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[en] Purpose: Data of a three-year follow-up after mechanical thrombolysis with the Hydrolyser catheter were evaluated. Patients have otherwise been treated by local thrombolysis. Method: 35 patients were treated by thrombolysis, balloon angioplasty, aspiration, local thrombolysis, and stent placement, if necessary. Morphological results following Hydrolyser treatment and additional treatment were evaluated. Results: Following Hydrolyser treatment a significant reduction of the degree and length of the occlusion was observed. Primary clinical success was 80%. Patency rate after 3 years was 0.5. 23% of all patients died in the follow-up period. Conclusion: The Hydrolyser treatment is a relevant alternative to local thrombolysis. This method reduces the time of treatment. The authors favor the lateral opening of the catheter to remove mural thrombus. (orig.)
[de]Ziel: Auswertung der Nachkontrollen von Patienten, die anstelle einer lokalen Lyse mit dem Hydrolyser trademark -Thrombektomiekatheter (HT), Ballondilatation (PTA), Aspirationsthrombektomie (PAT) oder Stent behandelt wurden. Methode: 35 Patienten wurden behandelt und ueber drei Jahre nachbeobachtet. Alle Patienten hatten thromotische/thrombembolische Verschluesse der unteren Extremitaet. Die Laesionen wurden alle mit dem Hydrolyser trademark -Katheter behandelt. Abhaengig von der Art der Laesion wurden die unterschiedlichen Zusatzverfahren eingesetzt. Das morphologische Resultat wurde sowohl nach dem Einsatz des Hydrolysers trademark als auch nach der sekundaeren Therapie beurteilt. Ergebnis: Nach Verwendung des Hydrolysers konnte in 21 Faellen eine weitgehende Rekanalisation erreicht werden. Nach sekundaerer Angioplastie wurde in 31 Faellen ein zufrieden-stellendes Resultat (keine relevante Reststenose) erzielt. Die primaere klinische Erfolgsrate lag bei 28/35 (80%). Die Offenheitsrate nach drei Jahren betrug 0,5. 8 Patienten (23%) waren verstorben. Schlussfolgerung: Das System verkuerzt oder ersetzt die lokale Lyse. Vergleichbar ist der Hydrolyser trademark nur mit dem SET-Thrombektomiesystem trademark, wobei den Autoren die laterale Absaugoeffnung guenstiger erscheint, um murale Thromben zu entfernen. (orig.)
[en] The basis principles of MRI are reviewed in order to understand how blood flow effects arise in conventional imaging. Then some of the ways these effects have ben used in MRI techniques specifically designed for vascular imaging, are considered. (author)
[en] Ureteral stenting is a routine, minimally invasive procedure performed for relief of benign or malignant obstruction. In case of ureteral stenosis, to allow a correct insertion of the stent, a predilatation of the ureter stenosis with a conventional balloon catheter can be necessary. In exceptional cases, it can be difficult to advance an 7-8 Fr JJ-catheter over a tight resistant ureter stenosis following unsuccessful high-pressure balloon dilatation. In the present report, we describe two cases of resistant ureter stenosis successfully dilated by a cutting-balloon following the failure of high-pressure balloon dilatation, allowing a correct and uncomplicated antegrade stent insertion.
[en] Complications of embolization and chemoembolization remain a problem even with the development of low-profile catheter material and the introduction of new embolization agents. In recent years many new embolization materials have become available for clinical use, so the possibilities and limitations of these new materials must be understood to allow safe and effective embolization. Although up to now some scientific work has been published reporting the basic risk of embolization procedures, the underlying pathomechanism remains the object of speculation. Besides complications like drug toxicity, allergic reactions, and bleeding of the puncture site, the characteristics of embolization materials must be known to understand the potential complications of nontarget embolization and reflux of embolization material. This article gives an overview of established and new embolization materials, their potential risks, and the underlying pathophysiology.
[en] Four patients with post-traumatic hemobilia were evaluated with arteriography over a 2-year period. In two patients hemobilia was of iatrogenic origin; in particular, one case appeared after a cholecystectomy, and the other was due to placement of a biliary stent with an endoscope. In the other two patients hemobilia was the result of a gun injury. Arteriography of the hepatic arterial system demonstrated two false aneurysms, extravasation of contrast medium through the biliary system in one patient and arterioportal fistula in another patient. It is concluded that arteriography of the hepatic arterial system is the method of choice for the evaluation and the possible treatment of patients with hemobilia. (author). 20 refs.; 4 figs
[en] We analyzed the cerebral arterio-venous circulation time of 141 cases of cranial DSA in 136 patients, for the assessment of cerebral circulatory dynamics. IV-DSA was 111 cases, IA-DSA 30 cases. The results were as follows: 1. There was no significant difference in arterio-venous circulation time between IA-DSA and IV-DSA, if the disease pattern was not considered (P > 0.1). 2. Prolongation of arterio-venous circulation time was noted in the cases of cerebral (cerebellar) hemorrhage, subarachnoid hemorrhage, intracranial hematoma, brain abscess, acute stage of cerebra-vascular occlusive disease, acute stage of postoperative follow up, and acute stage of cerebral contusion (p > 0.05). 3. Compared the chronic stage of cerebra-vascular occlusive disease, postoperative follow up, and cerebral contusion with acute stage, significant decrement of arterio-venous circulation time was resulted (p > 0.05). 4. DSA was a useful modality for the assessment of circulatory dynamics, including measurement of arterio-venous circulation time.