Biomedical subjects

D Scheinert

Publications and source records attributed to D Scheinert.

22 records · Page 2Linked to original sources

PubMed1999

[PTLA (percutaneous transluminal laser angioplasty) recanalization of femoral artery stenoses/occlusions after Angio-Seal administration].

PURPOSE: To demonstrate desobliration of Angio-Seal-induced femoral artery stenosis and occlusion by Excimer-laser assisted angioplasty and PTA. PATIENTS AND METHODS: The Angio-Seal hemostatic closure device was applied to the puncture site in 1500 patients after diagnostic or therapeutic coronary artery catheterisation. In 5 of 1500 cases symptoms of claudication occurred. Following the determination of the walking distance and ankle-brachial systolic pressure index (ABI) and diagnostic angiography, therapeutic percutaneous transluminal laser angioplasty (PTLA) and PTA was performed. RESULTS: 5 patients with acute symptoms of peripheral artery disease presented with superficial femoral artery occlusions (three cases) and high grade stenoses of the common femoral arteries (two cases). Angiographic and clinical improvement was achieved after PTLA/PTA in all five patients. The mean walking distance increased from 61 meters to 600 meters. The average ankle-brachial systolic pressure index increased from 0.40 to 0.82. CONCLUSIONS: PTLA/PTA is a satisfactory therapeutic method for femoral artery occlusion or high-grade stenosis following Angio-Seal application.

Aged↗

PubMed1999

[Results of "cross-over implantation of Palmaz-stents" with cross-over sheaths].

PURPOSE: Presentation of technique of cross-over stent implantation of Palmaz stents using a cross-over sheath. MATERIAL AND METHODS: Between 1996 and March 1997 72 patients presenting symptoms of peripheral artery disease received 136 Palmaz stents, which were implanted in a cross-over technique with the aid of a cross-over sheath. RESULTS: As indications for stent implantation occurred: occlusion (n = 14), recoil (n = 11), distinctive calcification (n = 32), recurring stenosis/occlusion (n = 32), perforation (n = 3), dissection (n = 31), and aneurysms (n = 2). The cross-over technique with the aid of a cross-over sheath was successful in all 136 cases. Within the first 24 hours 3 acute reocclusions occurred (all femoral). For stents placed in the iliac artery the primary patency rate was 93.3% at 12 months and for stents placed in the femoral artery 72.0%. Furthermore, this techniques allows for simultaneous stenting of pelvic, femoral or lower leg arteries (n = 17). By using this technique, stenting of the distal external iliacal artery, common femoral artery (CFA) and proximal superficial femoral artery becomes either possible for the first time or easier. CONCLUSION: If Palmaz stents with a length of 2-7.8 cm should be implanted in the cross-over technique, the use of a cross-over sheath is recommended.

Aged↗

PubMed1998

[Diagnosis of the abdominal vascular system by means of electron-beam computed tomography (EBT)].

PURPOSE: To evaluate the potential of electron-beam computed tomography (EBT) in the pre- and postinterventional assessment of vascular abdominal pathologies. MATERIAL AND METHODS: Forty patients with implanted transjugular portosystemic shunt (TIPS), 12 patients with peripheral arterial occlusive disease and 8 patients with infrarenal abdominal aortic aneurysm after endovascular implantation of bifurcation stents were prospectively examined with contrast-enhanced EBT during one year. The evaluation included analysis of time-density curves (TDC) and 3D reconstructions. Results were compared with Doppler sonography and/or DSA. RESULTS: In 30 of 40 TIPS patients, identical results were found with EBT, Doppler sonography and/or DSA. Reduced perfusions of the TIPS, which were subsequently confirmed by DSA, could not be shown with EBT in 3 patients. Nine of 12 patients with peripheral arterial occlusive disease and angiographically proven stenosis (> 75%) showed a reduced and delayed peak density of the time-density curves. The quantification of arterial stenosis, however, did not follow the angiographic values. In all patients with the implanted bifurcation stents, EBT could correctly exclude a leakage of the stent. CONCLUSION: EBT has certain advantages over conventional spiral CT in the evaluation of abdominal vascular pathologies due to the additional assessment of perfusion parameters. Clinical indications for the use of EBT are seen especially in the postinterventional follow-up of patients with implanted stents.

Abdomen↗

PubMed1998

[The value of a fabric-coated self-expanding stent in iliac arterial occlusions or aneurysms--the primary and long-term results].

PURPOSE: The objective of this study was to analyze the primary and long-term results of implanting self-expanding covered nitinol stents (EndoPro I) in iliac arteries. MATERIAL AND METHODS: A total of 48 EndoPro (length 8.3 +/- 4.2 cm) were implanted in 39 patients. In 22 cases (group A) the implantation was performed after excimer laser-assisted recanalization (PTLA) of long iliac occlusions (mean 9.8 +/- 3.9 cm). Other indications were aneurysmatic lesions (n = 16) and one arterial perforation (group B). RESULTS: In 21 of 22 patients of group A the patency of the blood vessel was successfully restored. In all cases of group B the aneurysmatic lesions were finally excluded. This was correlated with a clinical improvement of at least one grade (Rutherford criteria) in 86.4% of patients (group A). The primary patency rate based on clinical examination (treadmill test) and color-coded Doppler was evaluated at 6 (89.7%), 12 (87.1%), and 24 (84.2%) months follows up, respectively. Subacute thromboses occurred in two, relevant restenoses in three cases (group A). In three of these 5 cases the vessel segment was successfully reopened by PTLA or rt-PA thrombolysis, leading to secondary patency rates of 94.9% at 6 and 92.1% at 12 and 24 months, respectively. CONCLUSION: In cases of relevant dissection following PTLA of long pelvic artery occlusions implantation of covered stents is effective to stabilize the results. Furthermore, the device is well applicable to seal arterial ruptures or aneurysms.

Adult↗