Regensburg, Germany
| | - F Zeman
- Center for Clinical Studies, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - M Dollinger
- Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - C Hälg
- Department of Radiology and Nuclear Medicine, Kantonsspital Schaffhausen, Geissbergstrasse 81, 8208, Schaffhausen, Switzerland
| | - L P Beyer
- Department of Radiology, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - K Pfister
- Department of Vascular Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - P Kasprzak
- Department of Vascular Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - C Stroszczynski
- Department of Radiology, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - W A Wohlgemuth
- Department of Radiology, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| |
Collapse
|
10
|
Ehehalt K, Renner P, Zeman F, Pfister K, Riquelme P, Graf BM, Geissler EK, Kasprzak P, Schlitt HJ, Bein T, Hutchinson JA, Gocze I. High normal values of circulating immune cell subsets before surgery may be protective against development of postoperative acute kidney injury. Intensive Care Med Exp 2015. [PMCID: PMC4796074 DOI: 10.1186/2197-425x-3-s1-a626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
11
|
Ertl M, Schierling W, Kasprzak P, Schömig B, Brückl C, Schlachetzki F, Pfister K. P6. Optic nerve sheath diameter measurement – A tool to identify high risk patients for spinal ischemia after endovascular thoracoabdominal aortic aneurysm repair? Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
12
|
Oikonomou K, Kopp R, Katsargyris A, Pfister K, Verhoeven E, Kasprzak P. Outcomes of Fenestrated/Branched Endografting in Post-dissection Thoracoabdominal Aortic Aneurysms. J Vasc Surg 2014. [DOI: 10.1016/j.jvs.2014.10.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
13
|
Matkowski R, Kasprzak P, Jagas M, Zietek M, Blaszczyk D, Kotowska J, Szynglarewicz B. 179. Mammographic screening in the 3-million population region of Lower Silesia, Poland: Cost of cancer detection during initial and subsequent round. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
14
|
Grimme F, Reijnen M, Pfister K, Martens J, Kasprzak P. Polytetrafluoroethylene Covered Stent Placement for Focal Occlusive Disease of the Infrarenal Aorta. Eur J Vasc Endovasc Surg 2014; 48:545-50. [DOI: 10.1016/j.ejvs.2014.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 08/04/2014] [Indexed: 11/29/2022]
|
15
|
Oikonomou K, Kopp R, Katsargyris A, Pfister K, Verhoeven EL, Kasprzak P. Outcomes of fenestrated/branched endografting in post-dissection thoracoabdominal aortic aneurysms. Eur J Vasc Endovasc Surg 2014; 48:641-8. [PMID: 25176618 DOI: 10.1016/j.ejvs.2014.07.005] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [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: 03/10/2014] [Accepted: 07/06/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Fenestrated/branched thoracic endovascular repair (F/Br-TEVAR) is increasingly applied for atherosclerotic thoracoabdominal aortic aneurysm (TAAA); however, use in post-dissection TAAAs is still very limited. Experience with F/Br-TEVAR in the treatment of post-dissection TAAA is presented. METHODS Data were analysed from prospectively maintained databases including all patients with post-dissection TAAAs that underwent F/Br-TEVAR within the period January 2010 to July 2013 in two vascular institutions. Evaluated outcomes included initial technical success, operative mortality and morbidity, late survival, endoleak, aneurysm diameter regression, renal function, and reintervention during follow-up (FU). RESULTS A total of 31 patients (25 male, mean age 65 ± 11.4 years) were treated. Technical success was 93.5% and 30-day mortality 9.6%. Temporary spinal cord ischaemia occurred in four (12.6%) patients, with no case of permanent paraplegia. Mean FU was 17.0 ± 10 months. There were seven late deaths, all aneurysm unrelated. Estimated overall survival rates were 83.9 ± 6.7, 76.4 ± 7.9 and 71.6 ± 8.7% at 6, 12, and 18 months, respectively. Impairment of renal function occurred in two (6.4%) patients. Endoleaks were diagnosed in 12 patients during FU, including six type IB endoleaks and six type II endoleaks. Reintervention was required in seven (22.5%) patients. Mean aneurysm sac regression was 9.3 ± 8.7 mm, with a false lumen thrombosis rate of 66.7% and 88.2% for patients with a FU longer than 6 and 12 months respectively. CONCLUSIONS F/Br-EVAR is feasible for patients with a post-dissection TAAA. Although associated with additional technical challenges, and a significant need for reintervention, it leads to favourable aneurysm morphologic changes, and may play a more prominent role in the future for this type of pathology if long-term results confirm the good initial outcome.
