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Biomedical subjects

H Ingrisch

Publications and source records attributed to H Ingrisch.

At least 37 records · Page 2Linked to original sources
PubMed1981

[Excretion urogram with angiotomography sensitivity and specificity in the diagnosis of renal artery stenosis; a comparison with differences in renal size and contrast density on early films (author's transl)].

Intravenous bolus injection of contrast material with angiotomography permits direct demonstration and evaluation of the renal arteries during an excretion urogram. Angiotomography was carried out in 71 patients with suspected reno-vascular hypertension; the results were compared with contrast excretion and renal size on the two sides, and with the findings of catheter angiography. In the presence of haemodynamically significant stenosis the sensitivity of angiotomography was 87% and its specificity was 99%. The sensitivity of renal size differential was only 20% and of contrast excretion differential 47%. A combination of all three methods resulted in a sensitivity of 93%. The advantages of demonstrating the renal arteries as a part of an excretion urogram are discussed, particularly with respect to possible treatment.

Adult↗
PubMed1981

[Transluminal dilatation of the distal abdominal aorta and of the common and external iliac arteries (author's transl)].

Percutaneous transluminal angioplasty (PTA), a radiological procedure for dilating stenosed or occluded vessels, was carried out for 67 stenoses and three occlusions of the abdominal aorta or of the common or external iliac arteries. Seventy procedures were carried out; of these, 65 showed satisfactory primary results (observation period 15 days) ie, the clinical situation was improved. On four occasions the procedure had to be abandoned for technical reasons and, in one case, there was an early recurrence. Subsequently there were two late recurrences (after six and 24 months) during an observation period of three to 24 months. In the successfully dilated stenoses or occlusions there was a highly significant increase in the vessel diameter, with a highly significant reduction in the pressure gradient across the stenosis. The results are discussed. The authors conclude that in the presence of stenoses of the distal aorta or common or external iliac arteries PTA, which carries little risk and can be repeated, should be considered and attempted before surgical intervention.

Adult↗
PubMed1980

[New developments in diagnosis and treatment of renovascular hypertension (author's transl)].

Catheter-dilatation (percutaneous Transluminal Angioplasty=PTA) of renal artery stenoses can be applied successfully and without major risk even in patients with high operative risks. Therefore, the indication for the diagnostic evaluation of renal artery stenosis should be expanded to all patients suspected to have renovascular hypertension. Excretory urography combined with angiotomography offers the possibility to visualize the renal arteries and to either detect or exclude arterial stenosis. In the first part results of this procedure are presented. The bolus injection have been carried out on 415 patients without any serious side-effects. Using angiotomography 49 renal artery stenoses, 1 aneurysm and 1 AV fistula could be detected. Catheter-angiograms, angiotomograms and conventional rapid sequence urograms were compared in 91 patients. For angiotomography a sensitivity for the presence of renal artery stenosis of 93% and a specifity for the absence of arterial stenosis of 99% can be attained. In the second part, the results of PTA of renal artery stenoses in 35 patients are described. PTA was technically successful in 29 patients (83%). Three clinically silent complications are reported. In a mean follow-up period of 8,2-months, hypertension was normalized in 13 (45%) and improved in 10 (34%) patients. Renal insufficiency could be normalized in 7 out of 11 patients. These results make PTA the method of choice in treating renovascular hypertension. Only if this method is not applicable or technically not feasible, is the alternative for treatment surgical revascularization or conservative antihypertensive therapy.

Adult↗
PubMed1980

[Low dose thrombolytic treatment for revascularisation in arterial occlusion (author's transl)].

Acute and subacute arterial occlusions of between 4.5 and 29 cm long could be dissolved in 11 patients by infiltration of small amounts (4000 to 110 000 U) of streptokinase or urokinase directly into the thrombus using a catheter. Use of a Grüntzig catheter enabled dilatation of possible stenoses during the same session. In 3 femoro-popliteal obliterations where lysis and catheter dilatation did not lead to sufficiently patent lumina occlusion recurred. In 3 patients with wide-ranging obliteration of the femoral, popliteal and almost all the arteries of the calf almost complete revascularisation could be achieved. Only transient slight side effects of lysis and coagulation disturbances were observed systemically. For prophylaxis of reobliteration platelet aggregation inhibitors are given for pre- and long-term aftercare.

Adolescent↗
PubMed1980

Visualization of the renal arteries during excretory urography.

1. Intravenous excretory urography was modified and expanded in order to visualize the aorta and the renal arteries. 2. The new procedure consists of the rapid intravenous injection of contrast medium, determination of the circulation time between the injection site and abdominal aorta, tomography with a multileaf cassette with five films (angiotomography) and continuation of the investigation as with routine excretory urography. 3. In 343 patients a total of 739 single or multiple renal arteries were identified at least partially. Of these, 83% could be clearly outlined between the aorta and the first division. 4. In 71 hypertensive patients angiography and angiotomography were separately evaluated. With angiotomography all 165 single or multiple renal arteries seen with angiography were visualized at least partially, whereas a total of 149 (90%) of renal arteries could be completely outlined between the aorta and the first division of the renal arteries. 5. A sensitivity for the presence of renal artery stenosis of 92% and a specificity for the absence of artery stenosis of 99% can be calculated for angiotomography in the diagnosis of renal artery stenosis. 6. Thus this method permits the detection or exclusion of renal artery stenosis in almost three-quarters of patients with hypertension, without angiography.

