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J Raupach

Publications and source records attributed to J Raupach.

At least 19 recordsLinked to original sources
PubMed2006

Temporary liver blood-outflow occlusion increases effectiveness of radiofrequency ablation: an experimental study on pigs.

AIM: To evaluate the feasibility of liver blood outflow (LBOF) occlusion and its impact on the effectiveness of radiofrequency ablation (RFA). METHODS: The experiment was performed on 10 pigs. The animals were divided into groups A and B according to RFA protocol. In group A (n=5) the RFA time was that taken to reach the target temperature of 105 degrees C, whereas group B (n=5) had a constant RFA temperature of 105 degrees C and constant time of 8min. The liver blood flow (LBF) was quantified using Doppler ultrasonography before LBOF occlusion and after that. RFA were performed using an expandable 3cm RF needle. Two liver ablations created in different liver lobes were compared; the first ablation was created before balloon inflation and the second one was created under LBOF occlusion. The time required for RFA procedure, liver ablation volumes, shape and microscopic changes of the thermoablated zones were recorded. RESULTS: The LBF dropped significantly in all liver vessels after balloon inflation. The volume of the ablated area was 8.2+/-2.2cm(3) and increased significantly after LBOF occlusion to 17.4+/-3.8cm(3) (p<0.001), in group A. A significant enlargement of the ablated area with occluded LBF was registered in group B, it was 6.7+/-2.8cm(3) versus 19.4+/-1.8cm(3) respectively (p<0.01). CONCLUSIONS: Temporary LBOF occlusion led to a significant reduction in liver blood flow, enlargement of the thermoablated area volume and homogeneity of the coagulated zones.

Animals↗
PubMed2006

[Penetrating aortic ulcers--case report on endovascular therapy].

We report our experience with two cases of endovascular treatment of penetrating aortic ulcers (PAU). The first patient was a 71-year-old woman with 30 mm width aortic ulcer accompanied by intramural hematoma of the descending thoracic aorta. The second patient was an 80-year-old obese woman with 50 mm pseudoaneurysma of the abdominal aorta, which was result of PAU. Both patients were successfully treated by means of tubular stentgraft, implanted from surgical cut down of the right femoral artery. Penetrating aortic ulcer represents localized, potentially lethal pathology of the aorta. Together with dissection and intramural hematoma belongs among the acute aortic syndromes. During nature course PAU can progress to the acute classic dissection, pseudoaneurysma or rupture of the aorta. It is principally disease of elderly hypertensive patients. Early diagnosis and appropriate therapy improves prognosis of patients with PAU. Open surgical repair with synthetic graft has been the gold standard of treatment but endovascular therapy is an attractive option in risk elderly patients. It seems to be a safe, effective treatment but stability of results of this method should be proved.

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PubMed2006

[Role of percutaneous vertebroplasty and kyphoplasty in the treatment of oncology disorders of the spine].

BACKGROUND: The aim of the study is to present results of a prospective uncontrolled clinical study. Percutaneous vertebroplasty or kyphoplasty are minimally invasive methods based on polymethylmethacrylate (PMMA) bone cement application into the damaged vertebra. This leads to decrease of the pain and vertebral body stabilisation. Oncology disorders of the spine are relatively common, having a wide alternative of various methods of treatment. Patients, according to their findings and indication criteria, are treated surgically or conservatively, oncological treatment is usually based on radiotherapy. Authors discuss the role of these invasive procedures in the treating algorithm of patients with spinal metasthases and multiple myeloma. METHODS AND RESULTS: From September 2003 to December 2005, 21 percutaneous vertebroplasties in 14 patients, mean age 68.7 (47-80) year, were performed in our department. During one treatment session 1-2 vertebrae (total of 21 vertebrae) in level Th9 - L5 were treated. Vertebroplasties and kyphoplasty were performed under fluoroscopy guidance. Transpedicular acces was used. Totally, 3 asymptomatic complications were proved. As first, a bone cement leaked paravertebrally during L5 body treatment, as second, a bone cement leaked into paravertebral veins, and as third, a bone cement leaked into the intervertebral space. Visual analog scale (VAS) was 8.9 points before procedure, 1.9 point 3 months after procedure and 2.6 points 6 months after procedure. We did not prove a symptomatic or total complication. CONCLUSIONS: According to our experience, percutaneous vertebroplasty is an effective alternative treatment of painful oncologic spine disease.

