Percutaneous TransluminalAngioplastyTechnique, Early and Late Results

Edited by

c.T. Dotter A. R. Griintzig W. SchaapE.Zeitler

With 179 Figures

Springer-Verlag Berlin Heidelberg New York Tokyo 1983

CHARLES T. DaHER, M. D., University of Oregon, Health Sciences Center,Department of Diagnostic Radiology, Portland, Oregon 97201 , USA

Professor Dr. ANDREASR. GRONTZIG, Emory University School of Medicine,Department of Medicine, 1364 Clifton Ro ad, N.E. , Atl ant a, Georgia 30322 USA

Professor Dr. WERNER SCHaap, Aggertalklinik, D-5250 Engelskirchen

Professor Dr. EBERHARD Z EITLER, Klinikum Niirnberg, Radiologisches Zentrum,Flurstr. 17, D-8500 Niirnberg

ISBN-13 : 978-3-540-12654-6 e-ISBN-13: 978-3-642-69278-9001 : 10.1007 /978-3-642-69278-9

Library of Co ngress Catal oging in Public ation Data. Main entry und er title: Percutaneou s translumin al angioplasty.Bibliography: p. Includes index. I . Tr ansluminal angiopl asty - Addresses, essays, lectu res. I. Dott er . Char les T.[DNLM: I. An gioplasty, Tr anslumin al - Con gresses. WG 300 P429 1982] RD 59 8.5.P4 7 1983 6 17' .41 383- 19581

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Preface

In the past ten years , there have been significant advances in the diagnosis andtherapy of arterial vascular disease . While long-term morbidity can only beimproved by changing the patient's life-style and removing any risk factors thatmay be present (hypertension, hyperlipidemia, obesity, diabetes mellitus, nicotineabuse), symptomatic relief may be obtained by various procedures. Besidesconservative treatment of arterial occlusive disease (physical therapy, medicaltreatment) and surgical vascular interventions (thromboendarterectomy, bypassprocedures), balloon catheters introduced percutaneously under local anesthesiahave found incre ased application in virtually all areas for the dilatation andrecanalization of obstructive lesions in the past few years .

The technique of balloon dilatation, as introduced by Griintzig as a furtherdevelopment of the percutaneous interventions by Dotter and Judkins, is nolonger the decisive issue. The main objective of present clinical research is to de­termine the proper indications and patient selection for this procedure, whichhas found its place between conservative treatment and surgery.

The contents of this Symposium should provide some guidelines for the indi­cations and postprocedural therapy for the referring physician, the angiologist,and for the radiologist and cardiologist performing the dilatation.

We owe our thanks to all the specialists involved , who have provided us withthe benefits of their experience . Mrs. H. Beilmann and Dr. M. Wojtowycz con­tributed substantially to the preparation of the text. I would like to thank themand the staff of Springer-Verlag for their conscientious work in the interest ofcomposition and publication quality.

The large number of patients suffering peripheral vascular and coronaryarterial disease who could be helped objectively and subjectively by percutaneoustransluminal angioplasty (PTA) underscores the special value of this mode oftreatment. In addition, PTA also shows that close interdisciplinary communi­cation and cooperation serves the best interests of the patient .

E. Z EITLER

Contents

1. Tran sluminal An gioplasty : Method , Indication s, an d Rol e in Therap y. C. T. DOTI ER. . .

I. Diagnosis

2 . Noninva sive Di agno sis and Natur al Co urse of Arteriovascular Ob struction .W. SCHOOP 4

3. Ultra so und Techniques for Fo llow-up of Hemodyn amic Cha nges After PeripheralTransluminal An gioplasty. A . BOl.LlNGER.With 4 Figures. . . . . . . . . . . . . . . . . . . . . . 6

4 . Digit al Subtraction Angiogra phy - A Method of Follow ing Percutaneous Tran slumina lAn gioplasty . W. SEYf ERTH, G. DILl3AT, E . ZEITLER, and G. BOLLE. With 6 Figur es. . . . 13

5. Ev aluation of Peripheral Transluminal Angiopl asty by a Score System Applied toRoutine Arteriographic Images. A . BOLLINGER, E . SCHNEIDER, G . POULI ADIS.C. TORRES, and M. SCHLUMPF. With 2 Figur es . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

6. E xposur e of Phys icians and Pati ents to Radi ation During Transluminal D ilat ation andRecanali zat ion According to Dotter. F . aLB ERT, M . NELL, and H. BAUMRUCK. . . . . . . 24

n. Percutaneo us Transluminal Angioplasty: Instrumentation and Tec hnique

7. Sin gle Teflon Ca theters . E. Z EITLER. With 4 Figur es . . . . . . . . . . . . . . . . . . . . . . . . . . 26

8. Basic T echnology o f Ball oon Cath et ers. J . E. ABELE. With 2 Figures . . . . . . . . . . . . 31

9. Dil atation and th e Ex panding Balloon Cath eter. Advantages of the Expanding BalloonCa the ter. F . a LBERT, and N . MUZIKA. With 10 Figures ' " . . , 37