Collapse
Affiliation(s)
- K Oikonomou
- Department of Surgery, Division of Vascular Surgery, University Hospital Regensburg, Regensburg, Germany; Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nürnberg, Germany
| | - R Kopp
- Department of Surgery, Division of Vascular Surgery, University Hospital Regensburg, Regensburg, Germany
| | - A Katsargyris
- Department of Surgery, Division of Vascular Surgery, University Hospital Regensburg, Regensburg, Germany
| | - K Pfister
- Department of Surgery, Division of Vascular Surgery, University Hospital Regensburg, Regensburg, Germany
| | - E L Verhoeven
- Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nürnberg, Germany
| | - P Kasprzak
- Department of Surgery, Division of Vascular Surgery, University Hospital Regensburg, Regensburg, Germany.
| |
Collapse
|
16
|
Verhoeven E, Katsargyris A, Bachoo P, Larzon T, Fisher R, Ettles D, Boyle J, Brunkwall J, Böckler D, Florek HJ, Stella A, Kasprzak P, Verhagen H, Riambau V. Real-world Performance of the New C3 Gore Excluder Stent-Graft: 1-year Results from the European C3 Module of the Global Registry for Endovascular Aortic Treatment (GREAT). Eur J Vasc Endovasc Surg 2014; 48:131-7. [DOI: 10.1016/j.ejvs.2014.04.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 04/14/2014] [Indexed: 10/25/2022]
|
17
|
Brunkwall J, Kasprzak P, Verhoeven E, Heijmen R, Taylor P, Alric P, Canaud L, Janotta M, Raithel D, Malina W, Resch T, Eckstein HH, Ockert S, Larzon T, Carlsson F, Schumacher H, Classen S, Schaub P, Lammer J, Lönn L, Clough RE, Rampoldi V, Trimarchi S, Fabiani JN, Böckler D, Kotelis D, Böckler D, Kotelis D, von Tenng-Kobligk H, Mangialardi N, Ronchey S, Dialetto G, Matoussevitch V. Endovascular repair of acute uncomplicated aortic type B dissection promotes aortic remodelling: 1 year results of the ADSORB trial. Eur J Vasc Endovasc Surg 2014; 48:285-91. [PMID: 24962744 DOI: 10.1016/j.ejvs.2014.05.012] [Citation(s) in RCA: 250] [Impact Index Per Article: 25.0] [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: 08/13/2013] [Accepted: 05/12/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Uncomplicated acute type B aortic dissection (AD) treated conservatively has a 10% 30-day mortality and up to 25% need intervention within 4 years. In complicated AD, stent grafts have been encouraging. The aim of the present prospective randomised trial was to compare best medical treatment (BMT) with BMT and Gore TAG stent graft in patients with uncomplicated AD. The primary endpoint was a combination of incomplete/no false lumen thrombosis, aortic dilatation, or aortic rupture at 1 year. METHODS The AD history had to be less than 14 days, and exclusion criteria were rupture, impending rupture, malperfusion. Of the 61 patients randomised, 80% were DeBakey type IIIB. RESULTS Thirty-one patients were randomised to the BMT group and 30 to the BMT+TAG group. Mean age was 63 years for both groups. The left subclavian artery was completely covered in 47% and in part in 17% of the cases. During the first 30 days, no deaths occurred in either group, but there were three crossovers from the BMT to the BMT+TAG group, all due to progression of disease within 1 week. There were two withdrawals from the BMT+TAG group. At the 1-year follow up there had been another two failures in the BMT group: one malperfusion and one aneurysm formation (p = .056 for all). One death occurred in the BMT+TAG group. For the overall endpoint BMT+TAG was significantly different from BMT only (p < .001). Incomplete false lumen thrombosis, was found in 13 (43%) of the TAG+BMT group and 30 (97%) of the BMT group (p < .001). The false lumen reduced in size in the BMT+TAG group (p < .001) whereas in the BMT group it increased. The true lumen increased in the BMT+TAG (p < .001) whereas in the BMT group it remained unchanged. The overall transverse diameter was the same at the beginning and after 1 year in the BMT group (42.1 mm), but in the BMT+TAG it decreased (38.8 mm; p = .062). CONCLUSIONS Uncomplicated AD can be safely treated with the Gore TAG device. Remodelling with thrombosis of the false lumen and reduction of its diameter is induced by the stent graft, but long term results are needed.
