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Biomedical subjects

F P Kuhn

Publications and source records attributed to F P Kuhn.

At least 19 recordsLinked to original sources
PubMed1994

Current status of the Strecker stent.

Knitted flexible tantalum stents proved to be a valuable adjunct to percutaneous transluminal angiplasty (PTA) in the case of insufficient PTA results, and their use was established in the distal aorta, the iliac, the femoro-popliteal, the renal, and the coronary arteries. Recently, long arterial occlusions were defined as new indications for primary stenting; stent indications were further extended to the subclavian, the carotid, and the splanchnic arteries. Due to higher incidence of acute and late complications after stent treatment of small diameter arteries, patients have to be selected thoroughly. Newly designed drug-releasing stents tested in animal experiments promised to be suitable to diminish the incidence of late restenosis due to intinal hyperplasia, thus providing better long-term patency.

Angioplasty, Balloon↗
PubMed1993

[Experimental studies of the pressure stability of vascular endoprostheses].

Percutaneously implantable vascular prostheses used clinically (Strecker, Palmaz and Wall stents) were tested as realistically as possible with regard to their mechanical stability. The Palmaz stent showed the greatest pressure stability. Even at pressures above three atmospheres the stent remained within 20% of its nominal diameter. In contrast, the Wall and Strecker stents showed much less pressure stability. Depending on the diameter of the wire and of the stent, there was 20% reduction in diameter at pressures between 0.13 and 0.68 atmospheres. These results will contribute to an improved application of the vascular endoprostheses which have been tested.

Atmospheric Pressure↗
PubMed1992

[Renal stent implantation. The current indications, 2-year results and the possibilities for percutaneous stent recovery].

Use of the Strecker flexible balloon-expandable tantalum stent for treatment of renal artery stenosis after failed angioplasty or transaortic thrombendarterectomy was evaluated in 18 patients (17 hypertensive, 1 normotensive). Right (n = 10) and left (n = 6) renal arteries were involved; in 2 patients renal artery stenosis had developed after kidney transplantation. Indications for stent placement were inadequate immediate postangioplasty response (n = 16), and obstructing intimal flaps following transaortic endarterectomy (n = 2). Stent placement was technically successful (less than 20% residual stenosis) and patency was preserved in 14 patients. Mid-term results (mean, 12-13 months) of 11 patients showed restenoses (greater than 50%) in 2 patients, and improvement of hypertension in 8 patients. The Strecker stent may be helpful in treating residual stenosis after failed revascularization procedures of the renal arteries, although long-term efficacy of stent placement will not be known until trials with more subjects and longer follow-up periods are completed.

Adult↗
PubMed1992

[The imaging diagnosis of acute renal transplant obstruction with special reference to antegrade pyelography].

30 patients with an acute build-up of renal transplant were examined comparatively via antegrade pyelography (AP), computed tomography (CT) and sonography (SONO). In the proof of obstructions and compressions of the ureter of renal transplant, antegrade pyelography was superior to sonography and computed tomography. Perirenal collections of fluids were recognised correctly via sonography by 73% (11/15) and computed tomography by 87% (13/15). The computer tomogram is superior in the differentiation of perirenal collection of fluids. In establishing proof of the cause of an acute build-up of renal transplant it was evident that computed tomography with a sensitivity of 64% and a specificity of 94% was slightly superior.

Acute Disease↗
PubMed1992

Intraarterial 5-FU-infusion and simultaneous radiotherapy as palliative treatment of recurrent rectal cancer.

Palliative treatment of recurrent rectal cancer remains to be a challenge. From 1989 to 1991 13 patients with recurrent rectal cancer were treated with intraarterial infusion of 5-Fluorouracil and simultaneous radiotherapy in a palliative intent. Seven patients had received postoperative adjuvant radiotherapy with 56 to 60 Gy. Three patients had been treated with systemic chemotherapy. Radiotherapy of the recurrence was performed with 19.8 to 30.6 Gy in the pre-irradiated patients and with 50.4 to 59.4 Gy in the others. One complete remission, three partial remissions and nine minor responses were observed. Three patients had complete pain relief after the treatment, in the remaining patients major pain reduction was achieved. Palliation lasted from three to twelve months (median: five months). Our results indicate that locoregional chemo- and radiotherapy are a effective modality in recurrent rectal cancer.

