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M Szczerbo-Trojanowska

Publications and source records attributed to M Szczerbo-Trojanowska.

At least 19 recordsLinked to original sources
PubMed2006

Changes in cerebral hemodynamics after carotid stenting: evaluation with CT perfusion studies.

PURPOSE: To determine changes in cerebral perfusion parameters, based on CT perfusion imaging, in patients after unilateral transluminal angioplasty and stent placement. MATERIAL AND METHODS: 74 patients with symptomatic high - grade internal carotid artery stenosis (>70%) were studied with CT perfusion imaging before and - on average - 70 hours and 172 days after carotid stent placement. There were 50 patients with unilateral carotid artery stenosis and 24 with stenosis and accompanying contralateral internal carotid artery occlusion. CT examination was performed using a multidetector helical CT scanner (Light Speed Ultra Advantage, GE Healthcare, USA). Maps showing the absolute values of cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) were generated. RESULTS: In a group with unilateral carotid artery stenosis perfusion deficits were present in 84% of patients, ipsilaterally to stenosis. MTT elongation was noted (6.2-6.8s) together with decreased values of CBF (40-46ml/100g/min) and slightly increased CBV (3.2ml/100g). In this group, 3 days after stenting, 30% of patients had perfusion deficits, and after 6 months only 6%. In a group with carotid artery stenosis and contralateral artery occlusion severe perfusion deficits were noted in both hemispheres and they were present in 100% of patients. 6 months after stenting hypoperfusion was observed only in 17% of patients. CONCLUSIONS: Brain perfusion deficits, observed in a majority of patients with carotid artery stenosis tend to improve considerably after carotid artery stenting, in long - term follow up.

Aged↗
PubMed2004

Renal artery stenosis: value of contrast-enhanced ultrasonography.

Renal artery stenosis is the most common cause of potentially curable secondary hypertension. For a long time, angiography has been considered the "gold standard" in screening for renal arterial occlusive disease, but it is expensive and invasive. Magnetic resonance angiography and spiral computed tomography are safer alternatives to angiography but are expensive and not widely available. Due to the fact that duplex scanning is noninvasive, it has been advocated since the early 1980s as a screening test for renal vascular disorders. Factors that make duplex ultrasound an attractive screening measure for renovascular disease are its safety, suitability for outpatient use, and low cost. However, the frequency of artery variants, lengthy examination time, and technically inadequate test conditions limit the use of the direct duplex ultrasound detection of renal artery stenosis. Advances in Doppler technology may alleviate some of the current problems related to examination of renal arteries. One such technique is the use of echo-enhancing agents, which increase Doppler signal strength and can improve the sensitivity and specificity in Doppler ultrasound detection of renal artery stenosis.

Contrast Media↗
PubMed2001

[Endovascular treatment of thoracic aortic aneurysm--case report].

Thoracic aortic aneurysm (TAA) is life threatening disease. 76 to 50% of untreated patients die during 5 years. Mortality rate increases to 93% in patients with cardiopulmonary disease. Perioperative mortality rate is 15% and in patients with cardiopulmonary disease or urgent surgery, it amounts even 50%. Endovascular treatment of TAA was first reported in 1994. The introduction of stent-grafts has been a big progress in the treatment. A patient, 59 year-old man with TAA was described. He was admitted to our hospital for endovascular treatment of TAA. Both spiral CT and angiography were performed. The placement of the stent-graft was technically successful, but angiography showed the small leakage. Second stent was added. Angiogram confirmed the proper position of stent-grafts and complete exclusion of aneurysm. There was no incidence of neurological deficits. Spiral CT and angiography obtained at 3 month after procedure confirmed exclusion of aneurysm and satisfactory stent-graft position. The placement of endoluminal stent-grafts for repair of thoracic aortic aneurysms is technically feasible and safe procedure. Long-term studies are needed to compare its results with surgical treatment.

Aortic Aneurysm, Thoracic↗
PubMed2001

[Chronic venous occlusion in hemodialysis-related fistula: diagnosis and endovascular treatment].

The main reasons of fistula dysfunction are stenosis and thrombosis. There are two kinds of thrombosis: acute and chronic. Acute thrombosis is total fistula occlusion while chronic occlusion is partial venous occlusion with collateral veins, which lead to impair fistula's function. 450 dialysis fistulas were referred to US (ultrasound) examination. Among 392 patients with fistula dysfunction, 71 presented chronic venous occlusion in hemodialysis shunt. 35 patients were qualified to endovascular recanalization. The mean length of the occluded segment was 3-35 cm (subclavian vein 2-4 cm). 38 patients underwent angiography (35 before endovascular treatment). Technique of recanalization included antegrade venous puncture, insertion guidewire (0.021'), catheter (5 Fr), balloon catheter (5-8 mm) and in 2 cases stent placement. Colour Doppler allowed to diagnose 34 (97%) cases of chronic venous occlusion in hemodialysis shunt. Decrease of mean flow volume in brachial artery--709 +/- 395 ml/min. (50-1500 ml/min) was statistically significant (p = 0.0015). Normal mean flow volume was 1242 +/- 641 ml/min. 20 of 35 recanalization procedures were performed successfully. The main reason of failure was perforation or false channel. Mean primary patency was 75% after 3 months. Mean cumulative was 85% (10/12) after 6 months. Chronic venous occlusion is often present in hemodialysis shunt and reduces flow volume. Percutaneous recanalization results aren't magnificent but there is only kind treatment for many patients with fistula failure.

Adult↗
PubMed2000

[Basic terminology for describing hemodialysis fistula].

Many specialists: nephrologists, surgeons, radiologists and nurses pay much attention to dialyzed patient using different terminology. The presented work establishes the principal rules of describing hemodialysis fistula to find convergence in terminology.