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PubMed2005

[The endovascular treatment of the aortic trauma].

BACKGROUND: Traumatic injuries of the thoracic aorta are very frequent during motor vehicle accidents with sudden deceleration. Spiral CT has become the modality of choice for evaluating significant blunt trauma and grading system for aortic injury has been developed. Immediate diagnosis, introduction of antihypertensive therapy and endovascular treatment by means of stentgraft give a better chance for patients with blunt aortic injury. AIM: Prospective evaluation of results of endovascularly treated patients with blunt aortic injury. MATERIALS AND METHODS: We prospectively followed patients after endovascular treatment of acute aortic injury. Diagnosis was based on chest x-ray and CT examination. Stentgrafts were placed under fluoroscopic guidance and patients were routinely followed by CT and clinical visit. RESULTS: Between December 1999 and September 2004 we endovascularly treated seven patients (6 men, 1 woman, mean age 41.7 years) for blunt aortic injury of the thoracic aorta. Stentgraft was implanted between 5 hours and 6 days (mean 3.2 days) after injury. Seven stentgrafts were implanted in 7 patients in total. One patient died due to failure of endovascular technique for collapsed stentgraft. A new onset of lower legs paraparesis was detected in one patient. Other five patients are regularly followed (3-55 months, mean 30.7 months) without any complications. CONCLUSION: Endoluminal technique can be used successfully in the immediate repair of aortic trauma. At present time in our center, treatment by means of the stentgraft placement is the first line therapy in injured patients. It allows rapid stabilization of aortic trauma and further treatment of other injuries.

Absorptiometry, Photon↗
PubMed2005

[Percutaneous vertebroplasty].

Percutaneous vertebroplasty is a therapeutic, interventional radiologic procedure originally developed in France by Galibert, Deramond et al. (1987). The technique consists of the percutaneous puncture of the affected vertebral body, followed by injection of bone cement into a vertebral body for the relief of pain, and the strengthening of the bone. The procedure was used initially to treat aggressive hemangiomas, but it then was extended to the treatment of osteolytic metastases, multiple myeloma and osteoporotic compression fractures refractory to medical therapy. In this article we review the current techniques, indications for this procedure, preoperative and postoperative evaluations.

Bone Cements↗
PubMed2004

[Cooperation between a surgeon and an interventional radiologist in cases of internal bleeding].

INTRODUCTION: Internal bleeding still remains a serious condition, which must be urgently diagnosed and treated. In the Faculty Hospital in Hradec Králové the diagnosis of the internal bleeding source and its consequent treatment is managed under cooperation between a surgeon and an interventional radiologist. A CASE-REVIEW: In the case-review section of this report, a total number of five patients with serious cases of internal bleeding, the source of which was diagnosed and treated under cooperation between the above mentioned specialists is presented. The patients concerned suffered from the following: a trauma to the liver parenchyma, posttraumatic arterioportal shunts, an intraheparic aneurysm, a relaps of the uterine carcinoma with hemorrhaging into the colon and the vagina, bleeding into retroperitoneum. In all the cases the lesion was successfully treated and the hemorrhage was managed. DISCUSSION: Exact location of the bleeding artery during an arteriogragraphic examination is a prerequisite of a successful treatment of the condition. Both, the absorbable materials which allow gradual recanalization of the embolized vessel, and the non-absorbable materials may be used to conduct embolization of the affected vessel. It is necessary to haemodynamically stabilize the patient prior to the procedure. CONCLUSION: In many cases, the cooperation between a surgeon and an interventional radiologist allows for the source of the internal bleeding to be located and managed. It is indicated in certain cases of benign and malignant disorders and in some cases of the parenchymatose organs trauma.