Collapse
Affiliation(s)
- J Brunkwall
- Department of Vascular and Endovascular Surgery, University Clinics, University of Cologne, Cologne, Germany.
| | - P Kasprzak
- Section of Vascular Surgery, Department of Surgery, University of Regensburg, Department of Vascular Surgery, Klinikum Nuernberg, Nuremberg, Germany
| | - E Verhoeven
- Department of Cardiovasc Surgery Antonius Hospital, Nieuwegein, The Netherlands
| | - R Heijmen
- Department of Vascular Surgery, St Guys Hospital, London, UK
| | - P Taylor
- Department of Vascular Surgery, St Guys Hospital, London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Mehner T, Emmrich M, Kasprzak P. Discrete thermal windows cause opposite response of sympatric cold-water fish species to annual temperature variability. Ecosphere 2011. [DOI: 10.1890/es11-00109.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
19
|
Kolat P, Kobuch R, Hirt S, Janotta M, Kasprzak P, Schmid C. Total aortic replacement for extensive aneurysmal disease by staged hybrid procedure using E-vita open followed by percutaneous endovascular interventions. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
20
|
Pfister K, Krammer S, Janotta M, Jung E, Kasprzak P. Welche Nachkontrolle ist bei endovaskulärer Versorgung von abdominellen Aortenaneurysmen empfehlenswert? Zentralbl Chir 2010; 135:409-15. [DOI: 10.1055/s-0030-1262548] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
21
|
Rödel S, Geelkerken R, Prescott R, Florek H, Kasprzak P, Brunkwall J. The Anaconda™ AAA Stent Graft System: 2-Year Clinical and Technical Results of a Multicentre Clinical Evaluation. J Vasc Surg 2009. [DOI: 10.1016/j.jvs.2009.10.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
22
|
Jung EM, Uller W, Pfister K, Fellner C, Schreyer AG, Zorger N, Kasprzak P, Feuerbach S. Contrast Harmonic Imaging (CHI) mit quantativer Perfusionsanalyse im Vergleich zur CTA zur Detektion und Charakterisierung von Endoleaks nach endovaskulärer Behandlundg abdominaler Aneurysmen. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
23
|
Rennert J, Pfister K, Greiner B, Goessmann H, Prantl L, Feuerbach S, Kasprzak P, Jung EM. Kontrastverstärkter 3D Gefäßultraschall mit B-Flow im Vergleich zu 3D Power Doppler, 3D FKDS, CTA und MRA zur präoperativen Diagnostik der A. carotis interna Stenose: erste Ergebnisse. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
24
|
Pfister K, Rennert J, Greiner B, Jung W, Stehr A, Gössmann H, Menzel C, Zorger N, Prantl L, Feuerbach S, Kasprzak P, Jung E. Pre-surgical evaluation of ICA-stenosis using 3D power Doppler, 3D color coded Doppler sonography, 3D B-flow and contrast enhanced B-flow in correlation to CTA/MRA: First clinical results. Clin Hemorheol Microcirc 2009; 41:103-16. [DOI: 10.3233/ch-2009-1161] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- K. Pfister
- Department of Vascular Surgery, University Hospital Regensburg, Regensburg, Germany
| | - J. Rennert
- Department of Diagnostic Radiology, University Hospital Regensburg, Regensburg, Germany
| | - B. Greiner
- Department of Diagnostic Radiology, University Hospital Regensburg, Regensburg, Germany
| | - W. Jung
- University of Saarbruecken, Saarbruecken, Germany
| | - A. Stehr
- Department of Vascular Surgery, University Hospital Regensburg, Regensburg, Germany
| | - H. Gössmann
- Department of Diagnostic Radiology, University Hospital Regensburg, Regensburg, Germany
| | - C. Menzel
- Department of Diagnostic Radiology, University Hospital Regensburg, Regensburg, Germany
| | - N. Zorger
- Department of Diagnostic Radiology, University Hospital Regensburg, Regensburg, Germany
| | - L. Prantl
- Department of Plastic and Reconstruction Surgery, University Hospital Regensburg, Regensburg, Germany
| | - S. Feuerbach
- Department of Diagnostic Radiology, University Hospital Regensburg, Regensburg, Germany
| | - P. Kasprzak
- Department of Vascular Surgery, University Hospital Regensburg, Regensburg, Germany
| | - E.M. Jung
- Department of Diagnostic Radiology, University Hospital Regensburg, Regensburg, Germany
| |
Collapse
|
25
|
