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Biomedical subjects

H J Böhmig

Publications and source records attributed to H J Böhmig.

At least 19 recordsLinked to original sources
PubMed2003

The evaluation of run-off prior to infra-inguinal bypass reconstruction - a modified scoring system based on flow measurement.

OBJECTIVES: To compare angiographic scoring and flow measurements in the assessment of run-off prior infra-inguinal bypass. PATIENTS AND METHODS: In a series of 108 consecutive infra-inguinal bypasses, run-off was scored on the basis of pre- and post-operative angiograms and related to intra- and post-operative flow rates as determined by Doppler ultrasonography. RESULTS: There was a highly significant correlation between the angiographic score and flow (p = 0.0000), as well as between angiographic score (p = 0.0000), flow (p = 0.0000) and the level of distal anastomosis. Flow determined per crural vessel (quotient of flow to angiographic score) proved to be independent of the level of distal bypass anastomosis (p = 0.20). CONCLUSION: In this study, angiographic scoring and Doppler flow measurements were equally valid means for the assessment of run-off. Our system allows an objective assessment of run-off independently of the distal bypass anastomosis level and provides a functional estimation of run-off.

Adult↗
PubMed2001

Collagen versus gelatin-coated Dacron versus stretch polytetrafluoroethylene in abdominal aortic bifurcation graft surgery: results of a seven-year prospective, randomized multicenter trial.

BACKGROUND: A prospective randomized multicenter trial was performed to compare knitted gelatin-coated Dacron bifurcation grafts, knitted collagen-coated Dacron grafts, and stretch polytetrafluoroethylene (PTFE) grafts. METHODS: Between 1991 and 1998, 315 elective patients were randomized by age, gender, diabetes, runoff, indication (aneurysm, aortoiliac occlusive disease), and nicotine consumption at 3 centers of vascular surgery in Austria. The patients received gelatin-coated Dacron (GEL-D) grafts (n = 109), collagen-coated Dacron (COL-D) grafts (n = 100), or stretch PTFE grafts (n = 106). RESULTS: No intraoperative deaths occurred. The 30-day mortality was 3%. No difference was found between the 3 graft materials in long-term patency. The primary 5-year patency rates were 92% for GEL-D, 89% for COL-D, and 91% for stretch PTFE (P =.6001). The secondary 5-year patency rates also differed: 97% for GEL-D, 100% for COL-D, and 97% for stretch PTFE (P =.2062). Early occlusions were observed overall in 3% and late occlusions in 5% of patients. When both Dacron grafts were compared collectively with stretch PTFE, a difference was found in infection rate: Dacron 3% (6/209) versus PTFE 0% (0/106); P <.03. CONCLUSIONS: The bifurcation grafts of all 3 materials were comparable in primary and secondary patency rates, incidence of false aneurysms, and rate of perioperative complications. Graft infections were confined to the 2 Dacron grafts and did not occur in stretch PTFE grafts.

Aorta, Abdominal↗
PubMed2000

[Pacemaker in therapy of heart failure--biventricular stimulation].

The management of congestive heart failure remains a therapeutic challenge despite recent advances in drug therapy, including ACE inhibitors, beta blockade and spironolacton treatment. Patients affected with the disease still have a restricted quality of life and a poor prognosis in the long run. Epidemiologically, the incidence and prevalence are increasing due to improved survival from both coronary artery disease and arterial hypertension. A subgroup of patients presents with marked prolongation of the QRS-complex in the surface ECG, mostly with a left bundle branch block pattern. This acts as a marker for interventricular conduction abnormality and specifically indicates a reduced left ventricular systolic function. Biventricular pacing tries to resynchronize the abnormal activation pattern by actively influencing diastolic filling and systolic function. The mechanisms involved are supposed to be restoration of left ventricular septal mechanical synchrony, reduction in presystolic mitral regurgitation and optimization of diastolic function with the maximization of diastolic filling time. In this article the current role and future directions of biventricular pacing are discussed.

Animals↗
PubMed1998

[Subpectoral venous approach in implantable cardioverter defibrillator systems (ICD)].

Lead complications may have fatal consequences for ICD patients. Lead fractures have been reported to occur a long time after subclavian puncture during ICD-implantation. Damage can also be caused by the patient manipulating subcutaneous lead segments. In this report we describe a simple implantation technique which avoids the risks related to subcutaneous lead position and transmuscular subclavian vein puncture. In 16 patients, after preparation of the site of the device, we chose the subpectoral venous approach for the implantation of the leads from the ICD. Available approaches are the pectoral vein, the subpectoral section of the cephalic vein or a puncture of the subclavian vein which is fully visible from that size. Once the pectoral muscle has been sutured, the entire system is protected behind it. Apart from an early postoperative lead dislocation, no complications were observed in association with the operating technique within a mean follow-up period of 10.7 +/- 6.7 (SD) months. The advantages of this technique are as follows: There is no transmuscular subclavian puncture or exposure of the deltoideopectoral groove. The entire ICD system is situated under the pectoralis major muscle. Subcutaneous lead positions with the potential complications mentioned above can thus be avoided. The fact that a more complex technique and therefore a slightly lengthier operating time is required and that this technique is not particularly suitable for local anaesthesia may be regarded as disadvantages. Due to the small number of cases and the short follow-up period, a final conclusion on the application of this technique is not possible to date.

