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Biomedical subjects

F A Spengel

Publications and source records attributed to F A Spengel.

At least 37 records · Page 2Linked to original sources
PubMed1993

Efficacy and tolerance of recombinant tissue-type plasminogen activator in patients with thrombotic or embolic occlusions of leg-arteries.

The efficacy and safety of recombinant tissue-type plasminogen activator (rt-PA) was evaluated in 46 patients with thromboembolic arterial occlusions in leg arteries. rt-PA was given over 1-4 h with a maximum dose of 18 mg. The effect of rt-PA treatment was determined as patency of the occluded arteries in 44 different patients 14 days after treatment. In 41 patients at least one artery was recanalized (93%) by rt-PA, and in almost half of these patients (48%) no residual stenosis were detected after the lytic treatment. A slight residual stenosis was detected in 29% of the patients and a severe residual stenosis in 21%. An additional treatment with percutaneous transluminal angioplasty was performed in 23 of the 44 patients and successful in 21 (91%). In 8 patients an addition catheter-embolectomy was performed. No difference in patency rate was detected between patients with thrombotic and those with embolic occlusions. The age of the occlusion influenced the patency rate; occlusions under the age of 5 weeks showed a patency rate of 96% compared to 82% in older occlusions. The length of the occlusion did not have any influence on the outcome of the rt-PA treatment. From the results of this open study we conclude that a dose of up to 18 mg of rt-PA is both safe and effective in the treatment of thromboembolic occlusions in leg arteries.

Adult↗
PubMed1993

[Treatment of venous thrombosis].

In the treatment of deep vein thrombosis (DVT), a rapid clinical diagnosis supported by the appropriate equipment, the age of the patient, and the extent of the thrombosis are the major determinants of successful therapy. Active and conservative treatment should be aimed at the prevention of pulmonary embolisms, rethrombosis and elimination of the thrombus, while preserving venous valvular function, which in turn is essential to avoid the development of post-thrombotic syndrome. The treatment of acute DVT remains controversial. For this reason the indication, treatment, and recently published results of thrombectomy, thrombolysis, and the possibilities for preventing DVT are discussed.

Anticoagulants↗
PubMed1992

[Giant-cell arteritis limited to the femoral arteries].

A previously healthy 48-year-old woman developed, over several months, increasing pain in her hips, cervical and lumbar spine as well as the shoulders. In addition she developed intermittent claudication after walking 100-200 m. Erythrocyte sedimentation rate (ESR) was 35-43 mm in the first hour; the IgM concentration was raised to 610 mg/dl. Angiography demonstrated symmetrical occlusion of both superficial femoral arteries. An attempt at thrombolysis having failed, a biopsy of the femoral artery wall was obtained. This revealed a florid arteritis, in part as giant-cell arteritis with destruction of the elastic structures, while the adjacent muscle was unchanged. Subsequent biopsy of the temporal artery was normal. Treatment consisted at first of 60 mg prednisolone and 100 mg aspirin, both daily for 4 weeks. The ESR fell and the free-of-pain walking distance rose. There has been no recurrence of pain after stepwise reduction over one year of the steroid dosage until its discontinuation.

Aspirin↗
PubMed1992

Duplex and color Doppler ultrasound in the differential diagnosis of choroidal tumors.

There is paucity of data on the value of neovascular blood flow measurements in the differential diagnosis of human choroidal tumors, mainly due to difficulties in quantitating tumor vascularity in vivo. Color Doppler imaging and Duplex ultrasound, the combination of B-mode ultrasound and pulse Doppler analysis, were used to quantify tumor blood flow in 103 untreated tumors of the choroid. Pulsatile blood flow was detected at the tumor base of 62 choroidal melanomas (tumor height (TH) 3.1-11.7 mm) with a mean peak systolic frequency (MPSF) of 0.98 kHz (range 0.3-2.7 kHz). Compared to melanomas pulsatile neovascular flow in choroidal metastases (TH 2.1-6.5 mm, n = 12) was significantly higher (MPSF 1.87 kHz, range 0.8-3.5 kHz). No Doppler signals were elicited from age-related macular degeneration (n = 9), choroidal nevus (TH 1.5-2.1 mm, n = 18) and choroidal osteoma (n = 2). The results indicate that the quantitative measurement of tumor blood flow by duplex and color Doppler ultrasound may serve as a new diagnostic tool in the evaluation of intraocular tumors.

