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G P Gerritsen

Publications and source records attributed to G P Gerritsen.

9 recordsLinked to original sources
PubMed1993

Intravascular ultrasonography before and after intervention: in vivo comparison with angiography.

PURPOSE: To compare the additional capacity of intravascular ultrasonography versus angiography to assess morphologic features and lumen dimension, 37 patients undergoing vascular intervention of the common iliac or superficial femoral artery were studied. A total of 181 ultrasonic cross sections were analyzed (94 before and 87 after intervention). METHODS AND RESULTS: Before intervention intravascular ultrasonography distinguished normal cross sections (n = 17) from cross sections with a lesion (n = 77): soft (51%) versus hard (31%) lesions, and eccentric (75%) versus concentric (7%) lesions. After intervention intravascular ultrasonography documented dissection (43%), plaque rupture (10%), and internal elastic lamina rupture (8%). A good correlation between ultrasonography and angiography was found for the recognition of eccentric or concentric lesions and dissections. The degree of stenosis was assessed semiquantitatively by visual estimation of the degree of luminal narrowing from the angiograms and intravascular ultrasonic images and was categorized into four classes: (1) normal, (2) less than 50% stenosis, (3) 50% to 90% stenosis, and (4) greater than 90% stenosis. Intravascular ultrasonographic assessment of stenosis was in agreement with angiography in 78% of cases and showed more severe lesions in 22% before intervention. Similar data were observed after intervention, with 72% of results being in agreement and 28% of cases showing more severe lesions. The degree of stenosis was also quantitatively evaluated by computer-aided analysis of the intravascular ultrasonic images. The semiquantitative analysis by intravascular ultrasonography corresponded well with the quantitative analysis done by the computer-aided system. When both echography and angiography suggested that arteries were normal, quantitative intravascular ultrasonography identified lesions that occupied an average of 18% of the cross-sectional area of the vessel. CONCLUSIONS: This in vivo study shows that intravascular ultrasonography is capable of documenting detailed morphologic features. Semiquantitative ultrasonic data correlate closely with those of angiography, albeit stenoses were assessed as more severe on ultrasonography.

Aged↗
PubMed1992

[Placing of Hickman catheters under ultrasonic guidance].

We describe a new technique using ultrasound guided puncture of the subclavian vein and fluoroscopic control of the guide wire and the catheter position. Using this technique we performed 70 catheter introductions in 54 patients at the radiological department of the University Hospital of Rotterdam. Long term administration of chemotherapy was the most frequent indication for introduction of the Hickman catheter. The puncture related complication rate was compared with the complications of the 'blind' percutaneous puncture method, as mentioned in literature. All the ultrasound guided punctures of the subclavian vein were successful and no puncture related complications, such as pneumothorax, haemothorax or arterial puncture, occurred. Since ultrasound guided puncture of the subclavian vein in combination with fluoroscopic control of the guide wire and catheter reduces the risk of complications of introduction of Hickman catheters, we consider this technique superior to other methods.

Catheterization, Central Venous↗
PubMed1992

Effect of balloon angioplasty on femoral artery evaluated with intravascular ultrasound imaging.

