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Biomedical subjects

G Lechner

Publications and source records attributed to G Lechner.

At least 73 records · Page 4Linked to original sources
PubMed1984

[The PTFE plastic prosthesis as an arterial replacement: experiences over a 5-year period].

Unilateral iliac femoral reconstructions with PTFE are yielding good results-similar to those with Dacron, with patency rates of 75, 67, and 65% at 1, 2 and 3 years, respectively (Kaplan-Meier). PTFE has additional advantages compared with other materials: a) no need of preclotting; b) smooth inner surface-easy thrombectomy in case of thrombosis and c) good handling characteristics. In view of the above-mentioned facts PTFE can be recommended without restriction for unilateral pelvic reconstructions. The functional early results of bilateral aorto-femoral Goretex-Y bifurcation grafts in 50 cases after 2 years are encouraging. Long-term results are still pending. Reports of other groups using this material as aorto-bifemoral substitute are not yet available. The functional results with PTFE for femoro-popliteal grafts are not satisfactory: 35% after 2.5 years. Extra-anatomical bypasses yielded 70% one-year functioning rate. Especially the ring-or spiral-armoured PTFE grafts seem to be suitable for these reconstruction procedures.

Aged↗
PubMed1984

Lateral distant view for improved accuracy in locating rectal tumors.

The lateral distant view of the rectum is proposed for more precise identification of sites of rectal tumors for preoperative planning and to increase the number of sphincter-saving operations. In a prospective study of 39 patients with rectal tumors, radiologic and rectoscopic measurements of tumor levels were compared with each other and with the actual tumor site. Radiologic measurement on the lateral distant view showed that tumors usually are located much higher (2-11 cm) than is suggested by rectoscopic evaluation. Unlike rectoscopy, the lateral distant view also can be used for measuring the length of the anal canal. This measurement is important for evaluating the distance between the tumor and the inner end of the anal canal and reflects the width of a possibly tumor-free margin. Sphincter-saving operations could be predicted much better by the lateral distant view than by rectoscopy.

Adult↗
PubMed1984

[The PTFE-Y bifurcation prosthesis: early results].

During the past 2 years (April 1981-March 1983) 50 PTFE Y-grafts were implanted. The early results are good. Except one graft limb occlusion (8 months postoperatively), which was successfully managed by thrombectomy, all grafts are functioning well or did so until death. 5 patients (age 70-84 years, aortic aneurysm, additional vascular surgery) died 1 day to 8 weeks postoperatively. The death was not specifically related to the material of the new prosthesis. Advantages of PTFE are: a) no need of preclotting; b) absolute tight body of the prosthesis even in the heparinized patient; c) thrombectomy is easy to perform. Important technical details, mandatory for a safe operative procedure and for good functional as well as morphological results, are reported.

Adult↗
PubMed1983

[Subclavian-carotid artery transposition in the therapy of lesions of the proximal subclavian artery].

Employing an extrathoracic approach 10 patients were operated upon for 12 obstructive lesions of the subclavian arteries using carotid-subclavian anastomosis. The operation was indicated 3 times for the pathological entity of arterial stenosis embolizing into the vascular periphery, 3 times for claudication of the upper extremity and 4 times for cerebro-vascular insufficiency. Followed up to 31 months all anastomoses remained patent. All the complications were managed conservatively and were considered of minor importance.

Adult↗
PubMed1983

Bleeding aneurysm of the axillary artery, managed by a combined approach: interventional radiology and extra-anatomic bypass.

Twenty-two years after an obvious radical mastectomy with axillary lymph node dissection and postoperative conventional radiotherapy for carcinoma of the right breast, an 80-year-old lady was admitted because of the third bleeding episode within one year originating from the axilla. An aneurysm from the axillary artery was identified as the source of hemorrhage. Since the sites of irradiation had to be avoided, an extra-anatomic reversed saphenous vein graft was run from the right common carotid to the brachial artery. In the same session the bleeding was finally controlled by therapeutic embolization of the aneurysm using Gianturco-Anderson-Wallace coils. The postoperative angiogram showed the patent graft. Bleeding did not reoccur during the follow-up period of 17 months.

Aneurysm↗
PubMed1982

[Roentgenologic findings following total transposition of the stomach as a replacement for long segments of the esophagus].