Abdomen↗
PubMed2004

[Diagnosis of spontaneous arteriovenous fistula complicating aortoiliac aneurysm using spiral CT. Report of 3 cases].

Acute spontaneous arterio-venous fistula complicating atherosclerotic abdominal aortic aneurysm (AAA) is rare. This life-threatening setting is observed in 1-2% of all AAAs and 2-4% of ruptured of AAAs. The triad of abdominal or lower back pain, pulsatile abdominal mass, and continual abdominal machinery-like bruit is seen only in half of cases. Currently, CT angiography is a noninvasive technique which enables a rapid and exact preoperative diagnosis. The authors describe three cases of aortoiliac aneurysm complicated by an acute arteriovenous fistula which were diagnosed using spiral CT.

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PubMed2003

[Intravascular brachytherapy in the prevention of vascular restenosis].

Vascular restenoses currently represent a major problem in the treatment of vascular stenoses. One of new approaches in the prevention of restenoses is intravascular brachytherapy. Intravascular brachytherapy uses local irradiation of the stenotic vessel segment by ionizing radiation with the aim of prevention of restenosis. This is a new rapidly developing multidisciplinary approach based on collaboration of specialties of intervention radiology, intervention cardiology, angiology, nephrology and radiation oncology. This review examines current options of intravascular brachytherapy as well as results of clinical trials evaluating the efficacy of intravascular brachytherapy in the different anatomical regions. Intravascular brachytherapy may substantially reduce the rate of restenoses. However, intravascular brachytherapy should be currently used only in the setting of clinical trials. Optimal method of irradiation of the stenotic segment of the vessel is still to be defined.

Angioplasty, Balloon↗
PubMed2002

[Infectious aneurysm of the abdominal aorta caused by Salmonella: diagnosis, endovascular therapy].

The authors present a case of an infected abdominal aortic aneurysms by means of a minimally invasive endovascular method using a stent graft. This patient had already been treated by TIPS (transjugular intrahepatic portosystemic shunt) for repeated varicose bleeding due to liver cirrhosis. Standard surgical therapy of infected abdominal aneurysms and about advantages and possibilities of endovascular treatment with stent grafts are discussed. Regular follow-up of the patient and long-term antibiotics therapy are important for accurate assessment of an implanted stent graft into the infected abdominal aorta. Endovascular stent graft combined with antibiotic therapy may be an alternative to conventional open surgery in managing infected infrarenal abdominal aneurysms.

Aneurysm, Infected↗
PubMed2002

[Endovascular treatment of atherosclerotic stenoses of the subrenal aorta].

The authors present results of endovascular treatment of subrenal aortic atherosclerotic stenoses. Between 1996 and 2001 they treated 9 patients (5 men, 4 women, mean age 57.4 years). Aortic stenoses were caused by an atherosclerotic process in all cases. In addition, in three patients iliac arteries were affected by sclerotic lesions. The endovascular procedure consists of predilatation performed by a small calibre angioplasty balloon catheter and implantation of a stent. Three times a balloon expandable stainless steel stent was implanted and self-expandible nitinol stents were used in the six cases. The primary technical success rate was 100%, no major complications were observed. One distal embolization was successfully resolved by intraarterial thrombolysis. Only one stent restenosis occurred after 36 months. It was successfully treated by implantation of a longer stent. That means that the primary patency of stented subrenal aorta during a mean follow-up period of 19 months was 87.5%. The claudication interval improved in six patients and three patients were symptom free. Endovascular therapy can be recommended for short sclerotic stenoses of the infrarenal aorta. This miniinvasive technique has a high technical and clinical success rate, favourable long-term patency and low complication rate.

Angioplasty, Balloon↗
PubMed2001

Endovascular brachytherapy of transjugular intrahepatic portosystemic shunt.