Adult↗
PubMed1992

Quantitative color Doppler imaging in untreated and irradiated choroidal melanoma.

Histological data indicate the importance of tumor vascularization as a determinant of the biological behavior and the response to radiotherapy in choroidal melanoma. Duplex ultrasound and color Doppler imaging, the combination of B-mode ultrasound and pulse-waved Doppler analysis, were used to measure quantitatively neovascular blood flow in 31 patients with choroidal melanoma. Follow-up studies (20 patients) were performed to investigate the change of tumor blood flow in choroidal melanomas after radiotherapy. Blood flow was detected in 30 out of 31 melanomas (size 3.1-17.8 mm) within the tumor and at the tumor base with a mean peak systolic frequency of 1.0 kHz (range 0.3-2.7 kHz), a mean end diastolic frequency of 0.3 kHz (range 0.1-1.0 kHz), and a mean frequency of 0.7 kHz (range 0.2-1.3 kHz). Two and six months after 106Ru/106Rh beta-ray application, 19 patients showed a significant decrease in peak systolic frequency. This occurred with and in advance of the decrease in the tumor size. In one patient, a rising maximum systolic frequency after radiotherapy marked a recurrent tumor growth. Results indicate that the quantitative measurement of tumor blood flow by duplex ultrasound and color Doppler imaging may be a new diagnostic modality for monitoring the effectiveness of radiotherapy in choroidal melanoma.

Adult↗
PubMed1992

Quantitative duplex and color Doppler ultrasound in the follow-up of beta-irradiated (106Ru/106Rh) choroidal melanomas. A prospective study.

The tumor response to radiotherapy depends highly on the local oxygen concentration, which is governed by the tumor's microcirculatory network. The aim of this prospective study was to quantitate the neovascular blood flow in human choroidal melanomas prior to 106Ru/106Rh irradiation and during a 1-year follow-up period. Pulsatile blood flow was elicited by means of duplex and color Doppler ultrasound in 54 of a total of 55 untreated melanomas with a mean peak systolic frequency of 1.0 kHz (range 0.3-2.7 kHz). The neovascular blood flow decreased significantly 4 and 6 months after beta-irradiation. No intrinsic tumor vascularity was detected 8 and 12 months after treatment. In 3 patients, a rising peak systolic frequency occurred following radiotherapy in advance of recurrent tumor growth. Results indicate that the noninvasive quantitation of neovascular blood flow in irradiated choroidal melanomas by pulsed Doppler ultrasound offers a new diagnostic modality for assessing tumor recurrence.

Adult↗
PubMed1991

[Simpson's atherectomy in embolizing leg artery stenoses].

We report on the treatment and follow-up of six patients with an unilateral "blue toe" syndrome. This is caused by atheromatous micro-embolisation to the digital arteries and requires urgent attention due to the painful cutaneous necroses and impending digital gangrene. In all patients, Simpson's atherectomy of proximally situated femoropopliteal stenoses caused the pre-gangrenous digital changes to heal completely. In a mean observation period of ten months no relapse occurred. The embolising material was presumably parietal fibrino-platelet thrombi which could be observed with angioscopy and were regularly detectable histologically in the excised tissue.

Aged↗
PubMed1991

[Duplex sonography in ophthalmology: current approaches to research and perspectives].

Duplex ultrasound imaging combines the investigation of morphological structures and hemodynamic data analysis. In ophthalmology the technique permits a non-invasive evaluation of retinal and orbital vascular disorders for diagnostic purposes as well as the quantitative measurement of vascularity in intraocular and orbital tumors. We present current approaches to quantitate velocity patterns in the ophthalmic and retinal artery by Duplex ultrasound imaging. Results and clinical applications of Duplex ultrasonography studies designed to characterize the vascular network in intraocular and orbital tumors are reviewed.

Adult↗