[Intraindividual comparison of conventional PTA and balloon expandable stents in patients with bilateral stenoses or occlusions of the pelvic circulation].
Explore the source record for details and available documents.
Angioplasty, Balloon↗
Biomedical subjects
W Gross-Fengels
Publications and source records attributed to W Gross-Fengels.
[Magnetic resonance tomographic diagnosis of vascular processes in the vertebrobasilar system--analysis of 35 of our own cases and a literature review].
35 patients with abnormalities of the vertebrobasilar system were studied via magnetic resonance imaging (11 saccular aneurysms, 10 vascular malformations, 9 basilar arteries with dolichoectasia, 5 thromboses of the vertebral or basilar artery). The two smallest aneurysms of the basilar top had a diameter of 2-3 mm. Most vascular malformations could be differentiated by typical MRT symptoms. All 5 cavernous angiomas were negative in angiography (cryptic). The shape and size of the basilar artery and its relationship to the third ventricle were best demonstrated on coronal slices. Flow-related intraluminal loss of signal allows a differentiation between vascular perfusion and thrombosis already on plain images (partial) thrombosis and artery dissection can be differentiated from flow effects based on identical findings in at least two planes or additional gradient echo images.
Adult↗
[The importance of magnetic resonance tomography in the diagnosis and staging of renal cell carcinoma].
The use of magnetic resonance imaging (MRI) for diagnosis and preoperative staging of renal cell carcinoma was evaluated in 79 patients with 88 tumors. Gradient-echo and spin-echo images before and after intravenous administration of Gadolinium-DTPA were compared with the results of computed tomography (CT) and histologic staging. The two imaging techniques had comparable results: T-stage was predicted correctly with CT in 78.4% and with MRI in 84.0% of the cases, while the N-stage was accurately assessed in 81.8% and 79.5%, respectively. MRI had some advantages in diagnosing perirenal tumor spread and in excluding an infiltration beyond Gerota's fascia. Therefore, MRI is a true alternative to CT for staging large renal cell carcinomas and especially for patients with contraindications for iodinated contrast agents.
Adult↗
[Genetic disposition of atherosclerosis? Case report of a monozygotic pair of twins].
The case of a 64-year old pair of monozygotic male twins with atherosclerotic disease of the iliaca arteries is described and the related literature dealing with the genetics of atherosclerosis is reviewed. Both patients had corresponding clinical history and physical findings and showed an almost identically localised and a high degree of stenosis of the right iliac artery of similar appearance. In both cases percutaneous transluminal angioplasty (PTA) was performed prior to placement of Plamaz stents. The well-known risk factors of atherosclerosis are hypertension, hypercholesterolaemia, cigarette smoking, diabetes mellitus, obesity, physical inactivity, and psychosocial influences. However, a number of atherosclerotic lesions cannot be accounted for solely on the basis of current knowledge of these risk factors. The reported case produces evidence of genetic factors as contributing components in the pathogenesis of established atherosclerotic disease.
Arteriosclerosis↗
[Acute adverse effects and complications of central venous digital subtraction angiography (DSA). Results of 2,600 studies].
Side-effects and complications from 2,600 intravenous digital-subtraction-angiographies (IV-DSA) are reported. All studies were performed in a standardized technique using a non-ionic contrast agent (Iopromid 370 mg J/ml). Side-effects or complications were noted in 2.5% of all IV-DSA. Most often nausea (0.92%), urticaria (0.5%), angina pectoris (0.5%) and symptomatic alterations of blood-pressure (0.27%) were recorded. 8.4% of all reactions occurred with a delay of at least one hour. All side-effects and complications resolved, partly under symptomatic therapy. In one (0.04%) out of 2,600 studies a severe allergoid reaction occurred, affording intensive-care therapy. With proper patient selection and a suitable technique, IV-DSA may be regarded--within the angiographic methods--as a procedure of relatively low risk.