Adult↗
PubMed1995

[20 years orthograde venous bypass for infrainguinal arterial reconstruction].

During a 20-year period (1973-1993) a series of 684 orthograde vein bypass procedures with the translocated greater (or lesser) saphenous vein was performed in 629 patients (422 male, 207 female) of whom 221 (35%) were diabetics. There were 499 femoro-popliteal grafts to the infrageniculate popliteal artery, 158 femoro-crural and 27 popliteo-crural grafts. Indication for surgery was rest pain and/or tissue necrosis in 404, claudication in 277 and asymptomatic popliteal artery aneurysm in 3 extremities. All patients received long-term oral anticoagulation and were followed at regular intervals. At the concluding follow-up (01-06/1993) graft function was investigated by colour flow duplex scanning and/or arteriography. Cumulative patient survival at 1, 5, 10 and 15 years was 90.6%, 62.8%, 38.6% and 27.1%. Multivariate analysis (Cox-model) proved that preoperative clinical status (rest pain and tissue necrosis vs. claudication and asymptomatic popliteal artery aneurysm) (p < 0.0001) and diabetes (p < 0.001) were significant factors for survival. The 30-day patency rate was 93%, and the secondary cumulative patency rates (life-table method) were 85.7%, 78.6%, 73.8% and 65.9% at 1, 5, 10 and 15 years. Only the preoperative clinical status was a weak prognostic factor (Mantel p < 0.029) whereas diabetes or the level of proximal and distal anastomosis were without importance for graft performance. Cumulative limb salvage rates (life-table method) at 1, 5, 10 and 15 years were 91.2%, 85.6%, 83.4% and 79.9% for the 404 legs operated for rest pain and or necrosis; and they were 100%, 98.8%, 97.7% and 94.9% for the 277 legs with claudication.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

[Hyperthyroidism in operations for non-thyroid diseases].

During a 7 years period from 1979 to 1986 subtotal thyroidectomy and a nonthyroidal operation were carried out as an one-stage procedure in 101 patients with the coincidence of a nonthyroidal surgical disease and thyrotoxicosis. In none of the patients a postoperative thyreotoxic reaction was observed. The one-stage procedure was found to be especially advantageous in cases with an urgent nonthyroidal surgical indication.

Aged↗
PubMed1987

[Toxicity results of an adjuvant study with intraperitoneal chemotherapy in patients with stomach cancer. Current status and future prospects of intraperitoneal therapy].

The peritoneum is a frequent location of recurrent disease after surgical treatment of carcinoma of the stomach, colon, rectum or ovary. Usually this type of recurrence does not respond very well to systemic chemotherapy. The rational of intraperitoneal (ip) perfusion with cytotoxic drugs is based on a 2- to 3-log-fold increase in ip level over plasma concentration for certain chemotherapeutic agents. Hence, malignant cells in the peritoneal cavity can be exposed to very high concentrations of cytotoxic agents without serious systemic side effects. Remission rates of peritoneal carcinoma after ip perfusion of a range of chemotherapeutic substances varied from between 15 to 50%. Minimal information is available about adjuvant ip perfusion after operation for cure. Toxicity data are presented from our adjuvant trial using ip perfusion after operation for gastric carcinoma for cure with cisplatin in a randomized fashion. Altogether 59 perfusions were performed, with minimal systemic toxicity, no occurrence of peritonitis and only 1 portal infection. Immunological data show that 1 day after ip perfusion the concentration of natural killer cells is increased in 60% of all perfusions, but decreased only in 28%. We conclude that ip perfusion with cisplatin is a safe procedure with limited toxicity. The efficacy of this technique in peritoneal carcinosis is not yet proven in randomized trials. The observation period of our trial in the adjuvant stage after operation for gastric carcinoma is too short as get to assess the usefulness of the procedure.

Antineoplastic Agents↗
PubMed1977

[Orthograde, free, femoro-popliteo-crural, venous bypass].

A new method of autologous vein bypass with the nonreversed free transplanted great saphenous vein is described. By this technique, 53 patients received long femoropopliteal and 10 patients femorocrural bypasses, between March, 1973, and March, 1976. Patency rate was 88% after 1 year and 84% after 3 years. Operative procedure and results are reported in detail.

Adult↗