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H Seifert

Publications and source records attributed to H Seifert.

At least 73 records · Page 4Linked to original sources
PubMed1999

[Radiation exposure of the patient caused by transmission measurement for myocardial perfusion SPECT].

AIM: The aim was the determination of the radiation exposure to the patient caused by the transmission measurement for myocardial perfusion SPECT. METHOD AND MATERIAL: Beside the emission measurement (Tc-99m-MIBI, A = 500 MBq) the myocardial perfusion SPECT simultaneously includes a transmission measurement using a Am-241-line source (A = 5550 MBq). During a simulation of the myocardial perfusion SPECT (without Tc-99m-MIBI) dose measurements with thermoluminescent dosimeters were carried out using a thorax phantom. RESULTS: For an acquisition time of 20 min the absorbed doses amounted to: surface (xyphoid) 30 microGy, heart 25 microGy, lung 14 microGy, second thoracic vertebra 16 microGy, upper anterior mediastinum 16 microGy, liver 0 microGy. An estimation of the ratio of the effective doses caused by the transmission and the emission measurement of 3.6 x 10(-3) and 4.1 mSv, respectively, resulted in a value of 9 x 10(-4). CONCLUSION: The radiation exposure of the patient caused by the transmission measurement can be neglected, and is therefore not a limiting factor regarding the general application of transmission measurement for clinical myocardial perfusion SPECT.

Heart↗
PubMed1999

[Reduction of patient exposure by the use of digital luminescence radiography].

PURPOSE: To determine the minimum acceptable exposure for an adequate image quality using digital luminescence radiography (DLR) instead of screen-film system (SFS). MATERIAL AND METHODS: The impact of different physical and technical parameters on image quality and exposure was evaluated by obtaining radiographs of a test phantom. Conventional and digital radiographs of a humanoid phantom, an anatomical preparation or an animal were obtained using variable mAs. The image quality was rated by eight experienced radiologists using clinical criteria of image quality. The image quality evaluation was analysed using graphs. RESULTS: The exposure could be reduced by 60% for skull radiographs, 57% for abdominal radiographs, and 25% for chest radiographs of premature infants when using DLR instead of conventional SFS. CONCLUSION: DLR provides adequate image quality with reasonably low exposure.

Age Factors↗
PubMed1999

[A new papillotome for cannulation, pre-cut or conventional papillotomy].

UNLABELLED: A new papillotome was designed to overcome certain drawbacks of the needle-knife, that is most commonly used for precut sphincterotomies. The intention was to develop an instrument at least as good as the needle-knife or the Erlangen-type precut papillotome for precut procedures. In addition, it had to be suitable for direct cannulation of the biliary or pancreatic duct. PATIENTS AND METHODS: According to a prospective protocol 54 patients in whom a papillotomy was indicated were examined with the new instrument. The protocol allowed three futile attempts to cannulate or two inadvertant cannulations of the pancreatic duct with a standard cannula and hydrophilic guide wire before a precut was performed. The new baby-papillotome has a diameter of only 1 mm and a short 10 mm cutting wire. Similar to a guide wire it is introduced via a 6F- or 7F-introducer catheter. RESULTS: Cannulation of the desired duct (the bile duct in 48 patients, the pancreatic duct in five patients, Billroth II anatomy in three patients) was successful within one session in 98% (53/54). In one patient, the bile duct was successfully cannulated in a second session using the baby-papillotome, resulting in an overall success rate of 100%. Primary cannulation using the new papillotome without precut was obtained in 24% (13/54). Complications were mild pancreatitis in one patient and nonsignificant bleeding in three (immediate endoscopic hemostasis in all, no transfusions, no drop of hematocrit). There were no serious complications. CONCLUSION: The new baby-papillotome is suitable for precut as well as for primary cannulation. In this first series, the desired duct was cannulated in 98% within the first session with a low complication rate. Further studies of the new instrument seem desirable.

Catheterization↗
PubMed1998

Comparative in-vitro activities of trovafloxacin, ciproflaxacin, ofloxacin, and broad-spectrum beta-lactams against aerobe blood culture isolates.

