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Biomedical subjects

K Mathias

Publications and source records attributed to K Mathias.

At least 73 records · Page 4Linked to original sources

Percutaneous treatment of renovascular hypertension.

Percutaneous transluminal dilatation of a right sided fibrous renal artery stenosis was performed in a 5-year-old boy with severe hypertension. Biochemical and hemodynamic activity of the renal artery stenosis was demonstrated by measurement of renal venous renin concentration and of pre- and poststenotic blood pressure. Hypertension disappeared within 3 weeks and the renin values became normal. The method is less traumatic than operative revascularization and may be an alternative procedure to vascular surgery in the treatment of renovascular hypertension in childhood.

Angioplasty, Balloon↗

[Percutaneous transluminal dilatation of the subclavian artery (author's transl)].

Percutaneous transluminal balloon-catheter dilatation successfully removed the stenosis in three out of four patients with obstruction of a subclavian artery. The arm oscillogram became normal and after an average of four months later the three patients remain without symptoms. The method is particularly suitable, as an alternative to operative intervention, if the stenosis is in the proximal part of the subclavian artery.

Aged↗

[Alkaptonuric ochronosis - rare cause of bilateral meniscopathy (author's transl)].

Bilateral meniscus lesions without an adequate trauma are rare. We observed a patient with such an injury caused by alkaptonuric ochronosis. Radiographs revealed a calcifying degeneration of the intervertebral disks and osteoarthritic alterations of the large joints. The surgeon should think of this disease finding a yellow brown discoloration of the cartilage at arthrotomy.

Alkaptonuria↗

[Percutaneous catheter dilatation of carotid stenoses --animal experiments (author's transl)].

Thirty-one carotid artery stenoses were produced in thirty dogs by three different techniques. Twenty-three of these could be cured by transfemoral percutaneous catheter dilatation. High grade tight stenoses may present resistance which cannot be overcome by the catheter. Histological examination of the dilated vessels showed circumscribed changes in the vessel wall, with destruction of elastic membranes. From our experience of catheter dilatation of pelvic and lower limb arteries and of renal arteries, we consider it feasible to use this technique in selected patients with carotid stenosis.

Angiography↗

[Treatment of renovascular hypertension by catheter dilatation (author's transl)].

Percutaneous transluminal angioplasty in renal artery obstructions was performed in 10 cases. In 7 patients the hypertension was successfully treated and in one patient renal function could be restored. The procedure can be applied in atherosclerotic and fibromuscular stenoses as well as in stenosis of kidney grafts. In our opinion catheter dilatation should be prefered to vascular surgery, because it is efficient and inexpensive and has a low risk. Operation should be reserved to cases untreatable with angioplasty.

Adult↗

[Catheter dilatation of arterial stenosis after renal transplantation (author's transl)].

Post-anastomotic arterial stenosis after renal transplantation requires active intervention in order to save the transplant. As an alternative to a taxing surgical reoperation selective transluminal catheter dilatation was performed in one case and severe stenosis was removed. Rapid normalisation of blood pressure and recovery of excretory function should encourage further such therapeutic attempts in stenoses in these high-risk patients.

Catheterization↗

[Catheter recanalization of a post-traumatic occlusion of the popliteal artery (author's transl)].

An acute occlusion of the popliteal artery occurred in an 19-year-old football player as a result of a kick into the back of the knee. Twenty months later recanalization was successfully accomplished by percutaneous transluminal catheter dilatation. It is concluded that not only atheromatous but also post-traumatic arterial occlusions can be successfully treated by this method.

Acute Disease↗

[Percutaneous transluminal revascularization of lower-leg arteries].

In 19 of more than 130 patients treated with percutaneous transluminal angioplasty (PTA), obstructions of the distal popliteal artery and the lower leg arteries encouraged us to extend the treatment to this vascular region. Two weeks after PTA the arteries were patent in 16 of the 19 cases (84%). These results are comparable with those of vascular surgery, but are gained with less injury to the patient and a shorter hospitalization time.

Aged↗

[Topography and surgico-tactical principles of the mesocaval shunt].

The mesocaval shunt has special advantages. It can be applied also in patient with worse condition (Child B and C). The technically simple performance according to the original method of Drapanas is recommended provided that anatomical variants at the surgical trunk of the vena mesenterica superior are known. The anatomical situation should be investigated preoperatively by direct (umbilical vein catheter) or indirect mesentericography. The access via umbilical vein offers in addition the possibility of coronary vein embolisation in emergency patients.

Blood Vessel Prosthesis↗

[Angiographic diagnosis and therapy of acute and chronic gastrointestinal hemorrhages].

In acute gastrointestinal bleeding visceral angiography has been showing its importance for years. It contributes to diagnosis especially in cases with persistent acute hemorrhage. In chronic gastrointestinal bleeding conventional radiographic procedures such as upper gastrointestinal series and barium enema will be preferred to angiography. The function of the radiologist goes beyond mere diagnosis of gastrointestinal bleeding. Treatment with vasopressin via the angiographic catheter has proven its clinical value. This method will be indicated especially in cases with high risk anesthesia and surgery. It will help to postpone necessary surgery to a more favorable moment following hemostasis. Side effects such as hypertension and antidiuresis are relatively rare and easy to manage. Numerous substances are used for embolization showing that ideal material has not been found yet and further development seems necessary. In contrast to vasopressin treatment, vascular occlusion is often irreversible, complications (unwanted reflux of embolization material, necrosis and plugging of the catheter) are more difficult to manage. Superselective visualization of a bleeding artery is always needed. Embolization is justified in cases when a possibility for anesthesia and surgery cannot be foreseen. The electrical vascular occlusion using direct current is still in the phase of animal experiments; its clinical value has not sufficiently been assessed as yet.

Aneurysm↗