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D Bartels

Publications and source records attributed to D Bartels.

84 records · Page 5Linked to original sources
PubMed1976

[Possibilities of surgical treatment of the postthrombotic syndrome (author's transl)].

5% of the working population of the Federal Republic of Germany are suffering from a postthrombotic syndrome. Reconstructive venous surgery is only beginning to make progress as regards technique and number of cases. Over a period of four years and among a total of 2,000 cases of vascular surgery, there were only 112 operations on the venous system. Unilateral occlusions of the iliac vein are reconstructed by Palma Operation. The results of such interventions can be improved by creating a temporary arteriovenous fistula (14 observed cases, 12 of them functionning). In cases of thrombotic occlusion of the femoral vein, the equilateral saphenous vein can be implanted into the popliteal vein, thus providing an unimpaired runoff for the pump of the calf muscles (May-Operation). In this procedure, better haemodynamic conditions for the permeability of the graft can also be created by a temporary arteriovenous fistula established between the distal saphenous vein and the posterior tibial artery behind the ankle (9 observed cases, 8 of them functionning).

Acute Disease↗
PubMed1975

Transport ATPases of cardiac sarcolemma in 20,25-diazacholesterol induced myopathy.

20,25-Diazacholesterol, known to induce myotonia in skeletal muscle, also affects cardiac muscle as can be concluded from the development of cardiomegaly. At the same time (Na+, K+) ATPase of cardiac sarcolemmal membranes of the 20,25-diazacholesterol treated rats showed an increased activity as compared with control animals (91 percent and 46 percent stimulation respectively). The Ca++ stimulated ATPase showed the same tendency (96 percent and 64 percent stimulation). In the plasma of the treated rats creatine phosphokinase activity was found to be elevated whereas the amount of protein-bound iodine was decreased, a finding that is common in myotonic dystrophy.

Adenosine Triphosphatases↗
PubMed1975

[Apoplexy and stenosis of the renal atery (author's transl)].

A 48-year old man with stenosis of the right renal artery and hypertension of the renal artery and hypertension of the renal vessels suffered an apoplectic insult under antihypertensive therapy. The cause of this insult was found to be an acute total occlusion of the right carotid artery. At the same time there were stenoses of the right vertebral, the left common carotid and the left internal carotid arteries. Thromboendarterectomy of the right internal carotid artery, subclavio-carotid bypass on the left and thromboendarterectomy of the left intenal carotid artery and aortorenal bypass on the right were performed one after the other. The blood pressure can be premanently lowered, neurological symptoms no langer appear and the patient is completely able to work again.

Aorta, Abdominal↗
PubMedDate not supplied

Immediate occlusions dependent on the type of reconstruction.

In 507 reconstructive procedures on patients with chronic occlusions, we saw 4.1% immediate occlusions. We performed 409 thrombendarteriectomies, 40 dacron grafts, and 32 venous bypasses. As cause of the immediate occlusion, we found in 23 cases a dissection of the intima in the distal segment of the restored artery, in one case a bleeding from a perforation was discovered. Intimal dissection was found mostly after orthograde thrombendarteriectomy of the femoral and popliteal artery. The results of orthograde TEA could be improved by intraoperative angiography or direct opening of the distal popliteal artery. Intimal dissection after bypass operations are generally the result of technical errors.

Angiography↗
PubMedDate not supplied

Direct reconstructive venous surgery.

Unilateral occlusions of the pelvic veins may be corrected by a Palma operation. In the classic Palma operation the contralateral long saphenous vein is suprapubicly led to the opposite side and is anastomosed end-to-end or end-to-side with the common femoral vein of the occluded side. Just lately, spirally wall reinforced PTFE grafts showed more favourable results than Palma grafts. Circumscribed occlusions of the superficial femoral vein can be interposed by the May-Husni operation. Thereby the ipsilateral long saphenous vein is implanted end-to-side into the popliteal vein. We perform the Palma operation as well as the May-Husni operation under the protection of a temporary av-fistula. The ascending venography only permits to make a statement on the morphological operability, whereas the functional operability is indicated by means of phlebodynamometry. Phlebodynamometry and plethysmography are the best means to judge the functional result of the operation which is of importance for the patient. The results of the Palma operation can be regarded as very satisfactory, provided that the morphological and functional indication for the operation was correct. The use of the endothelium protective operative technique by Robert Mays as well as the application of a temporary av-fistula yield a success that is above 80 p.c. As against that, the May-Husni operation achieves less than 50 p.c. success, even if a temporary av-fistula is established in the area of the ancle. Less favourable are the results obtained by direct restorative interventions on the subclavian vein, so that these operations should only be indicated in exceptional cases.

Arteriovenous Shunt, Surgical↗
PubMedDate not supplied

Shoulder girdle compression syndrome.

Nowadays all compression syndromes at the upper chest like the costoclavicular syndrome, the scalenus syndrome, the hyperabduction syndrome and the Page-von Schroetter syndrome are included under the term of thoracic-outlet-syndrome. Apart from a constitutional disposition (cervical rib, anomalies of the tendons, etc.), it needs special factors like professional activities, sports, trauma, etc. to develop a T.O.S. syndrome. The symptoms range from prickling paresthesia, early fatigue, pains in shoulder and neck, claudication like pains and strong tendency towards swelling and rest pain or peripheral gangrene. Among 3126 vascular-surgical operations 128 transaxillary rib resections were performed during the time from June 1st, 1975 until March 31st, 1980. On 105 occasions rib resection was combined with the thoracic sympathectomy. In only 4 cases the resection of a cervical rib was sufficient to obtain decompression; in 15 cases the first rib had to be resected with a cervical rib. In 3 cases direct reconstructions of the artery and subclavian vein was performed by way of transaxillary approach. Postoperatively, 56% of the patients remained completely asymptomatic, 32% were decidedly improved and 12% unchanged.

Adult↗
PubMedDate not supplied

Arterial reconstruction for distal disease of the lower extremities by the in situ vein graft technique.

From January 1st, 1975 to December 31st, 1979, 285 femoropopliteal and femorocrural bypasses have been performed in 260 patients. In 57% of all cases the operation was carried out for limb salvage. The first 100 in situ transplants were angiographically examined 2 years after the operation. 5 years after the operation all patients were examined clinically, angiologically and by ultra sound Doppler technique. The patency rate amounts to 84% after 2 years and 76% after 5 years. With a patency rate of 57% after 2 years and 38% after 5 years the results achieved in the revascularization of a single crural artery are much more unfavourable. The results may be compared with those demonstrated by other authors who use the in situ technique. Compared to the classical venous bypass, the in situ bypass comes off a little better after a five years period.

Aged↗