11. Endovascular treatment of aortic aneurysm by endoprosthesisMiloš Šurlan, Vladka Salapura, 2000, izvirni znanstveni članek Povzetek: Aortic endoprosthesis are divided according to its shape, site of application,and construction material. Regarding the shape, there are tubular,unilateral and bifurcational endoprosthesis. Tubular are used mostly for treatment the thoracic aneurysm, and less for treatment of the abdominal aneurysms. For exclusion of abdominal aneurysm the bifurcational prosthesis ismostly used. Aortic endoprostheses are made of metallic support and prosthetic part. Supportive elements are made of stainless steel or nitinol, while the prosthetic part is made of dacron or PTFE. Metallic part of prosthesis attaches prosthesis to healthy part of aorta, above and below aneurysm, like sutures. It expands and gives support to the prosthesis. The procedure is precisely described for thoracic and abdominal aortic aneurysms. We describe the possible complications and the mechanism of leakage and its diagnosis. In the study are presented two cases of patients with aneurysm of thoracic aorta and one case with abdominal aorta, successfully treated in our Institution. The follow-up results after 2 years, in the patients with thoracic aortic aneurysm, and 6 months follow up in the patient with abdominalaortic aneurysm showed no signs of clinical or imaging complications.In conslusion, we were trying, on the basis of our experiences and results that have been recently published, to evaluate this method of treatment.
Objavljeno v DiRROS: 24.01.2024; Ogledov: 233; Prenosov: 57
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12. Diagnostic imaging, indications and measurements for the treatment of aortic aneurysm by endoprosthesisMiloš Šurlan, Vladka Salapura, Tomaž Kunst, 2000, pregledni znanstveni članek Povzetek: Background. This paper presents imaging diagnostics of an aneurysm of the aorta, indications, common contraindications and measurements for the construction and selection of an endoprosthesis. The examination using ultrasound is the most handy and economically justifiable method for detectingan aneurysm of the aorta, for monitoring asymptomatic aneurysm as well as patients having undergone an operation or those with an endoprosthesis. Another examination to visualise the aortic aneurysm is CT with or without contrastive medium. The plan for treating an aneurysm can be made with the help of a DSA, helical CT angiography and/or MRA. DSA shows wellthe lightness of the aneurysm and the aorta, as well as the changes insideof it, large arteries close to the aneurysm and the condition of pelvic arteries for the selection of the approach. The helical CT angiography and MRAin two or three dimensional reproduction in several directions enable an accurate measurement of an aneurysm, the aorta diameter above and below the aneurysm, and the evaluation of the quality of its wall. Conclusions. The indication areas for endoprosthesis are aneurysm of the abdominal aorta and those of the descending part of thoracic aorta. The treatment with endoprosthesis as a less invasive method is indicated in patients who risk a number of complications and even mortality when treated surgically. Endoprosthesis is made of metal stent and prosthesis. The stent attaches the endoprosthesis to the unaffected part of the aorta above and below the aneurysm, it sets the stent asunder and provides support. The prosthesis is made of Dacron synthetic fabric, which has very good properties for this purpose such as small compliance, porosity, permeability and extensibility. The endoprosthesis is introduced into the aorta through a catheter system withthe help of a special guide wire. The entering point is surgically opened common femoral or iliac artery.
Objavljeno v DiRROS: 24.01.2024; Ogledov: 259; Prenosov: 56
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13. Transjugular intrahepatic portosystemic shunt (TIPS)Miloš Šurlan, Janez Jereb, 2000, pregledni znanstveni članek Povzetek: Background. A clear presentation of TIPS indications and contraindications, which can be divided into absolute and relative, is given. Absolute indications are fresh and renewed bleeding of varices and inveterate ascites. Relative indications, on the other hand, are splenomegaly with hypersplenism, Budd-Chiari syndrome, liver transplantation and hepatorenal syndrome. Absolutecontraindications are severe liver dysfunction and right heart failure, while the relative ones polycystic liver degeneration, neoplasm, obstruction of the portal vein and severe local and systemic infection. Beforethe TIPS procedure, the level of dysfunction of the liver, right heart and kidneys is determined. Biochemical and blood tests, including a blood coagulation test, are made, the ammonia level in the serum is determined and possible obstructions/strictures of the portal vein are checked. A detailed description of the procedure, a care for patient and a operative monitoring are given. The success rate of the procedure is between 93% and 100% and the mortality rate within 30 days because TIPS is between 1% and 3%. The hemorrhage is stopped in 95% to 100%, the ascites is improved in 87% to 92% and the kidney function in 81%. In case of hypersplenism the thrombocytopenia is improved in 75% and leucopenia in 50% of patients. There are relatively fewcomplications during the procedure. Postoperative complications are more frequent due to stricture and obstruction of the shunt. After a two-year treatment the shunt is passable in 50% of patients. Thus, in a group of 29 patients, who were treated in the period of four years with an average monitoring period of two years, 22 patients (75,9%) are still alive and only 7died (24,1%). Six of dead patients suffered from alcoholic cirrhosis of the liver. In two cases the cause of death was not related to the TIPS and the cirrhosis of the liver. (Abstract truncated at 2000 characters).
Objavljeno v DiRROS: 23.01.2024; Ogledov: 251; Prenosov: 51
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14. Defecography: a report on 35 casesBreda Jamar, Katarina Šurlan Popović, 2000, izvirni znanstveni članek Povzetek: Purpose. To evaluate indications in the patients referred for defecography to our Institute between October 1996 and December 1999. Patients and methods. Inthis period, 35 patients (31 women and 4 men, their mean age being 56,5 and34,5 years, respectively) with defecation disorders disorders of 1 months to 17 years of duration were referred to us for defecography - 26 from proctology specialists and 9 from internal medical out-patient departments. After the rectum was filled with thick barium paste, spot shots from lateral position were made in different phases of defecation, with the patient sittingon a specially designed commode. Results. Rectocele was found in 21 cases, in 9 cases in association with rectorectal intussusception, in 3 with rectoanal intussusception and in 2 with herniation of rectal wall into ishiorectal fossa. Prolapse was found in 2 cases, and 4 rectorectal intussusception, 1 rectoanal intussusception and 3 fistulas were diagnosed. The findings were normal in only one case, while in 3 cases defectography showed functional abnormalities. In female patients, symptoms started after gynaecological operation in 11 cases and 6 cases after delivery. Eight women had to press perineum with their hand to faciliate defecation. Conclusions. Defecography proved useful in clarifying the pathology underlying patient's difficulties.
Objavljeno v DiRROS: 23.01.2024; Ogledov: 232; Prenosov: 50
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18. Percutaneous transluminal renal angioplasty - a multicentre study of the long term results : Belan A.... [et al.]A. Belan, Dušan Pavčnik, A. Petrosijan, L. Horvath, I. Rabkin, A. H. Muller, Miloš Šurlan, Janez Klančar, Jernej Knific, Pavel Berden, D. Vidmar, Rok Cesar, Igor Kocijančič, Staša Kaplan-Pavlovčič, 1990, izvirni znanstveni članek Objavljeno v DiRROS: 18.09.2023; Ogledov: 343; Prenosov: 105
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