Prantl L, Schreml S, Walter M, Kasprzak P, Stehr A, Nerlich M, Feurbach S, Jung EM. Evaluation of microcirculation of free flaps of the lower leg by contrast harmonic imaging (CHI) with time intensity curve (TIC) analysis. Clin Hemorheol Microcirc 2008. [PMID: 18503144 DOI: 10.3233/ch-2008-1100] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE The aim of the prospective study was to evaluate the macro- and microcirculation in the center and periphery of free flaps with high resolution vascular ultrasound. MATERIAL Fifteen patients with free parascapular flaps after lower limb trauma were examined six months postoperative. All ultrasound investigations were performed by one experienced examiner with a multi-frequency linear transducer (5-9 MHz, Logiq 9, GE). Flow evaluation was angle-optimized using digital image technology with the color coded Doppler sonography (CCDS) with measurement of the peak systolic, peak diastolic flow velocities and the resistance index (RI). Contrast harmonic imaging (CHI) with time intensity curve (TIC) analysis was used for quantitative evaluation of the tissue perfusion. Through a peripheral cubital cannula, a first bolus injection was made of 2.4 ml Sonovue to evaluate the perfusion near the flap center and the distal part of the flap. RESULTS The combined analysis of all 15 patients showed in the center and in the periphery of the flap a significant increase (p<0.01; Wilcoxon signed rank test) of the perfusion (relative units = RUs) in the period of 90-120 s after contrast medium application (center: baseline perfusion 2.23+/-0.31 RUs to 5.25+/-0.90 RUs after contrast medium; periphery: baseline perfusion 3.07+/-0.44 RUs to 5.80+/-0.57 RUs after contrast medium). The separate analysis of the non-bypass group (n=9) and bypass group (n=6) showed a clearly higher central flap perfusion after contrast medium application for the bypass group. The combined analysis of all patients showed RI-values amounting to 0.79+/-0.03. The RI-values of the bypass group were significantly higher than RI-values of the non-bypass group (p<0.05; t-test; p<0.05; Mann-Whitney rank sum test). CONCLUSION The high-resolution ultrasound represents an ideal method for detection of the flow and patency of the bypass and the small vessels of the free flap. The patency of microvascular anastomosis as well as the perfusion and microcirculation in different flap territories and tissue layers can be investigated using dynamic contrast-enhanced ultrasound with subtraction modalities.
Collapse
Affiliation(s)
- L Prantl
- Department of Trauma and Plastic Surgery, University of Regensburg, Regensburg, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Lenhart M, Finkenzeller T, Paetzel C, Strotzer M, Mann S, Djavidani B, Nitz WR, Link J, Feuerbach S, Kasprzak P. [Contrast-enhanced MR angiography in the routine work-up of the lower extremity arteries]. ROFO-FORTSCHR RONTG 2002; 174:1289-95. [PMID: 12375205 DOI: 10.1055/s-2002-34553] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Prospective evaluation of the effectiveness of contrast-enhanced moving-table magnetic resonance angiography (CE-MRA) as the sole routine tool for the diagnosis of peripheral arterial occlusive disease and determination whether it can replace catheter arteriography. SUBJECTS AND METHODS In a time period of 23 weeks, 100 consecutive patients were evaluated. A total of 112 contrast-enhanced moving-table MR angiograms were performed at 1.5 Tesla. A dedicated vascular coil system was used. It was evaluated in which cases MR angiography was sufficient to determine the treatment plan and in which cases limited quality required additional examinations. RESULTS In 93.75 % (105/112) of all examinations, the treatment plan was determined by MRA as the sole diagnostic tool. Twenty-two patients underwent surgery or percutaneous angioplasty based on MRA findings. Additional examinations due to impaired quality were performed in seven (6.25 %) cases: two MR angiographies of the pelvic arteries, one MR angiography of the calf, and four selective arteriographies because of venous overlay at the calf. CONCLUSION Contrast-enhanced MR angiography can take the place of catheter angiography in the routine work-up of patients with peripheral arterial occlusive disease. Further assessment might be necessary in five to ten percent of the cases when the diagnostic quality is inadequate, mostly due to venous overlay in the lower leg.
