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Biomedical subjects

G Kretschmer

Publications and source records attributed to G Kretschmer.

132 records · Page 8Linked to original sources

Percutaneous angioscopy: improved technique.

Ten angioscopies with a pressure infusion set resulted in similar visualization times and irrigation volumes as 42 angioscopies with a specially constructed roller pump. Diagnostic image quality, however, was obtained almost exclusively with the roller pump. Three examinations were nondiagnostic. Total viewing time per patient was approximately 1 min with the roller pump and 2 min with the pressure infusion system. In the 30 patients examined, angioscopy changed the initially chosen form of therapy in 5 patients.

Aged↗

Obliterations of the proximal subclavian artery: to bypass or to anastomose?

A clinical series has been analysed to determine which of two similar, extrathoracic "extraanatomic" methods of treating proximal blocks of the subclavian artery is the superior option. From 1975 until 1988 direct carotid-subclavian anastomosis was used in 32 patients and carotid-subclavian bypass in 19. There were no statistically significant differences for the probability of postoperative survival (p less than 0.877 Breslow; p less than 0.774 Mantel), intraoperative blood loss or the duration of anaesthesia. Those patients who had undergone subclavian artery repair had a significantly longer survival than those following carotid bifurcation endarterectomy (p less than 0.002 Breslow, p less than 0.0002 Mantel). As patients with subclavian lesions have a reasonable life-expectancy, they may possibly experience late complications of their vascular repair. Therefore it seems important to select the most durable operation, and direct carotid subclavian anastomosis has a significantly greater patency rate than bypass (p less than 0.006 Breslow, p less than 0.006 Mantel). Patients with preoperative symptoms of cerebrovascular insufficiency had a lower probability of survival than those with upper extremity claudication, although this did not reach statistical significance (p less than 0.205 Breslow; p less than 0.198 Mantel).

Adult↗

Aorto-Y-bifurcation graft: Dacron versus PTFE. Preliminary results of a randomized prospective study.

A randomized prospective study comparing PTFE-Y and Dacron-Y-grafts with regard to function rate, morphology, hemodynamic differences along the proximal anastomosis and body of the graft, complications and quality of material was performed. Between March 1983 and February 1987, 112 patients were admitted to the study. Randomization including the criteria of age, sex, indication to operation (chronic occlusive disease, aneurysm) run-off, diabetes, nicotine consumption and operative approach (transperitoneal, retroextraperitoneal) followed the methods of adaptive randomization developed by Pocock and Simon and was well balanced. Function rate and complications as well as morphological alterations showed no significant differences in either group. During a mean observation period of 24 months, Group I yielded a 97% and Group II a 95% function rate (Kaplan-Meier). In all patients but one in each group with limb graft occlusions (n = 5) function was regained by successful thrombectomy and profundaplasty. With respect to Doppler ultrasound differences in flow pattern, in four patients with enlarged proximal side-end anastomosis and adequate--not to large--incision is recommended performing the proximal anastomosis.

Anastomosis, Surgical↗