[Intravascular stents].
Explore the source record for details and available documents.
Angioplasty, Balloon↗
Biomedical subjects
J Triller
Publications and source records attributed to J Triller.
Superselective embolization of superior gluteal artery pseudoaneurysms following intramuscular injection: case report.
Two bleeding superior gluteal artery pseudoaneurysms occurred in a patient with advanced malignant disease following an intramuscular injection. This was diagnosed by angiography and successfully managed by superselective embolization. This avoided further surgery and no additional complication from the pseudoaneurysm occurred up to the time of the patient's demise.
Aneurysm↗
[Peripheral arterial complications of various catheter angiography methods].
Between 1980 and 1988 12,251 arterial punctures for cardiac catheterization (CC), percutaneous transluminal angioplasty (PTA), or pure diagnostic intraarterial angiography (IAA) have been performed in our clinics. 54 (0.44%), 39 (0.63%, CC), 12 (0.67%, PTA), 3 (0.07%, IAA) patients suffered from a complication at the site of the arterial puncture necessitating surgical correction. Adults developed false aneurysms or large hematomas whereas children tended to show thrombotic arterial occlusions. Generally the surgical procedures of these complications proved to be quite simple (over two thirds) but some, especially in children, turned out to be more difficult. 3 arterial spasms in children and 1 prolonged wound healing in the groin, all without long-term sequelae and 1 severe graft infection necessitating ligation of the common femoral artery with severe ischemic signs for several months were the only complications of our corrective surgical procedures. We therefore plead for these iatrogenic complications of arterial puncture for an early correction performed by a surgeon with at least some experience in vascular surgery.
Adolescent↗
Resectability of large focal liver lesions.
Despite modern imaging techniques evaluation of the resectability of large focal liver lesions is often difficult or impossible until the time of operation. Based on experience with 54 primary or secondary focal liver tumours, a simple morphological classification has been found to be reasonably predictive of resectability. All tumours were classified before operation using computed tomography, ultrasound and angiography; 38 patients underwent laparotomy. Dependent, 'hanging' tumours (n = 7) were resected in six cases, expansively growing 'pushing' tumours (n = 19) were resected in 18 cases, and infiltrating, 'invasive' tumours (n = 17) were not resected because of involvement with major vascular structures. Eleven small tumours (less than 5 cm) were not classifiable by this system. This simple classification may be a useful clinical concept in preoperative assessment of resectability of focal liver lesions. Hanging tumours should always be resected, and large expansile tumours are generally resectable despite their size. Invasive tumours can only be resected in exceptional cases.
Humans↗
[Diagnostic and therapeutic problems in angiomyolipoma of the kidney].
The diagnostic problems are being discussed specifically in 9 patients with angiomyolipoma. Ultrasound and computerised tomography show clear results in tumours with a fatty structure, where angiography is a better method to show vascular elements. Where an inhomogeneous tissue structure is given, an exact diagnosis is only possible by using a combination of different examination methods. It is important to define a renal cell carcinoma preoperatively, as during the operation a differentiation from an angiomyolipoma is in most cases not possible. With a correct diagnosis an organ saving operation can be performed on symptomatic patients, respectively a conventional management can be discussed for the treatment of asymptomatic patients.
Aged↗
[Vascular endoprosthesis of femoro-popliteal occlusive disease].
A self-expanding vascular endoprosthesis (wall stent) was implanted in 26 patients with femoropopliteal occlusive disease following recurrent stenosis or occlusion after percutaneous angioplasty. Implantation was successful in all cases and there were no complications. Five of the 26 patients developed a thrombosis in the first nine days; in four of these, thrombolysis was successful. Patency rate after one month was 96%, after three months 95%, after six months 85% and after nine months 87%. In order to prevent thrombosis after implantation, anticoagulant therapy is indicated. Poor distal flow encourages intimal hyperplasia and therefore recurrences.
Adult↗
[Acute intestinal hemorrhage in a pancreatic pseudocyst-colic fistula].
Chronic pancreatitis with a pseudocyst may cause acute massive intestinal bleeding due to simultaneous erosion of the splenic artery and transverse colon. This is a potentially lethal complication, which requires instant diagnosis and treatment. The pathogenesis, diagnosis and treatment of this condition are illustrated by two patients. Exact localisation of the source of bleeding is achieved by selective angiography of the visceral arteries. In shocked and inoperable patients, selective embolisation of the bleeding artery is the treatment of choice.
Acute Disease↗
[Initial experiences with the Kensey catheter in acute and chronic femoro-popliteal arterial occlusion].
Explore the source record for details and available documents.
Adult↗
[Use of arterial endoprostheses (stents): femoral, iliac, aortic and renal].
Explore the source record for details and available documents.
Angioplasty, Balloon↗
[The resectability of large focal liver lesions].
This paper presents a simple clinical concept of tumor morphology considered to be of value in the preoperative assessment of focal liver tumours. Based on preoperative clinical and radiological investigation and laparotomy in a large number of liver lesions, we propose a classification of liver tumours of special value in the preoperative assessment of resectability of large primary and secondary liver tumours.
Adenoma↗
[Angiography and intervention in tumors of the pancreas, liver and bile ducts].
The importance of angiography and of interventional radiology in tumours of the pancreas, liver and bile ducts is discussed. Angiography is performed prior to surgical intervention to assess tumour resectability, for a preoperative visualisation of vascular anatomy, as well as in non-diagnostic findings in ultrasound and computerised tomography. Diagnostic and therapeutic interventional techniques in the liver (fine needle puncture, perfusion, embolisation) and the bile ducts (PTC, ERCP, PTCD, endoprosthesis, stents) are performed selectively in tumour patients in close co-operation with surgeons, radiologists and gastroenterologists.