Collapse
Affiliation(s)
- M Lenhart
- Institut für Röntgendiagnostik, Klinikum der Universität Regensburg.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Albrich H, Feuerbach S, Kasprzak P, Glück T, Schölmerich J, Müller-Ladner U. Three-dimensional computed tomography for visualization of carotid bypasses in Takayasu arteritis. Rheumatology (Oxford) 2001; 40:235-7. [PMID: 11257170 DOI: 10.1093/rheumatology/40.2.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
28
|
Lenhart M, Herold T, Völk M, Seitz J, Manke C, Zorger N, Dorenbeck U, Requardt M, Nitz WR, Kasprzak P, Feuerbach S, Link J. [Contrast media-enhanced MR angiography of the lower extremity arteries using a dedicated peripheral vascular coil system. First clinical results]. ROFO-FORTSCHR RONTG 2000; 172:992-9. [PMID: 11199443 DOI: 10.1055/s-2000-9215] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSE To evaluate contrast enhanced magnetic resonance angiography (ceMRA) of the pelvic and peripheral arteries with a dedicated peripheral vascular coil system and automated table-feed technique in patients with arterial occlusive disease. METHODS Three-dimensional gadolinium-enhanced MR angiography in a two-step automatic table feed technique was performed in 45 patients using a 1.5 Tesla imager (Magnetom Symphony, Siemens). The pelvic arteries were imaged with a single injection of contrast material. The upper and the lower leg were imaged with a second injection of contrast material in an automated table feed technique using a dedicated vascular coil system. In 20 patients ceMRA was compared with digital subtraction angiography (DSA) as the standard of reference and in 25 patients ceMRA was performed solely. RESULTS Sensitivity and specificity for grading significant stenoses > or = 50% and occlusions (in parenthesis) were in the pelvic arteries 94.7%, 96.8%, (100%, 100%), in the arteries of the upper leg 92.3%, 93.3% (87.5%, 100%) and in the arteries of the lower leg 96.5%, 95.8%, (95.2%, 96.8%), respectively. Depiction of the runoff vessels of the lower leg was excellent in ceMRA. CeMRA was of diagnostic quality in all the patients. CONCLUSION Contrast-enhanced MRA using a dedicated peripheral vascular coil system increases the diagnostic quality of the lower leg. The runoff vessels can be evaluated. Thus, ceMRA in the presented technique is a diagnostic alternative to arterial angiography.
Collapse
Affiliation(s)
- M Lenhart
- Institut für Röntgendiagnostik, Klinikum der Universität Regensburg.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Affiliation(s)
- F Schlachetzki
- Department of Neurology, University of Regensburg, Regensburg, Germany.
| | | | | | | |
Collapse
|
30
|
Link J, Manke C, Rosin L, Borisch I, Töpel I, Horn M, Mann S, Jauch KW, Bogdahn U, Feuerbach S, Kasprzak P. [Carotid endarterectomy and carotid stenting. A pilot study of a prospective, randomized and controlled comparison]. Radiologe 2000; 40:813-20. [PMID: 11056973 DOI: 10.1007/s001170050828] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION A prospective, randomized and controlled trial is conducted to compare carotid endarterectomy and carotid stenting in high grade symptomatic carotid artery stenoses. METHODS According to the study design symptomatic patients with a angiographically high-grade (> or = 70%) internal carotid artery stenosis are included. Pre- and postinterventional diagnostics during the hospitalization period includes neurological assessment, duplex sonography of the cervical and cerebral arteries and magnetic resonance imaging of the brain. Follow-up examinations are scheduled after 1, 6 and 12 months and consist of a neurological assessment and duplex sonography. After 12 months selective angiography and magnetic resonance imaging of the brain will be performed additionally. During a period of 9 months up to now 23/137 patients treated for a carotid artery stenosis were included in the study, 11 patients underwent surgery and 12 patients carotid stenting. RESULTS Carotid stenting and endarterectomy was primarily successful without residual stenosis > 30% in each patient without the occurrence of stroke or death. In 18 follow-up examinations (neurological assessment including duplex sonography) of 13 patients (13 follow-up examinations after 30 days, 5 after 6 months) no relevant restenosis and no stroke occurred. CONCLUSION As of yet, carotid stenting was a safe procedure. Due to the small number of patients a definitive conclusion can not be drawn.
