Twenty-five years of experience from transfemoral catheter closure of patent ductus arteriosus.
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Biomedical subjects
Publications and source records attributed to L Wierny.
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The most severe complications in transarterial closure of the ductus arteriosus persistens are problems with placing the plug into the ductus (misfit plug size/ductus size) and the flow of closure materials into the aorta after instable fixation of the plug. In such cases surgical intervention by arteriotomy or aortotomy for the removal of the plug becomes necessary. Transvenous dilatation of the ductus arteriosus persistens after recognizing unstable plus positions or difficulties in fixing the plug prevents the mentioned complications.
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Report on the successful therapy of an erectile impotence by percutaneous transluminal angioplasty of the internal iliac artery in a patient with arterial obliteration.
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Patent ductus arteriosus was the first inborn cardiac defect ever eliminated by percutaneous transvascular therapy. The method, results, and complications of Ivalon plugging of the ductus in 208 patients between 5 and 62 years old and treated between 1967 and 1985 are described. Permanent closure was accomplished in 197 patients (94.7%). The following particular benefits are obtainable from the method: no need for thoracotomy; local anesthesia applicable to 65% of all cases; 30 mm average time of intervention; only moderate invasiveness to the patients; only 7 days of hospitalization; good cost-benefit ratio.
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In 16 patients suffering from occlusions of the pelvic and/or femoral arteries a combined treatment was performed: percutaneous transluminal angioplasty (PTA) and surgical reconstructive measures. Indications for this procedure are: 1. Stenoses of the pelvic arteries and occlusion of the ipsilateral superficial femoral artery with PTA for the iliac artery and endarterectomy for the femoral artery. 2. Occlusion of the iliac and the femoral arteries with a decreased run-off: PTA and lumbar sympathectomy. 3. Endarterectomy on one side and PTA contralaterally.
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Prove of a little hormonactive adrenal Adenoma in the ovary by katheterisation of vena femoralis and selective determination of Plasma-Testosteron in various regions of abdominal veins. Localisation of the tumor by routine diagnostic measures, even by Laparoscopy, had been impossible.
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