PubMed Health⌕ Search

Biomedical subjects

D A Loose

Publications and source records attributed to D A Loose.

At least 19 recordsLinked to original sources
PubMed1998

Low-dose iloprost infusions compared to the standard dose in patients with peripheral arterial occlusive disease Fontaine stage IV. DAWID Study Group.

BACKGROUND: Intravenous iloprost, titrated from 0.5 up to 2.0 ng/kg/min has been shown in patients with PAOD III/IV to significantly improve healing of trophic lesions, relief of rest pain, and reduce the rate of major amputation or death at 6 months as compared to placebo. The effect is considered related to improvement of the microcirculation. The aim of the present trial was to identify an optimum dose regarding treatment response and tolerability, by studying 4 doses of 25, 50, 75 and 100 micrograms iloprost daily. PATIENTS AND METHODS: 302 patients with PAOD IV were randomised via a double-blind fashion to one of the 4 doses. The primary endpoint was the responder rate at end of treatment. Responders were defined as patients with very good or good global efficacy, as judged by lesion healing and pain relief. Side effects were documented and a pre-defined benefit/risk index was calculated. RESULTS: No dose-dependency of iloprost regarding primary or secondary endpoints was observed. The rate of responders ranged between 48.7-53.5%. Side effects, mainly related to vasodilation, increased dose-dependently (p < 0.001, chi 2-test), with a significant decrease of the benefit/risk index from 2.19 +/- 1.19 to 1.64 +/- 0.97 (p = 0.012, ANOVA). Responders had a better outcome at 6 months than non-responders (2.6 fold higher rate of major amputation or death; life table analysis). CONCLUSIONS: It is concluded that iloprost should be titrated to the optimum rather than maximum tolerated dose, since a higher incidence of side effects not associated with an increased treatment response was observed at higher doses.

Aged↗
PubMed1993

Combined treatment of congenital vascular defects: indications and tactics.

Congenital AV shunting defects are not as rare as sometimes presumed, and they are four times more frequent in girls than in boys. Inadequate treatment can aggravate the patient's complaints by increasing the circulatory disturbance in the affected region. As a result, ischemic ulceration may develop. Special, usually interdisciplinary, treatment of such findings is mandatory. When AV communications are present, the combined treatment of surgical and nonsurgical techniques must be considered. Location and pathoanatomic type influence this choice. Clinical, functional, and hemodynamic parameters must also be evaluated in order to decide the optimal combination of therapeutic measures. Usually several phases of treatment are necessary.

Adolescent↗
PubMed1993

[Venous aneurysms].

Incidence, etiology, diagnostic procedures and therapy of venous aneurysms, basing on 152 own cases, are discussed. The main procedure for diagnosis is phlebography. It must be distinguished between aneurysms of epi- and subfascial veins. The localization determines the surgical procedure which represents the only successful therapy. Without proper treatment, venous aneurysms may be responsible for complications such as thrombophlebitis, thrombosis with pulmonary embolism, aneurysm rupture and compression of adjacent structures. The results of surgical treatment are excellent.

Aneurysm↗
PubMed1983

[Pseudo-Kaposi sarcoma].

Case report about a 45 year old man with hyperkeratotic papules and plaques on both lower legs now persisting for more than 20 years. After detection of arterio-venous shunts the initial clinical and histological diagnosis of Kaposi-sarcoma had to be replaced by the diagnosis of pseudo-Kaposi's sarcoma, a benign reactive process. In the pathogenesis of this disease arteriovenous shunts are of great importance.

Diagnosis, Differential↗
PubMed1977

[An investigation into the problem of streaming in the femoral artery by means of high speed serial angiography and synchronous pulse recording (author's transl)].

A method is described which allows one to correlate pulsephase dependant streaming and movement of the vessel wall by means of synchronous registration of pulse volume curves and the appearance of streaming as shown by serial angiograms. The results of this investigation in the femoral artery confirm the accepted view that the appearance of streaming depends on the movements of the vessel wall. The prognostic value for vessel reconstruction is discussed.

Angiography↗
PubMed1976

[Problems in the therapy of central arterial ectasias and elongations in long-lasting arteriovenous fistulas].

Acquired arteriovenous fistulas should be surgically cured as soon as possible after the diagnosis. In all the patients we treated, the arteriovenous fistula had existed for quite a long time, i.e. up to 26 years. These arteriovenous fistulas were surgically closed by the separation-method, the resection of the vessels and vascular reconstruction, or by the transvenous technique. - Arteriovenous fistulas, which have been in existence for quite a long time, result in cardiac dilatation, which can be cured after closure of the arteriovenous fistula. Furthermore, there can be pathologic changes of the vein and artery wall: chronic venous insufficiency and arterial ectasia can result. - After closure of the arteriovenous fistula our patients no longer complained of venous reflux disturbances. Even after closure of the arteriovenous fistula, an arterial ectasia is not reversible. The reasons for this are discussed. Symptoms, which occur after the closure of an arteriovenous fistula, which had existed for a long period and had produced a severe arterial ectasia, are looked upon as an autonomous disease. During the progress of this disease many complications can occur, even the rupture of the ectatic artery. The question is therefore discussed, whether it is justified to resect the ectatic arterial segment together with the arteriovenous fistula and to implant an alloplastic vascular graft in its place during the initial operation.

Arteriovenous Fistula↗
PubMed1975

[Light- and electronmicroscopic findings in nine auto-alloplastic vascular grafts (Sparks-Mandril) (author's transl)].

Auto-alloplastic arterial prostheses with a dacron mesh of 1 or 2 layers according to Sparks were investigated by light and electron microscopy after variable times of incorporation and perfusion. At the end of the organization-period the characteristic structure of the wall is composed of three layers. The interior layer is adapted to the form of the mandril, which holds the place of the lumen, the medial layer is formed according to the inforcing dacron-mesh. With increasing duration of incorporation the granulation tissue shows somewhat less inflammatory cells and capillaries and more collagen fibres. There were some characteristic disturbances of healing only partly due to infection, which resulted in focal or total necrosis of the granulation tissue: Not all of these findings were of clinical importance. Already after a perfusion time of 10 months an atherosclerosis of variable degree was found. This atherosclerosis started from mural thrombi and showed in the electron microscope proliferations of modified smooth muscle cells. Advantages and disadvantages of the autoalloplastic arterial prostheses are discussed.

Arterial Occlusive Diseases↗