Purpose: To evaluate the technical feasibility and efficacy of endovascular brachytherapy with Iridium-192 in the prevention of restenosis caused by neointimal hyperplasia of transjugular intrahepatic portosystemic shunt (TIPS).Materials and Methods: The endovascular brachytherapy with high dose rate automatic afterloading system was performed in six patients with recurrent of stenosis of TIPS. We used a single dose fraction of 12 Gy delivered at 3 millimeter (mm) from the source axis to the stenotic vessel segment in five patients with spiral Z-stent, and 15 Gy at 5 mm in one patient with Wallstent.Results: Follow-up time ranged from 148 to 639 days. In one patient, restenosis occurred in the treated vessel segment, diagnosed 71 days after endovascular brachytherapy by doppler ultrasound. All other patients were, during the follow-up time, without restenosis in the irradiated vessel segment. Radiation-associated side effects were not observed.Conclusions: Endovascular brachytherapy of TIPS is technically feasible and may be done as a part of the percutaneous revision of the shunt. This pilot study may be the largest experience of treating TIPS restenosis in humans to date. For definitive conclusions, a lot of studies are needed.

Journal Article↗
PubMed2001

Advancing health promotion in Australian general practice.

Health promotion activities, while having the potential to prevent disease and decrease the burden of ill health, often play a minor role in the health care offered by general practitioners. There are several identified barriers to the involvement of Australian general practitioners in health promotion. These include structural barriers and barriers within the practice setting, individual practitioner and patient factors, and difficulties in evaluating the outcomes of health promotion activities. This article explores the barriers to the engagement of Australian general practice with health promotion and reviews several recent initiatives that have the potential to increase the health promotion activities of general practitioners. These initiatives act at the level of the individual practitioner, the practice, and in the community. Despite the lack of a coordinated national approach, these strategies form an important development in general practice.

Accreditation↗
PubMed2000

Autologous vein stent-graft: feasibility study.

PURPOSE: To evaluate expandable stents healed into vein wall as autologous vein stent-grafts for endoluminal grafting. MATERIALS AND METHODS: Balloon expandable stents were placed into external jugular veins of eight dogs. Stent and vein patency was followed by ultrasonography. Five weeks after stent placement, jugular veins with endothelialized stent were harvested. The autologous vein stent-grafts were divided into two groups. In group A, autologous vein stent-grafts (n = 3) were placed immediately into Baker solution for microscopic examination. In group B, autologous vein stent-grafts (n = 3) underwent mechanical manipulation; they were compressed, mounted on angioplasty balloon, pushed through a 9-F sheath and dilated. The autologous vein stent-graft endothelialization and changes after mechanical manipulation were evaluated by light and electron microscopy. RESULTS: Stent placement was successful in seven dogs. One stent migrated into the pulmonary artery. One well placed stent was damaged by compression dressing and thrombosed. At 5 weeks, gross and microscopic examinations revealed the autologous vein stent-grafts were fully covered by a 0.115- +/- 0.036-mm-thick neointimal layer. Small wall thrombus was observed in one autologous vein stent-graft. Repeated manipulations did not result in any intimal damage or stent loosening in the autologous vein stent-grafts. CONCLUSION: Expandable stents healed into a vein have potential to be used as autologous vein stent-grafts for endoluminal grafting without risk of disruption during percutaneous transcatheter introduction.

Animals↗
PubMed2000

[Preservation of venous grafts].

