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Biomedical subjects

G Pimenoff

Publications and source records attributed to G Pimenoff.

6 recordsLinked to original sources

Endovascular treatment of aortic aneurysms in Finland: the first four years' experience.

BACKGROUND AND AIMS: In this study the results of endovascular treatment of aortic aneurysms in Finland are presented and compared to the results of the Eurostar registry. MATERIAL AND METHODS: A total of 229 patients with aortic aneurysm were treated in five different Finnish centres during 1996-2000. The data of these patients were collected prospectively by surgeon or interventional radiologist involved. During the same period of time 2464 patients were registered in the Eurostar registry. RESULTS: The procedure was performed successfully in 97% of patients in Finland, and the 30-day mortality was 0,9%. A graft limb thrombosis was detected in 9% of the patients in Finland. A permanent primary endoleak at the first 30-day control was seen in 23 patients (10%). During the follow-up 17 secondary endoleaks (7%) were detected. A secondary intervention was necessary in 26% of the patients. Three patients (1.3%) had late rupture of the abdominal aortic aneurysm. CONCLUSIONS: According to the Finnish short-time results, endovascular treatment of aortic aneurysms is safe and associated with relatively low morbidity and mortality. The mid-term results are more disappointing with relatively many graft thromboses and endoleaks, and a frequent need of secondary interventions.

Adult↗

Stent grafting for abdominal aortic aneurysms in Finland--a feasibility study.

BACKGROUND AND AIMS: Endovascular repair of abdominal aortic aneurysms (AAA) is a feasible procedure in selected patients. In order to assess how many AAAs are suitable for such a procedure, a survey has been conducted in Helsinki, Kuopio, and Tampere University Hospitals. MATERIAL AND METHODS: AAAs having a maximum diameter of 45 mm or more at ultrasonography were included for further evaluation and assessment by angiography and/or spiral CT angiography to determine the length and width of infrarenal aneurysmal neck as well as the dimensions of the distal abdominal aorta and iliac arteries. RESULTS: Among a total of 75 patients with AAA examined in three centres, ultrasonography overestimated the size of the aneurysm in 12 cases that were demonstrated by angiography and CT to have a diameter of less than 45 mm. Among those patients with larger aneurysms, 17 (27%) were suitable for endovascular repair. Stent grafting has been performed in 10 patients until May, 1997. Perigraft leakage occurred in one patient who required the insertion of an additional collar stent graft. CONCLUSIONS: Large numbers of suitable patients are not easy to find but, by performing joint screening in Finland, epidemiological data on suitable aneurysms and improving co-operation between centres can be achieved. Therefore, it would be wise to centralise endovascular repair of AAA.

Aortic Aneurysm, Abdominal↗

Local intra-arterial thrombolysis in limb-threatening ischaemia.

The purpose of this study was to determine the angiographic and clinical success rate and the immediate limb salvage and mortality rate after intra-arterial thrombolysis in limb-threatening ischaemia. A retrospective study of 66 patients treated with intra-arterial thrombolysis for 71 episodes of limb-threatening ischaemia was carried out. Immediate angiographic recanalisation rate, pre- and post-treatment ankle-brachial index (ABI) and clinical stage were established. Major amputations and deaths were recorded. The immediate primary angiographic recanalisation was complete in 25 cases and partial in 20 cases. Combined complete plus partial recanalisation rate was thus 63.4% (45/71). The overall mean ABI after treatment was significantly higher than before treatment (0.35 versus 0.68), excluding patients undergoing amputation. Clinical improvement was achieved in 59.2% of cases for one month after treatment. The amputation rate was 18.3% during the first month and 29.6% during the median follow-up of 16 weeks. The mortality rates were 6.1% and 33.3% respectively. Despite a high mortality the complications of thrombolysis were few emphasizing the relative safety of this method in treating limb threatening ischaemia. Furthermore, thrombolysis may identify the underlying pathology, which can be corrected by additional surgery or interventional procedure.

Adult↗

Microcatheter embolization of hemorrhages.

PURPOSE: To evaluate the efficacy of embolotherapy using microcatheters in patients with hemorrhage from various locations. METHODS: Among 29 patients there were 13 with severe epistaxis, 7 with gastrointestinal bleeding, 4 with hemorrhage in the kidney, 4 with bleeding in pelvic organs and 1 with bleeding in the shoulder region. In all cases, a Tracker-18 or Tracker-10 microcatheter was advanced coaxially through a 4.1 Fr guiding catheter in order to reach the bleeding site as distally as possible. Polyvinyl alcohol microparticles and/or platinum microcoils were used as embolic material. RESULTS: The bleeding was stopped in 90% (26 of 29) of cases. In 66% of cases the treatment was curative, in 7% preoperative, and in 17% palliative. There were 3 clinical failures. CONCLUSION: Microcatheter embolization is an effective and safe means of managing different kinds of hemorrhage of various causes from a variety of sites.

Angiography, Digital Subtraction↗