Biomedical subjects

J Leonhardi

Publications and source records attributed to J Leonhardi.

4 recordsLinked to original sources

PubMed2000

Current practice of temporary vena cava filter insertion: a multicenter registry.

PURPOSE: To evaluate the current practice of temporary vena cava filter placement and its complications. MATERIALS AND METHODS: A multicenter registry was conducted from May 1995 until May 1997 using a standardized questionnaire. One hundred eighty-eight patients were evaluated. Patient characteristics, filter indications, filter characteristics, and complications were registered. RESULTS: Deep vein thrombosis was proven in 95.2% of the patients. Main filter indication was thrombolysis therapy (53.1%). Average filter time was 5.4 days. An Antheor filter was inserted in 56.4%, a Guenther filter in 26.6%, and a Prolyser filter in 17.%. Transfemoral filter implantation was slightly preferred (54.8%). Four patients died of pulmonary embolism (PE) during filter protection. Major filter problems were filter thrombosis (16%) and filter dislocation (4.8%). When thrombus was found in or at the filter before explantation, additional thrombolysis was performed in 16.7%, additional filter implantation in 10%, and thrombus aspiration in 6.7%; 4.8% of filters were replaced with permanent filters. DISCUSSION: Temporary vena cava filters are placed to prevent PE in a defined patient population. Despite their presence, PEs still occur in a small percentage. Problems of filter thrombosis and dislocation have to be solved. CONCLUSION: The results of this multicenter registry support the need for innovative filter design, as well as a randomized, prospective study.

Adolescent↗

PubMed1999

[CT-assisted transthoracic puncture of pulmonary lesions and mediastinal infiltrations. A retrospective study of 300 patients].

With this retrospective study we evaluated the results and the complications of our 343 CT-guided transthoracic biopsies, which we performed in 300 patients with localised and infiltrative lesions of the lung and the mediastinum during 4 years, using the VacuCut-needle in 96% of our cases. In 256 pts. bronchoscopy without final diagnosis was performed before transthoracic biopsy. In 219 pts. (73.0%) we had positive results. In 209 pts. with malignancies the positive rate was 73.7%. In patients with benign processes the positive rate was less (67.8%). Out of 32 pts, suffering from mediastinal lesions 29 had malignancies. In 79.3% positive results were obtained. The rate of complications was low (9%) in 311 biopsies of pulmonary lesions, most were pneumothoraces (7.7%). Haemorrhages occurred in 4 pts. (1.3%) 5 pts. (1.6%) required drainage because of pneumothorax. On the base of our good results and the low complication rate we recommend CT-guided transthoracic aspiration biopsy with the VacuCut-needle as a useful and accurate diagnostic technique.

Adult↗

PubMed1997

[Tracheobronchomegaly--Mounier-Kuhn syndrome--case report and review of the literature].

Tracheobronchomegaly is a rare disorder. A marked dilatation of the trachea and the main stem bronchi is the characteristic sign measured as an enlarged transverse diameter (mean +/- 3 SD). Bronchiectasis is usual. In about one third of the published cases a diverticulosis was described as demonstrated in one our cases. For diagnostic modern radiological methods (CT including 3 D reconstruction, MRT) and bronchoscopy are recommended. The number and seize of the diverticula are documented by tracheography or by bronchography. In a part of all cases of tracheobronchomegaly the cause of the disorder is known. Therefore a division into congenital and acquired tracheobronchomegaly is useful.

Aged↗

PubMed1989

The value of angiography in cerebrovascular disease.

The expanding availability of digital subtraction angiography has essentially contributed in lowering the risks in the use of angiography of the cerebral arteries. The best results in imaging the cerebral artery are achieved by conventional subtraction angiography after selective catheterisation. This is, however, only important for diagnosis in intracerebral pathological changes distal of the Circulus Willisi or in connection with preoperative interventional radiological treatment. Pre-clinical diagnosis of patients with cerebrovascular occlusive disease as well as clinical diagnosis with Doppler and B-scan US sonography can be optimally complemented by DSA using 4-5 French catheters entered in the thoracic ascending aorta. Using this technique, the sensitivity and specificity with an image-matrix of 512 is diagnostically adequate and includes an only limited examination risk. Complication with lasting neurological defects will be least observed after intravenous pre-atrial application of contrast media and most after selective angiography of the carotid artery. Here the extent of the multiple arteriosclerotic obliteration is of essential importance. The quality of interpretation of the diagnostic findings essentially depends on indications not only about the grade of obliteration but also on the morphological details. At present DSA with application of contrast media into the thoracic ascending aorta in combination with the duplex-scan method represent the optimum for the diagnosis of cerebrovascular disease. In spite of lower specificity intravenous application of contrast media has to be preferred for post-operative controls and controls of progressing disease with "screening".

Carotid Arteries↗