Collapse
Affiliation(s)
- J Link
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Manke C, Nitz WR, Lenhart M, Völk M, Geissler A, Djavidani B, Strotzer M, Kasprzak P, Feuerbach S, Link J. [Stent angioplasty of pelvic artery stenosis with MRI control: initial clinical results]. ROFO-FORTSCHR RONTG 2000; 172:92-7. [PMID: 10719470 DOI: 10.1055/s-2000-12146] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To investigate the feasibility of MR-guided stent angioplasty of iliac artery stenoses under passive visualization. MATERIAL AND METHODS Three patients with short, concentric stenoses of the iliac arteries were enrolled. The vascular interventions were performed on a 1.5 T MR scanner (Magnetom Symphony, Siemens, Erlangen, Germany). Stents, guidewires, and balloon catheters were visualized on the basis of susceptibility artifacts. Contrast-enhanced MR angiography (ceMRA) was used to localized the stenosis prior to stent deployment. Nitinol stents were placed under MR-guidance using a fast 2D gradient echo technique. Balloon dilatiation was performed with an angioplasty catheter inflated with diluted gadolinium-DTPA. Postinterventional results were evaluated by ceMRA, DSA, and Doppler indices. RESULTS Position of the stent, stent deployment, and balloon dilatation were depicted by MR. All stents were correctly placed within the stenosis. Stent positions as monitored by MRI were identical to those seen on DSA images. All patients were treated successfully by the MR-guided intervention. CONCLUSION An MR-guided stent angioplasty of simple iliac artery stenosis is feasible under passive visualization.
Collapse
Affiliation(s)
- C Manke
- Institut für Röntgendiagnostik, Klinikum der Universität Regensburg
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Lenhart M, Djavidani B, Völk M, Strotzer M, Manke C, Requardt M, Nitz WR, Kasprzak P, Feuerbach S, Link J. [Contrast medium-enhanced MR angiography of the pelvic and leg vessels with an automated table-feed technique]. ROFO-FORTSCHR RONTG 1999; 171:442-9. [PMID: 10668508 DOI: 10.1055/s-1999-272] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To evaluate contrast enhanced magnetic resonance angiography (ceMRA) with an automated table-feed technique in patients with arterio-occlusive disease for imaging of the pelvic and peripheral arteries. METHODS Twenty-two patients underwent three-dimensional gadolinium-enhanced MR angiography in a three-step automatic table-feed technique on a Magnetom Symphony operating at 1.5 Tesla. Maximum intensity projection images (MIP) were generated from the subtracted and original studies. Image quality and venous contrast were evaluated by two groups of observers. 304 vessels (17 patients) were compared with DSA as the standard of reference. RESULTS All examinations were performed without any technical problems. Diagnostic quality of the MIP of subtracted data sets was superior to that of the unsubtracted images. Venous overlay was 61% in the lower leg. In a total of 599 observations, a sensitivity of 96% (95%, 82%) and a specificity of 87% (88%, 99%) were high compared to DSA in the detection of significant stenoses > or = 50% (> or = 75%, occlusions). Interobserver correlation was good (linear correlation 0.9). CONCLUSION Stepping-table digital subtraction contrast enhanced MRA is a promising technique in the diagnosis of peripheral arterio-occlusive disease.
Collapse
Affiliation(s)
- M Lenhart
- Institut für Röntgendiagnostik, Klinikum, Universität Regensburg.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Abstract
Long-term cognitive deficits after cardiac surgical procedures involving cardiopulmonary bypass have been well documented. The occurrence of prolonged cognitive changes after noncardiac surgery has not, however, been clearly established. Using the Cognitive Failures Questionnaire, which permits self-assessment of cognitive impairment, we studied 50 patients before and 2 months after coronary bypass surgery and major vascular surgical procedures. Pre-operative test scores did not differ between groups. Postoperatively, 24 cardiac surgical patients and 22 vascular surgical patients completed the questionnaire. Both groups reported significantly more cognitive failures occurring after surgery than in the pre-operative period. This suggests that there are factors other than the exposure to cardiopulmonary bypass during cardiac surgery that affect self-assessed, long-term postoperative cognitive sequelae.