Thirty-seven patients, in whom the stomach had been transposed in order to replace a long segment of the oesophagus, were studied. Radiologically important early complications and the late results of this surgical technique were correlated. Twenty-five patients were observed radiologically and clinically for a period of three to 20 months. The study was directed at the morphology of the transposed stomach and of the anastomosis, and particularly at the problem of gastro-oesophageal reflux. Knowledge of the operation site is essential for evaluating the transplant (pleura defect). Radiological examination is the most suitable method for evaluating the cervical extra-thoracic anastomosis in the early post-operative phase (six to ten days). It is also effective at a later stage for the early recognition of fibrotic stenosis which will require treatment. An attempt has been made to define an ideal situation following gastric transposition which will usually correspond with a good clinical result.

Adult↗
PubMed1982

[Assessment of the tracheal cross-section by computerised tomography (author's transl)].

Tracheal cross-sections can be measured by means of computerised tomography with hitherto unparalleled accuracy. Among the patients examined by the authors (43) women following tracheopexy because of tracheomalacia), computerised tomography yielded approximately 3 times as many pathological findings as was possible by conventional x-ray diagnosis. Over and above this, it is always possible to calculate the flow resistance, a fact which can be of great importance for therapy planning and control. Hence, in all cases where accurate visualisation of the tracheal cross-section is necessary, computerised tomography appears to be the method of choice at the present time.

Adult↗
PubMed1981

[Problems arising in connection with surgical management of renovascular hypertension (author's transl)].

65 consecutive renal artery stenosis reconstructions for the treatment of severe renovascular hypertension are reported. 63% of the cases were males, 37% females. The disease was caused by arteriosclerosis in 66% of cases and in 23% by fibromuscular dysplasia or other pathological changes of the renal artery; the mean age was 47 in the former. and 31 years in the latter group. An aortorenal saphenous vein bypass was performed in 35% cases, a dacron graft was used in 29% and thrombendarteriectomy was carried out in 23% cases. Positive results were achieved in 68.8% of the patients. 63% of the females became normotensive. Operative mortality due to faulty technique was 4.9% initially. The operative mortality has been zero since 1973. nor have there been any therapeutic failures on a technical basis. No significant correlation was established between age of the patients and result of operation.

Adult↗
PubMed1981

[Displacements and complications of superior vena cava catheter (author's transl)].

During a 16-months prospective study the frequency of displacements and complications of superior vena catheter has been investigated. The study showed, that the right jugular catheter has the lowest frequency of complications, and should be of primary choice. Pneumothoraces are rare with jugular vena catheters (0,05%), more frequently with subclavian catheters. Setting of superior vena catheter displacement in large veins is quite common. More important are catheter displacements in small veins, which are more frequent with jugular than with subclavian vena catheter (vena thoracica interna, vena pericardiacophrenica). Adequate X-ray control (high KV technic, sufficient amount of contrast medium) is necessary to recognize these complications. Correction of displaced catheter should be done under fluoroscopy. Serious complications s.e. tension pneumothorax and haematothorax are rare and should be treated surgically. In some cases no recognized extravasal catheterposition is followed by infusions into the pleural cavity or the mediastinum.

Aged↗
PubMed1980

[The diagnostic value of pharmacoangiography in tumourous and inflammatory diseases of bones and soft tissues (author's transl)].

The value of pharmaco-angiography (Priscol, angiotensin) in the diagnosis of tumourous and inflammatory diseases in bones and soft tissues was investigated in 81 patients. Priscol was used in 49 patients, angiotensin in 28 and both substances in four. It was shown that neither Priscol nor angiotensin produced results of diagnostic value, provided an optimal technique was used (antegrade, selective contrast injection with an adequate volume of contrast and in the absence of vascular spasm). Priscol was of value for reducing or preventing spasm in peripheral vessels. Angiotensin is superior to Priscol in demonstrating the angiographic criteria, but pharmaco-angiography did not result in a better distinction between tumours and inflammatory lesions.

Adolescent↗
PubMed1980

[Angiography in distal spleno-renal shunts (author's transl)].

The conception of Warren's Shunt--selective decompression of esophageal varices while maintaining prograde portal flow--was controlled by pre- and postoperative angiographic examinations on 12 patients: No change in portal perfusion was established angiographically in ten of the patients. Two patients developed aneurysmatic, arterio-portal fistulae as a result of postoperative portal decompression. In one of these cases, a thrombosis of the portal vein with hepatofugal perfusion of the left gastric vein was detected. The postoperative examinations indicated functioning shunts in 9 out of 12 patients. These results formed the basis for the discussion regarding the value of visceral angiography in the selection of the surgical technique and regarding its value in control of therapy. Surgical questions concerning the visceral vascular anatomy can be answered sufficiently. Furthermore, celiac and mesenteric angiography yield information on portal hemodynamics. Nevertheless, the additional application of invasive scintigraphy seems to be necessary for establishing quantitative radiological parameters of prognostic relevance.

Angiography↗