The in vitro activity of trovafloxacin, a new fluoroquinolone, was compared with that of ciprofloxacin, ofloxacin, fleroxacin, ceftazidime, piperacillin/tazobactam, and meropenem against 613 consecutively recovered blood isolates from recently hospitalized patients. Susceptibility testing was performed by agar dilution according to NCCLS guidelines. Test strains included Acinetobacter species (n = 26), Escherichia coli (n = 137), Enterobacter species (n = 27), Klebsiella species (n = 42), Proteus species (n = 16), Pseudomonas aeruginosa (n = 28), Serratia marcescens (n = 13), Stenotrophomonas maltophilia (n = 7), enterococci (n = 54), coagulase-negative staphylococci (n = 38), Staphylococcus aureus (n = 137), Streptococcus pneumoniae (n = 27), beta-haemolytic streptococci (n = 13), and viridans group streptococci (n = 48). The overall respective MICs at which 50% and 90% of isolates were inhibited (MIC50s and MIC90s) were as follows: trovafloxacin, 0.06 and 1 mg/l; ciprofloxacin, 0.25 and 4 mg/l; ofloxacin, 0.5 and 4 mg/l; fleroxacin, 0.5 and 16 mg/l; ceftazidime, 2 and 128 mg/l; piperacillin/tazobactam, 2 and 8 mg/l; meropenem, 0.06 and 4 mg/l. For the quinolones, the rank order of activity against gram-negative microorganisms was ciprofloxacin > trovafloxacin > ofloxacin = fleroxacin, against gram-positive organisms, trovafloxacin > ciprofloxacin = ofloxacin > fleroxacin. Data obtained showed the similar activity of trovafloxacin and ciprofloxacin against gram-negative pathogens and the superior activity of trovafloxacin against gram-positive bacteria thus making it a potential candidate for the empiric treatment of patients with suspected bacteremia and sepsis.

Anti-Bacterial Agents↗
PubMed1998

Glycoconjugate expression during early mouse oculogenesis.

The carbohydrate side-chain of glycoconjugates can show a developmentally regulated expression pattern. In order to analyse these changes during the development of the eye, 13 lectins were used to reveal glycoconjugates histochemically in 8.5- to 14-day-old mouse embryos. During this period, eyes develop from the most immature vesiculation of the neural plate neuroepithelium into a primitive stage with all structures present, such as pigment epithelium, not yet differentiated neuroretina and lens. A striking diversity of carbohydrate side-chain expression was observed in the preocular somatoectoderm and neural plate of 8.5-day-old embryos, as indicated by the binding of nine different lectins. Binding sites at the apical poles of neuroepithelium of five of these lectins (PNA, LCA, SBA, LPA and GSA-II) disappeared completely during further development. The binding sites of four other lectins, WGA, MPA, Con A and BPA, remained expressed during the course of development, being indicative for the carbohydrate side-chains beta-GlcNAc(1-4)Gluc, alpha-Gal(1-3)GalNAc, alpha-D-Man/alpha-D-Gluc and alpha-GalNAc. In contrast, binding sites for GSA-I, RCA-I (alpha-D-Gal), UEA-I (alpha-L-Fuc) and DBA (alpha-GalNAc(1-3)GalNAc) were not present at any developmental stage. The time point of gross changes of lectin binding sites correlates well with the period of neural tube formation. During later development from neuroectoderm to the ocular pigment epithelium, a sharp reduction in all lectin binding sites at the apical cell poles, except for WGA and MPA, was observed. WGA binding sites were present until embryonic day 10, while those for MPA were present until day 9. At the basal cell poles of the pigment epithelium, all lectin binding sites except for WGA were lost after embryonic day 11.5. These results indicate that there are sophisticated kinetics of glycoconjugate expression during the course of early embryonic development of ectoderm into its descendent tissues.

Animals↗
PubMed1998

Endoscopic injection of botulinum toxin for biliary sphincter of Oddi dysfunction.