Collapse
Affiliation(s)
- G Rödig
- Department of Anaesthesia, University Hospital, Frnz-Josef-Strauss Allee 11, 93042 Regensburg, Germany
| | | | | | | |
Collapse
|
34
|
Albrich H, Gmeinwieser J, Manke C, Strotzer M, Kasprzak P, Feuerbach S. [Transfemoral pelvic vein angiography with CO2: experiences with pressure- and volume-controlled injections]. ROFO-FORTSCHR RONTG 1999; 170:384-90. [PMID: 10341798 DOI: 10.1055/s-2007-1011058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate the efficacy of CO2 in aortobifemoral DSA with a pressure- and volume-controlled injector. MATERIALS AND METHODS In an intraindividual prospective study, 42 patients with arterial occlusive disease underwent stepwise aortobifemoral DSA with CO2 and with iopromid 300. RESULTS With Co2, diagnostic images were obtained in 74% of the iliac, 98% of the femoral, 89% of the popliteal arteries, but in only 36% of the arteries of the lower leg. 73% of the stenoses were correctly identified. With therapeutic relevance 8% of the stenoses were overestimated. The length of 1 of 53 occlusions was overestimated and 3 occlusions were simulated. No stenoses or occlusion was missed. There were no severe side-effects. The injector proved to be safe and easy to handle. Fragmentation of the CO2 bolus could be compensated by postprocessing with a minimum opacification summation mode. CONCLUSIONS With the equipment used, CO2 was a safe alternative to iodinated CM in routine stepwise aortobifemoral DSA of the iliac, femoral, and popliteal arteries. Because of the risk of overestimation, occlusions and high grade stenoses should be verified with selective injections or iodinated CM before PTA or operations.
Collapse
Affiliation(s)
- H Albrich
- Institut für Röntgendiagnostik, Klinikum der Universität Regensburg
| | | | | | | | | | | |
Collapse
|
35
|
Manke C, Geissler A, Seitz J, Lenhart M, Kasprzak P, Gmeinwieser J, Feuerbach S. Temporary Strecker stent for management of acute dissection in popliteal and crural arteries. Cardiovasc Intervent Radiol 1999; 22:141-3. [PMID: 10094995 DOI: 10.1007/s002709900350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Stent placement is a widely used bail-out treatment for dissection of peripheral arteries. Below the level of the superficial femoral artery permanent stenting is complicated by a high incidence of subacute thrombosis and restenosis. We present two cases of arterial occlusion due to acute iatrogenic dissection of the popliteal and distal fibular arteries. Successful treatment was achieved with a new bail-out procedure. Strecker stents were implanted to seal off the dissection flap. Stents were retrieved easily after 24 hr using a myocardial biopsy forceps. After stent retrieval the temporarily stented segments were patent and showed a larger lumen compared with segments treated by balloon dilatation alone. Temporary stenting is a simple and safe procedure and offers the advantage of tacking up dissection membranes and preventing recoil. Persistent presence of a metallic implant as a source of continued injury and stimulus for intimal proliferation is avoided.
Collapse
Affiliation(s)
- C Manke
- Department of Radiology, Klinikum der Universität Regensburg, Franz-Josef-Strauss-Allee 11, D-93053 Regensburg, Germany
| | | | | | | | | | | | | |
Collapse
|
36
|
Manke C, Strotzer M, Seitz J, Lenhart M, Aebert H, Kasprzak P, Kaiser B, Feuerbach S. [Ischemic complications in aortic dissection--percutaneous treatment with balloon fenestration and stent implantation]. ROFO-FORTSCHR RONTG 1999; 170:198-204. [PMID: 10101362] [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: 02/11/2023]
Abstract
PURPOSE To describe principles and results of percutaneous treatment of ischemic complications of aortic dissection. MATERIALS AND METHODS In five cases (four patients) aortic dissection was clinically complicated by renal (n = 4), iliofemoral (n = 2) or mesenterial ischemia (n = 1). After evaluation by means of computed tomography, angiography, and manometry, treatment consisted of balloon fenestration of the intimal flap, stent placement or both. RESULTS Eleven of 25 vascular beds were classified as ischemic. Treatment consisted of 11 balloon fenestration procedures in 3 patients, in one case supported by stent placement across the dissection membrane. Stents were placed in five renal arteries, one stent was placed in the true lumen of the aorta. One iliac artery was treated with balloon dilatation. One renal artery dissection became symptomatic after balloon fenestration and was treated successfully by stent placement. In all cases ischemia was resolved by endovascular treatment. All patients had persistent relief of symptoms. Mean follow-up time is 5.8 months. CONCLUSION Ischemic complications of aortic dissection can be effectively and safely treated with stent placement and balloon fenestration.
