[Renal angiomyolipoma].
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Angiomyolipoma↗
Biomedical subjects
H M Strunk
Publications and source records attributed to H M Strunk.
Dacryoliths: nonsurgical fluoroscopically guided treatment during dacryocystoplasty.
PURPOSE: To evaluate dacryocystoplasty with fluoroscopically guided nonsurgical removal of dacryoliths in the treatment of dacryolithiasis. MATERIALS AND METHODS: Ten patients with severe epiphora due to partial (n = 8) or complete (n = 2) obstruction of the nasolacrimal duct system associated with dacryolithiasis underwent fluoroscopically guided removal of dacryoliths during dacryocystoplasty. Balloon dilation was performed initially to widen the nasolacrimal duct obstructions and to fragment dacryoliths. This was followed by forced irrigation with saline solution through the canaliculi. In patients with incomplete dacryolith washout, a 6.3-F sheath was advanced in a retrograde fashion into the nasolacrimal sac, and forced irrigation was repeated with aspiration of the fragments through the sheath. In two patients with therapy-resistant dacryoliths, additional fragmentation of the concrements was performed with a gooseneck snare. RESULTS: Removal of dacryoliths was technically successful in all patients (complete removal, n = 6; partial removal, n = 4). During a follow-up period of up to 18 months, complete resolution of epiphora was achieved in five patients, and five patients showed partial resolution of their symptoms. CONCLUSION: Fluoroscopically guided removal of dacryoliths during dacryocystoplasty is a feasible nonsurgical therapy with good clinical results and may be used as an alternative to dacryocystorhinostomy.
Calculi↗
[Results of angiographic follow-up of percutaneous stent implantation in the pelvic arteries with a comparison between Wall and Palmaz stents].
51 occlusions of iliac arteries and 67 stenoses have been treated, including 22 patients with bilateral lesions. Indications for stent implantations were: vascular occlusions (51), restenosis following previous PTA (22) and immediate unsatisfactory results or extensive dissection after PTA (45). Successful placement of a stent was achieved in 116 out of 118 attempts. Period of observation averaged 16 months (3-36 months). Stent occlusion was observed in 8 cases. There was mild intima hyperplasia in 25 patients and in a further 14 intima hyperplasia exceeded 75%. Patency rate after 36 months was 67%; 74 wall stents and 39 Palmaz stents were patent, a patency rate of 73 and 65% respectively after 24 months.
Adult↗
[Iliac artery occlusion: antegrade catheterization for stent placement].
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Angioplasty, Balloon↗
Five-year results of iliac and femoropopliteal angioplasty in diabetic patients.
Results of 127 iliac and femoropopliteal transluminal angioplasties in 97 diabetic patients are presented. Patients who had undergone iliac (n = 70), femoral (n = 41), and popliteal (n = 16) angioplasties for stenoses up to 15 cm long were followed up for 6-60 months. In diabetic patients presenting with only claudication or adequate runoff, the 5-year iliac patency rate was 76% and the femoral patency rate was 60%; these results were comparable with those found in nondiabetic patients. For limb salvage, 3-year patency rates were 66% for iliac, 37% for femoral, and 37% for popliteal angioplasties, and 5-year patency rates were 29% for iliac, 7% for femoral, and 0% for popliteal angioplasties. Severe peripheral ischemia, poor runoff, and diffuse stenoses all had negative effects on angioplasty results.
Actuarial Analysis↗
Acute Budd-Chiari syndrome: treatment with transjugular intrahepatic portosystemic shunt.
The case of a 28-year-old man with acute Budd-Chiari syndrome due to veno-occlusive disease is reported. Transjugular intrahepatic portosystemic shunt (TIPS) was performed after upper gastrointestinal endoscopy, duplex sonographic and abdominal computed tomographic examination, inferior cavogram with hepatic venous catheterization, and transvenous biopsy. A 10-mm parenchymal tract was created. The patient did well after the procedure; ascites resolved and liver function improved markedly. The shunt has remained patent up to now for 6 months.
Acute Disease↗
Luminal changes in downsteam arteries after percutaneous interventions in iliac arteries: implications for balloon or stent size determination.
PURPOSE: To evaluate changes in the diameter of downstream iliac arteries after percutaneous interventions, which may be important for stent or balloon size determination. PATIENTS AND METHODS: Angiographic studies were reviewed respectively for 31 patients in whom a unilateral common iliac artery occlusion (n = 10) or a high-grade stenosis (> 75%; n = 21) was treated with stent implantation (26 patients) or balloon angioplasty (five patients). RESULTS: Before intervention, the ipsilateral downstream arteries showed a luminal reduction in 26 of 31 patients (mean 24% +/- 11.0; range, 6%-64%) compared with the opposite artery. This side-to-side difference was statistically significant for the external iliac artery (P = .000007) and for the common iliac artery distal to the obstruction (P = .017). In 17 of 26 patients, the side-to-side difference of the downstream external iliac artery was fully reversible immediately after intervention. In five patients, a luminal widening was noted. No change was seen in only four patients. CONCLUSION: Because downstream arteries often show a marked luminal widening after intervention, determination of balloon or stent size cannot be based solely on the diameter of downstream ("normal") ipsilateral artery before intervention.
Adult↗