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Biomedical subjects

W Theiss

Publications and source records attributed to W Theiss.

At least 37 records · Page 2Linked to original sources
PubMed1994

New aspects in ultrasound-guided compression repair of postcatheterization femoral artery injuries.

BACKGROUND: This study was undertaken to expand the understanding of ultrasound-guided compression repair (UGCR) of postcatheterization femoral artery injuries. METHODS AND RESULTS: In a series of 62 patients with pseudoaneurysms (n = 53) or arteriovenous (AV) fistulas (n = 9), UGCR was performed as a nonsurgical method in the treatment of postcatheterization femoral artery injuries. When the communicating channel could be visualized (43 cases), pressure was focused on it; otherwise (10 cases) the extraluminal cavity itself was compressed. In 45 cases, the elimination of flow in the pseudoaneurysm and/or the communicating channel could be achieved only with simultaneous temporary complete occlusion of the femoral artery. UGCR was successfully performed in 25 of 27 cases of false aneurysms (93%) in patients without anticoagulation and in 14 of 26 patients (54%) on anticoagulants. Three of 9 AV fistulas could be repaired by this method. No apparent correlation could be found between the therapeutic success and the size of the pseudoaneurysm or the age of the lesion. CONCLUSIONS: In patients on anticoagulants and in patients with AV fistulas, the detection of a communicating channel that could be obliterated by direct mechanical compression was discerned as a discriminant factor of success.

Adult↗
PubMed1994

[Estrogens and cardiovascular diseases: should current guidelines be changed?].

Survey about oral contraceptives and postmenopausal hormonal replacement therapy and the effects on coagulation system. The question to withdraw oral contraceptives 4 weeks before a gynecological operation cannot be answered sufficiently. The pros and cons have been discussed. Thromboembolic disorders in the history of a patient are contraindications for oral contraceptives. It can be anticipated, that this rule will be changed in future. There are no scientific hints, which could bring a phlebitis or varicosis in connection etiologically with a thromboembolic disorder during oral contraceptives.

Cardiovascular Diseases↗
PubMed1994

[Transcutaneous electric muscle stimulation--a "new" possibility for the prevention of thrombosis?].

Adhesive electrodes for transcutaneous electrical stimulation of the calf were applied on the skin of 11 patients with ruptures of the fibular ligaments (treated surgically or conservatively with cast) during the period of immobilisation (four weeks). Muscle stimulations were performed several times a day over a period of at least 15 minutes with a small rechargable muscle stimulation apparatus. Duplex sonography revealed that a significant rise of the venous flow velocity could be achieved with an 8.5-fold increase of the venous flow velocity as measured over the popliteal vein. Transcutaneous muscle stimulation might move to be a "new" efficient method for the prophylaxis of deep vein thrombosis.

Ankle Injuries↗
PubMed1990

[Fibrinolytic therapy of acute venous thrombosis].

Fibrinolytic therapy carries a greater risk in the treatment of deep-vein thrombosis than mere anticoagulation. It must therefore be considered an elective measure in the case of a young patient with extensive thrombotic disease who wishes removal of the thrombus in order to reduce his risk of postthrombotic sequelae. Regardless the type of fibrinolytic agent used and of the dosage employed, one must reckon with a mortality of 1%. One can expect good results in 80-90% of the patients with fresh thrombi.

Dose-Response Relationship, Drug↗
PubMed1989

[Long-term results following fibrinolytic treatment of deep venous thromboses in the area of the pelvis and leg].

68 patients who underwent fibrinolytic treatment due to deep vein thrombosis of the lower extremity were followed-up after a median time interval of 6.3 years. Phlebography was carried out in all patients prior to and following fibrinolytic treatment. 28% of all patients showed complete patency and 38% partial patency. 34% showed no improvement. For the long term follow-up, physical examination, doppler-sonography, phlebodynamometry and vein occlusion plethysmography were assessed. The acute intervention, regarding treatment, turned out to be the crucial prognostic parameter. While late symptoms and clinical findings on the one hand and site, extent and age of thrombosis prior to fibrinolytic treatment on the other hand did not correlate with one another, symptoms and clinical findings did indeed correlate quite well with the outcome of fibrinolytic treatment. Postthrombotic syndrom was rare in cases with complete patency. In cases where patency was only partially or not at all achieved, postthrombotic syndrom was present to a higher degree the more central and the more extensive the remaining thrombosis was.

Adolescent↗
PubMed1988

[Which laboratory parameters are useful and necessary in fibrinolytic therapy?].

Even sophisticated assays of blood coagulation and of fibrinolysis cannot predict the clinical success of thrombolytic therapy, nor can they prevent bleeding complications. Nevertheless, some laboratory monitoring is indicated before thrombolytic therapy to rule out contraindications, and it should also be performed during thrombolytic therapy as a guideline for substitution therapy in case of bleeding and for control of concommitant or subsequent anticoagulant therapy. An initial assessment should comprise the assay of fibrinogen, prothrombin time, partial thromboplastin time, and a platelet count. One to two hours after initiation of thrombolytic therapy and at its end (as well as at 12-hourly intervals in between in prolonged courses of thrombolytic therapy), a fibrinogen assay and a test that is sensitive to fibrin(ogen) degradation products (e.g. thrombin time, reptilase time, prothrombin time) should be performed.

