Current practice of temporary vena cava filter insertion: a multicenter registry.

PURPOSE: To evaluate the current practice of temporary vena cava filter placement and its complications. MATERIALS AND METHODS: A multicenter registry was conducted from May 1995 until May 1997 using a standardized questionnaire. One hundred eighty-eight patients were evaluated. Patient characteristics, filter indications, filter characteristics, and complications were registered. RESULTS: Deep vein thrombosis was proven in 95.2% of the patients. Main filter indication was thrombolysis therapy (53.1%). Average filter time was 5.4 days. An Antheor filter was inserted in 56.4%, a Guenther filter in 26.6%, and a Prolyser filter in 17.%. Transfemoral filter implantation was slightly preferred (54.8%). Four patients died of pulmonary embolism (PE) during filter protection. Major filter problems were filter thrombosis (16%) and filter dislocation (4.8%). When thrombus was found in or at the filter before explantation, additional thrombolysis was performed in 16.7%, additional filter implantation in 10%, and thrombus aspiration in 6.7%; 4.8% of filters were replaced with permanent filters. DISCUSSION: Temporary vena cava filters are placed to prevent PE in a defined patient population. Despite their presence, PEs still occur in a small percentage. Problems of filter thrombosis and dislocation have to be solved. CONCLUSION: The results of this multicenter registry support the need for innovative filter design, as well as a randomized, prospective study.

[The post-traumatic intrapulmonary haematoma (author's transl)]. / Das posttraumatische intrapulmonale Hämatom.

The case of a 29-year-old female patient is presented as an example of formation and resorption of a post-traumatic intrapulmonary hematoma. This case is compared with the findings in the literature and discussed. The importance of diagnostic differentiation from malignant coin lesions is pointed out.

[Transluminal angioplasty of renal artery stenosis for the treatment of renal hypertension (author's transl)]. / Transluminale Angioplastie von Nierenarterienstenosen zur Behandlung des renalen Hochdrucks.

Three patients with hypertension due to renal artery stenoses were treated by percutaneous transluminal angioplasty with the coaxial-balloon-catheter system as it is used for the dilatation of coronary arteries. The pressure gradients before and after dilatation are recorded. Pressure of the three patients came directly after treatment down significantly. Reduction of antihypertensive drug therapy was possible in two patients, one patient is without therapy 4 weeks after the procedure.

[Pseudo tumours of the adrenals--errors in interpretation and their avoidance (author's transl)]. / Pseudotumoren der Nebenniere--Fehlinterpretationen und ihre Vermeidbarkeit.

In 13 patients an adrenal tumor was suggested by non-invasive roentgenologic studies (scout films of the abdomen, intravenous urograms, tomograms). The lesions turned out to be misdiagnosed after patients had undergone arteriography. Variations of the spleen, superimpositions of the tail of the pancreas and fluid filled hollow viscus were found to be the reason for this adrenal 'pseudo-tumors'. The possibilities of diagnosing those 'lesions' without doing invasive studies are discussed.

[Supra renal metastases. The rôle of angiography (author's transl)]. / Nebennierenmetastasen--Stellenwert der Angiographie.

Fifteen cases of metastatic involvement of the adrenal glands are described. There are three groups of metastatic lesions: 1. metastases of distant tumors 2. metastases of malignant tumors of the ipsilateral kidney 3. direct extension of tumor to the adrenals Neovascularity was angiographically demonstrated in all cases. 13 of 15 patients had hypervascular metastases and 12 showed enlarged adrenal arteries. The angiographic findings are discussed and compared to those found in the literature.

[Angiographic appearance of intravenous tumor growth in the portal and hepatic veins ("thread and streaks sign") (author's transl)]. / Angiographischer Nachweis intravenöser Tumorexpansion in Vena portae und Vena hepatica ("thread and streaks sign").

Report of two cases with the angiographic signs of tumor growth in the portal and hepatic veins in hepatocellular carcinoma. Discussion of the angiographic and pathologic-anatomic findings and review of the literature.

[Hepatic vein angiography for the demonstration of intrahepatic tumours (author's transl)]. / Die Lebervenenangiographie zum Nachweis von intrahepatischen Tumoren

Fifteen patients with suspicion of metastases of the liver were examined in order to demonstrate the angiographic signs and the diagnostic possibilities of retrograde hepatic vein angiography. By this method, in all of our patients a scintigraphically doubtful or suspicious finding could be cleared up. Since hepatic vein angiography is superior to arteriography, sonography and scintigraphy with regard to identification of minor metastases, but is technically a complicated special examination, it should be applied as an extended diagnostic measure additionally to the other examinations.

[Angiography of carcinomas of the renal pelvis (author's transl)]. / Die Angiographie des Nierenbeckenkarzinoms

The angiographic criteria of 19 renal pelvic carcinomas were analysed. Two groups of signs, direct and indirect, could be detected. Of 19 histologically proved cases of renal pelvic carcinomas, the diagnosis had not been made angiographically in the case of a small tumor, which was 11 mm in diameter. The usefulness of preoperative angiography for diagnosis and operative planning is emphasized.

[Carotico-cavernosus fistula after subclavia-carotis interna bypass (author's transl)]. / Sinus-cavernosus-Fistel nach Subclavia-carotis-interna-Bypass

A case of occlusion of the right common carotid artery combined with stenosis of the left common carotid artery is reported. Immediately after surgery a carotico-cavernosus fistula was observed on the right side. The clinical picture and the therapeutical problems are discussed; 4 X-ray and 2 fundus photographs are presented.

[Angiographic technique in assessment of renal mass lesions]. / Technik der Angiographie bei Nierentumoren

The advantages of pharmacoangiography and of selective renal venography as supplementory procedures to ordinary renal arteriography in the assessment of renal mass lesions are stressed. A new technique combining these procedures is introduced, and three examples are given.