Angiography↗
[A combined surgical and interventional-radiologic procedure in bile duct obstructions].
Surgery for biliary obstruction may be complicated by the presence of intrahepatic stones and, in difficult anastomoses, by the possibility of recurrent stricture formation. In order to decrease the need for further operation, the first surgical repair in selected cases should allow access for later radiological intervention. Primary operation consists of biliary digestive anastomosis using established techniques with a Roux-en-Y-loop. A limb of the Roux-loop may be brought to the abdominal wall and secured to the anterior parietal peritoneum to allow access for later radiological intervention either by utilizing an established tubal tract into the Roux-loop or by later puncture of the loop under ultrasound guidance. Since October 1986 we have treated 11 patients utilizing this technique. Six patients had complex strictures following cholecystectomy and two patients had obstructions secondary to alveolar or cystic Echinococcosis. One stricture was due to a previous liver resection, one followed previous operation for congenital atresia of the biliary tract and one consisted of multiple strictures and stones associated with oriental recurrent pyogenic cholangitis. In all 11 patients, postoperative radiological imaging was possible. In 6 patients, 14 radiological manoeuvers were carried out for dilatation or for removal of stones and debris. There were no complications. During a median follow-up of 11 months no patient needed further surgical intervention. The indications and techniques are outlined.
Adult↗
[Angiography in peripheral arterial occlusive disease. Comparison between large-format angiography, digital subtraction angiography and intermediate-format technic].
With peripheral venous injection of contrast medium, DSA serves to diagnose occlusive peripheral arterial disease in some 90% of cases. Indications for iv-DSA are occlusions and stenoses in the area of the iliac and femoral arteries, as well as in the proximal lower leg. Intraarterial DSA with fine needle is additionally indicated in some 10% of patients for examination of the distal lower leg arteries. In non-diagnostic DSA, conventional angiography using 100-mm technique may be performed with the same angiographic unit.
Angiography↗
[Anticoagulant therapy and hematoma of the rectus muscle sheath].
Explore the source record for details and available documents.
Abdomen, Acute↗
[Visceral angiography with intra-arterial DSA and programmed 100-mm technic].
One hundred and seventy specially selected visceral angiograms were carried out on 96 patients using I-A DSA and 100 mm technique. 85.2% of the I-A DSA and 91.7% of the 100 mm images were of good quality. I-A DSA produced comparable or better quality than the 100 mm technique in 66% during the arterial phase, in 79% during the parenchymatous phase and in 70% during the venous phase. The 100 mm technique produced better quality in a third of the cases during the arterial phase and in a quarter of the cases during the parenchymal and venous phases. The indications for the 100 mm technique are failure of I-A DSA or the need for high spatial resolution.
Angiography↗
[Focal nodular hyperplasia of the liver].
The differential diagnosis of focal nodular hyperplasia of the liver (FNH) encompasses a variety of hepatic mass lesions with differing prognosis and therapy. Ten patients with FNH confirmed by histology form the basis of this review of the pathogenesis, the clinical features and of diagnostic and therapeutic aspects. - FNH is usually diagnosed fortuitously in women of childbearing age. It is considered to be a reactive process rather than a true neoplasia, and its biological behaviour seems to be modified by female sex steroids. In contrast to liver cell adenoma, rupture and bleeding are exceptional. For the diagnosis of FNH a combination of dynamic computed tomography and 99mTc sulphur colloid liver scintigraphy is most reliable, whereas ultrasonography lacks specificity. Once the diagnosis of FNH is established, surgery usually is unnecessary.
Adult↗
[Intravenous digital subtraction angiography].
Thanks to its high contrast resolution, intravenous digital subtraction angiography (IV-DSA) makes it possible to examine the arteries after injection of contrast media into a peripheral arm vein. IV-DSA is indicated in patients with clinical suspicion of arterial stenosis, occlusion, aneurysm or anomaly (ascending and descending aorta, aortic arch and its great vessels, and the renal, iliac, femoral and popliteal arteries). In many such patients, IV-DSA successfully replaces intraarterial catheter angiography. The advantages of IV-DSA (with a peripheral injection technique) as compared to conventional angiography, include its non-invasive character, a lower complication rate and less discomfort for the patient. The disadvantages of IV-DSA include poorer image quality due to lower concentration of contrast media in the vessels, reduced spatial resolution and the need for larger volumes of contrast media. The indication for conventional angiography is an inconclusive intravenous study due to motion artifacts and/or poor resolution.
Analog-Digital Conversion↗
[Peripheral venous and peripheral arterial digital subtraction angiography in occlusive diseases of the lower extremity].
The possibility of employing peripheral venous and peripheral arterial digital subtraction angiography was examined in 351 patients of 65 to 95 years of age with arterial occlusive disease of the lower extremity. After peripheral venous contrast medium injection (using a Venflon needle 1.7-2.0 mm, 40 ml nonionic contrast medium, 20-30 ml NaCl, flow 15/s), conclusive assessment of vascular tone is possible in 86% of the cases. Indication for IV DSA is supplied chiefly by stenoses and occlusions situated proximally or bilaterally in the region of the distal aorta abdominalis, the iliacal, femoral and popliteal arteries. The distal adjacent segment is demonstrated well in 81 to 95 per cent of the cases up to the level of the trifurcation. Image quality is poor in 30% of the images of the lower leg, whereas no assessment is possible in 11% of the cases. IA DSA with fine needle (needle 0.8 mm, 3-5 ml contrast medium, 3-7 ml NaCl) is indicated in 8% of the patients to clarify the distal lower leg arteries, especially in preceding extensive proximal vascular occlusions. Conventional angiography can be largely replaced by combining peripheral venous and peripheral arterial DSA with fine needle technique.
Aged↗