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- Ljungdahl, Mikael, et al.
(författare)
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Arterial embolisation in management of massive bleeding from gastric and duodenal ulcers
- 2002
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Ingår i: European Journal of Surgery. - : Oxford University Press (OUP). - 1102-4151 .- 1741-9271. ; 168:7, s. 384-390
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: We have tried angiography and selective arterial embolisation as a complement or another option in patients with massive bleeding from peptic ulcers who were considered poor candidates for surgery. DESIGN: Prospective, descriptive study. SETTING: University hospital, Sweden. PATIENTS: Since 1998, 18 patients (11 women) with a median age of 78 years (range 53-94) had selective arterial embolisation for uncontrollable bleeding from peptic ulcers. INTERVENTION: Superselective angiographic catheterisation and embolisation of the arterial branch that was supplying the ulcer. MAIN OUTCOME MEASURES: The success rate of haemostasis and the overall outcome. RESULTS: 13 patients were treated after failed endoscopic treatment to stop bleeding or to control recurrent bleeding after initial arrest, while 5 patients were treated for recurrent bleeding after emergency operations for bleeding ulcers. Most of the ulcers were in the duodenum. The patients were haemodynamically unstable and had a median haemoglobin concentration of 72 g/L (50-98). Embolisation of the arterial branch that was supplying the ulcer was feasible in all patients. Permanent haemostasis was achieved in all but one patient, although two patients needed a second embolisation for recurrent bleeding. One patient had the bleeding controlled at an emergency operation, but eventually died of respiratory complications. There were no serious complications of embolisation. CONCLUSION: Angiographic embolisation may be an effective way to stop massive bleeding from gastroduodenal ulcers. Emergency operations in poor surgical candidates can therefore be avoided.
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- Löfberg, Anne-Marie, et al.
(författare)
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Distal percutaneous transluminal angioplasty through infrainguinal bypass grafts
- 2002
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 23:3, s. 212-219
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Tidskriftsartikel (refereegranskat)abstract
- AIM: to evaluate the results of transluminal angioplasty (PTA) performed through infrainguinal bypass grafts for stenotic or occlusive lesions at the distal anastomosis and/or in the runoff arteries. Design: retrospective clinical study. MATERIAL AND METHODS: forty-one patients underwent 57 procedures at the distal anastomosis (n=13), in the runoff arteries (n=32) or at both locations (n=12) at a median of 9.6 months (range, 2-76 months) after infrainguinal bypass grafting. Nineteen procedures were on the popliteal artery, the rest on the crural arteries. Eleven procedures related to occlusions less than 5 cm in length. RESULTS: technical success was achieved in 91%. Primary and primary assisted graft patency rates at 3 years were 32% and 53%, respectively. There were no significant differences in patency rates with regard to the graft material, the type of lesion, the level of PTA, the status of runoff and the use of thrombolysis before PTA. No patients underwent amputation as a direct consequence of failed PTA or graft occlusion. One patient underwent acute surgical intervention due to graft occlusion at the time of attempted PTA. CONCLUSION: the results of PTA at the distal anastomosis and/or in the runoff arteries in limbs with infrainguinal bypass seemed to be inferior to the results of surgical revisions reported in literature. However, as failed PTA did not jeopardise vein-patch angioplasty or jump grafting, it is a reasonable alternative to surgical intervention in selected cases.
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- Sherif, Amir, et al.
(författare)
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Endovascular approach to treating secondary arterioureteral fistula
- 2002
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Ingår i: Scandinavian Journal of Urology and Nephrology. - 0036-5599 .- 1651-2065. ; 36:1, s. 80-82
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Tidskriftsartikel (refereegranskat)abstract
- Two patients with the rare entity of arterio-ureteral fistula are presented. Both highlight the predisposing factors of radiation, major surgery in the region, history of vascular surgery and presence of double-J-stent. Both patients presented with the clinical sign of intermittent gross hematuria. Both patients were successfully treated by endovascular intervention using graft covered stent.
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