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Biomedical subjects

U Goerttler

Publications and source records attributed to U Goerttler.

18 recordsLinked to original sources
PubMed1979

Treatment of arteriovenous angiomas of the kidney: surgical intervention and intra-arterial embolization.

Angiomas of the kidney are benign vascular dysplasias, which usually can be identified angiographically. If there are no clinical symptoms treatment is not necessary. In cases of hematuria and/or hypertension either intra-arterial superselective embolization seems to cause less functional loss of the renal parenchyma, whereas excision often leads to heminephrectomy or even total nephrectomy. Even if the angioma is initially not completely embolized followup study to 2 years has shown complete occlusion of the angioma, either owing to inflammatory reactions or redistribution of blood flow and diminished blood pressure. Two cases of renal angiomas are presented. Treatment consisted of intra-arterial superselective embolization in 1 case and surgical clipping of the supplying arterial branch in the other.

Adult↗
PubMed1979

[Arterio-venous angioma of the kidney: embolisation and two year follow-up (author's transl)].

Successful embolisation of an arteriovenous angioma of the kidney with gel foam suspension is described, with a two year follow-up. Embolisation cured hypertension, which had otherwise resisted treatment, and stopped haematuria. The need for careful follow-up is stressed with long-term observations using both angiography and scintigraphy of the affected kidney. The intra-arterial embolisation with gel foam resulted in a redistribution of blood-flow which led to complete success of treatment even thought the vascular malformation had not been totally obliterated.

Adult↗
PubMed1978

[Artificial embolization before septic amputation].

By artificial embolization before extensive septic amputation arrosion bleedings that are otherwise noncontrollable can be prevented. Resorbable gelatine (Gelforam) is suitable for embolization. For safety one can leave a balloon catheter above the embolized vessel segment for several days.

Accidents, Traffic↗
PubMed1977

[Indication for embolization (author's transl)].

Indications for transcatheter therapeutic embolization are presented in 24 patients who underwent this treatment within the past two years. The indication for this procedure regarding clinical success is discussed. Failure to control massive hemorrhage caused by tumor, trauma or a.v. shuntformation (congenital or acquired) are considered as main indications. It is emphasized that the surgical risk may possibly be reduced by preoperative embolization of well-vascularized lesions. Some of these lesions become operable by presurgical embolization.

Adolescent↗
PubMed1977

[Balloon occlusion of the renal artery in operative urology (author's transl)].

A double lumen Swan Ganz balloon catheter is introduced percutaneously into the renal artery. Temporary and repeated occlusion of the artery by inflation of the balloon are combined with hypothermic perfusion of the kidney. Thus extensive nephrolithotomies can be done without time limit as in warm ischemia. The operation field is blood-less and the parenchym is protected by perfusion. There is no need for pedicle dissection or external cooling. One complication is seen when the catheter is slipping out of the artery in cases of short renal arteries and the patient is in an extremely bent operation position for intercostal approach. Ballon occlusion without perfusion is helpful in tumor nephrectomy. Preoperative embolization is not necessary when this technique is used. Embolization means an additional procedure with further complications.

Adenocarcinoma↗
PubMed1977

[Prostatic gland arteriography. Vascular supply, diagnosis and differential diagnosis of adenoma and carcinoma of the prostate (author's transl)].

Vascular supply and architecture of the prostate are studied by 100 arteriographic surveys of the pelvis. The prostatic arterial supply can be differentiated in urethral and capsular branches. In a further group of 38 patients with prostate gland disease selective bilateral arteriographies of the internal iliac arteries were performed. In 18 patients with the clinical diagnosis of prostatic adenoma, arteriography detected a carcinoma of the prostate gland. These diagnoses were proven by microscopy. In 10 patients with clinically suspected carcinoma, 5 were diagnosed by arteriography as malignant and also confirmed microscopically. The predominant angiographic criteria of prostatic carcinoma are irregular spotted stain of the involved parenchyma, hypervascularity of the urethral vascular branches, and pathological vessels.

Aged↗
PubMed1977

[Successful intra-arterial embolization of bleeding carcinoma of the prostate (author's transl)].

The very first case of successful therapeutic embolization for hematuria from carcinoma of the prostate is presented. In a 76-year-old patient with necrotic carcinoma of the prostate, stage D transurethral operations showed no success. By selective intra-arterial embolization via the internal iliac arteries (using Gelfoam), hematuria could be stopped definitely and did not occur any more. Follow-up study showed no complications or necrosis in this procedure.

