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At least 973 records · Page 54Linked to original sources

[Experiences with endoscopic recanalization using the Nd-YAG laser in tumor ileus and inoperable rectal cancer].

In the time period from January 1, 1987 until October 1, 1988, a total of 17 patients with an advanced colorectal tumor underwent transendoscopic laser treatment with the Nd-YAG laser. Eight patients had a tumor-dependent passage disorder with a large intestinal ileus as initial finding. Recanalisation and decompression of the intestine were successfully performed in 7 cases, so that placement of an anus praeternaturalis could be avoided. In another 8 patients the advanced rectal tumors were subjected to laser irradiation, 6 times because of subtotal stenosis and 3 times because of tumor bleeding. A locoregional radiatio (afterloading) was performed in each case.

Aged↗

[Development of an ultrasonic system for the recanalization of coronary arteries].

We have devised an electro-acoustic system for the production and propagation of ultrasounds. With this system, linear vibrations can be transmitted through guides that are routinely used for coronary dilatation. Experiments performed on anatomical specimens have shown that ultrasounds are effective in destroying atheromatous formations. In addition, we tested this effectiveness with a setting that modelled the use of this system on the coronary vessels in terms of prerequisites: presence of a carrying catheter, aqueous environment, attention to vascular sinuosities and protection of arterial walls. The biological safety of low-frequency ultrasounds was tested in vitro and in animals. In view of these preliminary results, the subsequent development of an electro-acoustic system to be used in man seems to be justified.

Animals↗

[Urokinase recanalization of extensive thrombosis of the superior vena cava secondary to an implantable perfusion device].

A superior vena cava syndrome developed suddenly in a 36 year old man who had been undergoing chemotherapy via an implanted venous access catheter for 18 months. Venography showed superior vena cava thrombosis extending bilaterally to the subclavian veins. Direct local thrombolysis with low-dose Urokinase resulted in partial recanalisation with an excellent clinical result despite the persistence of an endovenous sequestrum situated at the catheter tip, a sequela of previous thrombosis. This case underlines the importance of direct local thrombolysis in patients with a Port-a-Cath system complicated by a thrombosis.

Adult↗

[A case of myocardial infarction due to the left main trunk lesion, in which percutaneous coronary recanalization and emergency coronary-aorto bypass graft, and subsequent percutaneous coronary angioplasty were effective not only from a viewpoint of survival but from comeback to social life].

A case of acute myocardial infarction due to the lesion in the left main coronary artery was reported. A 50-year male was referred to our department for suspected acute myocardial infarction. Physical examination on admission revealed slight cyanosis with cold sweating due to severe chest pain. Pulse was irregular and heart rate was 78 beats/min. Blood pressure was 100/80 mmHg. A series of electrocardiograms (ECG) and laboratory data provided the diagnosis of wide-ranged anterolateral infarction in the left ventricle. Emergency coronary angiograms taken without delay showed a subtotal occlusion (99% stenosis) of the left main coronary trunk (LMT) before the initiation of intracoronary thrombolysis (PTCR). Following the intracoronary infusion of urokinase of 1,200,000 units, symptoms and ECG changes transiently improved but worsened later, and LMT stenotic lesion and delayed filling of myocardium were similar with before PTCR. Emergency coronary-aorto bypass graft (CABG) was undertaken without a significant delay to both the left anterior descending artery (LAD) and left circumflex coronary artery (LCX). With these treatments, the patient could survive despite the wide area of infarction due to LMT lesion. Coronary angiograms performed 37 days after the CABG showed that the graft to LAD was completely occluded and the LCX graft was patent with partial stenosis. Treadmill test at this time induced an anginal episode with ischemic ECG changes on moderate exercise, indicating the presence of significant area of ischemic myocardium. For salvage of the ischemic myocardium, percutaneous transluminal coronary angioplasty (PTCA) was successfully performed for the LMT stenosis, resulting in no episode of angina nor ischemic ECG changes during exercise loading.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗

The role of recanalization in tubal pregnancy after sterilization.

Recanalzation at the site of tubal ligation is one of the causes of the failure of such a procedure. The underlying factor could be a pre-existing proliferative disease of the tube, i.e. salpingitis isthmica nodosa. The plexiform type of re-canalization that resulted in the presented case might the cause of the tubal pregnancy. The presence of amenorrhea and /or irregular uterine bleeding in a patient with tubal sterilization requires meticulous investigations to avoid the high morbidity rate associated with missed ectopic gestation. The use of HCG assays and laparoscopic evaluation could improve diagnostic ability in similar cases.

Adult↗

[Spontaneous arterial recanalization--a case report].

Spontaneous thrombolysis with recanalisation of peripheral arterial vessels is a well-known, albeit rare phenomenon. The probable mechanisms of this phenomenon is the activation of local fibrinolytic processes by local mediators of the vascular endothelial cells. Vascular stenoses of atherosclerotic origin are also subject to regression, depending on the plasma LDL level. Reangiography is indicated for determining further therapy planning if there is a change in clinical signs towards either improvement or deterioration. Reangiography is imperative if the previous angiography was performed before more than three months.

Arterial Occlusive Diseases↗

Intravenous radionuclide angiography after unilateral hypogastric artery ligation. Suture material and recanalization.

Pelvic angioscintigraphic examination of seven patients after unilateral hypogastric artery ligation has been performed. Immediately after the operation asymmetric perfusion has been observed in all women. Subsequent control examination of 4 patients ligatured by nonabsorbable suture has shown persisting unilateral hypoperfusion. Angioscintigraphy of 3 patients with ligature, done by absorbable suture proved normalization of hypoperfusion and restoration of symmetry.

Adult↗

[Transcranial sonographic monitoring of the blood flow of the middle cerebral artery in recanalizing operations of the extracranial internal carotid artery].

During endarterectomy of the internal carotid artery (ICA) blood flow velocity of the ipsilateral medial cerebral artery (MCA) was continuously monitored in twelve patients with the help of a new transcranial pulsed Doppler system. Additionally, the basal cerebral arteries where examined pre- und postoperatively in order to evaluate criteria for selective intraoperative shunting and to document flow improvement following ICA reconstruction. All patients had symptoms, either of TIA or of minor stroke. Five of them had in addition a contralateral ICA occlusion. During intraoperative carotid cross-clamping on the patients with unilateral ICA lesions, MCA blood flow dropped to zero in only one of them. In the other cases, a 20 to 60% flow reduction occurred indicating cross-filling or/and collateral blood supply via the posterior circulation. More severe MCA flow reductions were found in patients with contralateral ICA occlusion, with the occurrence of a no-flow state in two of them. All patients were operated on with an indwelling shunt. Its effect on MCA blood flow varied considerably. Apparently, the shunt was necessary in some patients but was superfluous in the majority of them. Transcranial Doppler meets the basic criteria of an examination technique to be recommended for monitoring. The method is noninvasive. The parameter, i.e. MCA flow velocity, can be evaluated on-line. It is representative and highly sensitive for cerebral circulatory disturbances and impending ischemia in the carotid territory. Transcranial MCA flow monitoring does not affect the course of the operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Percutaneous transluminal recanalization of chronic stenoses and occlusions of peripheral arteries].

It is reported on indications and results of percutaneous transluminal angioplasty using the Grüntzig- and Olbert-type balloon catheter technique. It is also referred to the expansion of PTA to the treatment of multiple obliterations in different layers with vascular surgical procedures. Today the essential indications for PTA are iliac stenoses on one or both sides, stenoses of the femoral and popliteal artery as well as short occlusions of the superficial femoral and popliteal artery of less than 10 cm.

Angiography↗