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[Percutaneous endovascular dilatation and recanalization in multiple stenoses and occlusions of the arteries of the pelvis and lower extremities].

Endovascular interventions were performed in 36 patients with multiple occlusive-stenotic lesions of main arteries of the pelvis and lower extremities. Femoral retrograde, antegrade and contralateral accesses were used. The importance to observe main principles of roentgenendovascular surgery is stressed such as organ preservation, atraumatic character, shorter time of staying of the patients at the hospital. The authors show advantages of one-step reestablishing of blood flow in all parts of the vascular bed subject to endovascular dilatation. The authors note that in certain clinical situations the roentgenendovascular surgery for multiple obliterating lesions must be performed in two steps and through different accesses.

Angioplasty, Balloon↗

[Peroperative endoluminal dilatation or recanalization (DELPO or RCPO) in arteriopathies of the lower extremities. A new therapeutic weapon for the vascular surgeon. Apropos of 42 cases].

Forty-two DELPO or RCPO were performed using coaxial balloon catheters through surgical vascular approach for 35 cases of advanced lower limb arterial disease (stages: pronounced II: 6, III: 13, IV: 12, subacute ischemic: 4). The DELPO involved the following arteries: iliac: 12, deep femoral: 3, superficial femoral: 12, popliteal: 5, leg artery: 8, stenosis of popliteal anastomosis: 2, and was combined with a reconstructive arterial operation in 26 cases (proximal: 11 times, distal: 14 times or intersegmental: twice in relation to the surgical procedure). The DELPO was conducted alone in 9 cases and the RCPO alone in 6 cases, the surgical approach being preferred to the percutaneous route. Early results were rated as good in 89%, with clinical failures requiring amputation in 4% and failure of the method in 7%. The DELPO allows two objectives to be reached. First, when combined with a surgical procedure it reduces the extent and therefore the degree of surgical aggression while creating improved hemodynamic conditions for vascular reconstruction (improved proximal or distal beds or both). Second, when performed alone DELPO or RCPO enable safe, reliable treatment of lesions usually approached by a percutaneous endoluminal dilatation procedure.

Aged↗

Percutaneous recanalization of total iliac and femoro-popliteal artery occlusions.

Eighty-five arterial occlusions (18 iliac and 67 femoro-popliteal) have been treated by Percutaneous Transluminal Angioplasty (PTA) in 69 patients. The immediate clinical success rate (48h) was 27.7% and 73.1% for the iliac and the femoro-popliteal lesions respectively. The length of the lesions successfully treated ranged from 1 to 9 cm in the iliac and from 1 to 18 cm in the femoral arteries. Technical failure, always due to intramural passage in the obstructed segment, occurred in 55.5% of the iliac and in 17.9% of the femoro-popliteal obstructions. The choice of guide wire and catheter is basic for the success of the procedure. Complications occurred in 8 cases (9.4%), but none required surgery. In a follow-up period of 4 years the cumulative success rate was 22.2% and 65.6% for the iliac and femoro-popliteal obstructions respectively.

Aged↗

[Significance of vertebral angiography for the diagnosis and therapy of vertebrobasilar occlusive disorders with special reference to vascular recanalizing procedures].

Between 1980 and 1985 a total of 912 vertebral angiographies were performed in 793 patients, 198 of whom had ischemic symptoms attributable to the hindbrain circulation. The complication rate was 6%. With due consideration for the clinical findings and those recorded by Doppler ultrasound and computed tomography, vertebral angiography is indicated in vertebrobasilar occlusive disease if anticoagulation, percutaneous transluminal angioplasty (PTA) or local intraarterial fibrinolytic therapy (LIF) of the hindbrain circulation is intended, and also if there is a discrepancy between the clinical findings and the results of computed tomography or Doppler ultrasound examination. With today's sophisticated angiographic techniques (e.g. DSA) and the possibilities opened up by modern interventional neuroradiological techniques, the complication rate of vertebral angiography now seems to be lower than previously.

Angioplasty, Balloon↗