ABSTRACT
Background. A nonrecognized pneumothorax (PTX) may become a life-threatening tension PTX. A reliable point-of-care diagnostic tool could help in reduce this risk. For this purpose, we investigated the feasibility of the use of the PneumoScan, an innovative device based on micropower impulse radar (MIR). Patients and Methods. addition to a standard diagnostic protocol including clinical examination, chest X-ray (CXR), and computed tomography (CT), 24 consecutive patients with chest trauma underwent PneumoScan testing in the shock trauma room to exclude a PTX. Results. The application of the PneumoScan was simple, quick, and reliable without functional disorder. Clinical examination and CXR each revealed one and PneumoScan three out of altogether four PTXs (sensitivity 75%, specificity 100%, positive predictive value 100%, and negative predictive value 95%). The undetected PTX did not require intervention. Conclusion. The PneumoScan as a point-of-care device offers additional diagnostic value in patient management following chest trauma. Further studies with more patients have to be performed to evaluate the diagnostic accuracy of the device.
ABSTRACT
The value of stenting in emergency situations in interventional angioplasty procedures is widely accepted. Stenting remains controversial as a therapeutic method for use beyond the acute phase, as the results reported in the acute phase are characterized by a wide range. This study reports the implantation results of Palmaz-Schatz stents in 64 cases mostly for failed PTCA. Stents were mounted on Monorail-PVC-balloon catheters. The acute success rate was 96.8%. In two cases with stent misplacement CABG was performed within 48 h. No lethal events occurred in the acute phase. Stent thrombosis has only been seen in four cases (6.5%) so far under subtle monitoring of the anticoagulant regime. Restenosis rate (definition: NHLBI-4) according to serial angiography 6 and 12 weeks after implantation was 4.25% at 6 weeks, with a cumulative rate of 19.4% up to 12 weeks. All recurrences eligible for PTCA have been successfully redilated. A high extracardiac complication rate--predominantly groin hematoma--is the main disadvantage of the procedure. Surgical repair was necessary in 11.4% up to 6 weeks after implantation. Surprisingly high was also the incidence of hematuria, also in 11.4%, in the phase of high anticoagulation. In conclusion, stenting is an effective therapeutic method to avoid emergency CABG and elective CABG in most cases of failed PTCA.
