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Biomedical subjects

B Nachbur

Publications and source records attributed to B Nachbur.

At least 55 records · Page 3Linked to original sources
PubMed1987

Combination of short- and long-term catheter thrombolysis for peripheral arterial occlusion.

To save time and expenses we developed a combined program of local short-term catheter thrombolysis (CTL) in the angiographic laboratory followed by a long-term CTL on the ward if necessary to achieve patency. Out of 66 patients with arterial occlusion in the femoro-popliteal region the occluded segment was re-opened by short-term CTL alone in 22 patients (36%), and in 24 out of the remaining 44 patients by long-term CTL, giving a total primary success rate of 71%. Angiographic analysis showed that primary clinical success depended on the patency of run-off vessels in the calf after CTL. Complications occurred in five patients, necessitating surgical revision in only one. Two years after intervention 64% of the primarily recanalized arteries were still patent as shown by non-invasive examination.

Aged↗
PubMed1986

[Significance of thymectomy in the treatment of myasthenia gravis pseudoparalytica in a patient sample in Bern].

A retrospective assessment has been made of the medium to long-term outcome in 40 consecutive patients with myasthenia gravis in whom thymectomy was performed. Treatment of myasthenia gravis, when combined with thymectomy, was associated with a 40.6% complete remission rate and with partial remission in 43.8% of our cases, provided no thymoma was present. In the latter cases (n = 8) the results of surgical treatment were significantly poorer. This is in accordance with other reports in the literature. Based on our experience we are convinced that radical extended thymectomy, including resection of neighbouring mediastinal fat tissue, using longitudinal sternotomy for access, is the method of choice. This mode of treatment has been advocated by a number of authors in recent years, and we have reason to believe that this therapeutic concept will give rise to improved results in the patient group with thymoma also. In our series, such factors as sex, age and time interval between onset of disease and operation date were of minor importance and had no significant prognostic value. Due regard must of course be paid to the unspecific risks associated with age. Operative thymectomy is indicated whenever myasthenia gravis is diagnosed, with the exception of those cases presenting with ocular symptoms alone (group 1 of Osserman's classification).

Adolescent↗
PubMed1986

[Computed tomography of an aortoiliac aneurysm with ureteral stenosis].

10 patients with uni- or bilateral ureteral stenosis due to an aortoiliac aneurysm were evaluated by computed tomography. In 6 patients the complicating ureteral stenosis was caused by an inflammatory aneurysm, in 3 patients by an arteriosclerotic aneurysm, and in 1 patient by a secondary expanding aneurysm of the internal iliac artery following aortofemoral reconstruction. CT allowed non-invasively to document the association between ureteral stenosis and aneurysm. Post-operative follow-up CT studies of the 6 patients with an inflammatory aneurysm revealed a time dependent regression or complete disappearance of the perivascular fibrosis.

Aged↗
PubMed1986

Complications in percutaneous transluminal dilatation of renal arteries.

We propose a classification of the complications in renal artery percutaneous transluminal angioplasty (PTA) according to their severity and their direct or indirect relationship to PTA. Minor complications are reversible within the normal recovery period after PTA, while major complications are irreversible or reversible but necessitate extended hospitalization or surgery. The following complications are reported in the literature as being directly related to PTA: hemorrhage at the puncture site, hemorrhage from renal or access artery perforation or rupture, occlusive or nonocclusive dissection of the renal or access arteries, renal artery thrombosis, renal artery spasm or embolism leading to segmental renal infarction, peripheral artery embolisation, and balloon rupture complications. The indirectly related complications include transient or irreversible renal insufficiency, contrast media hypersensitivity, pressure-drop-related cerebral or myocardial ischemia, and anticoagulation-related hemorrhage infections. In our own series of 105 PTA in 80 patients, complications occurred in 11% of which 4% were major, 1% indirectly related to PTA leading to death. In the reports available, the rate of major complication ranges between 3 and 10%, and the death rate around 1%.

Adult↗
PubMed1985

[Effects of the Tibetan herbal preparation Padma 28 in intermittent claudication].

