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        תוצאת חיפוש

        יוני 2001

        אברהמי, מרגלית נוימן-לוין, מנשה חדד, ארנון קורן, ג'ק דהן, גלית סיבק ואביגדור זליקובסקי
        עמ'

        Treatment of Traumatic False Aneurysm of the Thoracic Aorta with Stent Graft

         

        R. Avrahami, M. Noyman-Levine, M. Haddad, A. Koren, J. Dahan, G. Sivak, A. Zelikovski,

         

        Department of Vascular Surgery, Rabin Medical Center, Beilinson Campus, Petah Tikva

        and Sackler School of Medicine, Tel-Aviv University, Israel

         

        The treatment of traumatic false aneurysm of the thoracic aorta by endovascular stent graft may have advantages over conventional surgery. This is a case study of two women suffering from false aneurysm of the thoracic aorta caused in one by a knife injury and in the other by a car accident. After the patients became hemodynamically stable, a commercially available endothelial stent graft (Talent, Gor) was deployed. Recovery was rapid in the first patient. The second patient required emergency laparotomy for venous bleeding one day after stent placement; she died two weeks later, mainly from organ failure.

        Conclusions: Endovascular techniques can be used in selected cases to treat thoracic false aneurysms thereby avoiding the complexity and morbidity of conventional surgery.

        ינואר 2001

        ר' חדאד, מ' כהן, ע' קפלן, ר' גרינברג וח' קשתן
        עמ'

        Photodynamic Therapy of Nasal Basal Cell Carcinoma

         

        R. Haddad, M. Cohen, O. Kaplan, R. Greenberg, H. Kashtan

         

        Dept. of Surgery, Tel Aviv-Sourasky Medical Center

         

        Photodynamic therapy (PDT) is a noninvasive modality used topically for several skin cancers. We evaluated the effects of PDT on basal cell carcinoma (BCC) of the nose, using aminolevulinic acid (ALA) as a photosensitizer and a non-laser light source (Versa-LightTM). The advantages of this light source are synergistic, hyperthermia and fewer side effects.

        A paste of 20% ALA was applied topically to biopsy-proven BCC of the nose. Lesions were covered with occlusive light-shielding dressing and after 18 hours they were submitted to 10 minutes of exposure to the light. Initial evaluation was made after 21 days and every 3 months thereafter. Patients who did not respond after 2 treatments were referred for surgery.

        Mean follow-up in 31 patients was 19 months (range 6-36). There were no significant side-effects. There was complete response in 24/27 (88.9%), in whom there was recurrence in 2/27 (7.4%).
         

        אפריל 2000

        יונתן כהן, פייר זינגר, מנשה חדד ואביגדור זליקובסקי
        עמ'

        Elective Repair of Infra-Renal Aortic Aneurysm 


        J.D. Cohen, P. Singer, M. Haddad, A. Zelikovski

         

        Depts. of General Intensive Care and Vascular Surgery, Rabin Medical Center, Beilinson Campus; and Sackler Faculty of Medicine, Tel Aviv University

         

        Age over 80 years is generally considered an independent risk factor in elective surgery for abdominal aortic aneurysm (AAA). As the general population increases in age, more elderly are likely to be candidates for such surgery.

        We studied prospectively 100 consecutive patients undergoing elective AAA surgery between 1992-1995. All were operated on by the same team of anesthetists and surgeons and all were transferred to the general ICU for at least the first 24 hours. 16 were above the age of 80 (Group I) and 84 below (Group II).

        We recorded preoperative factors (demographics, medical history, risk factor indices, EKG findings, as well as left ventricular ejection fraction (LVEF) and stress imaging when indicated); intraoperative factors (duration of surgery, size of aneurysm, complications and units of blood transfused); postoperative factors (length of ICU stay, duration of ventilation, APACHE II [Acute Physiological and Chronic Health Evaluation] and TISS [Therapeutic Intervention Scoring System] scores; complications in the ICU, need for readmission to the ICU, and mortality).

        In Group I LVEF was greater (p=0.03) and aneurysm size significantly larger (p=0.036), but there were no other significant differences between the 2 groups with regard to pre- and intraoperative data. Group I patients were not ventilated as long (p=0.038), but there were no significant differences in outcome factors. Mortality for the whole group was 5% and was not significantly different in the 2 groups (1/16 in Group I and 4/84 in Group II).

        We conclude that there is no excess morbidity or mortality in octogenarians undergoing AAA surgery. However risk of the aneurysms rupturing is significantly greater since they are larger. We suggest that age not be considered the sole criterion for aneurysm repair, or at least not in selected patients with normal LVEF.

        יוני 1998

        ר' אברהמי, מ' חדד, ס' וטמברג, א' שטלמן, א' קורן, ג' דהן וא' זליקובסקי
        עמ'

        Popliteal Vascular Trauma

         

        R. Avrahami, M. Haddad, B. Watemberg, E. Stelman, A. Koren, J. Dahn, A. Zelikovski

         

        Dept. of Vascular Surgery, Rabin Medical Center (Beilinson Campus), Petah Tikva

         

        6 cases of popliteal vascular trauma are presented, 3 due to posterior dislocation of the knee and 3 due to crush injury. The patients were referred from another hospital and some had undergone unnecessary angiography when ischemia was present, leading to delay in surgery. All patients presented with distal ischemia and underwent reconstructive surgery; 2 subsequently underwent below-knee amputation because of irreversible ischemia and sepsis.

         

        Urgent operation for popliteal vascular trauma is necessary whenever there is ischemia and intraoperative angiography may be necessary. There should be reconstruction of the artery and vein when there is concomitant venous damage, and fasciotomy and debridement are important. The harmful potential of occult popliteal vascular injuries and their ostensible mild presentation present a challengfor the emergency room surgeon.

        יוני 1997

        ר' אברהמי, מ' לוינסון, מ' חדד וא' זליקובסקי
        עמ'

        Traumatic Common Carotid-Internal Jugular Fistula: Positive Aspect

         

        R. Avrahami, M. Liverson, M. Haddad, A. Zelikovsky

         

        Dept. of Vascular Surgery and Anesthesia, Rabin Medical Center, Beilinson Campus, Petah Tikva and Sackler Faculty of Medicine, Tel Aviv University

         

        A 42-year-old man presented with a penetrating neck injury from a pellet gun. Physical examination showed an open 1 cm wound on the right side of the neck, hematoma of the right sternocleidomastoid muscle, and carotid artery injury. He was hemodynamically stable and there was no neurological deficit. Arteriogram of the neck disclosed a pseudoaneurysm with an arteriovenous fistula between the common carotid artery and internal jugular vein. At surgery, the tears in the carotid artery and jugular vein were sutured and a vacuum drain was introduced. The postoperative course was uneventful, and the patient was discharged 5 days later. Instead of the expected results of a penetrating carotid artery injury, such as blood loss, airway obstruction or neurological deficit, the arteriovenous fistula caused by the pellet actually saved the patient's life. Blood flow from the artery via the pseudoaneurysm to the jugular vein kept the patient in stable condition.

        הבהרה משפטית: כל נושא המופיע באתר זה נועד להשכלה בלבד ואין לראות בו ייעוץ רפואי או משפטי. אין הר"י אחראית לתוכן המתפרסם באתר זה ולכל נזק שעלול להיגרם. כל הזכויות על המידע באתר שייכות להסתדרות הרפואית בישראל. מדיניות פרטיות
        כתובתנו: ז'בוטינסקי 35 רמת גן, בניין התאומים 2 קומות 10-11, ת.ד. 3566, מיקוד 5213604. טלפון: 03-6100444, פקס: 03-5753303