Arm↗
PubMed1998

Power Doppler imaging in the evaluation of extracranial vertebral artery compression in patients with vertebrobasilar insufficiency.

OBJECTIVE: The recent introduction of Power Doppler Imaging (PDI) made a promise for better visualization of blood vessels lying in regions anatomically difficult for ultrasound imaging, i.e. vertebral arteries. The purpose of our study was to assess usefulness of PDI technique in visualization of vertebral artery course and to assess its utility in the detecting spondylotic vertebral artery compression in patients with vertebrobasilar insufficiency (VBI). METHODS: A total of 428 patients with VBI symptoms was evaluated. A total of 282 (66%) patients related their symptoms to a specific head position. Thus, all Doppler examinations were performed in four head positions: hyperextension, flexion and right/left rotation and also in a position reported by a patient to produce symptoms. PDI technique was employed as vertebral artery mapping for precise PW-Doppler range gate placing. RESULTS: Vertebral artery compression was found in 73 (17%) patients: 65 unilateral and eight bilateral. The diagnosis was based on flow decrease or its absence shown on PW-Doppler scans, after a specific head turning. CONCLUSION: Vertebral artery compression, related to a specific head position is relatively frequent in patients with VBI symptoms, especially in an older population commonly suffering from cervical spondylosis. PDI facilitates noninvasive Doppler US diagnosis by showing the real course of vertebral artery, particularly its intertransverse portion.

Aged↗
PubMed1998

Pulsating mass after accidental artery trauma: diagnosis with duplex ultrasound and the role of angiography.

BACKGROUND: Pulsating mass located close to peripheral arteries is usually considered as a result of arterial wall injury. Clinically important is to distinct pseudoaneurysm from haematoma and also to evaluate proximal and distal arterial bed for the assessment of the injury extent. A few previous reports claim good results of duplex Doppler US diagnosis of iatrogenic (post-catheterization) femoral artery injuries. This paper presents diagnostic findings of arterial injuries caused by accidental trauma. PATIENTS AND METHODS: A retrospective analysis of 49 patients with post-traumatic pulsating mass close to peripheral artery was performed. The diagnostic results of both sonography and angiography were reviewed. All the patients underwent B-mode and duplex Doppler US examination using PW-, color- and power Doppler imaging techniques. RESULTS: 34 pseudoaneurysms were diagnosed correctly with typical B-mode, color/power Doppler images and PW-Doppler spectral waveforms. The lack of flow signal and distinctive B-mode images enabled proper diagnosis of 13 haematomas. In 2 patients duplex Doppler US misdiagnosis occurred, because of secondary pseudoaneurysm formation, primary diagnosed as haematoma. The 47 correct US findings gave 96% efficacy in distinguishing pseudoaneurysm from haematoma, which compares well with the other studies. In 20 patients suffering from peripheral ischemia, US examination, in spite of proper distinction between pseudoaneurysm and haematoma was unable for precise estimation of proximal and distal arterial damage. Thus, it was successfully supported with angiography before surgical decision making. Angiography was also necessary in 8 patients with severe injuries of carotid, subclavian and palmar arch arteries, hardly accessible for ultrasound penetration. CONCLUSIONS: We conclude that duplex Doppler US is essential for noninvasive, unequivocal distinction between pseudoaneurysm and haematoma but it could not completely replace contrast angiography in the evaluation of post-traumatic pulsating mass caused by severe, extensive trauma, frequently complicated with peripheral ischemia or located in regions with poor access for ultrasound penetration.

Adult↗
PubMed1993

[Use of arterial embolization in treatment of pulmonary hemorrhage].

Embolization of bronchial and systemic arteries is a method of choice in treatment of pulmonary hemorrhages in patients with existing contraindications to surgical therapy. Embolization was carried out in 57 patients with pulmonary hemorrhages in the course of pulmonary tuberculosis, mycetomas, bronchiectases, malignancy, vessel malformations and post-traumatic changes. In all patients it terminated hemorrhages. During the 5 year follow-up period recurrencies were seen in 14% of the patients warranting additional embolization.

Adult↗
PubMed1985

[Catheter embolization: parenchyma-preserving therapy of renal bleeding of nonmalignant etiology].

9 patients with life-threatening renal bleeding of non-malignant origin, including trauma, AV fistulas, pseudoaneurysms and polycystic kidneys, were embolised after angiographic demonstration of the leakage. In all cases, the bleeding was stopped and in one case only nephrectomy was necessary 3 days after the initial embolisation procedure. Transcatheter renal embolisation should be performed as selectively as possible. With this technique most of the renal parenchyma can be saved. Embolisation is a safe and inexpensive procedure which also can be performed in critically ill patients.

Adult↗
PubMed1985

[Catheter embolization of the thoracic arteries in the treatment of lung hemorrhage].

In cases of acute, life-threatening pulmonary haemorrhage, immediate angiographic localisation of the source of haemorrhage is mandatory. Instead of a surgical intervention, transcatheter angiographic therapeutic embolisation may be performed. Embolisation is an effective method with only minimal complications, in favourable contrast to the 23 to 30% mortality encountered with surgical procedures. Embolisation, therefore, should be the first procedure in patients presenting with acute pulmonary haemorrhage. It must be emphasised that in cases of chronic pleuro-pulmonary diseases bleeding occurs not only from bronchial arteries. In 64% of these cases, the bleeding artery originates from a thoracic or diaphragmatic artery. The authors were able to treat 26 of 34 pulmonary haemorrhages (76%) by transcatheter embolisation. In 4 of these patients recurrent haemorrhage was treated by transcatheter embolisation. Severe complications were not noted in any case.

Adult↗