Search PubMed⌕ Search

Biomedical subjects

W Hepp

Publications and source records attributed to W Hepp.

At least 73 records · Page 4Linked to original sources
PubMed1985

[High recurrence rate following axillofemoral bypass: is continued use still justified?].

124 axillofemoral bypass grafts were performed in 105 high risk patients with chronic aortoiliac occlusive disease (1970-1983). Graft thrombosis occurred in 49.35% of 77 unilateral grafts, mostly as early occlusion, whereas in cases of 20 axillobifemoral bypass procedures the incidence of graft thrombosis was 35.0%. By graft thrombectomy, if necessary combined with reconstruction of the femoropopliteal artery segment, and graft exchange the patency rates could be improved in both groups. After 5 years of patency rate was 52.57% in the unilateral and 81.48% in the bifemoral group. In both groups the patency times of every second graft could be prolonged respectively for 16 and 18.8 months. On the whole considering the bifemoral procedure was superior to the unilateral. Considering the high rate of graft thrombosis and the poor long term results, esp. in cases of unilateral grafts, the initial euphoria of using the axillofemoral bypass was not justified. Therefore nowadays the indication for axillofemoral bypass is handled more strictly: high risk patient without any other possibilities to avoid amputation.

Aortic Diseases↗
PubMed1984

Traumatic occlusion of both internal carotid arteries.

Two cases of bilateral occlusion of the extracranial internal carotid artery after blunt trauma to the head and neck are presented. Sixteen similar cases have been reported in the literature, and at least 150 case reports exist on unilateral blunt trauma of carotid arteries. The 25-day post-traumatic latent interval in one of our cases is the longest to date. The diagnosis of both of our cases was established by directional cw-Dopplersonography, whereas previously the only diagnostic method available in cases with negative CT scan and latent interval was angiography. In the differential diagnosis of craniocerebral or craniocervical trauma, particularly following delay between injury and onset of neurological symptoms, Dopplersonography is a necessary test additional.

Adult↗
PubMed1984

[Transplant occlusion following aortofemoral bifurcation bypass: causes, therapeutic measures and results].

35 patients with graft thrombosis following aortobifemoral bypass grafting were analysed retrospectively (1971-1983). In 24 of these patients aortobifemoral bypass graft was performed in our own hospital and the thrombosis rate was 9.1%. 40 bypass branches and 54 graft occlusions were involved. Late occlusions were more common (75.9%), occurring after an average time interval of a little more than 5 years. Inadequate peripheral run-off with progression of the atherosclerosis was the cause in 37.5%. In 40.0% the site of occlusion was in the proximal segment of the graft, where kinking related to anastomotic technical problems played a major role. The transfemoral ring or balloon thrombectomy was successful in 45.5%. In 24.2%, however, this had to be combined with a bypass procedure (femoropopliteal or femorocrural). A change of the graft was indicated in 48.5%, but this was considered too risky in 30.3% (extraanatomic bypass: change of graft = 1.7:1). In the case of poor distal run-off a peripheral corrective procedure was a must for graft patency. In every second patient this could be achieved by profunda revascularisation. Occlusions at the central bifurcation segment are better prevented by proper anastomotic techniques. A graft with a short main trunk anastomosed to the high infrarenal aortic segment ensures a safer anastomosis and a proper position of the graft branches with little possibility of kinking. Since the routine use of this method a graft thrombosis caused by central technical problems has not been seen.

Aged↗
PubMed1984

[Diagnostic significance of intravenous digital subtraction angiography of the supra-aortic extracranial vascular system. Comparative study of i.v. DSA and plain film angiography].

Digital intravenous subtraction angiography (DSA) and conventional film angiography were used to evaluate the diagnostic reliability of DSA-examinations. In 90% of 650 DSA-angiogramms the image quality was diagnostic. For 124 carotid angiographies a comparison of both methods was possible and gave a sensitivity of 87%, a specificity of 96% and an accuracy of 90% for the DSA examinations. The authors believe that digital subtraction angiography is suitable as a screening method for supraaortal vascular occlusive diseases.

Aged↗
PubMed1983

[Value of intravenous digital subtraction angiography (DSA) for the assessment of surgical blood vessel reconstruction].

Intravenous digital subtraction angiography (DSA) was obtained in 55 cases after reconstructive procedures of the carotid arteries, the pelvic and lower limb arteries. In 48 cases (87%) the studies were of technically satisfactory or good quality. On DSA 32 vascular reconstructions were normal and 16 had typical complications like occlusions, stenoses, aneurysms and insufficient run-off. -Experience indicates that the spatial resolution of DSA is adequate for clinical purposes such as determining graft patency or the presence of postoperative complications. Because DSA is less invasive than catheter angiography, postoperative evaluation of patients having undergone peripheral surgical revascularization should start with DSA.

