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Biomedical subjects

G W Kauffmann

Publications and source records attributed to G W Kauffmann.

At least 127 records · Page 7Linked to original sources
PubMed1990

Interventional radiological treatment of malignant biliary obstruction.

Percutaneous transhepatic procedures have gained a strong position in the diagnosis and treatment of malignant biliary obstruction. Diagnostic cholangiography can easily be converted into therapeutic drainage, which is often the first step towards further diagnostic work-up (biopsy, percutaneous cholangioscopy) and tumour ablation and/or intraductal irradiation. Plastic endoprostheses and balloon- or self-expandable metallic stents are the therapeutic alternatives to achieve permanent internal drainage of bile.

Bile Duct Neoplasms↗
PubMed1988

Extraction of an intracardial catheter embolus using combined radiography and transesophageal echocardiography.

Embolism of a fragment of a central venous catheter is a serious clinical complication, especially when the fragment cannot be made visible by radiological methods. We report a case where such a fragment could only be localized by transesophageal echocardiography (TEE). With combined use of x-rays and TEE, the catheter embolus was successfully extracted using a conventional Dormia catheter. For similar situations the described procedure is recommended.

Adult↗
PubMed1988

Percutaneous transhepatic removal of biliary endoprostheses using a snare.

A method using a snare for the percutaneous transhepatic removal of occluded or malpositioned biliary endoprostheses is described. This technique was used in two patients. In one, the snared endoprosthesis was pulled into the duodenum, while in the second patient the prosthesis was pulled out through transhepatic tract without complications.

Aged↗
PubMed1987

[Intraluminal Palmaz stent implantation. The first clinical case report on a balloon-expanded vascular prosthesis].

A 74-year-old patient suffering from severe iliac artery stenosis and claudication was chosen to be the first candidate in the world to receive the Palmaz stent, a balloon-expandable intraluminal stent. This procedure was done in the Department of Radiology, University of Freiburg, FRG. The intervention and postprocedural course were uneventful. His walking distance improved from less than 100 m to unlimited walking capacity. The intra-arterial pressure gradient and ankle-arm pressure ratio also returned to normal.

Aged↗
PubMed1986

Experimental basis of angioinfarction for the treatment of renal hypertension.

Collateral circulation and recanalization represent the main problems of organ-ablating renal embolization. Different animal models were used to study the influence of central, peripheral, and capillary occlusion on organ necrosis. The first laboratory experiments were performed to optimize transcatheteral application of the embolization media tested (Gelfoam powder, Histoacryl, Ethibloc). Experiments with the model of a normal rat kidney (n = 400) showed that only capillary embolization homogeneously occluding the entire arterial system resulted in complete organ necrosis, while following central (renal artery ligation) or peripheral (Gelfoam powder) occlusion, areas of intact parenchyma remained. Ethibloc/glucose proved to be the embolization medium best suited for capillary embolization (radiopaque, inert, slow resorption). Studies with the model of unilateral renal hypertension of the rat (n = 146) demonstrated the equivalent therapeutic efficiency on blood pressure of Ethibloc embolization (57% cured, 21% improved) compared to surgical nephrectomy (50% cured, 29% improved), whereas renal artery ligation (85% failed) resulted in minor improvement only. In order to adapt capillary embolization with Ethibloc/glucose to clinical angiographic techniques, we performed angioinfarction of canine kidneys (n = 15): the use of a balloon catheter is mandatory. This guarantees blood stasis during the embolization procedure and avoids embolic reflux. Possible clinical indications of capillary embolization in renal hypertension as a less invasive method are, e.g.: malignant nephrosclerosis; renovascular or glomerulonephritic contracted kidneys, and renal dysplasia. Indications for super-selective vaso-occlusion are renal aneurysms, a-v malformations, and segmental hypoplasia.

Angioplasty, Balloon↗
PubMed1986

[Diagnostic imaging potentialities of nuclear resonance tomography. Changes in vertebrae, ligaments and intervertebral disks in comparison with computed tomography].

This is a study of 49 patients with lesions of the spine excluding primary tumors of the spinal cord. All patients were examined by computed tomography and magnetic resonance imaging. Comparing both methods we observed slight diagnostic advantages for magnetic resonance imaging in inflammatory and neoplastic disease. Especially for evaluation of the spinal cord and subarachnoid space MR-imaging is far superior to computed tomography.

Adult↗
PubMed1985

[Temporary preoperative balloon catheter blockage of a traumatic giant aneurysm and of an a.v. fistula of the vertebral artery].

A new method of embolisation with a dilatation catheter is described as an example in a case with traumatic aneurysm and an a.v. fistula of the vertebral artery. The lesion was temporarily occluded with a conventional catheter for angioplasty and operated upon. The method is available for e.g. rapid management in case of imminent rupture of traumatic aneurysms, multiple lesions of vessels and for operative reconstruction of traumatised arteries.

Accidents, Home↗
PubMed1985

[Intra-arterial DSA for control of aortocoronary bypass--an alternative to coronary angiography].

Intraarterial DSA is a suitable method for early postoperative control of coronary artery bypass grafts. Small quantities of contrast media with low iodine content are injected into the aortic root. Investigations can be carried out with a routine fluoroscopic and digital equipment; additional cine-technique and analogue memory disc are not necessary. At an image rate of 3/s the bypass anastomoses can be exactly visualized in 75%, whereas diagnostic information was not sufficient in only 4% of all cases. The use of modern F-5-catheters and the nonselective injection make this method a less invasive alternative to coronary angiography. It is particularly useful in evaluation of short- and long-term results.

Adult↗
PubMed1985

[Improvement of arteriography technics by new thin catheters].

New, small, polyurethane French 4 and French 5 sized catheters with a commensurately large lumen are described. In combination with DSA they allow low doses of contrast media in renal insufficiency and facilitate selective and superselective manipulations. The high flow specification also permits use in "conventional" angiography.

Angiography↗
PubMed1985

[Capillary embolization of a hemorrhaging kidney tumor. An unusual case report].

Experimental results of embolization of normal organs did not clarify the value of transcatheter vessel occlusion in the treatment of renal carcinoma. In experimental embolization of chemically induced renal rat tumors the concept of capillary embolization was developed and showed excellent results even in end-stage tumors. In consequence this concept was adapted and transferred to clinical tumor embolization. Of 30 patients, that have been embolized up to now using Ethibloc in combination with 40% glucose as occlusion medium, one case is reported herein with a very favourable outcome. The female patient had intensive venous infiltration of a renal carcinoma accompanied by severe hematuria (T3NxM0V2). Because a patient that seems to be practically cured 30 months after embolization demonstrating massive tumor shrinkage to less than 10% of the original size in CT-controls the use of transcatheter vessel occlusion should again be investigated in association with surgical alternatives.

Capillaries↗
PubMed1984

[Experimental conditions for embolization treatment of renal hypertension].

An experimental study was carried out on 146 rats with hypertension in order to determine whether the intensive collateral circulation which develops in reno-vascular hypertension is responsible for the high failure rate following clinical embolisation. Ethibloc embolisation, which fills the capillaries, is as effective as nephrectomy, whereas ligature of the renal artery fails to affect the hypertension.

Animals↗