Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery.

We present our experience with 105 patients in whom percutaneous transluminal angioplasty was performed in 112 stenosed or occluded supra-aortic arteries. Symptoms of cerebrovascular and/or vertebrobasilar insufficiency were present in 104 of the 105 patients. The angioplasty was successful in 35 stenoses of the internal carotid artery, 2 stenoses of the common carotid artery, 1 stenosis of the external carotid artery, 15 stenoses of the vertebral artery, 3 stenoses of the innominate artery and 44 stenoses of the subclavian artery. There were only 4 minor-complications (2 haematomas, 1 transient ischemic attack, 1 small thrombus of the internal carotid artery which was detected by 111-indium platelet scintigraphy and treated by thrombendarterectomy before the appearance of neurological symptoms). All patients were symptom free after angioplasty. During the observations period of 3 to 109 months (average 58 months) there were only two cases with re-stenosis after subclavian angioplasty. The results of more than 700 personal and international published percutaneous transluminal angioplasties of supra-aortic arteries are presented. The results suggest that angioplasty of supra-aortic arteries is an effective method. On strict definition of the indications, the complication rate for angioplasty of the supra-aortic arteries is not likely to be higher than that for operative treatment.

[Physical measures for the improvement of venous reflux]. / Physikalische Massnahmen zur Verbesserung des venösen Rückstromes.

The various physical methods are described which shall promote an improvement of the venous backflow from the lower extremities within the prevention of thromboembolism. Reviewing the recent results from literature the external pneumatic compression therapy is regarded as most effective method and a newly developed device for the intermittent pneumatic compression treatment is described.

[Combination of arterial and venous vascular diseases]. / Uber die Kombinationen von arteriellen und venösen Gefässerkrankungen.

The coincidence of arterial and venous vascular diseases in the region of the extremities is demonstrated. The frequency and the pathophysiological connections are explained and a subdivision of the different forms of combination is made. The therapy has to orient itself at the pathophysiological processes of the individual case, where the arterial as well as the venous vascular region is to be included in the treatment.

[Results of a computer-based analysis of peripheral pulse waves in arterial occlusive diseases of the lower extremity]. / Die Ergebnisse einer rechnergestützten Auswertung peripherer Pulswellen bei arteriellen Verschlusskrankheiten der unteren Extremitäten.

A system of data acquisition and computer analysis for pulse wave measurements, realized by means of electronic oscillography (Boucke-Brecht system) or impedance rheography, is described. The system includes: 1. Computer-compatible data acquisition and registration 2. Conversion of data into digital form 3. Data processing and evaluation of parameters 4. Classification. Records are taken from equivalent points of left and right lower extremities. Computer analysis is performed off-line using a small computer (TPA-i). The computer program evaluates the following parameters: 1. Time intervals and amplitudes of pulse propagation time, inclinations, crest time, peak width, maximum and minimum of dicrotic wave 2. Areas between pulse curve and baseline 3. Extremes of 1st and 2nd derivates for the dynamic characterization of signal 4. Fourier coefficients All parameters are computed for 12 single pulse cycles and finally averaged, printed out, and stored in a data bank. The diagnostic significance of all these parameters was examined and evaluated for separation of normal and pathological curves. With linear discriminance analysis a correct classification of about 90% was obtained. Advantages of computer analysis are: 1. Time-consuming visual evaluation is avoided. 2. Accuracy and reliability of diagnosis are improved. 3. Additional parameters offer more diagnostic information. Further investigations are directed toward reducing the number of parameters and developing an efficient screening method for early diagnosis of peripheral arterial obstructions.

[Percutaneous transluminal angioplasty of the subclavian artery]. / Die perkutane transluminale Angioplastik der A. subclavia.

In 1981, percutaneous transluminal angioplasty (PTA) of the subclavian artery was performed in 10 patients. 8 stenotic lesions were localized in the first segment and two in the third segment respectively. Dilatation was performed with the Grüntzig balloon-catheter ranging from 4 to 7 French. PTA was successful in 9 of the 10 cases. Success of dilatation was documented by recording blood pressure, normalization in the pre- and poststenotic segment and by clinical results. Success of PTA depends on exact angiographic studies, adequate indication and subsequent anticoagulation treatment. Early results after PTA are excellent. PTA of stenotic subclavian arteries has proved an alternative to surgical management.

[Clinical and angiographic appearance of traumatic peripheral arteriovenous fistula]. / Klinisches und angiographisches Erscheinungsbild der traumatischen peripheren arteriovenösen Fistel.

Issuing from 33 patients with traumatic peripheral arteriovenous fistulas on the basis of an impressive case is reported on pathophysiological changes and it is referred to a possibly early operative correction of these peripheral arteriovenous shunt connections.

[Percutaneous transluminal angioplasty (PTA) of branches of the aortic arch (author's transl)]. / Die perkutane transluminale Angioplastik (PTA) von Aortenbogenästen.

The authors give a report on their first results of percutaneous transluminal angioplasty of aortic arch branches in 4 patients. In 3 cases, stenosis of left subclavian arteries were treated by PTA with good result. One patient had a stenosis of both carotid arteries which were dilated with moderate effect. In all patients symptoms were removed. There were no complications.

[Comparison of various screening methods for the diagnosis of chronic ischemic heart disease]. / Vergleich verschiedener Screeningmethoden zum Nachweis einer chronische ischmischen Herzkrankheit

The screening phase of a multifactorial intervention study which is carried out under the direction of the WHO and the aim of which is the influence on mild forms of hypertension, hypercholesterolaemia and slightly disturbed glucose tolerance was supplemented by an electrocardiogram after work under the conditions of screening. The questionnaire contained in the investigation program for the statistical establishment of a typical angina pectoris after work according to Rose and the modified electrocardiographic test after work were tested concerning their evidence in the early recognition of a coronary sclerosis. As reference test served the Watt-step-test recommended by a group of experts of the WHO. An extensive correlation between screening after work and Watt-step-test was found. Questionnaire according to Rose and gradual load, however, had a smaller correspondence. The result of other investigations was that the distribution of the factors of risk does not give any clear reference to the existence of a latent coronary insufficiency.