BACKGROUND AND STUDY AIMS: Endoscopic sphincterotomy is not without risks, and is also ineffective in about half of patients with type III sphincter of Oddi dysfunction (SOD), i.e. those without clinical evidence of biliary obstruction (normal liver tests, normal bile duct diameter, and regular drainage time at endoscopic retrograde cholangiography). The present study therefore investigated the efficacy and safety of endoscopic botulinum toxin (BTX) injection into the papilla of Vater, and analyzed whether the symptomatic response to BTX injection might be a predictor of outcome for endoscopic sphincterotomy. PATIENTS AND METHODS: Twenty-two patients who had undergone cholecystectomy and had manometrically confirmed type III SOD were enrolled during a three-year study period. All patients received treatment with an endoscopic single-shot injection of 100 mouse units of BTX into the papilla of Vater. Initial symptomatic responses were analyzed six weeks later. If the BTX injection had been ineffective, or if biliary symptoms recurred after initial benefit during the follow-up period, endoscopic manometry and endoscopic sphincterotomy were performed. All patients then received further prospective clinical follow-up examinations. RESULTS: With the exception of one patient with mild pancreatitis (4.5%), no side effects were observed after endoscopic BTX injection. Six weeks after BTX injection, 12 SOD patients (55%) were symptom-free, but ten patients (45%) were not. However five of these ten SOD patients who did not experience symptomatic benefit from BTX injection had normal basal sphincter of Oddi pressures (< 40 mmHg) at this time, and none of these five patients was free of complaints after subsequent endoscopic sphincterotomy. Two of the remaining five patients with sustained sphincter hypertension after BTX injection benefitted from endoscopic sphincterotomy. Eleven of the 12 SOD patients who had initially responded to BTX injection developed recurrent symptoms after a median period of six months. Manometry revealed sphincter hypertension in all 11 cases, and all patients became free of complaints again after endoscopic sphincterotomy during a median follow-up of a further 15 months. Overall, 11 of the 12 patients who responded to BTX injection, versus two of the ten patients who did not gain pain relief after BTX injection, later benefitted from endoscopic sphincterotomy (p < 0.01). CONCLUSIONS: Endoscopic injection of botulinum toxin into the papilla of Vater is a safe procedure and provides short-term relief of symptoms in half of patients with type III SOD. Our results also indicate that the clinical response to BTX injection can predict whether SOD patients will gain long-term benefit from endoscopic sphincterotomy.

Adult↗
PubMed1998

Dose reduction in thorax radiography in simulated neonates with additional filtration and digital luminescence radiography.

PURPOSE: To determine the minimum acceptable radiation dose for an adequate image quality in thorax a.p. radiographs of neonates using mobile X-ray equipment. MATERIAL AND METHODS: The influence of additional filtration (1.0 mm Al + 0.1 mm Cu) on image quality and radiation dose was determined for the speed class 400 screen-film system (SFS) and digital luminescence radiography (DLR) by making radiographs of a test phantom. Conventional and digital thorax a.p. radiographs of a rabbit were produced using various tube current-time products. The quality of the rabbit radiographs was judged by eight radiologists applying image quality criteria according to the German guidelines and the recommendations of the European Community. RESULTS: The added filter resulted in a dose reduction of 39% at 66 kV. DLR gave a further dose reduction of 25% in comparison to the speed class 400 SFS while maintaining adequate image quality, i.e. the radiographs were clinically acceptable with regard to quality criteria. CONCLUSION: The radiation dose resulting from thorax a.p. radiographs of neonates can be reduced by approximately 50% with the use of additional filtration and DLR.

Animals↗
PubMed1998

Survival of Acinetobacter baumannii on dry surfaces: comparison of outbreak and sporadic isolates.

Acinetobacter spp. are important nosocomial pathogens reported with increasing frequency in outbreaks of cross-infection during the past 2 decades. The majority of such outbreaks are caused by Acinetobacter baumannii. To investigate whether desiccation tolerance may be involved in the ability of certain strains of A. baumannii to cause hospital outbreaks, a blind study was carried out with 39 epidemiologically well-characterized clinical isolates of A. baumannii for which survival times were determined under simulated hospital conditions. The survival times on glass coverslips of 22 strains isolated from eight well-defined hospital outbreaks in a German metropolitan area were compared with the survival times of 17 sporadic strains not involved in outbreaks but rather isolated from inpatients in the same geographic area. All sporadic isolates have been shown by pulsed-field gel electrophoresis to represent different strain types. There was no statistically significant difference between the survival times of sporadic strains of A. baumannii and outbreak strains (27.2 versus 26.5 days, respectively; P < or = 0.44) by the Wilcoxon-Mann-Whitney test. All investigated A. baumannii strains, irrespective of their areas of endemicity or epidemic occurrence, have the ability to survive for a long time on dry surfaces. Antimicrobial susceptibility testing showed that A. baumannii outbreak strains were significantly more resistant to various broad-spectrum antimicrobial agents than sporadic strains. Both desiccation tolerance and multidrug resistance may contribute to their maintenance in the hospital setting and may explain in part their propensity to cause prolonged outbreaks of nosocomial infection.

