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    Wyświetlanie 1-5 z 5
    Tytuł:
    New Method of Forced Implantation of Permanent Catheters for Hemodialysis into Critically Stenosed or Occluded Central Veins
    Autorzy:
    Przywara, Stanisław
    Iłżecki, Marek
    Terlecki, Piotr
    Zubilewicz, Tomasz
    Powiązania:
    https://bibliotekanauki.pl/articles/1395845.pdf
    Data publikacji:
    2014-12-18
    Wydawca:
    Index Copernicus International
    Tematy:
    vascular access for hemodialysis
    permanent catheters for hemodialysis
    central venous occlusive disease
    Opis:
    The aim of the study was to report a novel technique of forced implantation of catheters for hemodialysis into critically stenosed or occluded central veins, without preceding angioplasty or stenting. Material and methods. Sixteen patients with central venous occlusive disease, requiring urgent hemodialysis underwent this procedure. Catheterization of stenosis - occlusion was initially performed with soft guidewire, subsequently exchanged to stiff guidewire. Forced insertion of dilators, peel-off sheath throughout the stenosis or occlusion and finally implantation of the catheter completed the procedure. Our technique does not require pre-procedural angioplasty or stent deployment. Results. In all patients postoperative hemodialysis was managed with satisfactory adequacy. No early or late complications related to the procedure occurred. We did not observe any clinically significant aggravation of symptoms of central vein stenosis or occlusion. Complications, not-related to the procedure included one, late skin entry site infection and one, late catheter thrombosis. These were managed without the necessity of catheter exchange. Conclusions. Our technique of forced implantation of catheters for hemodialysis into critically stenosed or occluded central veins without previous balloon predilatation or stenting is simple and diminishes the total cost of the procedure. Provides quick vascular access for hemodialysis in life threatening situations.
    Źródło:
    Polish Journal of Surgery; 2014, 86, 9; 405-409
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Percutaneous Endovascular Abdominal Aortic Aneurysm Repair Within the Infrarenal Region. Preliminary Report
    Autorzy:
    Iłżecki, Marek
    Zubilewicz, Tomasz
    Terlecki, Piotr
    Przywara, Stanisław
    Powiązania:
    https://bibliotekanauki.pl/articles/1396436.pdf
    Data publikacji:
    2013-10-01
    Wydawca:
    Index Copernicus International
    Tematy:
    ProStar XL
    aneurysm
    PEVAR
    infrarenal
    Opis:
    The aim of the study was to thoroughly evaluate the closure device ProStar XL in terms of its efficiency and safety in the percutaneous endovascular treatment of abdominal aortic aneurysms in the infrarenal section of the body. Additionally, it was crucial to assess if there were any occurrences of regional complications at any step of the procedure. It was also important to stipulate the estimated hospitalization period as well as the overall cost of the PEVAR treatment with the use of ProStar XL. Material and methods. The analysis included 21 cases with PEVAR performed in the infrarenal region. The final success was achieved in 98.2% of the cases. One PEVAR case (that constituted 0.2% of this group) was unsuccessful because of the bleeding while the placement of the sutures with the use of ProStar XL was being performed. Results. This resulted in the emergency treatment of the CFA with the continuous stitch (Prolene 5-0). During the postoperative period the above described patient was given 2 units of the Packed Red Blood Cells (PRBC). However, this complication (unexpected bleeding) did not influence the length of the hospitalization period in any significant way. Conclusions. Percutaneous vascular closure device ProStar XL used in the treatment of the common femoral artery (CFA) constitutes a necessary and safe supplement for Endovascular Aortic Aneurysm Repair (EVAR). The implementation of ProStar XL closure device proves to significantly shorten the hospitalization period after the EVAR treatment. Additionally, the safety of the entire procedure is exponentially linked to the experience of the operating surgeon.