Aged↗
[Aortobronchial fistulae as late complications following the surgical correction of aortic isthmus stenosis].
Three patients (2 men, aged 39 and 52 years, one woman, aged 47 years) developed hemoptysis 3-19 years after surgical resection of coarctation of the aorta. Digital subtraction angiography in the two men was suspicious of an aortobronchial fistula. An emergency thoracotomy revealed the diagnosis in the woman: she died during the operation of intractable arterial bleeding, the initial operation having been atypical (insertion of a graft extending across the isthmus to the ascending aorta). The 52-year-old man died of left heart failure after pneumonectomy (for massive bleeding into the left lung). An aneurysm sack at the aortic isthmus was resected and a vascular graft implanted in the 39-year-old man. There have been no further hemoptyses. These cases emphasize the need for including aortobronchial fistula as a cause of hemoptysis.
Adult↗
[Malignant tumors of the normotopic kidneys and ureters following kidney transplantation].
There is an 4.2-23% incidence of cancer in renal transplant recipients. A closely meshed radiological follow-up is important as shown in 3 patients who developed a carcinoma of the kidney or ureter within 1-5 years after renal transplantation. This includes routine sonography of the whole abdomen, in case of pathological findings CT respectively MRI, i.v. urography, retrograde urography and angiography if needed.
Adult↗
[Conventional and cine-MRT in patients with aneurysms of the abdominal aorta].
We studied 40 patients with aneurysms of the abdominal aorta by MRI. These results were compared with those obtained by real-time sonography (n = 40), angiography (n = 32) and CT (n = 16). In 30 patients the imaging results were compared--as far as possible--with the operative findings. MRI proved more reliable, especially if compared with sonography, in evaluating renal or iliac artery involvement. Mural thrombi were detected more often (93%) by MRI than by CT (85%) or sonography (83%). Cine-MRI showed strong turbulences in 33%. Turbulences did not correlate with the size of the aneurysm.
Adult↗
[Balloon-expandable stents in arterial changes of the iliac arteries. Early and follow-up results of 65 interventions].
69 balloon-expandable vascular endoprostheses (Palmaz stents) were placed in 65 iliac arteries of 57 patients. The indications for stent placement were total occlusions (n = 15), restenosis after PTA (n = 13), dissections (n = 4), post-operative strictures (n = 3) or others (n = 30). The peak systolic pressure gradient dropped from 43.9 to 2.9, the mean pressure gradient to 1.9 mmHg after stent placement. This was significantly lower than conventional PTA (residual peak systolic pressure gradient: 5.8). Complications occurred in 7.7% of all interventions. 78.4% of the patients showed no limiting claudication after stent placement. Angiographic controls after 47 weeks demonstrated an average intima proliferation of 0.4 mm, not leading to significant restenosis. Cumulative patency after 16 months was 96%. Iliac stents became an effective and in certain situations indispensable adjuvant to PTA.
Adult↗
Arteriovenous fistula simulating a solid tumor of the kidney.
In this report we describe a 57-year-old male hemophiliac with an acquired renal arteriovenous (AV) fistula presenting as a renal mass. Even after intravenous pyelography, ultrasound and computed tomography, a carcinoma seemed possible. Causes, symptoms and therapy of renal AV fistulas are shown and pitfalls in the usual diagnostic approach are discussed.
Angiography↗
[Radiologic diagnosis of pulmonary embolism].
Explore the source record for details and available documents.
Angiography, Digital Subtraction↗
[A rare constellation of findings: bile duct cancer, ulcerative colitis, deep venous thrombosis of the leg].
A case of a 28-year-old patient with long-standing chronic ulcerative colitis is presented, in whom cholangiocarcinoma was diagnosed by CT and ultrasound guided liver biopsy. This association is well known, because the incidence of bile duct carcinoma in patients with chronic ulcerative colitis is increased. A possible precursor of the disease is thought to be primary sclerosing cholangitis which also more frequently occurs in patients with ulcerative colitis. Our patient was initially hospitalized for deep venous thrombosis, which in retrospect had to be interpreted as a paraneoplastic syndrome.