The objective of the work was to find an optimal preservation medium for short-term preservation of venous grafts which could be subsequently used to line metal stents. The external jugular vein of dogs (n = 15) was removed surgically, divided into portions and immersed into preservation media. For hypothermic preservation (+4 degrees C) solutions of Optisol (Chiron, USA), University of Wisconsin (Baxter, USA), Eurocollins (Fresenius, GFR) and saline (Bieffe Medital, Italy) were used. For normothermic preservation (+37 degrees C) in an atmosphere with 5% CO2 Dulbecc's medium for tissue cultures (Sigma, USA) was used. During hypothermic preservation the specimens were kept for 24 hours, 3 and 7 days, during normothermic preservation in Dulbecc s medium also for 24 hours, 3 and 7 days. The specimens were evaluated by light microscopy and raster electron microscopy. The results revealed that minimal changes on the endothelia of venous grafts occurred during normothermic preservation in Dulbecc's medium where after 7 days the endothelium did not become detached and the vitality of cells did not change. During hypothermic preservation the solution of Wisconsin University proved most suitable. By addition of 5% human albumin to this solution it proved possible moreover to reduce pyknosis of the endothelial cell nuclei. The specimens kept in saline displayed deformities of the nuclei, oedema and loss of endothelia incl. incipient oedema of the cellular wall already after 24 hours of hypothermic preservation. The authors consider the use of this solution unsuitable for preservation.

Animals↗
PubMed1999

[Complications of endovascular therapy of abdominal aortic aneurysms. Analysis and possible treatment].

The required result of correctly implemented endovascular treatment is bridging and elimination of the aneurysmatic sac from the blood flow in the aorta. Perfusion of the sac after release of the endovascular prosthesis is one of the most frequent complications of endovascular treatment. The majority of these perfusions is caused by a leak of the endovascular prosthesis at the site of the stented anastomosis, or more rarely by a collateral flow into the aneurysmatic sac or rupture of the endoprosthesis. Perfusion of the sac "endoleak" complicates endovascular treatment in cca 30%. During the postoperative period about half the perfusions recede spontaneously and about half require further treatment. Based on their own experience the author submits suggestions for the classification of leakage of endovascular prostheses with regard to the method of their treatment.

Aortic Aneurysm, Abdominal↗
PubMed1999

[Percutaneous therapy of obliterative disease of the femoropopliteal arteries using stents--2 years' experience].

PURPOSE: To evaluate the clinical results and short and mid-term stent patency in patients with femoropopliteal stent placement. MATERIAL AND METHODS: Forty-one patients (42 limbs) underwent stent placement--27x into superficial femoral artery, 15x into popliteal artery. There were inserted 44 self-expandable stents. In 3 cases PTA of stents and in 2 cases local endovascular brachytherapy were performed because of restenosis. The mean follow-up is 12.9 months (1-24 months). RESULTS: Stents were successfully inserted in all cases. Clinical improvement at the time of latest follow-up occurred in 77% of patients, no improvement in 13% and clinical worsement in 10% of patients. Primary patency rates at 6 months, 12 an 24 months were 83.8%, 67.7% and 67.7%, respectively. Primary assisted patency were 90.3% at 6 months, 77.4% at 12 months and 77.4% at 24 months. CONCLUSION: Stents implantation in femoropopliteal arteries is a method of choice after suboptimal angioplasty results in patients with critical limb ischemia for whom no reasonable surgical alternative exists.

Adult↗
PubMedDate not supplied

Endovascular brachytherapy in the prevention of vascular restenosis.

PURPOSE: To evaluate the technical feasibility and efficacy of endovascular brachytherapy for prophylaxis of restenosis after femoropopliteal percutaneous transluminal angioplasty (PTA). MATERIALS AND METHODS: Ten patients with recurrence of stenosis in the femoropopliteal region underwent PTA followed by endovascular irradiation with Iridium-192 a high-dose rate after-loading technique. We used a single fraction of dose 12 Gy given in 3 mm from the source axis in the stenotic vessel segment. RESULTS: During follow-up of 59-580 days restenosis occurred in four patients 111, 460, 472 and 580 days after irradiation. All other patients are without restenosis. No radiation-associated side effects were observed. CONCLUSIONS: Endovascular brachytherapy of restenosis in the femoropopliteal region is technically feasible, and may be done as a part of the PTA. These encouraging results open the possibility of reduction of restenosis by the present method.

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