[Transjugular vena cava umbrella placement (author's transl)]. / Die transjuguläre Kava-Schirm-Implantation. Indikation, Technik, Komplikationen durch Migration.

In order to prevent venous emboli originating from the veins of the lower extremities to pass through the inferior V. cava, its passage can be blocked without interrupting the blood stream. This is done by inserting an umbrella filter in the inferior V. cava above the entrance of the renal veins. 55 transjugular umbrella filters were inserted in the period from 1.8. 1972 to 31. 10. 1979. There were 4 cases of dislocation among them, which are described in detail.

Management of concomitant occlusive disease of the supraaortic and lower-limb arteries.

Angiography examinations of the extracranial cerebral arteries in patients with peripheral occlusive disease of the lower limbs indicate cerebro-vascular disease more often than might be assumed from clinical-neurological examinations alone. In total, 61.5% of the patients examined showed lesions of the extracranial cerebral arteries which necessitated an operation. The elimination of risks in an operation requiring extensive peripheral vessel reconstruction necessitates initial supraaortic vessel reconstruction. Of the 48 patients with reconstructions in both vascular systems, none has suffered any postoperative neurological dysfunction. Concomitant occlusive disease of the supraaortic and peripheral arteries should not be treated simultaneously.

[Operative treatment of deep vein thrombosis (author's transl)]. / Atiologie, Diagnostik und operative Behandlung der akuten Bein-, Becken- und unteren Hohlvenenthrombose.

From 1973 to 1977 a total of 63 patients with thrombosis of the deep veins in leg and pelvis and in the V. cava inferior was treated by operative thrombectomy. Prior to the operation all patients were submitted to phlebography. The mean age of all was 52 years. One patient died from pulmonary embolism during thrombectomy, there was no further hospital mortality. Because of low mortality incidence and rarely postthrombotic complications we prefer the operative treatment of deep vein thrombosis. The preoperative cavography helps to avoid pulmonary embolism during thrombectomy.

[Surgical treatment of therapy resistant ulcus cruris (author's transl)]. / Chirurgische Behandlung des therapieresistenten Ulcus cruris.

30 patients with chronic venous ulcerations of the lower leg, unable to be cured definitely by commonly known medical, local or surgical therapy are reported. All patients were submitted to the little known ulcer circumcision published by Nussbaum in 1873. During a postoperative period of up to 10 years there was no recurrence of ulcers in any case. The operation is simple and time saving. Requiring an average hospital stay of 24 days, thus saves expenses as well. The procedure is described and the clinical results obtained have been documented.

[New technic of the transjugular cava blocking in the removal of acute pelvic vein and inferior vena cava thrombosis]. / Eine neue Technik der transjugulären Cavablockade bei der Ausräumung der akuten Beckenvenen- und unteren Cavavenenthrombose

Thrombosis of the inferior vena cava rarely occurs. However, it mostly develops by continous growth from thrombosis of the deep leg and pelvic veins. Thrombus formation in the inferior vena cava carries a potentially lethal risk because of possible involvement of the renal veins with consecutive renal failure or development of fulminant pulmonary embolism. Therapy of choice consists in early diagnosis and immediate thrombectomy. Choice of the operative procedure is of the utmost importance for immediate and late results. Our technique consists of inserting a balloon catheter via a side vessel of the internal jugular vein and placing it into an infrarenal position, where it is blocked, thereby preventing blood flow from the area to be cleared. Three cases in which this technique was employed are presented.

[Orthotopic saphena bypass in situ (author's transl)]. / Der orthotope Saphena-Bypass in situ

A procedure intended to restore the obliterated femoropopliteal arterial pathway is described. The vena saphena magna is canulated with a silicone tube, thus fixing the valves against the venous wall, the side vessels thrombose and close by secondary organization. After 6 to 8 weeks the transformed vein will be interposed instead of the obliterated arterial segment. The advantage of the operative procedure described consists in considerably reduced operative trauma compared with the well-known methods. Clinical results of 20 patients are presented.

[Prolonged extracorporeal membrane oxygenation in the treatment of burns-induced shock lung (authors transl)]. / Prolongierte extrakorporale Membranoxygenierung wegen Schocklunge bei drittgradiger Verbrennung Fallbericht über einen 83stündigen Einsatz einer GE-Dualung bis zur Wiederkehr ausreichender Sauerstoffdiffusion in der Lunge

A case of third-degree burns involving 35 per cent of the body surface is reported with occurred in a 28-year-old man. On the 6th day progressive pulmonary insufficiency developed which 3 days later necessitated extracorporeal membrane oxygenation. Oxygen diffusion capacity gradually improved and the patients resumed spontaneous respiration with oxygen enriched air. He died 5 days after membrane oxygenation was discontinued due to massive haemorrhages from an infection at the site of the femoral by-pass. The technique adopted for the perfusion, which lasted 83 hours, is described.

[Angina abdominalis: Clinical findings and therapy (author's transl)]. / Klinik und Therapie der Angina abdominalis

Angiographic and clinical findings of angina abdominalis are demonstrated by the clinical course of four patients. Two of them suffered from athero-sclerotic stenosis and the remaining two from compression of the coeliac trunc respectively the upper mesenteric artery by fibrotic strings. One patient was treated by an interposition of a saphenous vein graft another one by tissue decompression. Two patients were not operated upon, because one of them had sufficient collateral circulation on angiography, and the other denied an operation, he died one year after diagnosis because of an occlusion of the coeliac trunc and the upper mesenteric artery with following gangrene of the small and large intestine. Danger of complete intestinal necrosis following arterial vessel occlusion as well as reconstructive operative procedures on arterial occlusion should be considered.