III. Percutaneous Transluminal Angioplasty: Mechanism and Morphology

10. Th e Morphological Co ncept of Percutaneous Tran sluminal An gioplasty. H . J . LEU. 46With 7 Figures .

II . Pathological Basis for Percutaneous Catheter and Bailon R evasculari zation .D. SINAPI US. With 4 Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

12. Result s of An imal Ex pe rime nts With Bailon Dilatation . C. L. Z OLLIKOFER,W. R . CASTANEDA-Z UNGIA, and K. AMPLATZ. With 10 Figures " .. . . . 60

13. Radiological Pattern at and After Angiopl asty . F .-J. ROTH, G. CAPPIUS, andE. FINGERHUT. With 8 Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

IV. Medica l Treatment

14. Percutan eous Transluminal Angioplasty: Adjunct Drug Th er ap y. E.-I. RICHTER andE . Z EITLER. With 4 Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

15. Plat elet Act ivat ion at the Time of Percutaneous Tran sluminal An gioplasty.W. BLATILER, N. FOUl.LON, G. C APPIUS, and F .-J . ROTH. With 4 Figures . . . . . . . 91

16. Results With Addi tion al Use of SP 54 in Percutaneous Transluminal Angioplasty.L. HORVATH, K. FENDLER, and I. ILLES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

17 . Nafazatrom: A New Antithrombotic Compound. F . SEUTER. With 3 Figures . . . . . . . 98

VIII Co ntents

V. Prim ary Re sult s: Leg Arte ries

18. Femoropopliteal Arteries. E. ZEITLER, E. -I. RICHTER, and W. SEYFERTH. With 8 Figur es 105

19. An gioplastyofthe Iliac and Inguin al Arteries. F.-J. ROTH and G . CAPPIUS. With 6 Figur es I 15

20. Percutaneous Translumin al An gioplasty in Cas es of Sten osis in the Region of the Infra­ren al Abdomin al Aorta and the Aortoiliac Bifurcat ion . H. INGRISCH, W. SEYFERTH,and G . KOFER. With 2 Figures 127

2 I. Rel apse Treatm ent by Percutan eou s Transluminal Dilatati on . I. SCHMIDTKE andF.-J . ROTH . .. ... . . . . . . . . . . .. . . . . . . . . . . ... .. . . .. . .. .. . . . . . . . . . . . .. . . . 131

VI. Percut aneous Transluminal Angioplasty in Combina tion With Fibrino lysis

22 . Fibrinolysis and Tran sluminal Cathe ter Treatment: A Multistage Approach for theRemoval of Chronic Arterial Occlusions. M. MARTIN, B. J . O . FIEBACH, andT. GODULA . With I Figur e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140

23. Clot Lysis in Peripheral Arteries. H. HESS. With 6 Figures . . . . . . . . . . . . . . . . . . . . . . 145

24. Early Experience of Catheter Lysis. F.-J . ROTH, G. CAPPIUS, and I. SCHMIDTKE. With4 Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I54

VII. Complications

25. Complications During and Aft er Percutaneous Tran slumin al An giop last y. W.SEYFERTH, M. ERNSTING, R. GROSSE-VORHOLT, and E. ZEITLER. With 5 Figure s . . . 161

26 . Prevent ion of Complicat ions in Percutaneous Translumin al An giop lasty . L. HORVATH,I. ILLEs. and K. FENDLER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170

VIII. Percutan eous T ranslumina l Angio plasty: Late Result s in Leg Arte ries

27. Lon g-Term Paten cy Rates Af ter Percut an eou s Transluminal A ngiop lasty fo r Iliac andFe moropoplitea l Ob stru ction s. E. SCHNEIDER, A. GRONTZIG, and A . BOLLINGER 175

28. Ten-Year Result s of Per cut an eou s Ca the ter Treatm ent in Cases of Femo rop oplitealA rte rial Occlusion in Stage II. I. SCHMIDTKE. With 3 Figur es . . . . . . . . . . . . . . . . . . . 18 I

29 . Late Result s of Percutan eou s Transluminal An gioplasty of Leg A rteri es With SpecialReference to the Popliteocrural Region . W. O STHEIM-D z EROWYCZ. With 4 Figures. . . 191

30 . Late Result s of Percutan eou s Ca the ter Treatment in Iliac Sten oses - A RetrospectiveStudy. H. RIEGER, F.-J . ROTH. E. ZEITLER, T . PALDEN. M. WEGENER, and W. SCHOOI'.With I Figure 194

3 I . Factors Influencing Early and Late Follow-up Result s After Percut an eous TransluminalAngioplasty of the Lower Limb Arteries. F. MAHLER, A. G ALUNO, P. PROBST, andB. NACHBUR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199

32. Long-T erm Results of Iliac and Femoropopliteal Angioplast y. R. F. COLAI'INTO. With6 Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202

33. Long-Term Results of Translumin al Angiop lasty of the Femoral Arteries .H. D. BERKOWITZ, R. K. SPENCE, D. B. FREIMAN, C. F. BARKER, B. ROBERTS,G . MCLEAN, and E . RING. With 5 Figure s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207