Adult↗
PubMed1992

[Spontaneous renal artery dissection].

The clinical clues of sudden arterial hypertension, acute pain in the side, proteinuria, hematuria, abdominal bruits and renal failure are suspicious for spontaneous dissection of the renal arteries, even in the absence of one or more of the above-mentioned symptoms. To confirm the diagnosis and to provide appropriate therapy, immediate renal arteriography is mandatory, otherwise acute loss of renal tissue may occur. We report on one patient with spontaneous dissection of the renal arteries.

Aortic Dissection↗
PubMed1991

Renal artery stenosis: preliminary results of treatment with the Strecker stent.

Use of the Strecker flexible balloon-expandable tantalum stent for treatment of renal artery stenosis after failed angioplasty or transaortic thromboendarterectomy was evaluated in 10 patients (nine hypertensive, one normotensive). Left (n = 3) and right (n = 5) renal arteries were involved; renal artery stenosis in two patients had developed after kidney transplantation. Indications for stent placement were inadequate immediate postangioplasty response (n = 7), development of considerable restenosis after angioplasty (n = 1), and obstructing intimal flaps following transaortic endarterectomy (n = 2). Stent placement was technically successful (less than 20% residual stenosis) and patency was preserved in eight patients. Of the seven hypertensive patients with successful implantation, two were cured, three had improvement, and two had no change at latest follow-up evaluation (mean, 10.6 months; range, 6-12 months). The Strecker stent may be helpful in treating restenosis after failed revascularization procedures, although the precise indication, true safety, and long-term efficacy of stent placement in renal arteries will not be known until trials with more subjects and longer follow-up periods are completed.

Adult↗
PubMed1991

Color coded duplex sonography in the diagnosis of peripheral vascular disease--applications in the evaluation of peripheral aneurysms, follow-up after arterial graft surgery and deep venous thrombosis.

Color coded duplex sonography has definitive advantages over conventional duplex sonography for investigation of lower limb vessels. It contributes significantly to the non-invasive evaluation of peripheral aneurysms and complications associated with arterial puncture. After arterial graft surgery it is an effective imaging method to check bypass patency and evaluate suspected complications. Furthermore, color coded duplex sonography is sufficiently accurate to definitely diagnose lower extremity DVT, when not technically compromised. Postthrombotic vascular changes and clot alteration under anticoagulant treatment can be demonstrated with high sensitivity.

Anastomosis, Surgical↗
PubMed1991

[Radiologic diagnosis in hyperparathyroidism].

The most important radiologically detectable effects of the primary and secondary hyperparathyroidism of the skeletal system and the periarticular soft tissue structures are presented. In the following sensitivity and specificity of radiological imaging--sonography, scintigraphy, computed tomography, magnetic resonance imaging, arteriography and selective venous sampling--in the preoperative diagnostic of the parathyroid adenomas are discussed. Therefore, radiological imaging can be omitted before primary surgery. It was only in secondary surgery that radiological process proved useful and a guide during surgical intervention.

Bone Diseases↗
PubMed1991

[Retroperitoneal myxoid liposarcoma of the kidney capsule as a cause of Budd-Chiari syndrome].

A retroperitoneal myxoid liposarcoma of the renal capsule must be differentiated from renal cell carcinomas, angiomyolipomas, fibrogenous lipomas, fibrolipomas and mixed tumours containing fat tissue. Myxoid liposarcomas can lead to intracaval tumour thromboses, which is often the case with renal cell carcinomas and revealed clinical with Budd-Chiari syndrome. Computed tomography and magnetic resonance imaging give additional information in the diagnosis of intracaval tumour thromboses and show the exact expansion of the topographic-anatomical structure.

Aged↗
PubMed1991

[Color-coded duplex sonography].