BACKGROUND: Intravascular ultrasound was used to assess the immediate effect of balloon angioplasty on the superficial femoral artery. METHODS AND RESULTS: In 16 consecutive patients, corresponding ultrasonic cross sections (n = 72) before and after balloon angioplasty were qualitatively and quantitatively analyzed. The qualitative data were compared with angiographic findings. Before intervention, the angiographically demonstrated obstructive lesions were confirmed by intravascular ultrasound. Ultrasound enabled discrimination between soft (n = 43) and hard (n = 29) lesions, as well as between eccentric (n = 57) and concentric (n = 15) lesions. After balloon angioplasty, the presence of a dissection assessed angiographically in 14 patients was confirmed by intravascular ultrasound. Additional morphological information provided by ultrasound included plaque rupture in 14 patients and internal lamina rupture in six patients. Quantitative ultrasound data revealed an increase in free lumen area from 9.7 +/- 4.7 to 18.3 +/- 7.0 mm2 (p less than or equal to 0.01), an increase in minimal lumen diameter from 2.8 +/- 0.7 to 3.6 +/- 1.2 mm (p less than or equal to 0.01), and an increase in media-bounded area from 21.7 +/- 5.4 to 28.3 +/- 5.8 mm2 (p less than or equal to 0.01). The lesion area for the majority of cases (n = 32) remained unchanged (13.0 +/- 4.9 mm2 versus 12.9 +/- 4.6 mm2), or the lesion disappeared partially (from 9.1 +/- 0.9 to 4.3 +/- 1.4 mm2, n = 4, p less than or equal to 0.01) or totally (from 10.1 +/- 4.2 to 0 mm2, n = 6). Stretching of the arterial wall was further evidenced by medial thinning from 0.55 +/- 0.19 to 0.34 +/- 0.11 mm (p less than or equal to 0.01). CONCLUSIONS: Luminal enlargement by balloon dilatation is achieved primarily by overstretching the arterial wall, with the lesion volume remaining practically unchanged. Overstretching is accompanied almost always by dissection and plaque rupture and occasionally by an internal lamina rupture.

Aged↗
PubMed1991

Assessment of arterial disease and arterial reconstructions by intravascular ultrasound.

Clinical application of intravascular ultrasound to assess arterial atherosclerotic disease was introduced in humans after extensive in vitro and in vivo animal studies. Real-time images, obtained with a 30 MHz element mounted on a 5 F catheter, consistently confirmed angiographic images, up till now considered to be the gold standard. In addition to these data, ultrasonic cross-sectional imaging provided information on the composition of atheroselectic lesions and the size and shape of the lumen. Based on the experimentally derived criteria for tissue characterization, a better insight into arterial morphology could be obtained, allowing improved planning of interventional or reconstructional procedures. Moreover intravascular ultrasound has proved valuable as a post-interventional procedure to monitor and assess the quality of interventional results. The ultrasound images are clearly superior to angiographic studies, albeit the ultrasonic information is an adjunct to angiography and, as yet, not a substitute. We present our initial experience with intravascular ultrasound obtained in patients with substantial peripheral arterial disease.

Angioplasty, Balloon↗
PubMed1989

Intravascular ultrasonic imaging: histologic and echographic correlation.

The feasibility of assessing arterial wall characteristics with an intravascular 40 MHz ultrasonic imaging device was determined in vitro. Ten autopsy specimens of human arteries, with and without atherosclerosis, were studied. A close relationship was observed between the histologic section and the corresponding ultrasonic cross-section with regard to the location, maximum plaque thickness and extent of the atherosclerotic lesion along the circumference of the vessel wall. Based on echogenicity of the atherosclerotic lesion, ultrasound could distinguish four basic types of atherosclerotic plaque components: 1. hypoechoic: a reflection of lipid deposits; 2. soft echoes: reflective of fibromuscular tissue; 3. bright echoes: representative of fibrous tissue; 4. bright echoes with shadowing behind the lesion: representative of calcium deposits. It is anticipated that development of such a catheter-tip imaging system combined with recanalisation methods will be of immense benefit for the precise localisation and identification of vessel wall pathology, precise positioning of a recanalisation instrument (laser device, atherectomy catheter) and subsequent use of this recanalisation procedure and for assessing the effect of recanalisation.

Adult↗
PubMed1980

Conservative management of splenic trauma.

Conservative management of splenic rupture in 4 patients is described. Because of the possibility of late septic complications the reconstruction of the spleen, partial splenectomy or non-operative treatment is recommended before splenectomy.

Adolescent↗
PubMedDate not supplied

Emphysematous cholecystitis.

Emphysematous cholecystitis is an acute inflammation of the gallbladder caused by gas forming bacteria. The diagnosis is easily made on a plain abdominal X-ray showing air in the gallbladder. A fatal case is presented and some aspects of the disease are discussed.

Aged↗