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Biomedical subjects

Hans-Peter Dinkel

Publications and source records attributed to Hans-Peter Dinkel.

22 records · Page 2Linked to original sources

Accidental small bowel perforation after antegrade femoral artery access for percutaneous thromboembolectomy and angioplasty.

PURPOSE: To report a rare complication of antegrade femoral access for percutaneous aspiration thromboembolectomy and transluminal angioplasty. CASE REPORT: A 73-year-old obese woman underwent antegrade femoral aspiration thromboembolectomy for lower limb arterial embolism. Fifteen hours later, she presented with acute abdomen and decreased hemoglobin. Computed tomography showed small bowel obstruction, incarcerated femoral hernia, and free peritoneal air and fluid suggesting bowel perforation. Emergent laparotomy revealed an incarcerated, perforated femoral bowel loop and 4-quadrant peritonitis. CONCLUSIONS: Femoral hernia injury is an exceptional complication of vascular interventions. Knowledge of this potential hazard may help to avoid its occurrence.

Aged↗

Endovascular aneurysm exclusion along a femorodistal venous bypass in active Behçet's disease.

PURPOSE: To report the endovascular repair of dual aneurysms along a femorodistal venous bypass graft in a patient with Behçet's disease. CASE REPORT: A 55-year-old man of middle European ancestry with Behçet's disease had dual aneurysms evolve along the proximal segment of a femorodistal venous bypass that had been implanted 2.5 years earlier for recurrent false aneurysm formation. Owing to the lack of suitable venous conduits and the active nature of the disease, the aneurysms were successfully excluded with overlapping Hemobahn and Jostent endografts; the immunosuppressive therapy was intensified. Rupture of the aneurysms was successfully prevented, but the stent-grafts thrombosed 6 weeks later owing to exacerbation of the underlying disease. CONCLUSIONS: Endovascular exclusion of aneurysm in venous bypass grafts in Behçet's disease is feasible. Although the stent-grafts thrombosed, they did prevent rupture of the aneurysms.

Aneurysm↗

Multidetector CT virtual bronchoscopy to grade tracheobronchial stenosis.

OBJECTIVE: The purpose of this study was to compare the efficacy of noninvasive multidetector CT (virtual bronchoscopic images, axial CT slices, coronal reformatted images, and sagittal reformatted images) in depicting and allowing accurate grading of tracheobronchial stenosis with that of flexible bronchoscopy. MATERIALS AND METHODS: Multidetector CT and flexible bronchoscopy were used to examine 200 bronchial sections obtained from 20 patients (15 patients with bronchial carcinoma and five without central airways disease). Multidetector CT was performed using the following parameters: collimation, 4 x 2 mm, pitch, 1.375; and reconstruction intervals, 2 mm. Postprocessing was performed using surface rendering and multiplanar reformatted images. CT images were independently interpreted by two radiologists. The tracheobronchial stenoses revealed on flexible bronchoscopy were graded by a pulmonologist. RESULTS: Virtual bronchoscopic findings, axial CT scans, and multiplanar reformatted images were highly accurate (98% accuracy for virtual bronchoscopic images, 96% for axial slices and coronal reformatted images, and 96.5% for sagittal reformatted images) in revealing tracheobronchial stenosis. In allowing accurate grading of tracheobronchial stenosis, images from virtual bronchoscopy correlated closely (r = 0.91) with those of flexible bronchoscopy. Because use of virtual bronchoscopic images reduced the overestimation of stenosis, these images allowed better assessment of stenosis than did axial CT slices (r = 0.84) or multiplanar reformatted images (r = 0.84) alone. CONCLUSION: Multidetector CT virtual bronchoscopy is a reliable noninvasive method that allows accurate grading of tracheobronchial stenosis. However, it should be combined with the interpretation of axial CT images and multiplanar reformatted images for evaluation of surrounding structures and optimal spatial orientation.

Adult↗

Complex, traumatic rupture of the thoracic aorta in a child: diagnostic findings and delayed surgery.

We report the unusual case of a 4-year-old girl with traumatic aortic rupture. A conventional chest X-ray showed an enlarged mediastinum. Spiral CT and transthoracic echocardiography demonstrated a mediastinal hematoma, bilateral pleural effusion, and a rupture of the aortic arch. Semi-elective surgery, 4 days after the accident, confirmed rupture of the aortic arch with dislocation of the left carotid artery and the Ductus of Botalli. The vessels were subsequently repaired without complication. After a follow-up of 10 months, the child has fully recovered.

Accidents, Traffic↗