Blood Coagulation Tests↗
PubMed1987

[Fibrinolytic treatment of deep venous thromboses with streptokinase at an ultrahigh dosage].

Twenty-one patients with deep vein thrombosis were treated for six hours per day in accordance with an "ultrahigh" dose scheme with 1,500,000 units/hour streptokinase. A maximum of two such cycles were administered in the first ten patients, and the subsequent patients received up to five cycles as required. In terms of clinical chemical parameters, a pronounced lowering of fibrinogen with corresponding elevation of fibrin(ogen) cleavage products regularly occurred during the first cycle. There were great differences in the individual times for which these alterations persisted (12-72 hours). The alterations during the subsequent cycles were very much less, probably because of the pronounced lowering of the plasminogen concentration. The clinical tolerance (including hemorrhagic complications) was roughly comparable with that of a streptokinase treatment with conventional doses. Phlebographic checking of the result of treatment showed that the ultrahigh dosed intermittent dosage scheme is a highly effective treatment procedure with which the duration of treatment can be appreciably shortened compared to conventional dosage schemata: in four cases, a full recanalization could already be attained after a single cycle.

Adolescent↗
PubMed1987

[Syncopes of unclear etiology. Diagnosis, follow-up observation and pacemaker therapy].

Clinical findings after syncopal attacks were evaluated in 295 inpatients for examining their clinical significance and the course and prognosis in syncopes of unclear aetiology. This was done after having defined the criteria for "very probable" and "possible" causes of the syncopes. A "typically rhythmogenic" anamnesis had a sensitivity rating of 79%. Long-term ECG proved the most frequent contribution to clarification. Doppler examination of the carotid artery was hardly relevant. Patients with tachycardia usually suffered from cardiac disease (coronary heart disease or cardiomyopathy). Bradycardia predominated in patients with a clinically "healthy" heart, especially in elderly patients. An overall percentage of 37% of the cases could not be clarified despite thorough clinical examination using all available diagnostic tools. Follow-ups over two years and outpatient examinations revealed a favourable prognosis in patients whose syncopes had remained unexplained: No further syncopes had occurred in 75% of these patients over a period of two years. In 12% of the subjects the cause was identified by the follow-up examinations. In 95.5% of the patients subjected to pacemaker treatment no syncopes recurred. A relatively small proportion (19.5%) of the patients with unclarified syncopes continued to suffer from syncopes, the aetiology of which could not be determined during the 2-year follow-up period. This group of patients would require better diagnostic techniques, e.g. long-term ECGs over several days or long-term EEGs.

Adolescent↗
PubMed1987

[Effect of respiration on variations of central venous blood temperature].

We examined the course of right ventricular blood temperature before, during and after treadmill exercise in three patients with implanted cardiac pacemakers, and in two healthy volunteers. Temperature measurements were performed with a specially developed 5F electrode with an incorporated thermistor (measurement accuracy: 1/100 degrees C). After electronic amplification, the temperature signals were recorded on a three-channel strip chart recorder, together with ECG and respiration (measured by impedance plethysmography). In one of the volunteers, blood flow in the jugular and femoral veins was recorded by Doppler sonography, before and after exercise. We observed a decrease in central venous blood temperature with inspiration and an increase with expiration before, during and after exercise. The amplitudes of the variations became smaller during exercise, reached a maximum immediately after exercise and returned to their resting values within a few minutes after the end of exercise. We suppose different distributions of venous blood flow in different phases of the respiratory cycle to be the reason for the respiration-induced variations in central venous blood temperature. Under exercise conditions, the influence of respiration on the blood flow in the larger veins is small compared to the influence of an increased cardiac output; at rest, respiration has a more pronounced effect on venous blood flow. The analysis of our blood flow measurements in the femoral and jugular veins supported this assumption.

Adult↗
PubMed1986

[Principles of physical prevention of thrombosis].

Physical methods of prophylaxis against deep vein thrombosis aim to counteract the stasis of venous blood flow that occurs during immobilisation. Prospective randomized studies have documented that perioperative electrical calf stimulation, intermittent pneumatic compression, and graduated compression stockings effectively reduce the frequency of post-operative deep-vein thromboses. However, up to date it has not been proved that they also reduce the incidence of fatal pulmonary embolism, and so these physical methods represent no valid alternative to the pharmacological methods of prophylaxis against thromboembolic events. Their use is justified, however, when the pharmacological agents are contraindicated, and as an adjunct to the pharmacological methods.

Clothing↗
PubMed1984

Peripheral arterial occlusion and amaurosis fugax as the first manifestation of polycythemia vera. A case report.

A patient with polycythemia vera, who presented digital arterial occlusion and episodic monocular blindness as the first clinical signs of the disease is described. After an early diagnosis, reduction of the cellular blood volume, and intraarterial perfusions with adenosine triphosphate (Laevadosin) followed by reserpine (Serpasil) led to adequate local tissue perfusion. No surgical intervention was required and visual disturbances disappeared. The patient has now been in a stable phase of the disease for 7 months without subsequent treatment.

Adenosine Triphosphate↗