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H Kobeiter

Publications and source records attributed to H Kobeiter.

25 records · Page 2Linked to original sources
PubMed1999

Surgical transluminal iliac angioplasty with selective stenting: long-term results assessed by means of duplex scanning.

PURPOSE: The safety of iliac angioplasty and selective stenting performed in the operating room by vascular surgeons was evaluated, and the short- and long-term results were assessed by means of serial duplex scanning. METHODS: Between 1989 and 1996, 281 iliac stenotic or occlusive lesions in 235 consecutive patients with chronic limb ischemia were treated by means of percutaneous transluminal angioplasty (PTA) alone (n = 214) or PTA with stent (n = 67, 23.8%). There were 260 primary lesions and 21 restenosis after a first PTA, which were analyzed separately. Stents were implanted in selected cases, either primarily in totally occluded arteries or after suboptimum results of PTA (ie, residual stenosis or a dissection). Data were collected prospectively and analyzed retrospectively. Results were reported in an intention-to-treat basis. Clinical results and patency were evaluated by means of symptom assessment, ankle brachial pressure index, and duplex scanning at discharge and 1, 3, 6, and every 12 months after angioplasty. To identify factors that may affect outcome, 12 clinical and radiological variables, including the four categories of lesions defined by the Standards of Practice Committee of the Society of Cardiovascular and Interventional Radiology, were analyzed separately. The statistical significances of life-table analysis of patency were determined by means of the log-rank test. RESULTS: There were no postoperative deaths or amputations. Local, general, and vascular complications occurred in 2.1%, 1.3% and 4.7% of cases, respectively (total, 8.1%). The mean follow-up period was 29.6 months. The cumulative patency rates +/- SE of the 260 PTAs (including 55 PTAs plus stents) were 92.9% +/- 1.5% at 1 month, 86. 5% +/- 1.7% at 1 year, 81.2% +/- 2.3% at 2 years, 78.8% +/- 2.9% at 3 years, and 75.4% +/- 3.5% at 5 and 6 years. The two-year patency rate of 21 redo PTAs (including 11 PTAs plus stents) was 79.1% +/- 18.2%. Of 12 predictable variables studied in the first PTA group, only the category of the lesion was predictive of long-term patency. The two-year patency rate was 84% +/- 3% for 199 category 1 lesions and 69.7% +/- 6.5% for 61 category 2, 3, and 4 lesions together (P =. 02). There was no difference of patency in the stented and nonstented group. CONCLUSION: Iliac PTA alone or with the use of a stent (in cases of occlusion and/or suboptimal results of PTA) offers an excellent long-term patency rate. Categorization of lesions remains useful in predicting long-term outcome. PTA can be performed safely by vascular surgeons in the operating room and should be considered to be the primary treatment for localized iliac occlusive disease.

Adult↗
PubMed1998

[Transluminal treatment of abdominal aortic aneurysms. Might one obstruct the renal arteries?].

During transluminal treatment of an aneurysm of the abdominal aorta, the proximal part of the stent may sometimes lay over the ostia of the renal arteries. Animal studies have shown various scarring patterns depending on the type of stent used and its duration of implantation. The Gianturco and Wallstent appear to be better tolerated than the Palmaz stents. The AA have shown that, with the Strecker stents, a neointima developed between the meshes of the stent over a surface of 43% +/- 30% in 6 weeks. May and Parodi report some occlusions in their clinical series. In the AA's series using Vanguard, no renal artery was thrombosed despite the fact that the stent lay over the artery on 2 occasions in 105 patients. In conclusion, the consequences of the proximal part of a stent laying over the ostium of a renal artery depend mainly on the type of stent used. "Wide mesh" stents are probably the best to use to prevent serious renal complications.

Animals↗
PubMed1998

[Which investigations should be selected for the preoperative assessment before the decision for treatment of abdominal aortic aneurysm by endoprosthesis: arteriography, tomodensitometry or magnetic resonance imaging?].

PURPOSE: To determine the best imaging technique to obtain all the necessary information before the placement of an aortic endoprosthesis. METHOD: Each technique is assessed from a review of the literature and the AA's own experience (21 endoprostheses); the advantages and disadvantages of each technique are discussed. RESULTS: 1) Arteriography (with a calibrated catheter), always considered at the investigation of choice to determine the feasibility of the technique, gives no information on the aortic wall; 2) spiral CT scanning is superior to basic scanning in giving a 3-dimensional picture. Many authors have concluded that spiral CT-scanning has replaced aortography, but its limitation, at the moment, is in the quality of the assessment of the renal arteries (number, stenosis); 3) magnetic resonance imaging has not been studied to any extent in terms of assessment for endoprosthetic treatment. Early results are promising and will be described. CONCLUSIONS: At the present time, the best compromise is spiral-CT scanning in thin sections with 3-dimensional reconstruction. The AA combine this with arteriography to visualise the renal arteries in particular, and the distal bed.

Angiography↗
PubMed1996

[Role of magnetic resonance imaging in liver pathology].

The increasingly common use of ultrasound examination of the liver has led to increased detection of hepatic tumours, showing a hitherto unsuspected prevalence. Improved techniques in MRI, such as dynamic sequences and new contrast media, are ameliorating the detection and characterization of the lesions, in particular with regard to computed tomography. In addition, since MRI is more sensitive to different components than in computed tomography, it permits better study of diffuse diseases such as haemochromatosis or fatty infiltration, particularly in pseudotumoural forms. The continuing progress in system improvement makes MRI an excellent method for diagnosis of bile duct disorders, especially in case of obstruction.

Biliary Tract Diseases↗
PubMed1996

[In adult urology, when should ultrasonography, computed tomography, intravenous urography be requested?].

The authors recall the indications for the medical imaging examinations most frequently used in adult urology, depending on the organ, syndrome or disease to be investigated. The indications for intravenous urography (IVU) are increasingly rare, but it remains the reference examination to study the pyelocaliceal cavities. Ultrasonography, combined with KUB, generally provides a diagnosis, especially in the emergency setting. Computed tomography (CT) is the reference examination for the investigation of all types of renal lesions, but also lesions of other organs, especially in the case of neoplastic disease.

Adult↗