    Źródło:
    Polish Journal of Surgery; 2013, 85, 10; 563-568
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    The evaluation of the effectiveness of Tachosil in the treatment of lymphorrhea of the postoperative wound in the selected group of patients, after vascular reconstructive surgeries – preliminary report
    Autorzy:
    Iłżecki, Marek
    Zubilewicz, Tomasz
    Przywara, Stanisław
    Terlecki, Piotr
    Powiązania:
    https://bibliotekanauki.pl/articles/1396515.pdf
    Data publikacji:
    2013-12-01
    Wydawca:
    Index Copernicus International
    Tematy:
    lymphorrehea
    Tachosil
    drainage
    Opis:
    Lymphorrhea of a postoperative wound after vascular reconstructive surgeries does not occur frequently but it accounts for a major complication. It should be brought to attention that during the intraoperative period it is impossible to diagnose any damages within the lymphatic system of the operated area. Additionally, the treatment of lymphorrheawith thermal abrasion does not usually bring the desired outcome. Therefore, the extended time of the postoperative wound treatment with the lymphatic drainage constitutes a standard method in such cases. The aim of the study was to evaluate the effectiveness of Tachosil surgical patch in the treatment of lymphorrhea of the postoperative wound in a selected group of patients who have undergone vascular reconstructive surgeries. Additionally, the aim of the study was to analyze the results and draw conclusions pertaining to the validity and effectiveness of the treatment with the use of Tachosil surgical patch. Material and methods. The observed group included 10 patients with lymphorrhea developed during the postoperative period. 6 of the observed patients have undergone the vascular reconstructive surgery with the implantation of the vascular prosthesis (distal femoropopliteal reconstruction bridge - 3 patients; iliofemoral reconstruction bridge - 1 patient; angioplasty of the common femoral artery (CFA) with the use of the prosthetic patch - 1 patient; the implantation of the bifurcated (type Y) aortofemoral prosthesis - 1 patient). The remaining patients in the observed group have undergone the restoration of patency of the CFA. Additionally, 1 patient has undergone the resection of the pseudo aneurysm in the distal part of the iliofemoral prosthesis. The vascular reconstructive surgery required the denudation and isolation of the common femoral artery from the surrounding tissue as a step 1. The persisting lymphorrhea of the postoperative wound, in the volume of more than 200 ml per day during the first 3 postoperative days, indicated the necessity for the inguinal wound revision. In addition, Tachosil surgical patch was applied at that time. The drain was placed over Tachosil patch. Results. Complete stop of lymphorrhea was shorter by 4.87 days in patients treated with the use of Tachosil in comparison to control group. These patients also had an average hospitalization time shorter by 3.88 days than patients in the control group. Conclusions. Early intervention in the cases of lymphorrhea of the postoperative wound allows planning and conducting successful treatment. The use of Tachosil surgical patch in the treatment of lymphorrhea of the postoperative wound shortens the treatment and hospitalization periods. The use of Tachosil in the treatment of postoperative lymphorrhea appeared to be significantly more effective than the standard drainage method of treatment. Results obtained through this study pave the way for the research on other possible applications of Tachosil in the cases of lymphorrhea after vascular reconstructive surgeries.
    Źródło:
    Polish Journal of Surgery; 2013, 85, 12; 687-692
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Efficacy Evaluation Of Bio Trombina ® 400 In Mini Mall Y Invasive Treatment of Complications (Pseudoaneurysms), After Venipuncture for Diagnostic Purposes. Authors’ Own Experience – Case Study of 38 Patients
    Autorzy:
    Iłżecki, Marek
    Zubilewicz, Tomasz
    Przywara, Stanisław
    Wojtak, Andrzej
    Kęsik, Jan Jakub
    Olejniczak-Nowakowska, Małgorzata
    Terlecki, Piotr
    Powiązania:
    https://bibliotekanauki.pl/articles/1395774.pdf
    Data publikacji:
    2014-08-01
    Wydawca:
    Index Copernicus International
    Tematy:
    embolization
    pseudoaneurysm
    trombin
    Opis:
    Common use of venipuncture on upper and lower limbs for diagnostic purposes (such as coronarography or arteriography), and also during the course of treatment (angioplasty), very often bares a complication in the form of pseudoaneurysms. According to various reports, the incidence of pseudoaneurysms ranges from 0.005% to 0.5% of all vascular procedures requiring arterial cannulation (Common Femoral Artery, Brachial Artery, Radial Artery). The use of Bio Trombina® 400 in the embolization of pseudoaneurysms allows minimally invasive and effective treatment. The aim of the study was to evaluate the efficacy of pseudoaneurysm embolization with the use of Trombina 400, authors’ own experience. Material and methods. In the years 2011 - 2013, the authors of this study performed 38 vascular interventional procedures involving pseudoaneurysms as complications of venipuncture in upper and lower limbs for diagnostic and treatment purposes. All procedures involved the direct injection of thrombin into the chamber of the pseudoaneurysm under the guidance of USG Doppler (6.2 MHz linear head). 34 cases presented single chamber pseudoaneurysms while 4 cases involved multi- chamber pseudoaneurysms, which required several thrombin reinjections (Bio Trombina® 400) into each of the chambers. Pseudoaneurysm maximum size of 4 cm was set as an inclusion criterion for the embolization procedure. Furthermore, all pseudoaneurysms with a significantly wide tract in transverse dimensions were treated as an exclusion criterion because of high risk of the peripheral arteries embolization. Results. Initial success was observed in 36 patients (94.73%) in the first day after the procedure, 1 patient (2.63%) underwent thrombin reinjection procedure in the second day after the first embolization. Another patient (2.63%) underwent an open procedure in which the Common Femoral Artery was accessed, the clot evacuated, and CFA was sutured with continuous suture Prolene 6-0. Conclusions. 1. Embolization of pseudoaneurysms with USG Doppler-guided thrombin injection is an effective course of treatment for complications of cannulation. 2. The safety of pseudoaneurysm embolization depends on a surgeon’s experience. It is also crucial to keep in mind the inclusion and exclusion criteria for this type of procedure (the size of a pseudoaneurysm, the width of its base). 3. Furthermore, its cost effectiveness and short hospitalization period make pseudoaneurysm embolization an effective and valuable alternative to the classic approach.
    Źródło:
    Polish Journal of Surgery; 2014, 86, 8; 359-363
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Selected factors of fibrinolysis in the Buerger’s disease
    Autorzy:
    Terlecki, Piotr
    Feldo, Marcin
    Przywara, Stanisław
    Iłżecki, Marek
    Kęsik, Jan J.
    Borowski, Grzegorz
    Wroński, Jacek
    Zubilewicz, Tomasz
    Powiązania:
    https://bibliotekanauki.pl/articles/1396478.pdf
    Data publikacji:
    2013-11-01
    Wydawca:
    Index Copernicus International
    Tematy:
    Buerger’s disease
    fibrinolysis
    Opis:
    Thrombangiitis obliterans (TAO marked by coexistence of thrombotic and inflammatory changes of neurovascular tract has evoked a considerable dispute concerning pathogenesis of this disease. The aim of the study was to define the level of activation of fibirinolitic system in course of TAO disease by means of determination its basic constituents as well as to examine the essence of level of fibrinolysis disorders in pathogenesis and development of this disease. Material and methods. Fifty patients with thrombangiitis obliterans (TAO), 30 patients with peripheral occlusive disease - PAOD (ASO) and 20 healthy volunteers (K) have been subjected to the examination. We determined the activity some factors of fibrinolysis: t-PA, PAI-1, PAP, plasminogen, α2-antiplasminogen, D-dimmer as well as euglobulin lysis time. The analysis comprised 7 features and 8 factors of variability: a membership to a group of patients, sex, age, smoking, aggravation of the disease within last 3 months, occurrence of Raynaud’s symptom, a degree of ischemia according to Fontaine, time the disease lasted. Results. The significant differences between the average were checked by means of t-Student test or variance analysis (ANOVA) and co-relation rate r (Pearson). We concluded that the average value of PAI-1 in the group TAO was significantly higher than in comparison with ASO group. The increased values were revealed in case of 76 % of patients. The euglobulin lysis time was vitally extended in case of 60% of patients in ASO group. In all three groups higher levels of α2-antiplasmin were detected in case of elderly patients compared to the younger ones. Conclusions. The obtained results allow us to ascertain the state of potentially weakened fibrinolysis in case of patients with Buerger’s disease as well as with PAOD.
    Źródło:
    Polish Journal of Surgery; 2013, 85, 11; 630-637
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
      Wyświetlanie 1-5 z 5

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