Color Coded Duplex-Sonography (CCD) is the latest development in ultrasound equipment for non-invasive evaluation of the vascular system. Compared to conventional Duplex-Sonography the advantage of CCD is the ease of handling and quicker diagnosis, although there in no significant increase in information with CCD. The main indications for CCD are superficially located circumscribed vascular lesions as in carotid artery stenosis, tumors in the neck, disturbed renal transplant perfusion, hemodialysis vascular access shunts, deep vein thrombosis, testicular torsion and complications following vascular surgery of the extremities. The abdominal applications are limited.

Humans↗
PubMed1990

[Color-coded Doppler sonography--possibilities for application in the neck area, the abdomen and the extremities].

Colour coded Duplex sonography has definite advantages over duplex sonography for the investigation of neck and limb vessels. Diagnosis of arterial stenoses, occlusions and aneurysms can be readily made. The method also allows to follow the evolution after vascular surgery and percutaneous transluminal angioplasty. Deep venous thromboses can be reliably detected without the use of contrast media. Application for abdominal vascular diagnosis is still limited.

Abdomen↗
PubMed1990

[Diagnosis of atherosclerotic lesions of the extracranial carotid artery using duplex sonography and IA-DSA. A prospective pathologically and anatomically controlled study].

Fifty patients were studied prospectively. The extracranial portions of the carotid arteries were examined by duplex sonography and IA-DSA in order to demonstrate haemodynamically significant stenoses or plaques which might give rise to emboli and the findings compared with the pathologic specimens. The results indicate high sensitivity (up to 90%) for more than 75% detection of stenoses. On the other hand ulceration was diagnosed sonographically with an accuracy of 66% and plaque hemorrhage with an accuracy of 56%.

Aged↗
PubMed1990

[The diagnosis of deep venous thromboses of the leg. Color-Doppler sonography versus phlebography].

Angiodynography of the pelvic and deep leg veins was compared with ascending phlebography in a prospective study, comprising 102 examinations. Improved detection of flow following the introduction of the so-called "slow flow technique" permitted direct visualisation of the tibio-fibular veins in the second stage of this study (26 examinations). Demonstration or exclusion of femoro-popliteal thrombosis achieved a sensitivity of 95% and 90% respectively and a specificity of 99% and 97%. During the first part of this study, demonstration of calf vein thrombosis had a low sensitivity of 72%. This was improved by the introduction of a new high-pass filter resulting in the detection of all occlusions (nine). The sonographic signs of acute and chronic occlusions overlap somewhat. Colour demonstration showed eccentric, non-linear channels in two out of three cases and was able to exclude thrombus, although the veins could not be compressed.

Adult↗
PubMed1990

[Color-coded Doppler sonography of deep venous thrombosis--possibilities and limitations in the area of the veins of the pelvis and the lower leg including postthrombotic changes].

A comparative angiodynographic and phlebographic examination of 150 extremities in a total of 119 patients was performed in respect of the visualisation of the veins of the pelvis and lower leg. Controls regarding the course of disease with conservative treatment of a thrombotic occlusion were carried out between the 2nd and 6th weeks after the acute incident. Despite restricted examination conditions in the pelvic region, the examination yields satisfactory proof of the presence or non-existence of an iliac vein thrombosis. Improved flow detection enables the visualisation of the veins of the lower leg and the diagnosis even of incomplete thromboses of the veins of the lower leg. Colour-coded Doppler sonography is highly sensitive in detecting postthrombotic vascular changes, and hence angiodynography is a non-invasive method that is useful in checking on the success of conservative therapy subsequent to the treatment. This method is an essential improvement compared with conventional sonography in respect of the difficult differentiation between fresh venous thromboses and late postthrombotic changes.

Adolescent↗
PubMed1990

[Radiologic findings of lymphangiomyomatosis: a case report].

Lymphangiomyomatosis (LAM) is a rare disease that occurs predominantly in women of reproductive age. We report on a 17-year old female patient with chylothorax and smooth muscle proliferation of lymphatic vessels in the retrocrural, retroperitoneal and mesenteric space. Radiological procedures and especially computerized tomography proved particularly suitable for detecting abdominal changes and their localisation.

Adolescent↗