Aged↗
PubMed1977

[Vena cava occlusion-syndrom by leiomyosarcoma. Two case reports (author's transl)].

Two cases of occlusion of the inferior vena cava by leiomyosarcoma are reported. This localisation is extremely rare for mesenchymal tumors. The neoplasm originated from the wall of the vena cava, expanded forward into the lumen of the vessel, in one case up to the right atrium. Collateral circulation, anasarca edema and varices develop by this occlusionsyndrome. The fatal outcome of the disease is usually determined by right heart failure and not by metastases directly. In most cases diagnosis is made by autopsy. In cavography the differential diagnosis of thrombosis might include the rare possibility of leiomyosarcoma of the caval vein. Only early diagnosis makes succesful surgical therapy possible.

Aged↗
PubMed1976

[Modified in situ perfusion of the kidney using balloon catheters].

Experiences with the in situ hypotherme perfusion in the operative treatment of calculus in kidneys and calices are reported. A modified technique is presented using an inflatable Swan-Ganz-ballon catheter for simultaneous blocking of renal blood flow and perfusion.

Adult↗
PubMed1976

[Roentgenologic diagnosis of splenic trauma (author's transl)].

Description of radiologic criteria in splenic trauma. Abdominal plain film: Enlarged shadow of the spleen with blurred margins; elevation - or rupture - of the left diaphragm; homogenous radiodensity in the left hypochondriac region; fractures of ribs or transverse process. Angiography is indicated in doubtful cases to clarify the following lesions: contusion, sub-or extracapsular hematoma, rupture and fragmentation. Possible diagnostic errors in arteriography (63 examined cases) are discussed.

Adult↗
PubMed1976

[Changes of cutaneous blood flow after aortofemoral angiography (author's transl)].

Temperature versus time curves were registered during aortofemoral angiography in 48 patients. The cutaneous temperature was initially reduced in 46 of the patients. This phenomenon was interpreted as a temporary decrease of blood flow and can not be explained by hypertonicity of contrast media, but indicates additional pharmacodynamic effects. Reactive hyperemia depends on pathologic alterations of large and small vessels.

Contrast Media↗
PubMed1975

[Super-selective cerebral angiography. I. Animal experiments and methods of a simple technique (author's transl)].

The experimental basis and the results of a simple and easy catheter technique for the super-selective angiographic demonstration of small arteries in dogs are described. By Seldinger technique, a catheter is placed in the main artery near the origin of a branch. A selective catheter is then passed through it and placed in the arterial branch being demonstrated. With this "telescopic" technique, it was possible to achieve super-selective angiography of external branches with a lumen less than 2 mm. and also filling of the internal carotid artery and its branches without any complications, using seven dogs. The application of this technique for super-selective cerebral angiography in man is discussed.

Animals↗
PubMed1975

[Super-selective cerebral angiography. II. Use and first results in man (author's transl)].

The use and first results of a super-selective cerebral angiographic technique in five patients as previously described and using a simple telescopic catheter principle are reported. Two patients were examined in order to determine onset of death and three who had been in a coma for several weeks following severe cerebral trauma. In one patient the examination was unsuccessful because of difficulties with the puncture. In one patient in whom death was to be determined, no filling of the intracranial arteries against cerebrovascular resistance was possible, although the catheter tip was placed in the carotid syphon. In three patients, super-selective filling of the anterior cerebral arteries proved possible. Compared with routine carotid angiography, more detailed information could be obtained and there was no overlap between individual arteries. There were no untoward effects from this catheter procedure.

Adolescent↗
PubMed1975

[Coronary-angiographic demonstration of the dilating effect of dipyridamole on coronary arteries and its inhibition by caffeine (author's transl)].

Selective coronary cineangiographies are performed repeatedly in 13 mongrel dogs. The contrast medium itself has no demonstrable dilating effect upon the vessels. After the first injection of 0.2 mg/kg of dipyridamole the left anterior coronary artery is significantly (p less than 0.001) dilated, which is in contrast to some results described in literature. Immediately after an injection of high doses of caffeine (10 mg/kg) the previously enlarged coronary diameter decreases significantly (p less than 0.001). During the action of caffeine subsequent infections of dipyridamole result in a very small, or no change in coronary diameter. The coronary-dilating effect of dipyridamole can be inhibited by high doses of caffeine (10 mg/kg).

Angiocardiography↗