Adult↗
PubMed1980

[The technique for demonstrating the renal arteries during an excretion urogram. Bolus technique--timing--simultaneous tomography (author's transl)].

The aorta and renal arteries, as far as their intrarenal branches, can be demonstrated in the course of an excretion urogram if the contrast medium (1 ml/kg body weight, maximum 60 ml) is injected at a flow rate of 10 to 15 ml/sec (Bolus technique). The intravenous bolus injection was carried out in 180 patients without any significant complications. In order to obtain the correct timing on a single film it is necessary to determine the circulation time from the arm vein to the abdominal aorta in each individual. The addition of 0.2 to 0.3 mCi 99mTc to the contrast medium makes it possible to determine the circulation time accurately. This varied from 9 to 22 seconds. By using tomography with 1 cm cuts and a 4.5 cm format, it was possible to show the left or right renal arteries from the aorta to their intrarenal branches in 82% patients. In 126 (70%) of the 180 patients, both renal arteries were demonstrated. The demonstration of renal arteries during the course of an excretion urogram represents an advance on the conventional technique. The indications are discussed.

Adolescent↗
PubMed1980

[Percutaneous transluminal angioplasty of a stenosis of an aorto-renal venous interposition transplant (author's transl)].

Following successful surgical treatment of renal artery stenosis, restenosis may be expected in 5 to 17% of cases. Percutaneous transluminal angioplasty with a dilatation catheter is a safe alternative to repeated surgery. The author describes the first such treatment of a stenosis in an aorto-renal venous interposition transplant. As a result, the patient's blood pressure was reduced, drug treatment could be given in a lower dose and surgery was avoided.

Blood Pressure↗
PubMed1979

[Investigations on pain reduction during peripheral angiography (author's transl)].

An attempt was made to reduce pain during femoral angiography by adding 1 mg. of Lidocaine/ml. contrast medium in the course of 95 examinations. In a further 87 patients, Diazepam was injected intravenously before the injection of the contrast-Lidocaine mixture. Pain and the feeling of heat was compared with a control group who received contrast medium with 10% physiological saline. There was a highly significant reduction in pain sensation as a result of Lidocaine; pain was further reduced by additional Diazepam, which also reduced heat sensation, but resulted in a fall in blood pressure. High risk patients did not suffer any significant complications. Lidocaine is well suited for out patients, but Diazepam requires a longer period of observation. General anaesthesia has been used only if patients insisted on it or if there was known contrast reaction.

Angiography↗
PubMed1978

[Prevention of re-occlusion after recanalisation of occluded arteries by the catheter method (author's transl)].

In a double-blind study, prevention of re-thrombosis was tested on 101 patients in whom stenosis or segmental occlusion of a large artery of the lower limbs had been successfully removed by the intraluminal catheter method. The combination of 75 mg dipyridamol and 330 mg acetylsalicylic acid, three times daily by mouth, proved to be slightly more effective than acetylsalicylic acid alone at the same dosage. In the group with the combined treatment 84% of the arteries remained open, compared with 70% on acetylsalicylic acid alone.

Arterial Occlusive Diseases↗
PubMed1978

[Echographic or radiographic cholecystography? (author's transl)].

In a prospective echographic and radiographic investigation of 281 patients and in a retrospective evaluation of 86 operated patients, echography and radiography gave approximately equally accurate diagnoses. By using both methods no pathological finding will be overlooked. For reasons of radiation protection, echographic examinations should be carried out first. If the echographic results agree with the clinical findings the radiological cholecystography can be dispensed with. Radiological investigation should be carried out if the echographic findings are at variance with the clinical findings. Consequently echographic cholecystography certainly cannot replace radiography, but it does contribute in that radiographic examination can be used selectively.

Cholecystography↗
PubMed1977

[Lung function scintigraphy in the diagnosis of regional disturbances of ventilation (author's transl)].

Lung function scintigraphy is the method of choice for the diagnosis of regional ventilation disturbances. The aim of this study was to determine which of various parameters is the most reliable. Sensitivity of the 3-minute retension test is 96%, of the single breath 45%, equilibration 32% and of the ventilation index, only 28%. Sensitivity of the various parameters for demonstrating multi-focal ventilation abnormalities is 100% for the 3 minute retention test, 32% for single breath, 19% for equilibration and 21% for the ventilation index. The underlying basis for these findings is discussed and it is concluded that it is possible to simplify the technique when dealing with regional ventilation abnormality in obstructive airway disease, but not when dealing with other restrictive changes.

Airway Obstruction↗