[Occlusion spiral for therapeutic vessel embolization. Self production, administration and use].
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Biomedical subjects
Publications and source records attributed to F Stösslein.
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30 patients underwent implantation of the Mobin-Uppin filter for recurrent life threatening pulmonary embolism. 20 patients could be followed by phlebography. In 11 cases obstruction of the inferior vena cava was observed. Due to the collaterals having developed in the intermediate time there were no significant clinical symptoms below the obstruction.
In 53 external patients with extensive malignant renal tumours before nephrectomy the renal artery was closed centrally by radioopaque ivalonchips. 46 arteries were completely obturated, in 7 cases the embolization was incomplete. This method of embolization is indicated preoperatively because there are some advantages concerning technique of operation. In or ivalon-material there was only one complication without clinical symptoms. The occurring ischemic pain was controllable by medicaments and eased off within some hours. Directly after transcatheter occlusion the patients can be transported back under first aid conditions in hospital where will be nephrectomy carried out.
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In 16 patients suffering from occlusions of the pelvic and/or femoral arteries a combined treatment was performed: percutaneous transluminal angioplasty (PTA) and surgical reconstructive measures. Indications for this procedure are: 1. Stenoses of the pelvic arteries and occlusion of the ipsilateral superficial femoral artery with PTA for the iliac artery and endarterectomy for the femoral artery. 2. Occlusion of the iliac and the femoral arteries with a decreased run-off: PTA and lumbar sympathectomy. 3. Endarterectomy on one side and PTA contralaterally.
Aortography and subsequent angiography of the A. carotis communis (Seldinger technique) was carried out in a 51-year-old man suffering from cerebrovascular insufficiency (transitory hemiparesis, disturbances in word finding). Complete interna occlusion from the carotid fork, no formation of collaterals in the ophthalmic artery region. After the last administration of the contrast medium loss of sight on the side of the carotid angiography (right side). Reappearing of retinal circulation only on the following day. Treatment with Radecol, Prednisolut, amyl nitrite. No return of slight, --Discussion of the two releasing possibilities; washing-in of embolic material and arterial spasms. A survey in the form of tables is given of nine similar complications which were found in the literature. Comprehensive bibliography.
Possibilities and indications for reconstruction of the femoro-popliteal and femoro-crural region are dealth with. Autogenous veins still are the favoured graft material for the femoro-popliteal/crural bypass. If an autogenous vein is not available bovine arterial grafts, Gore-Tex-PTFE prostheses or modified human umbilical cord vein are alternative materials.
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A case of an embolization of an Anthéor vena cava filter into the pulmonary artery with disastrous exit 9 days after placement is described. The possible reasons are discussed.