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Biomedical subjects

G Kasza

Publications and source records attributed to G Kasza.

5 recordsLinked to original sources
PubMed1997

Internal carotid stent implantation with angioscopic control.

Stent implantation is a method, which is being used more and more often, mainly in the field of peripheral arteries, but coronary stent implantation is also well-known. The authors apply this procedure for patients, who besides the carotid bifurcation stenosis also suffer from the internal carotid stenosis in a longer section of the artery. The indication are as follows: 1 in the case of internal carotid stenosis in a longer section we assure the flow with the help of carotid thrombendarterectomy and slove the run-off with balloon catheter dilatation and stent implantation. 2. in the case of a stenosis in a short section we use stent implantation to avoid dissection of the intima. With each intervention we perform the carotid bifurcation thrombendarterectomy. The authors made the first intervention 15 months ago, since then we have performed 17 stent implantations. One of the 17 patients developed a temporary stroke (TIA). This is a new method, further cases are needed for long-term experiences. Intervention under eye-control can be carried out with more confidence. As regards to the post-operative medicinal treatment, the administration of thrombocyte aggregation-blockers or heparinoid preparation (e.g.: PPS-SP 54) after the stent implantation has become a routine therapy. Summarized the foregoing, these cases constitute about 10-15% of all carotid operations, therefore the authors would like to make it clear, that this is not a routine method, but a possibility, strictly respecting the above-mentioned indications.

Aortic Dissection↗
PubMed1997

The basic and the practical way of treating of diabetic foot.

Developed atrophic ulcer and infected alterations of the foot, as a result of complications of DM, according to the available literature, 40-80% of the performed amputations are not necessary even though in practice they do occur. In our practice even the severely altered and infected extremities which look serious are considered as primarily a savable extremity if the conditions are present. The state of circulation of the extremity and the condition of the limb are evaluated carefully, and the sugar level is monitored continuously. According to our experience, every progressing process, the alteration of the host sugar level can be held as responsible. That is why after the early therapeutic period, careful monitoring of the insulin level is a priority. At our out-patient department we are daily confronted during routine wound inspections by cases of necrotizing osteomyelitis which to our experience are doomed for removal. In 1995 at the out-patient section of the vascular surgery ward we saw over 9000 patients, more than 500 of which included patients with diabetic angio/neuropathy complications. The nursing of this group of patients during that year only to 33 large vessel reconstructive operations and 26 cases of amputations. We conclude from the above statistics that not all cases of osteomyelitis cases should lead to limb amputation. Due to the nature of the condition, careful monitoring with early preventive measures, plus family support play a crucial role in the outcome of the condition. This complex process is better handled if special diabetic centres were set-up to monitor patients progress.

Ambulatory Care↗
PubMed1994

[Aorto-bifemoral bypass through retroperitoneal "mini"-incision (preliminary report)].

The large vertical midline or transverse transperitoneal approaches used to the conventional aortoiliac reconstruction are accompanied with a relatively high postoperative morbidity and mortality rate (2% to 5%) even in patients who are good risks undergoing aortic surgery. The purpose of this study was develop a new technique for aorto-bifemoral bypass operation to minimize the operative stress on these patients. The recommended left paramedian retroperitoneal approach using 5-6 cm skin-incision and a special retractor with three dimensional vision and using modified surgical instruments directly with eye control, offers the possibility to decrease the operative stress significantly and the sufficient control of the serious bleeding might occur. If it is necessary this exposure can be immediately converted to a conventional approach by simply enlargement of the incision. In our first case the functional results were very good and consequently hospitalization time and the convalescence period were short. This minimal access approach appears to diminish the catabolic response and is hopefully associated with accelerated recovery and virtual abolition of large wound-related complications. It could become the procedure of choice for selected patients with obstructive or aneurysmal aorto-iliac disease.

Anastomosis, Surgical↗