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Biomedical subjects

K H Barth

Publications and source records attributed to K H Barth.

At least 73 records · Page 4Linked to original sources
PubMed1981

Percutaneous transluminal angioplasty of homograft renal artery stenosis in a 10-year-old girl.

Hypertension caused by 90% stenosis of a transplant renal artery was effectively treated by percutaneous transluminal angioplasty of the stenosed artery. Following dilation no pressure gradient existed across the stenosis. Hypertension had developed in a 10-year-old girl with caudal regression syndrome and recurrent pylonephritis five months following homograft transplantation for chronic renal failure. Since percutaneous transluminal angioplasty was performed, the blood pressure has remained within age-related normal limits.

Adolescent↗
PubMed1980

Therapeutic embolization with detachable balloons.

In our first 18 months' clinical experience with embolization in the chest and abdomen using detachable balloons, successful results were obtained in 34 of 38 patients. One and 2-mm detachable silicone balloons, which can occlude vessels 4--8 mm in diameter, were employed. Prolonged balloon inflation was routinely achieved using iso-osmotic iodipamide meglumine as the filler and limiting inflation volumes to experimentally determined maximums. Improvements in introducer catheter design simplified delivery of the balloon into a variety of circulations. Detachable balloons are not suitable for all embolization purposes, and they are frequently used in conjunction with other agents. When used properly, balloons produce a permanent occlusion that is extremely selective and potentially reversible up to a certain point in the procedure. The balloon technique enables the angiographer to occlude vessels at distances of 2--10 mm beyond the introducer catheter, thus avoiding the need for subselective catheterization and minimizing the dangers of inadvertent embolization.

Angiography↗
PubMed1980

[Therapeutic embolization in the extracranial head and neck region with a new detachable balloon system (author's transl)].

A system of detachable silicone balloons for therapeutic vascular embolization is described together with applications in the extracranial head and neck. Embolization was performed in 8 cases, 5 of which were preoperative and 3 for definitive treatment. The preoperative embolizations were to reduce intraoperative blood loss and to facilitate limited surgery. Advantages of detachable balloon embolization are flow directibility, selectivity and correctibility prior to balloon detachment. These advantages are used best in the case of AV-fistulas. The present balloon system allows occlusion of vessels 1--4 mm in diameter. Balloons are filled with isoosmolar contrast material.

Adult↗
PubMed1980

Transfemoral balloon catheterization for hepatic wedge pressure measurements.

A method for obtaining wedged hepatic venous pressures with a balloon catheter is described. The catheter is introduced percutaneously into the femoral vein. This method is easier to perform than the venous cutdown technique used with Swan-Ganz catheters, and the results are more representative of average parenchymal pressure than standard wedged catheter measurements are.

Catheterization↗
PubMed1980

Transcatheter embolization in the management of congenital arteriovenous malformations.

Congenital arteriovenous malformations (AVMs) with multiple arterial feeders in eight patients were managed by transcatheter embolization with a combination of polyvinyl alcohol foam (Ivalon), detachable silicone balloons, and wool coils. Due to the extensive number of arterial feeders often present, multiple procedures with several days in between were frequently necessary. When possible, surgical resection after embolization is the procedure of choice. Inoperable AVMs are best managed by segmental distal embolization of all arterial feeders with a permanent occluding material. Embolization therapy as a primary form of management is considered palliative and temporary relief of symptoms is usually achieved.

Adolescent↗
PubMed1980

Comparison of 133Xe single-breath and washout imaging in the scintigraphic diagnosis of pulmonary embolism.

To compare the utility of 133Xe single-breath (SB) and prolonged washout (WO) imaging in the scintigraphic diagnosis of pulmonary embolism, ventilation and perfusion studies of 66 patients who had pulmonary angiography within 48 hours were reviewed. The single-breath-perfusion (SB-P) and washout-perfusion (WO-P) studies agreed in 59 of 66 patients (89%). Each of the seven patients with disparate interpretations had an SB-P interpretation with a high probability for pulmonary embolism and a WO-p reading of low probability, with 133Xe retention in areas which appeared normal on the SB image. Single-breath images with 133Xe are not suitable as the sole determinant of ventilation-perfusion (V-P) match or mismatch, especially when subsegmental perfusion defects are present. Prolonged washout imaging improves the specificity of V-P imaging in patients with suspected pulmonary embolism.

Adult↗
PubMed1980

Demonstration of venous thrombosis by computed tomography.

Thrombosis within the iliofemoral venous system was diagnosed by computed tomography (CT) in five patients. In three patients thrombosed veins were documented by venography and in all five cases, the presence of venous thrombosis was substantiated by the clinical findings. Venous thrombosis in the iliofemoral veins and inferior vena cava has a typical appearance on CT scans. A thrombosed vein appears dilated with a low density intraluminal content and a high density wall after contrast enhancement. By its anatomic location, a thrombosed vein can be differentiated from other tubular structures such as bowel loops or obstructed ureters which may have a similar appearance.

Adult↗
PubMed1980

Traumatic pseudoaneurysm of the thoracic aorta in close proximity to the anterior spinal artery: a therapeutic dilemma.