In a placebo-controlled double blind study the effect of Padma 28, a Tibetan herbal prescription, on patients with intermittent claudication was investigated. After two weeks without vasoactive therapy 23 patients were treated by Padma 28 and 20 by placebo. The patients had a disease history of at least 8 months, a steady state for symptoms (maximum walking distance below 250 m), and were distributed randomly in the two groups. After 16 weeks the patients treated with Padma 28 exhibited on standardized ergometry an increase of some 100% (p less than 0.01) in the maximum as well as painfree walking distance. The control patients showed increases of 21% in maximum (p less than 0.05 as compared to Padma 28), and 46% in painfree walking distance. The drug was well tolerated and no drop-out ensued because of side effects.

Clinical Trials as Topic↗
PubMed1984

Early phlebographic results after iliofemoral venous thrombectomy.

The results of conventional venous thrombectomy performed in 37 patients with acute iliofemoral thrombosis were evaluated with special reference to early postoperative phlebography. In all patients thrombosis was verified preoperatively by angiography. No mortality was encountered, but the leg of one patient with phlegmasia coerulea dolens and advanced venous gangrene had to be amputated at the above-knee level. Four patients had pulmonary embolism in relation to surgery. Based upon postoperative phlebography, complete clearance of all obstructed segments was achieved in 5 patients only (13.5%), and subtotal or partial restoration resulted in 9 patients (24%). In 16 cases (43%) postoperative phlebograms appeared equivalent to the preoperative study, and in 7 cases (20%) additional vein segments were occluded. Despite the relatively high incidence of recurrent thrombosis, prompt relief of symptoms occurred in the great majority of patients. The more favorable angiographic results were obtained in the ilio-femoral segment; in contrast, new occlusions were predominantly found in the popliteal-crural segments. Restoration of a venous passage was not correlated with the duration of symptoms; in most instances, the removed clots appeared organized and adherent to the vein intima, even in patients with a short clinical history. With regard to probable etiological factors, somewhat better results were achieved for patients exposed to previous surgery or trauma and for patients with severe medical illness. In our view indications for venous thrombectomy should be rather restrictive; successful clearance and long-term patency can be expected mainly in patients with clots lying in the ilio-femoral segment surrounded by contrast medium in the distal portion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Percutaneous transluminal angioplasty of the arteries of the lower limbs: a 5 year follow-up.

A total of 482 percutaneous transluminal angioplasties (PTAs) of the arteries of the lower limbs were performed in 411 patients between 1977 and 1983. The 5 year patency rate, calculated by the life table method, was 83% for iliac and 58% for femoropopliteal PTA. Clinical improvement after the procedure was confirmed by a significant drop of the arm-ankle pressure difference: 48 +/- 5 mm Hg before vs 17 +/- 5 mm Hg 2 years after iliac PTA (p less than .01) and 73 +/- 5 mm Hg before vs 28 +/- 6 mm Hg after femoropopliteal PTA (p less than .01). The majority of reocclusions occurred within the first year after angioplasty. Patients with stenoses or occlusions of less than 3 cm had a favorable long-term patency rate of 74%. Conversely, patients with femoropopliteal occlusions presenting with pain at rest, diabetes, occlusions of greater than 3 cm, or poor distal runoff had an elevated rate of reocclusion. Complications, which occurred in 8% of the patients in whom PTA was attempted, included local hemorrhage, dissection, embolism, and spasm necessitating surgical intervention in 2%. No deaths or amputations were a direct consequence of PTA. PTA of arteries of the lower limbs may thus be regarded as a valid complementary treatment to vascular surgery in patients with occlusive disease of the peripheral arteries.

Aged↗
PubMed1984

[Computer tomography of mycotic aortic aneurysm].

The CT findings in 2 patients with mycotic aortic aneurysms are presented. CT was helpful in establishing the diagnosis by detecting the presence of aneurysms surrounded by an abscess and reactive enlargement of the lymph nodes. CT should be the first investigation for patients with suspected aortic aneurysms and with fever of unknown origin.

Aneurysm, Infected↗