Acinetobacter↗
PubMed1998

[Comparison of 51Cr-EDTA with 99m-Tc-DTPA slope clearance for estimation of glomerular filtration rate using the one compartment model].

AIM: Of this study is to determine the relationship between 51Cr-EDTA and 99mTc-DTPA slope clearance applying the "one-compartment model". METHODS: The "one-compartment model" was chosen to calculate and to compare the glomerular filtration rates of 25 patients with normal and pathological creatinin values after injection of 51Cr-EDTA and 99mTc-DTPA simultaneously. RESULTS: The two clearance values correlated well (r = 0.996), and the 99mTc-DTPA clearance was systematically higher (28%). The 99mTc-DTPA was calculated and compared after taking three plasma samples. Taking two samples, only minor differences were seen and the correlation was high (r = 0.992). CONCLUSION: The results of this study encouraged us to adopt the use of 99mTc-DTPA instead of 51Cr-EDTA in determining the glomerular filtration applying the "one-compartment model" in slope with two plasma samples.

Chromium Radioisotopes↗
PubMed1998

Angiotensin-converting enzyme gene insertion/deletion polymorphism and peripheral arterial occlusive disease.

BACKGROUND: The deletion polymorphism of the ACE gene is linked to a high risk of cardiovascular disease due to the permanent activation of the local and systemic renin-angiotensin systems (RAS). The aim of this prospective study was 1. to compare the ACE insertion/deletion polymorphism in individuals with a healthy vasculature with that of patients suffering from peripheral arterial occlusive disease (PAOD), and 2. to determine whether associations existed between specific clinical parameters and the ACE genotype which the PAOD patients expressed. PATIENTS AND METHODS: Determinations of ACE I/D gene polymorphism were made using a polymerase chain reaction (PCR) technique on 98 patients with clinical stage II PAOD according to Fontaine and 240 healthy individuals who served as controls. All patients and controls came from central Germany. Clinical variables which included duration of clinical symptoms, a familial history of the disease, arteriosclerosis score (ASF, providing an estimate of the extent of atheromatosis at femoral artery bifurcation) and plasma ACE activity were correlated with the genotypes taking the cardiovascular disease risk factors which were present into consideration. RESULTS: Differences in ACE genotypes between patients with PAOD (D/I: 0.57/0.43) and control group individuals (D/I: 0.59/0.41) were not observed. In comparison with the II genotype, the DD genotype was associated with a shorter duration of disease (p = 0.01), a positive family medical history (p = 0.022) and a higher plasma ACE activity (p = 0.026). The ASF did not correlate with the ACE I/D gene polymorphism. CONCLUSION: Evidence that the deletion allele is linked to the manifestation of PAOD could not be found in the patients studied. One can assume, however, that the deletion allele has a progression promoting effect on the disease.

Aged↗
PubMed1997

[Comparative experimental studies on rigidity, deformation and blunting behavior of various total hip endoprostheses under dynamic load].

The biomechanical reasons for moving and loosening of the acetabular cup and femoral prosthesis are still unclarified. Especially, chronic and mechanical overloads of the interfaces, which are caused by the change of stiffness and damping properties of the whole system, cannot be excluded. To date, the description of dynamic behaviour of hip-joint endoprostheses from the viewpoint of material selection and design is insufficient. On the basis of comparative experiments, this publication aims to complete the knowledge about mechanical properties of artificial hip joints. Primarily, we focused on the quantitative registration of certain influences (e.g. design, dimensions and material) on the dynamic properties of different kinds of acetabulum cups. Therefore, a significant new test method was developed for this examination. Conventional test methods work according to the principle of constancy of maximum forces and excitation frequencies. They do not consider the forces of inertia resulting from body mass, even though these reaction forces are decisive for the dynamic properties and mechanical behaviour of the components of endoprostheses. A selection of representative implants from several manufacturers were tested according to the new test method, which is based on the "mass-spring, absorber" principle. The examined prostheses concerned differed in material, method of fixation and geometric dimensions. The results of these examinations give clues to the repercussions of the mentioned parameters on the dynamic behaviour of endoprosthetic systems. In order to evaluate the results, hip joints from animals were also examined and provided relevant information for desirable alternative solutions to the problem in view of construction and material.

