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Biomedical subjects

K Geterud

Publications and source records attributed to K Geterud.

13 recordsLinked to original sources
PubMed2002

Treatment of femoral pseudoaneurysms. Percutaneous US-guided thrombin injection versus US-guided compression.

PURPOSE: Thrombin injection in femoral pseudoaneurysms has been suggested to be superior to traditional US-guided compression. Our aim was to evaluate results with compression therapy with special reference to use of thrombin in case of failure. We also studied 7 patients who underwent primary thrombin injection. MATERIAL AND METHODS: We retrospectively reviewed all (n=44) femoral artery pseudoaneurysms diagnosed at our department during October 1998-May 1999. US-guided compression with the Femostop device or US-guided thrombin injection (100-1000 IU) was the first choice according to the physicians' preference, followed by the other regime if the first choice was non-successful. RESULTS: Thirty-nine (89%) of the patients received anticoagulation treatment and/or concomitant antiplatelet drugs. Out of the 44 patients, 37 were treated with compression as the first choice. This regime was successful in 22 (59%). This group included 2 lesions that resolved spontaneously after initially failed compression and 1 deep venous thrombosis after treatment. The persistent 15 pseudoaneurysms after failed compression received thrombin injection, and it was also the primary therapy in 7 patients. Complete thrombosis within the pseudoaneurysm was immediately induced after treatment. One early recurrence required a second injection. No complication of thrombin was noted and no surgery was required. CONCLUSION: US-guided thrombin injection is an effective treatment for embolisation of pseudoaneurysms. The technique is superior to compression therapy.

Aged↗
PubMed1993

Stone recurrences in kidneys made stone-free by percutaneous extraction.

Of 100 renal units which were made stone-free by percutaneous stone extraction in 1985, 86 (86.0%) were re-examined radiologically up to 5 years after operation. The re-examination was performed because of symptoms or as part of a regular check-up or after calling the patient. Intrarenal calcifications were diagnosed in 27 of 86 (31.4%) of the renal units, but only in 11 (12.8%) were there stones requiring treatment.

Adolescent↗
PubMed1993

Embolisation therapy in the midgut carcinoid syndrome: just tumour ischaemia?

Forty-eight patients with midgut carcinoid tumours and disseminated disease were treated at our unit 1986-1991. All patients underwent primary surgery with optimal tumour reduction. Twenty-seven patients with bilobar liver metastases had subsequent embolizations of the hepatic arteries to further reduce the functional tumour mass and were thereafter treated with a low dose of octreotide. The response to this treatment was evaluated by CT at 3 months postembolization. The patients could then be divided into 13 responders (no visible hepatic tumours or more than 50% reduction, group I) and 14 non-responders (less than 50 reduction or progression, group II). When these patients were studied biochemically and in terms of prognosis, the reduction of 5-HIAA levels postembolization was much more pronounced in group I (80 +/- 3%) then in group II (28 +/- 12%). The biochemical and radiological responses were long-lasting in group I, none of the patients needed further ischaemic treatment. Of specific interest were 3 patients with bilobar disease, who after selective unilobar embolisation normalised their 5-HIAA levels and had bilateral tumour regression. These findings indicate involvement of systemic effects in addition to tumour ischaemia alone. The initial biochemical response with marked decrease of 5-HIAA levels in combination with tumour regression may thus serve as an indicator of good prognosis.

Adult↗
PubMed1992

Bilateral asynchronous renal cell carcinoma. Computed tomography of the contralateral kidney 10-43 years after nephrectomy.

Computed tomography (CT) was carried out in 31 patients 10-43 years after surgery for renal cell carcinoma, 10 belonging to a consecutive series of patients operated upon at one urological department 10 years previously. Twenty-eight patients were symptomless, and 3 had flank pain, severe fatigue and hematuria, respectively. Cancers in the remaining kidney were found 13-21 years after nephrectomy in 4 of 31 patients (12.9%). The 3 patients with symptoms were among these 4. An adenoma was found in 1 patient 10 years after nephrectomy. The cancers were treated by renal resection in 2 patients, multiple tumors made nephrectomy necessary in 1 patient and 1 patient was not operated upon because of disseminated disease. The adenoma indicated future checkup by CT. Three of the 4 new cancers had a dismal outcome. The renal parenchyma was found to be essentially normal in all the other 26 patients, irrespective of the widely varying time interval between nephrectomy and CT. Asynchronous bilateral renal cell carcinoma has a poor outcome which presumably can be improved by early diagnosis and aggressive treatment. CT is the method of choice for early detection and follow-up of renal tumors. It should be carried out every other year after nephrectomy for renal cell carcinoma.

Adult↗
PubMed1991

Management of disseminated midgut carcinoid tumours.

