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Biomedical subjects

F Mahler

Publications and source records attributed to F Mahler.

194 records · Page 11Linked to original sources
PubMedDate not supplied

A comparison study of self-expandable stents vs balloon angioplasty alone in femoropopliteal artery occlusions.

In a group of 26 patients percutaneous transluminal (balloon) angioplasty (PTA) and stents (Wallstents) were applied and in another 26 matched patients PTA alone was used as primary treatment for femoropopliteal occlusions of 3 cm or longer. Five patients with stents showed early thrombosis necessitating catheter thrombolysis and/or thrombus aspiration. Ten patients had recurrent stenoses within 12 months, mostly due to neointimal hyperplasia. Following three late catheter reinterventions, a cumulative secondary patency rate of 69% was achieved after 12 months. The group of patients treated by PTA alone showed a 12 months patency rate of 65% without reinterventions. In 8 other patients, stents were inserted for recurrent obstructive or PTA-resistant lesions, and similar results as with the stents above were obtained. Thus, these stents do not improve primary results of PTA in femoropopliteal occlusions but may be useful secondarily after unsuccessful PTA.

Aged↗
PubMedDate not supplied

Angioplasty of the terminal aorta: follow-up of 20 patients treated by PTA or PTA with stents.

Twenty patients with distal aortic stenosis were treated by PTA for intermittent claudication and, in 3, 'blue toe' syndrome. Additionally, a self-expandable endoprosthesis (stent) was inserted into the aorta in three of the patients. The overall primary success rate (including those with a stent) was 100% with all patients becoming free of symptoms. Mean arm-ankle pressure difference decreased from 48 mmHg to 9 mmHg (P less than 0.01). During a median follow-up period of 15 months no patient had recurrence of claudication, embolism, or deterioration of the non-invasive parameters. Thus, PTA seems suitable for treating stenoses of the abdominal aorta, even in the presence of distal microembolization. Balloon dilatation, with the addition of stents in resistant cases, offers a valuable alternative to surgery in distal aortic stenosis.

Adult↗
PubMedDate not supplied

Renal artery stenosis and evaluation of the effect of endoluminal dilatation. Comparison of dynamic CT scanning and I-131-OIHA renogram.

Percutaneous transluminal dilatation was performed in 16 patients with hypertension and renal artery stenoses. Dynamic CT scanning and an I-131-OIHA renogram was performed before and after dilatation. After the procedure (follow-up greater than or equal to 3 months) the hypertension was assessed clinically as normalized in six, improved in five, and unimproved in five patients. The attenuation difference at dynamic CT scanning between both kidneys at the time of peak enhancement following intravenous bolus injection of contrast material diminished significantly from 16 +/- 4 HU before to 7 +/- 6 HU (P = 0.015) after dilatation in the patient group with cured hypertension, whereas the relative opacification of the poststenotic kidneys increased from 43.6 +/- 2.4% to 47.4 +/- 1.7% (P = 0.014). The results of the Isotope renogram showed a similar increase of the relative function of the poststenotic kidneys from 33 +/- 5% to 38 +/- 7% (P = 0.227) and significant improvement of the clearance from 112 +/- 34 to 175 +/- 48 ml/min/1.73m2 (P = 0.040). The results of both techniques did not significantly change in the group of patients with only moderate improvement of hypertension. Deterioration of the results occurred in those patients in which the hypertension remained unchanged.

Adult↗
PubMedDate not supplied

Clinical speculation: is specificity back? This time thromboangiitis obliterans.

Do men with thrombangiitis obliterans (TO) show conspicuous personality features and behavior? Twenty-one men with TO were compared with 20 men with coronary artery disease (CAD). All diagnoses were angiographically confirmed. Mean ages were 40.1 (TO) and 43.4 years (CAD). Semistructured, open-ended interviews were conducted. Interview-behavior: TOs were more hostile, minimizing, evasive, and complicated than CADs (p < .001). The interviewer reacted with more anger, impatience, boredom, astonishment, and less empathy towards TOs (p < .001). Adult behavior: TOs had changed their place of work more often (p < .001), had more absentism from work (p < .001), and had more debts (p = .01) unrelated to the present illness. They smoked more before the illness (p = .01) and continued to smoke more frequently during their illness than CADs (p < .003). They were more often single or divorced (p < .05) and had more conflicts in their relationships (p < .001) than CADs. During conflicts, TOs more often shouted or withdrew and less frequently tried to resolve conflicts with humor and discussions (p < .001) than CADs. TOs were more frequently dissatisfied with their life situation than CADs (p < .001). TOs more often passively submitted to their illness than CADs, who tried to cope by giving up smoking and by exercising (p < .001). Childhood: TOs more often mentioned a bad relationship with their father than CADS (p = .01) and had more disciplinary problems at home and in school (p = .002). TOs show remarkable personality features.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Acute and long-term effects of prostaglandin E1 assessed by clinical and microcirculatory parameters in critical limb ischemia: a pilot study.

We treated 14 patients suffering from critical limb ischemia (CLI) as defined by the Consensus Document, and in whom possibilities of surgical or percutaneous arterial reconstruction were excluded, by PGE1 60 micrograms i.v. daily during 3 weeks. Effects were evaluated by clinical, macrocirculatory and microcirculatory parameters during a follow-up of 1 year. After treatment with PGE1, we noted a significant reduction in analgesic use and in pain score. The average tcpO2 values on the forefoot in the supine and sitting positions, with or without inhalation of O2 through a face mask, showed a significant improvement after 3 weeks, as well as capillary stage. Laser Doppler flux did not change, but was significantly higher in diabetic patients than in nondiabetics with CLI. In 4 patients (28%) no improvement could be found after 3 weeks' treatment. Although in 6 patients the improvement lasted for up to 4 months, the legs eventually deteriorated. In 4 patients (28%) the legs were preserved after 1 year without further active therapy. No patient with initial tcpO2 values above 40 mm Hg in the supine and 100 mm Hg in the sitting positions during O2 inhalation lost a leg. Although other effects like local care could have influenced the outcome favorably, we noticed a beneficial albeit transient effect of PGE1 for the majority of our patients with CLI. TcpO2 measurements with O2 inhalation might be a valuable predictor of a positive long-term result.

Adult↗