Acetabulum↗
PubMed1997

Endosonography-guided fine-needle biopsy of indurated pancreatic lesions using an automated biopsy device.

BACKGROUND AND STUDY AIMS: We have designed and evaluated a prototype automated spring-loaded biopsy needle for endoscopic ultrasonography (EUS)-guided tissue sampling of indurated lesions in which sampling using conventional aspiration needles has failed. PATIENTS AND METHODS: EUS-guided fine-needle biopsy using the new device was performed in four patients (two men, two women, mean age 65 years) with indurated pancreatic lesions that could not be penetrated with a conventional manually operated aspiration needle. The lesions were located in the head of the pancreas in two patients, in the genu in one, and in the body in one. RESULTS: The automatic biopsy needle allowed penetration of the pancreatic lesions in all cases. The biopsy route was transduodenal in two patients, and transgastric in the other two. The biopsies provided a core specimen for histological and cytological diagnosis in all cases. No complications occurred. CONCLUSION: The spring-loaded biopsy needle allows tissue sampling of indurated pancreatic lesions that cannot be penetrated with conventional aspiration needles. Further studies are warranted to determine whether this device can improve the results of EUS-guided fine-needle aspiration biopsy.

Adenocarcinoma↗
PubMed1997

Detection of the adrenal glands by endoscopic or transabdominal ultrasound.

BACKGROUND AND STUDY AIMS: The value of transabdominal and endoscopic ultrasound (EUS) in detecting normal adrenal glands is not yet established. The aim of our study was to evaluate whether these techniques can be routinely used to visualize the adrenal glands in patients without suspected adrenal pathology. PATIENTS AND METHODS: Transabdominal ultrasound was validated by examination of 10 corpses and was performed in 80 healthy volunteers (3.5 and 5 MHz). EUS of the left adrenal gland was performed in 154 consecutive patients referred for various other reasons. In 20 patients we attempted to visualize the right adrenal gland as well. RESULTS: Both adrenal glands were correctly identified in all of the 10 corpses once they were opened. In healthy volunteers, the right adrenal gland was visualized by transabdominal ultrasound in 79/80 patients (99 %) and the left adrenal gland in 55/80 patients (69 %). EUS allowed detection of the left adrenal gland in 151/154 patients (98%). In three patients EUS failed because of grossly distorted anatomy. In 6/20 patients we were also able to detect the right adrenal gland by EUS, which was obvious in two cases because of incidentalomas. CONCLUSION: Visualization of the right adrenal gland is almost always possible by transabdominal ultrasound, while its detection by EUS is successful only in some cases. The left gland is more difficult to detect by transabdominal ultrasound, while it can nearly always be seen using EUS. Therefore, a combined transabdominal and endoscopic ultrasonographic approach is useful for visualization of the adrenal glands and may enable diagnosis of even small adrenal masses.

Adrenal Glands↗
PubMed1997

Distribution of Acinetobacter species on human skin: comparison of phenotypic and genotypic identification methods.

At least 19 genomic species are recognized as constituting the genus Acinetobacter. However, little is known about the natural reservoirs of the various members of the genus. An epidemiological study was therefore performed to investigate the colonization with Acinetobacter spp. of the skin and mucous membranes of 40 patients hospitalized in a cardiology ward and 40 healthy controls. Single samples were obtained once from each of nine different body sites, i.e., forehead, ear, nose, throat, axilla, hand, groin, perineum, and toe web. Identification of Acinetobacter isolates was achieved by using phenotypic properties and was compared to identification by amplified ribosomal DNA restriction analysis. Selected isolates were further investigated with sodium dodecyl sulfate-polyacrylamide gel electrophoresis, ribotyping, and DNA-DNA hybridization. Plasmid profile analysis was used for epidemiological typing. Thirty patients (75%) and 17 controls (42.5%) were found to be colonized with Acinetobacter spp., and the colonization rates of patients increased during their hospital stay. The most frequently isolated species were Acinetobacter lwoffii (47%), A. johnsonii (21%), A. radioresistens (12%), and DNA group 3 (11%). In contrast, A. baumannii and DNA group 13TU, the most important nosocomial Acinetobacter spp., were found only rarely on human skin (0.5 and 1%, respectively) and their natural habitat remains to be defined. A good correlation between phenotypic and genotypic methods for identification of Acinetobacter spp. was observed, and only two isolates could not be assigned to any of the known DNA groups.