Collapse
Affiliation(s)
- C Manke
- Institut für Röntgendiagnostik
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Renders L, Goerig M, Schreiber M, Kasprzak P, Hauser I. Successful surgical revascularization of a kidney transplant after PTA-induced arterial dissection of the allograft renal artery. Nephrol Dial Transplant 1997; 12:1264-6. [PMID: 9198066 DOI: 10.1093/ndt/12.6.1264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- L Renders
- Medizinische Klinik IV, Universität Erlangen Nürnberg
| | | | | | | | | |
Collapse
|
38
|
Kasprzak P, Riedel S, Raithel D. [Results of vascular surgery reconstructions after PTA]. Chirurg 1995; 66:93-100. [PMID: 7712866] [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: 01/26/2023]
Abstract
From 1986 through 1994 263 patients underwent vascular treatment due to 266 PTA complications. Complications at the site of the puncture were found in 35 patients (13.2%), at the site of dilatation in 210 (78.9%), and due to macro-embolism in 21 (7.9%). The most frequent pathology was thrombosis in 135 patients (50.7%). 62% of all operations were performed immediately or few days after PTA. The primary (secondary) patency rate after one month in AK femoro-popliteal reconstructions was 84% (88%), in BK reconstruction 69% (74%), after aorto-iliac reconstruction 90% (96.8%), in renal artery reconstructions 96% (96%), and in surgical interventions in the innominate artery and the subclavian artery 100%. In our opinion the unfavourable early results, especially after BK femoro-popliteal reconstructions, are due to a deterioration of the run-off caused by peripheral microembolisation. Of the aorto-iliac and limb artery reconstructions 7.1% required major amputation. The second most frequent complications were wound infections in 6.5%.
Collapse
Affiliation(s)
- P Kasprzak
- Klinik für Gefässchirurgie, Klinikum Nürnberg
| | | | | |
Collapse
|
39
|
Heilberger P, Kasprzak P, Raithel D. [Spontaneous dissection of the common carotid artery]. Chirurg 1992; 63:675-8. [PMID: 1395866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- P Heilberger
- Gefässchirurgische Abteilung Zentrums für Chirurgie, Klinikum Nürnberg
| | | | | |
Collapse
|
40
|
Raithel D, Kasprzak P, Gentsch H, Noppeney T. [Morbidity and mortality following resection of an aortic aneurysm in the aged]. Langenbecks Arch Chir 1986; 369:349-53. [PMID: 3807546 DOI: 10.1007/bf01274387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
From August 1984-August 1985 118 abdominal aortic aneurysms were treated surgically in the City Hospital Nuremberg. The mean age was 68.9 years, with 26.3% being over 75 y.; and there was a notable decline of elective procedures in this group, which was particularly jeopardized by cardial arrhythmias and renal insufficiency. The lethality was 0 in elective procedures, but reached 50% for symptomatic and over 50% for perforated aneurysms in the old age group. The high lethality of ruptured aortic aneurysms justify elective operation of aortic aneurysms in high age.
Collapse
|
41
|
Kasprzak P, Olbert F, Hagmüller GW, Denck H. Combined catheter-fibrinolytic therapy of pulmonary embolism (CCFT). Ann Radiol (Paris) 1984; 27:327-331. [PMID: 6742755] [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]
|
42
|
Olbert F, Kasprzak P, Muzika N, Schlegl A. Percutaneous transluminal dilatation and recanalization: long-term results and report on experience with a new catheter system. Ann Radiol (Paris) 1984; 27:349-56. [PMID: 6234845] [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: 01/19/2023]
|
43
|
Olbert F, Kasprzak P, Mendel H, Schlegl A, Denck H. [Percutaneous transluminal angioplastic intervention in the area of the distal abdominal aorta as well as in the area of the pelvic vessels--indications, technic and results (the Olbert catheter system)]. Med Welt 1983; 34:180-3. [PMID: 6220189] [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: 01/19/2023]
|
44
|
Eckersdorf B, Rybiński K, Tazbir J, Kasprzak P, Balcerzak R. [Experimental allo-paratopic heart transplantation in dogs as a biological bypass of the left ventricle]. Z Exp Chir 1979; 12:89-93. [PMID: 382659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
1. The authors' model of paratopic cardiac replacement by means of a branched Dacron prosthesis is considered a simple method for left-heart replacement. 2. This experimental model is a suitable temporary left-heart substitute in acute cardiac failure. Removal after rejection is easy. 3. The modified model can also be used in experimental acute right-heart failure.
Collapse
|