Operative therapy is generally advocated for the management of chronic traumatic pseudoaneurysms of the aorta. A potential complication of both thoracic and abdominal aortic aneurysmectomies is paraplegia secondary to infarction or ischemia of the spinal cord. The present report describes a patient with a traumatic aneurysm of the lower thoracic aorta immediately adjacent to the origin of the anterior spinal artery, both delineated angiographically. In this particular situation, it was elected to follow the patient because the aneurysm was asymptomatic, small, and chronic, and because the risk of spinal cord injury associated with aneurysmectomy was estimated to be high. Serial computerized tomography (CT) scanning was used as a means of measuring the exact aneurysm size. Operation will be recommended if the aneurysm produces symptoms or enlarges, as demonstrated by CT scans.

Adult↗
PubMed1980

Renal oncocytoma. Further diagnostic observations.

Radiographic findings of the 2 new cases of oxyphilic renal adenoma, so-called renal oncocytoma, are reported and compared to previous descriptions. Ultrasonography shows no typical findings, but the vascular capsule of this tumor may show enhancement on computed tomography. Angiography contributes the most specific findings, because of the vascularity of these tumors: In the larger lesions a typical 'spoke wheel pattern' can be expected which may not be as prominent in smaller tumors. Notable is the absence of abrupt arterial caliber changes, AV shunting and contrast puddling which sets this tumor apart from the great majority of vascular renal cell carcinomas. The incidence of renal oncocytomas appears to be rising.

Adenoma↗
PubMed1979

Therapeutic embolization with detachable silicone balloons. Early clinical experience.

A recently developed percutaneous transcatheter technique for selectively occluding arteries with detachable silicone balloons was applied in four patients. Uncontrollable hemorrhage from carcinoma of the cervix was controlled by selective uterine artery occlusion in one patient. Life-threatening hemorrhage from cystic fibrosis in another patient was controlled by balloon occlusion of a bronchial artery. A patient with hypernephroma and another with right ischial fibrous histiocytoma each had preoperative occlusion of the arteries supplying the neoplasms to reduce operative blood loss and to obviate the need for surgical ligation of the internal iliac artery in the latter patient. Detachable balloon embolization techniques represent a nonoperative method for permanently occluding arteries without the risks of inadvertent embolization.

Adenocarcinoma↗
PubMed1979

Percutaneously placed biliary stents in the management of malignant biliary obstruction.

The management of malignant obstruction of the biliary tree is difficult and often unsuccessful. Advances in the technique of percutaneous transhepatic catheterization have made possible the nonoperative internal drainage of obstructed lesions. We report successful decompression of ten patients with unresectable biliary neoplasms using percutaneously placed internal biliary stents.

Adult↗
PubMed1979

Embolotherapy with detachable silicone balloons: technique and clinical results.

Catheter techniques and early clinical results of therapeutic embolization with detachable silicone rubber balloons are described in 13 patients. Effective control of post-traumatic or spontaneously occurring hemorrhage or preoperative devascularization of neoplasms was achieved in 10 patients. Three additional patients, one each with pelvic arteriovenous malformation. pulmonary arteriovenous malformation, and hemangioendothelioma of the liver, were partially treated by balloon occulsion. Therapeutic embolization with detachable silicone balloons provides a method of long-term, extremely selective arterial occlusion with reduced risks from inadvertent embolization of neighboring circulations.

Abdomen↗
PubMed1979

Hemodynamic significance of iliac artery stenosis: pressure measurements during angiography.

Peak systolic pressure gradients were obtained before and after vasodilatation in 42 patients (50 limbs) with arteriographic iliac artery stenosis of questionable significance. Patients were divided into three groups according to per cent narrowing of the iliac artery. Pressure gradients across the site of stenosis tended to be significant in patients with greater than 75% stenosis (greater than or equal to 20 mm Hg) but not in patients with less than 50% stenosis; patients in the middle group (50-75% stenosis) demonstrated a wide variance. Thus the arteriogram is not an accurate indicator of hemodynamically significant lesions, particularly in patients with 50-75% stenosis where pressure measurements are of greatest value. Variations in the aortic and femoral artery systolic peak pressure occurred following vasodilatation, indicating the importance of simultaneous pressure recording.

Adult↗
PubMed1979

Mesenteric vascular effects of prostaglandins F2 alpha and B2. Possible advantages over vasopressin in control of gastrointestinal bleeding.

Mesenteric vascular effects of prostaglandins B2 and F2 alpha were studied and compared to those of vasopressin in the dog, cat and baboon. Vasopressin reduced superior mesenteric blood flow (SMBF) 80-100%, and significantly increased hepatic arterial blood flow and systemic arterial pressure. Prostaglandin B2 produced vasodilatation at low doses and biphasic vasodilatation/vasoconstriction at high doses. Prostaglandin F2 alpha elicited only vasoconstriction, reducing SMBF, left gastric, and inferior mesenteric blood flow 80-100%. Systemic arterial pressure was not significantly changed. Thus, vasopressin and prostaglandin F2 alpha are equally effective mesenteric vasoconstrictors. Because of reduced systemic effects, prostaglandin F2 alpha has excellent potential as a mesenteric vasoconstrictor to control gastrointestinal hemorrhage.

Animals↗