Acinetobacter↗
PubMed1997

Multicenter study using standardized protocols and reagents for evaluation of reproducibility of PCR-based fingerprinting of Acinetobacter spp.

Seven laboratories in six European countries examined 40 isolates belonging to the Acinetobacter calcoaceticus-Acinetobacter baumannii complex to investigate whether standardized protocols and quality-controlled reagents could produce reliable, discriminatory, and reproducible PCR-based fingerprinting results. Four PCR protocols with different primers (primers DAF4, ERIC-2, M13, and REP1 + REP2) were used. The epidemiological conclusions reached by the participating laboratories were substantially correct, with 96.4% of the total isolate grouping allocations agreeing with the consensus view. All laboratories identified the main epidemiological clusters, and each laboratory also identified two non-outbreak-related isolates. There were no significant differences between the isolate grouping results obtained by the different protocols and with the different primers. Visual comparison indicated that the standardized protocols and reagents yielded reproducible fingerprint patterns, but with some variations in particular band intensities. Minor variations in fingerprint profiles were detected, but computer-assisted analysis of PCR fingerprints obtained on agarose gels demonstrated that 88.3 to 91.6% (depending on the source of DNA) of the patterns clustered correctly, while 96.4 to 98.9% of the patterns clustered correctly following automated high-resolution laser fluorescence analysis. Correlation of the patterns for isogenic isolates ranged from 83.3 to 86.6% but was slightly better (mean correlation, 87.1%) for centrally prepared DNA extracts than for DNA extracts prepared by individual laboratories (mean correlation, 84.7%). It was concluded that independently produced PCR fingerprint patterns can be obtained reproducibly for Acinetobacter spp. at the practical level if (i) quality-controlled reagents, (ii) standardized extraction of DNA, and (iii) standardized amplification conditions are used.

Acinetobacter↗
PubMed1997

Patient doses from standard and spiral CT of the head using a fast twin-beam system.

Investigations were carried out on a novel type of CT scanner, the Elscint CT-Twin, for comparison and optimization of the patient dose caused by standard and spiral CT of the head. For selected CT parameters, organ doses of the Alderson head phantom were measured with thermoluminescent dosemeters. Organ doses were also calculated using the normalized computed tomography dose index (CTDIn) combined with organ dose conversion factors. Then effective doses were deduced. For standard and spiral head CT examinations brain, red bone marrow and bone surface receive the main contributions to effective dose. This amounts to 0.9 and 0.8 mSv for routine standard and spiral CT, respectively, if the combination "dual-slice" mode, 250 mAs per rotation, 5 mm nominal slice width and a packing factor of 1.0, is applied. In clinical practice, for spiral CT head examinations the effective dose has been reduced to 0.7 mSv while guaranteeing adequate image quality, as assessed by determination of low and high contrast resolution. The effective dose values obtained are in the lower part of the range of values published in the literature. The dose determinations showed that, from the aspect of radiation protection of the patient, CT examinations with nominal slice widths between 0.5 and 1 mm as well as packing factors greater than 1.0 should be restricted to really necessary cases.

Head↗
PubMed1997

[Endoscopic prosthesis implantation in stenoses and fistulas of the proximal cervical esophagus].

Endoscopic placement of an esophageal prosthesis is a well established palliative treatment for esophageal carcinoma. However, the treatment of high cervical tumors using commercially available plastic prostheses is problematic. We modified the design and implantation techniques of the Celestin prosthesis to accommodate high cervical tumors and report our results in 38 patients. Over a 7 year period 42 modified Celestin prostheses were implanted in 38 patients with high cervical esophageal tumors. 15 had stenosis only, 22 had a stenosis and fistula, and one had a fistula without stenosis. Graduated bouginage up to 38 Fr or 42 Fr for large prostheses was performed prior to stent placement in an average of 2.3 sessions. There were no procedure-related complications. Only in one case the prosthesis had to be withdrawn after reimplantation because of intolerable painful foreign body sensation. Improvement of dysphagia was achieved in 34 patients. The fistulas could be adequately bridged and sealed in 17 of 23 patients. Prostheses migrated in 11 cases (proximally, n = 6; distally, n = 5). Mean patient survival in 28 patients followed until death was 86 days (range 5-338 days).

Adult↗