[Angina pectoris in coronary anomalies]. / Angina pectoris bei Koronaranomalie.

Nocturnal angina occurred in a 43-year-old man. Biplane left-ventricular angiography demonstrated normal left ventricular function (ejection fraction of 75%) with mild apical hypokinesia. The right coronary artery had a normal origin, was dominant and its lumen smooth. The left coronary artery also originated from the right coronary cusp, the left main stem coursing between the pulmonary artery and aorta within the aortic wall. It had a long, 40% stenosis. During atrial stimulation (130 beats/min) angiography demonstrated a 60% increase in luminal narrowing. Because of the symptoms caused by the stenosis in the anomalous coronary artery a mammary artery implant into the anterior interventricular branch and a vein graft to the circumflex artery were performed. The patient has since been free of symptoms. In relatively young persons the presence of coronary artery anomalies should be considered in the differential diagnosis even of atypical chest pain; indications for cardiac catheterization with angiography should be broad.

[Intra-aortic balloon pulsation in diagnostic coronary angiography]. / Intraaortale Ballonpulsation bei diagnostischer Koronarangiographie.

Percutaneous intraaortic balloon counterpulsation was established during diagnostic cardiac catheterization in 24 patients (ten patients with impending cardiogenic shock and 14 patients with unstable angina pectoris IIIa refractory to maximal medical therapy). Hemodynamic stabilization was obtained and pain disappeared in every patient within a short time. There was no myocardial infarction before surgical intervention. Five patients out of ten with impending cardiogenic shock and 12 out of 14 with unstable angina pectoris type IIIa survived the hospital period. There were three complications during intra-aortal balloon-pulsation: one patient suffered septic infection and two required surgical intervention because of peripheral embolization. Intraaortic balloon pumping is useful to enable catheterization of high-risk patients and to prevent myocardial infarction.

[Percutaneous transluminal angioplasty in the region of the renal artery--indications, technic and results]. / Perkutane transluminale Angioplastie (PTA) im Bereich der Arteria renalis--Indikation, Technik und Ergebnisse.

The paper reports the results obtained by percutaneous transluminal angioplasty (PTA) in the treatment of renal artery stenosis in 25 patients with secondary hypertension and discusses indications and the technique used. The follow-up period ranged from 0.5 to 12 months. All interventions were performed with the Olbert catheter system. Following PTA a significant decrease in systolic, diastolic and mean arterial pressure was observed in nearly all patients. The response of the plasma renin activity (PRA) to orthostatic stimulation and pharmacological stimulation by furosemide was determined in a subset of 15 patients before and after PTA. A significant decrease in both basal and stimulated PRA values was observed subsequent to PTA. The decrease in PRA values after successful PTA did not, however, correlate with the extent of the blood pressure changes.

[Transcatheter therapy in the icterus patient: extracorporeal drainage--endoprosthesis]. / Transkathetertherapie beim ikterischen Patienten: extrakorporale Drainage--Endoprothese.

Percutaneous transhepatic cholangiography, as well as the therapeutic possibility of extracorporeal biliary tract drainage and insertion of an endoprosthesis are discussed in this paper. The results are presented of 19 patients treated by extracorporeal drainage and of 12 patients treated by insertion of an endoprosthesis, with a successful outcome in each group. The clinical parameters, the reduction in bilirubin values after treatment and improvement in the patient's condition and general well-being are discussed.

[Percutaneous transluminal vasodilatation. Long-term results and report on experiences with a new system of catheters: transaxillary technic]. / Perkutane transluminale Gefässdilatation. Langzeitergebnisse und Erfahrungsbericht mit einem neuen Kathetersystem: transaxilläre Technik.

A report is given on the result of 567 transluminal vasodilatations, some of which have been followed up for more than five years. The results of conventional techniques were compared with a new catheter technique. The complication rate with the newly-adopted system is much lower than with conventional ones, while the reocclusion rate is only about 10%, which is about half of the figure obtained in the period up to July 1981 when the new technique was introduced.