[Peripheral arterial reconstruction].
Explore the source record for details and available documents.
Arterial Occlusive Diseases↗
Biomedical subjects
H J Florek
Publications and source records attributed to H J Florek.
[Current status of vascular surgery].
German vascular surgery compares favourably to international standards. Reconstruction of the complete vascular systems are carried out by experts in specialized centres. Sophisticated techniques are applied to the open and intravascular procedures of small and large vessels. Prosthesis grafts and vein autografts are often used with the help of atraumatic surgical equipment. The external quality control by the German Society of Vascular Surgery and the introduction of continuous medical education in vascular surgery help to maintain this high quality standard. There is a lack of vascular operation, a prerequisite for the development of further independent centres.
Education, Medical, Continuing↗
[Cardiovascular risk in arterial vascular surgery reconstruction].
Perioperative cardiac complications can limit the outcome after major vascular surgery where the underlying severe coronary artery disease is considered to be the main source. We describe the results of a prospective study including 201 patients undergoing elective vascular surgery. After looking at the encouraging low complication rate (mortality 0.99%, non-fatal myocardial infarction 2.98%, cardiac complications 9.95%) we would recommend the discussed diagnostic strategy. Specialized and expensive cardiac testing should be reserved for a few cases.
Aged↗
[Carotid surgery--reliable and speculative aspects].
The current status of endarterectomy in carotid artery stenosis is evaluated in prospective randomized studies. The results are very good and high quality. Endovascular therapy is in feasibility studies, and the complication rate is too high compared with the gold standard endarterectomy.
Carotid Stenosis↗
[Ultrasound angiography in diagnosis of deep venous thrombosis and post-thrombotic syndrome. A prospective comparative study].
PURPOSE: Aim of the present study was to establish the value of ultrasound angiography compared with colour duplex sonography and phlebography in the diagnosis of deep venous thrombosis of the leg and insufficiency of the perforating vein. METHOD: Sixty-two patients with deep venous thrombosis of the leg and 30 patients with post-thrombotic syndrome and perforating vein insufficiency underwent diagnostic examination by colour duplex sonography, ultrasound angiography and phlebography. Endoscopic varicose surgery was taken as the gold standard for diagnosis of perforating vein insufficiency. RESULTS: In the diagnosis of deep venous thrombosis, the specificity of colour duplex sonography was 92% in the thigh, 100% in the popliteal area and 89% in the lower leg. Colour angiography showed higher specificity. 95%, in the lower leg. In a diagnosis of perforating vein insufficiency, accuracy specificity of the three procedures was 60% for colour duplex sonography, 47% for phlebography and 80% for ultrasound angiography. CONCLUSIONS: The diagnosis of venous thromboses in the lower leg can be further improved by means of ultrasound angiography. Ultrasound angiography is the best method for demonstrating insufficiency of the perforating vein.
Adult↗
[Principles of antibiotic prophylaxis in vascular surgery].
Explore the source record for details and available documents.
Antibiotic Prophylaxis↗
Comparison of tissue plasminogen activator and urokinase in the local infiltration thrombolysis of peripheral arterial occlusions.
Recanalization of the vascular lumen by means of local fibrinolysis is of major importance in the treatment of peripheral arterial occlusive disease. While urokinase and streptokinase have been extensively used for local fibrinolysis, there have been few studies of infiltration thrombolysis with genetically engineered tissue plasminogen activator (rt-PA). The aim of the investigation reported here was to establish whether there is any difference between urokinase and rt-PA in the short- and long-term outcome of local fibrinolytic therapy. One-hundred twenty patients (70 men, 50 women) with acute or subacute femoral (n = 21), femoropopliteal (n = 33), popliteal (n = 13) or popliteocrural (n = 53) thrombotic occlusions were randomized to local lysis using urokinase or rt-PA, and 6 months later follow-up investigations took place. Recanalization of thrombotically occluded vessels, particularly in the lower leg, was found more frequently, and after treatment of shorter duration, with rt-PA. Large local haematomas occurred in 8% of cases in the urokinase group and 15% in the rt-PA group. No serious haemorrhages were encountered in either group. Six months after treatment, the rt-PA group showed lower rates of Fontaine stage III and IV disease and amputation than the urokinase group, with a higher number of patients in Fontaine stage IIb. This study shows that local lysis with rt-PA yields better results than urokinase, not only in the short term but also 6 months later.
Adult↗
[Long-term results after caval filter implantation].
In order to help clarify the long-term results of filter implantation and how best to manage the post-operative care, 92 patients with implanted filters were observed for up to 6 years. The follow-up examinations included detailed interrogation, a clinical investigation, plain abdominal radiography in two planes, contrast-enhanced computed tomography of the vena cava and colour-coded duplex sonography of the vena cava and the veins of the pelvic and legs. In the early phase of the study, two patients who received Günther filters in 1988 experienced dislocation of the filter after 3 months. In the later phase, 85% of those treated with oral anti-coagulants and compression showed patent pelvic veins in areas where, at the time of filter implantation, there had been thrombi with the potential to cause embolism. In 72 cases, the inferior v.cava proved to be patent in the area of the filter.
Aged↗
[Diagnosis of iatrogenic vascular injuries with color-coded duplex ultrasound].
Between January 1991 and October 1992, 1052 patients who had previously undergone coronarography were examined for iatrogenic lesions around the catheter entry point. Some 3% of them were found to have local complications in the form of haematomas, aneurysms, and arteriovenous fistulas. At the time of investigation 75% of patients with local complications were on oral anticoagulants. In over half of those who had complications on oral anticoagulants there was no alternative to surgical treatment. Colour duplex sonography has the advantage that it can be repeated as often as possible; thus, in cooperation with the cardiac surgeon, the necessity and urgency of surgical intervention in cardiac risk patients can be assessed on an ongoing basis.
Aneurysm, False↗