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H Laubach

Publications and source records attributed to H Laubach.

8 recordsLinked to original sources
PubMed1998

Early carotid endarterectomy after non-disabling ischaemic stroke: adequate therapeutical option in selected patients.

OBJECTIVE: To evaluate neurological outcome and long-term results of early carotid endarterectomy (CEA) after non-disabling stroke. MATERIALS: Retrospective study between 1980 and 1995 of 56 patients undergoing CEA within 4 weeks of a transient (n = 15) or a permanent non-disabling (n = 41) ischaemic stroke. METHODS: Analyses of preoperative cerebral CT imaging, neurological outcome (mod. Rankin-scale) and long-term results (life-table analyses according to Kaplan-Meier). RESULTS: Incidence of early CEA increased from 1.7% (27 out of 1636) in the period 1980-1993 to 7.8% (29 out of 374) between 1994 and 1995. CEA was indicated after a neurological plateau phase was established (median interval 14 days). Fifty-seven per cent of the CEA patients had a minor ischaemic infarction (area < 2 cm), 18% showed a large territorial ischaemic infarction (area 2-5 cm) in cerebral CT imaging. Two patients deteriorated postoperatively (minor stroke rate 4%) but no major stroke or death occurred. Life-table probability of stroke-free survival (mean follow-up 42.7 months) was 94%, 90% and 84%, respectively, after 1, 2 and 5 years. Kaplan-Meier survival rates were 96%, 91% and 86% after 1, 2 and 5 years. CONCLUSIONS: Early CEA after non-disabling stroke is a safe procedure in selected patients.

Adult↗
PubMed1998

Medical readiness training exercise in El Salvador, Central America, 1996.

Medical Readiness Training Exercises (MEDRETEs) can be a valuable training tool for U.S. Army personnel in remote areas of deployment. We report our experience of the MEDRETE in El Salvador in 1996. Working with foreign physicians of the host country was a positive experience in which we learned local customs and mutual cooperation. Evaluation and treatment of nearly 6,000 patients increased goodwill in the community and provided an opportunity for teamwork for Army Reserve medical units, including increased discussions of public health issues. We also report on the field applicability of the advanced laboratory and pharmacy equipment we included in our training.

Adolescent↗
PubMed1997

[Carotid endarterectomy in the early phase after a non-disabling stroke: 1980-1995 results].

In 56 patients, carotid endarterectomy (CEA) was performed 14 days (median) after a non-disabling carotid-related stroke with a perioperative minor stroke rate of 3.6%. Even large ischemic brain infarcts on CT scan did not exclude patients from CEA, as long as the patient had reached a neurologic plateau. The data from this study indicate that CEA can be performed safely in properly selected patients, and might reduce the high risk of a recurrent stroke (5%-9.5% within 30 days).

Adult↗
PubMed1996

[Carotid TEA and perioperative thrombolysis: a new concept in therapy of acute ischemic stroke].

In seven carotid-related acute hemispheric strokes with simultaneous embolic occlusion of the middle cerebral artery thrombolysis with urocinase or rt-PA was performed preoperatively (n = 3) or intraoperatively (n = 4) after carotid endarterectomy. Four patients recovered totally, three patients showed a remarkable improvement and were able to walk postoperatively. The combination of carotid endarterectomy and thrombolysis (simultaneous or staged) is a new option in the emergency treatment of an acute carotid-related stroke and should be evaluated in prospective interdisciplinary studies.

Adult↗
PubMedDate not supplied

Emergency carotid endarterectomy.

OBJECTIVE: Evaluation of the therapeutical efficacy of emergency carotid endarterectomy (CEA) in neurologically unstable patients. PATIENTS AND METHODS: Three groups of a consecutive series of 71 emergency CEAs performed from 1980 to July 1998 were classified: (1) acute onset of severe stroke (n = 16), (2) progressive stroke/stroke in evolution (n = 34), and (3) crescendo transient ischemic attacks (n = 21). Cerebral coma, cerebral haemorrhage, and major ischemic stroke established in cranial computed tomography scans were contraindications for surgery. The neurological outcome was assessed by the modified Rankin scale. Long-term survival and long-term stroke recurrences were analyzed. RESULTS: The recovery/minor stroke rates (Rankin 0-3) in acute stroke, progressive stroke, and crescendo transient ischemic attacks were 56.3, 76.4 and 80.9%, respectively; the combined major stroke/mortality rates (Rankin 4-6) were 43.7, 23.6 and 19.1%, respectively. Intraoperative angiography in 39 patients detected early carotid reocclusions in 2 and intracranial embolism in 7 patients. Local application of thrombolytic agents (n = 5) may contribute to a better neurological outcome in emergency CEA. Life table probabilities of major strokefree survival were 74.5, 71.6, and 53.7% after 1, 2, and 5 years, respectively (including perioperative strokes). Life table probabilities to suffer no stroke recurrence during follow-up were 96.7, 96.7 and 85.3%, respectively (perioperative strokes excluded). CONCLUSIONS: Emergency CEA may be worthwhile in selected patients. Completion angiography is mandatory. Emergency CEA should be included in therapeutic strategies for ischemic stroke.

Adult↗