Adenocarcinoma↗
[Life threatening aortobronchial fistula as a late complication following surgical correction of aortic isthmus stenosis].
An aortobronchial fistula is a rare cause of hemoptysis and most commonly occurs in patients with thoracic aneurysms. If undiagnosed, this entity is uniformly fatal. However, with early recognition and surgery, the survival rate exceeds 80%. We present history and outcome of 3 patients with fistulas due to previous surgery of coarctation of the aorta and discuss the value of different diagnostic procedures.
Aortic Aneurysm↗
[The effect of the imaging geometry of angiographic equipment on the measurement of vessel diameters: the significance for PTA and stent implantation].
The diameter of arteries in the angiogram is determined by the geometry of the angiographic unit and the position of the vessel in the body section. The position of the arteries in the middle portion of the pelvis is subjected to a wide variability due to their curved course, and cannot be precisely predicted even if the individual body diameter is known. Magnification of the pelvic arteries on a.p. angiograms typically ranges between 30 and 40%, and increases with patient thickness. Therefore, PTA of the pelvic arteries produces overdilatation, even if the balloon diameter is smaller than the vessel diameter measured on the a.p. film. If the balloon diameter exceeds the measured vessel diameter by 1 or 1.5 millimetres, vessel overdilatation may reach up to 70% of the original size.
Adult↗
[Stents in iliac vascular changes].
The results of 79 iliac stent placements in 64 patients are reported. The technical success rate was 96%. The systolic pressure gradient dropped from 44 mmHg before to 2.8 mmHg after stent placement. This differed significantly as compared to a group treated by conventional PTA (gradient 5.8 mmHg). The cumulative patency after 18-20 months was 90%. Angiographic controls up to 19 months after "stenting" demonstrated only one secondary stent occlusion. Iliac stents therefore are a very valuable supplement to classic PTA.
Angioplasty, Balloon↗
[Is intravenous digital subtraction angiography sufficient for planning radiologic interventions in acute and chronic arterial obstructions of the pelvis and leg vascular systems?].
The therapeutical procedure in acute and chronic arterial obstructions of the pelvic and upper leg arteries may often be based on the results of intravenous DSA (i.v. DSA). In patients with peripheral arterial disease and before interventions below the knee are contemplated, i.v. DSA is not sufficient and has to be replaced by arterial DSA (IA DSA). I.v. DSA facilitates technical planning and performance of radiological vascular interventions and has the potential to reduce the complication rates. Nevertheless, the definitive decision to perform PTA and the choice of the appropriate technique continue to be made on the results of the arteriography/i.a. DSA, which has to be routinely obtained at the beginning of any procedure.
Angiography, Digital Subtraction↗
[Techniques, results and risks of chemoembolization of malignant liver tumors].
This is a report on 55 chemoembolizations (ChE) in 31 patients with primary (n = 10) and secondary (n = 21) liver malignomas. Probing of the segmental arteries was always possible by means of a coaxially placed 3F catheter system. Chemoembolization was effected with a mixture of ivalon particles, 20 mg mitomycin or 40-60 mg epirubicin and an ethibloc solution. More than 75% of the patients showed a decrease in tumour size and/or tumour density. The proportion of surviving patients was 80.6% after 6 months. Within this period, extrahepatic metastases were seen for the first time in 19.4% of the patients. References in literature on techniques and results of chemoembolization are discussed.
Adult↗
[Diagnosis of a suspected pulmonary embolism in a centrally localized bronchial carcinoma].
Case report of a 57-year old male patient suffering from a central bronchial carcinoma, causing complete unilateral non-perfusion of the left lung (v. Euler-Liljestrand reflex). Discussion of the possible diagnostic methods especially on difficulties in differential diagnosis to pulmonary embolisation.
Carcinoma, Squamous Cell↗