Aged↗
PubMed1982

[The axillofemoral bypass as an aortoiliac principle of reconstruction in high risk patients. Long term results from 1970-1979 (author's transl)].

A total of 95 consecutive high-risk patients (average age of 68.28 years) underwent 114 axillofemoral bypass operations for revascularization of 116 lower extremities (1970-1979); 84.48% were in stage III and IV. Four bypass variations were used: unilateral bypass (70.8%), crossing bypass (4.4%), bilateral procedure (10.6%) and axillobifemoral bypass (14.2%). In elective operations, the operative mortality was 6.3%; in emergency operations one of 3 patients died. The unilateral bypass including the 5 patients on whom the crossing bypass was used showed a cumulative 5-year patency rate of 51.60%; the bifemoral bypass had a rate of 77.14% and in cases of bilateral bypass no graft was patent after 5 years. Graft thrombosis was the most common complication (47.37%); successful revision was possible in only 53.75%. In case of bifemoral procedure, graft thrombosis occurred in only 29.41%. Therefore, the authors recommend that stricter indications be employed for surgery: an axillofemoral bypass operation should only be performed in cases in stage III and IV for limb salvage and only in a "real" high-risk patient. In addition, the axillobifemoral variation should also be preferred in all cases of bilateral occlusive disease with unilateral symptomatology.

Age Factors↗
PubMed1980

[Aneurysm of the infrarenal abdominal aorta].

The experience with 125 consecutive patients who underwent operations for infrarenal aortic aneurysm is presented. Two intervals of four years each were reviewed and compared: period A (1970-1974) and period B (1975-1978). With a simpler and shorter technique (dissection method), and more frequent operations (+72%), the operative mortality in cases of nonruptured aneurysms decreased from 14.3% (A) to 2,1% (B); in cases of ruptured aneurysms, from 61,1% (A) to 48,4% (B). In cases of elective operation there was no significant correlation of mortality to age, concomitant coronary disease (52,5%), and occlusive disease of peripheral vessels. The improved results are due to simplification and standardization of operative procedures and to use of efficient intensive care possibilities.

Age Factors↗
PubMed1979

Experimental studies on the use of microwaves for the localized heat treatment of the prostate.

High frequency tumor therapy requests heating of a well defined area, whereas the surroundings should be unaffected. This sort of therapy should be more tolerable than a whole body heating. For this purpose a new developed microwave applicator (433.9 MHz) for local heat application was tested in animals. Using this rectally insertable applicator the prostate of dogs were irradiated. The temperature of the rectum, the urethra and the prostate were measured and recorded using specially developed thermistor probes. The effect of hyperthermia on the prostate and the surrounding tissue was analyzed macroscopically and micromorphologically. It was shown that local heating of the prostate of dogs is possible. The induced damages of the prostate and surrounding tissue is not severe enough to be untolerable.

Animals↗
PubMed1979

[Reconstructive measures to prevent lower extremity amputation for atherosclerotic occlusive disease in old age and the results obtained between 1973 to 1977 (author's transl)].

Within a 5-year-period 102 patients over the age of 70 were admitted with atherosclerotic occlusive disease. All patients had rest pain or necrosis. In 12,8% only a primary amputation could be performed. The procedures and results of reconstructive surgery on 89 patients were demonstrated: mortality rate of 11,2%, a secondary amputation rate of 13,5% and improvement of 75,3%. The problems after amputation in the senium are discussed.

Age Factors↗
PubMed1979

[External mechanical cardiac stimulation. Methods and possible application (author's transl)].

External mechanical cardiac stimulation represents a noninvasive method for myocardial stimulation which has significant advantages of external electric stimulation. This paper describes a new method using pressure- and shockwaves for transthoracic cardiac stimulation. On the basis of animal experiments the potential value of external mechanical stimulation for emergency medicine and various other therapeutic and diagnostic procedures are discussed.

Animals↗
PubMed1978

[Reconstructive surgery of the peripheral arteries in elderly people].

The results of reconstructive surgery of atherosclerotic occlusive disease in the senium are reported on 71 patients. Mortality rate of 14.68% and improvement of 63.38% showed clearly better results than described in literature with an amputation mortality rate between 26% and 60%. In the authors' opinion also in the senium the reconstructive surgery of the peripheral arterial system should be preferred if general and local operability are given.

Age Factors↗