Search

We present a monocentric analysis of the lumbar artery compression syndrome (LACS) in the form of a case report.Literature information was collected about the symptoms, diagnosis and treatment of this rare disorder in the context of the existing data.The current medical literature includes only one report about three cases of LACS, collected over 20 years in France and Germany. We compared these cases with the experience of the European Vascular Center Aachen-Maastricht.The symptoms of this rare disorder are dominated by reversible, motion-dependent paralysis of the legs. Compression of the right lumbar arteries by muscular fibres or connective tissue is a fundamental cause.Surgical treatment, which means decompression of the lumbar arteries via a thoracolaparotomy, is an appropriate therapy with few complications and good long-term results.Georg Thieme Verlag KG Stuttgart ? New York.

A common reason for painful lesions of the popliteal fossa are baker's cysts. An important differential diagnosis is the popliteal artery aneurysm, which is rare, but is associated with severe complications. The preferred method of diagnosis is the colour-coded duplex ultrasound. By showing the case of a 58-year-old man, who experienced life-threatening complications caused by an insufficient diagnosis before the operation of a Baker's cyst, we want to underline the importance of preoperative duplex ultrasound diagnosis in this context.

The post-thrombotic syndrome (PTS), long-term sequelae of a deep vein thrombosis (DVT), reduces quality of life and is of great socio-economic importance. Despite conservative treatment which does not directly facilitate recanalization more than 25% of patients develop PTS. Early thrombus removal may decrease the incidence and severity of PTS. Although the evidence for surgical thrombectomy is weak which allows an early and rapid recanalization, this therapy appears to reduce the risk of PTS and iliofemoral thrombosis. Systemic thrombolysis can reduce the incidence of PTS but it is no longer recommended due to serious bleeding complications. Previous studies with new endovascular catheter-guided procedures allowing local application of thrombolysis and thrombus aspiration displayed promising results. However, so far one prospective randomised study (CaVent study) with long-term results has revealed a significant reduction of PTS. The current evidence recommends early thrombus removal for patients at high risk for PTS. New endovascular procedures such as catheter-guided thrombolysis allow rapid thrombus removal but more prospective randomised studies are necessary to ensure the long-term success of this therapy.Georg Thieme Verlag KG Stuttgart ? New York.

Background. The postthrombotic syndrome (PTS) as a long-term consequence of deep vein thrombosis (DVT) is caused by venous obstruction and/or chronic insufficiency of the deep venous system. New endovascular therapies enable early recanalization of the deep veins aiming for reduced incidence and severity of PTS. Methods. A Medline search was performed for studies using catheter-directed thrombolysis (CDT) or thrombectomy (PMT) in DVT using the search terms deep venous thrombosis, catheter-directed thrombolysis and percutaneous mechanical thrombectomy. Results. The success of surgical thrombectomy depends on the age of the thrombosis. While systemic thrombolysis is not recommended due to the poor success rate (1 out of 4) and high risk of bleeding, catheter-derived thrombolysis (CDT) provides a more effective therapy with a significantly reduced risk of bleeding. Newer CDT systems combine thrombolysis with mechanical components in order to increase the effectiveness of this therapy; however, the available data are mainly derived from small case series. The CaVent study, a prospective randomized study with long-term results for CDT, revealed a reduction of PTS after 2 years for CDT compared to conservative therapy. Conclusion. Although the available data display the feasibility of catheter-based techniques, further prospective randomized studies are necessary to establish this therapy.

Einleitung: Die pharmako-mechanische Thrombolyse zur Behandlung der tiefen Venenthrombose hat durch die Verbesserung der Kathetertechnologie an Interesse gewonnen. Material und Methoden: Das EKOS® EndoWaveTM System kombiniert einen Infusionskatheter zur kontinuierlichen Medikamenteninfusion [for full text, please go to the a.m. URL], 127. Kongress der Deutschen Gesellschaft für Chirurgie

Einleitung: Der Einsatz von alloplastischem Material in der Therapie der Narbenhernie ist etabliert. Um eine Dislokation der Netzprothese zu vermeiden, wird eine nicht-resorbierbare Netzfixierung in der Bauchdecke empfohlen. Jedoch kann die Fixierung des Netzes in der Bauchdecke postoperative Schmerzen[for full text, please go to the a.m. URL], 126. Kongress der Deutschen Gesellschaft für Chirurgie

Einleitung: Die Insuffizienz intestinaler Anastomosen ist weiterhin eine der bedeutensten Komplikationen in kolorektalen Chirurgie. Die Entstehung der Anastomoseninsuffizienz ist multifaktoriell. Eine direkte Beeinflussung der Anastomosenheilung durch lokale Applikation des Aminoglykosid-Antibiotikums[for full text, please go to the a.m. URL], 126. Kongress der Deutschen Gesellschaft für Chirurgie