Forty-one patients with disseminated midgut carcinoid tumours were treated over a 6-year period according to a strict programme including primary surgical treatment. In 10 patients, a total remission of the disease was obtained. Patients with bilobar hepatic disease had ischaemic treatment of their liver metastases by hepatic arterial embolisation after primary surgical and medical treatment (low dose octreotide). Thus, by combining surgical, radiological and medical treatment modalities, we wanted to offer these patients optimal palliation. This treatment programme resulted in good symptomatic relief in all patients accompanied by a marked reduction in 5-hydroxyindoleacetic acid (5-HIAA) levels. At recurrence of symptoms in combination with rising 5-HIAA levels, embolisation was repeated. Ten of the treated patients have deceased during the observation period, but only 5 from their carcinoid disease.

Adult↗
PubMed1991

Use of a tamponade catheter in the bleeding nephrostolithotomy track.

Bleeding from the nephrostomy track, which is the most common major complication of percutaneous extraction of renal stones, was treated in 5 patients with the Kaye double-lumen nephrostomy tamponade catheter. This treatment was effective in all cases. The procedure eliminates the need for more invasive measures like embolisation and open surgery with renal resection, both of which cause loss of functioning renal parenchyma.

Adult↗
PubMed1989

Percutaneous renal and ureteric stone extraction. Report on the first 500 operations.

A consecutive series of the first 500 percutaneous renal and ureteric stone extractions in 451 patients was analysed. During the period studied, percutaneous extraction was offered to all patients with conventional indication for stone removal except a few, very early ureteric stone patients in whom open lithotomy was carried out. Ureteroscopy and extracorporeal shock wave lithotripsy had not come into routine use. Four hundred and seventy-eight stone operations (96%) could be performed by the percutaneous route; early in the series, 21 open operations and one transurethral Dormia basket extraction were performed, mainly because of failed mobilisation of ureteric stones (12 patients) or various peroperative complications (9 patients). The target stones were completely removed in 88% of all percutaneous procedures, with the best results in the largest group of patients with 6-20 mm solitary stones or 2-3 stones less than or equal to 10 mm. Stones in the ureter and pelvi-ureteric junction without any other concomitant stones were all completely removed. Bleeding was the most frequent peroperative complication. No kidney was lost. An 84-year-old man died of intercurrent disease postoperatively.

Female↗
PubMed1988

Influence of percutaneous renal stone extraction on renal function.

The total and separate renal function was studied in 10 patients by means of 51Cr-EDTA-clearance and gamma camera renography with 99mTc-DTPA before and 2 weeks to 5 months after percutaneous renal stone extraction. There was no major complication related to the operations. There was no significant change of function as measured as the glomerular filtration rate. The stone extraction procedure was well tolerated by the kidneys.

Chromium Radioisotopes↗
PubMed1988

Percutaneous surgery for stones in pyelocaliceal diverticula.

The technique used for percutaneous extraction of stones in pyelocaliceal diverticula and the results of the procedure in 13 patients are presented. Nine patients have been free of their pre-operative symptoms, pain and/or bacteriuria, since removal of the stones.

Adult↗
PubMedDate not supplied

Radiation dose to patients and personnel during fluoroscopy at percutaneous renal stone extraction.

The radiation dose to patients and personnel was estimated during 11 percutaneous renal stone extractions. For the patients the energy imparted, the mean absorbed dose to various organs, and the effective dose equivalent were estimated. For different personnel categories some organ doses and the effective dose equivalent were also estimated. Large differences in the radiation dose between patients were observed. The mean effective dose equivalent to the patient was 4.2 (range 0.6-8.3) mSv, and the energy imparted 285 (range 50-500) mJ. These figures are comparable to those reported for routine colon examination and urography. For the personnel there were also large differences between individuals and categories. The highest radiation dose was received by the radiologist. It was estimated that a radiologist who performs 150 percutaneous renal stone extractions per year will receive a yearly contribution to his/her effective dose equivalent of 2.4 mSv. Even when the contribution from other diagnostic and interventional radiologic procedures is added, the total effective dose equivalent hardly exceeds 5 mSv or 1/10 of the present dose limit for persons engaged in radiologic work. For the hands of the radiologist there is a risk of doses closer to the present limit for single organs or tissues of 500 mSv/year.

Aged↗
PubMedDate not supplied

Computed tomography after percutaneous renal stone extraction.

Eighty patients were examined with computed tomography (CT) of the kidney and the retroperitoneal space after percutaneous stone extraction. Most examinations were done within a week after the operation. The morphologic changes were usually small or none. In 7 patients minor renal or perirenal fluid collections were found. Their operations had been complicated by bleeding or leakage. In 66 patients CT was compared with conventional radiographs. Residual stones were more often detected by CT. They were usually small. Percutaneous renal stone extraction is considered a safe and efficient method.

Adolescent↗