[Long iliac artery occlusions: Feasibility, short- and mid-term outcome]. / Perkutane Therapie langstreckiger Beckenarterienverschlüsse: Technische Durchführbarkeit, kurz- und mittelfristige Ergebnisse.

PURPOSE: It was the aim of the following study to determine the feasibility of the recanalization of long occlusions in iliac arteries and to establish its patency rate. MATERIAL AND METHODS: We retrospectively evaluated the data of 23 patients (15 male and 8 female) with occlusions of the iliac arteries with a mean length of 12 cm (range: 9-15 cm). The occlusions were situated either in the common iliac artery (CIA) (n = 3), in the external iliac artery (EIA) (n = 12) or in both CIA and EIA (n = 7). In one patient three vessels, the common femoral artery included, were involved. The recanalization procedure was performed with wire and catheter from retrograde and, in case of a failure, from antegrade in a cross-over technique. RESULTS: Recanalization succeeded in all patients. Technical success defined as residual stenosis < 30 % was seen in 20 of 23 patients. Early reocclusions were seen in four patients, in three of whom, the stent dilatation had been incomplete. Late reocclusions were observed in three patients, one of whom had already had early reocclusion. The reason was stent breakage in one, stent dehiscence in the second and restenosis in the third patient. All of the patients with reocclusion either early or late, had received covered stents. In four patients restenosis developed within 30 months: It was successfully treated by ballon dilatation or stent. Embolism during the recanalization procedure was observed in six patients. Embolism was observed on the ipsilateral side in five, and on the contralateral side in one patient. In each patient who had experienced embolism, balloon dilatation had been performed before stent implantation. CONCLUSION: 1) There is some evidence that the recanalization of long iliac artery occlusions is feasible. 2) The main reason for early and late reocclusions is either rest stenosis or restenosis. 3) Covered stents should only be used in selected cases. 4) Primary stenting is the treatment of choice in order to prevent embolism.

[Selective proximal vagotomy (SPV). Experience and technic using the LDS device]. / Selektive proximale Vagotomie (SPV). Erfahrungen und Technik mit dem LDS-Gerät.

In the period between January 1974 and 1977, a total of 358 selective proximal vagotomies were performed in patients with gastroduodenal ulcers avoiding pyloroplasty if possible. This report is concerned with intra- and postoperative experience with Burge's operating technique, incorporating LDS instruments from the USSC. The use of the instrument in preparing the proximal stomach is discussed. The instrument is recommended for reducing the time needed for emergency and simultaneous operations and for performing vagotomy in high risk patients.

The carbon-tetrachloride-hepatotoxicity as a model of liver damage. First report: Long-time biochemical changes.

176 Growing female Wistar rats get injections of 1 ml CCl4 per kg twice a week. Seven days after the beginning of the experiment over a period of eight weeks blood samples were collected after the decapitation of the animals for liver function tests. The CCl4-hepatotoxicity seems to have a three or four phased course. The first phase of two or three weeks is characterised by a necrosis, demonstrated by the rising enzymes values, and a beginning damage of the liver as shown by the decreasing value of the pseudocholinesterasis. The second phase of two or three weeks is charcterised by as massive fatty infiltration and an increasing necrosis, demonstrated by the high plateau of the triglycerides, the increase of SGOT and the BSP-retention and the decrease of the pseudocholinesterases. These values may correspond to a liver fibrosis at the end, too. The third phase is marked by more increasing values of the SGOT, hydroxyproline, triglycerides and BSP-retention. The final decrease of the pseudocholinesterasis and liver weight demonstrate a reduced synthetical ability and an atrophy of the liver. The rats were in this last phase in a nearly pre-final state. --These biochemical changes of the CCl4-hepatotoxicity which correspond to histological damages reported elsewhere seem to be a good measure to characterise liver damage quantitatively and qualitatively. The therefore may be used as a model for systematical studies in the repair of a disturbed liver function.