34. Late Results Aft er Percut an eousTransluminal Angioplast y ofiliac and FemoropoplitealObstructive Lesions - A Cooperative Study. H. G AlLER, A. G RONTZIG, andE. Z EITLER. With 2 Figur es . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 15

35 . Late Result s A fter Percutaneous T ransluminal An gioplasty for Iliac Art er y Steno sis.W. OSTHEIM-D z EROWYCZ. With 3 Figur es . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 19

36 . Percutaneous Tran slum inal An giop lasty for Limb Salvage - Progress in Therapy forSevere Leg Ischemi a With Rest Pain and Gangren e. E . SCHNEIDER, A. GRONTZIG,and A. BOLLINGER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222

Contents IX

IX. Percutaneous Transluminal Angioplasty of Coronary Arteries

37. Percutaneou s Coro nary An giopl asty - A Critical Revi ew of Its Clinical Application.A . R. G RONTZIG, J . W. H URST, and C. R. HATCHER. . . . . . . . . . . . . . . . . . . . . . . . . 227

38. Transbrachial Corona ry Dilat at ion :Technique, Indicat ion s, Result s, and Co mplications.G. KOBER,N . D. SCHERER,S . D OWINSKY,R. HOPF,and M. KALTENBACH. With 6 Figures 230

39 . Transbrachial Transluminal Dil at at ion of Abdominal and Periphe ral Arteri es.K. BACHMANN and G . RAAB. With 2 Figure s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236

X. Percutaneous Transluminal Angioplasty for Supra-aortic Stenoses

40 . Percutaneous Transluminal A ngiopl asty of th e Vert ebral Arteries . A . MOTARJ EME,J . W . KEIFER, A . J . ZUSKA, and P. NABAVI. With 1 Figure. . . . . . . . . . . . . . . . . . . . . . . 241

40a. Percutan eous Translumina l An giopl asty of th e Supra-ao rt ic Arteries. E . Z EITLER,G . BERGER, and R . SCHMITr-ROTH. With 6 Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . 245

XI. Percutaneous Transluminal Angioplasty of Renal Arteries

41. Lon g-Term Re sults of Percutaneou s Tran sluminal Angioplasty for RenovascularHyperternsion Us ing the Coaxial Ca the te r Te chnique in Pat ients With Atherosclerosisand Fib ro muscula r Dyspl asia. F. MAHLER, Z. GLOCK, P. PROBST, P. WEIDMANN, andB. NACHBUR. With 5 Figures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262

42 . Treatment of Ren ovascular H ype rte nsion by Per cut an eou s Transluminal An gioplastyof Tw o Ren al Arteries in a 5-Year-Old Boy. F . MAHLER, R. GHISLA, M. HAERTEL,O . O ETLIKER, A . KRNETA, and E. Rossr, With I Figure . . . . . . . . . . . . . . . . . . . . . . . . 269

43. Follow-up in Patients Under going Percut an eous Transluminal Angiopl asty for RenalArte ry Stenosis and Occlusion . W.-D. BUSSMANN, P. GROTZMACHER, R . RUMINSKY,W. FASSBINDER, S. DOWINSKY, D. R UMMEL, M. KALTENBACH, and W. SCHOEPPE. With8 Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272

44 . Renal An giopl asty in Hypertension : Technique , Rad iolo gical and Clinica l Results, andComplication s in 134 Dilat ations. C. B. A . J . PUIJLAERT, G . G. G EYSKES, J. H. J . R UIJs,H. P. J . WOSTEFELD, and W. P. T. MALI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279

45. Percutaneous Translumina l An giopl asty of Renal Arteri es - A T he rape utic Principle.Ca se Report of 128 Patients With Renovascular Hyperten sion . E. LOHR, H. C.WEICHERT, H. HARTJES, and A. SCHRIJVERS. With I Figur e . . . . . . . . . . . . . . . . . . . . . 28 1

46 . Te chnique , Ind icat ion s, Co mplicatio ns and Re sults of Percutan eou s TransluminalRen al A rte ry Dilata tion. E.-I. RICHTER, E. KRONERT, and E. Z EITLER. With 6 Figur es 28 6

XII. Indications for Percutaneous Transluminal Angioplasty

47 . Spec ial Ind ications fo r Angioplasty . F.-J . ROTH an d G . CAPPIUS. With 7 Figur es . . . . 296

48. Re sul ts of Percutane ou s Translumina l An giopl ast y of the Deep Femoral Arter y - APreliminary Study. H. RIEGER, F.-J . ROTH, and W . SCHOOP. With 2 Figures . . . . . . . 308

49 . Percutaneous Tran slum inal An giopl ast y as a Co mpleme nt to Surgery . A. MOTARJEME,J . W. KEIFER, A. J . ZUSKA, and P. NABAVI. With 5 Figures . . . . . . . . . . . . . . . . . . . . . . 3 12

50 . Th e Place of Percutaneous Tra nsluminal Angioplas ty in the Th er ap y of a Clinic forVascular Diseases . M. KOHLER, C. DEMMER, and F.-J . ROTH . . . . . . . . . . . . . . . . . . . 321

51 . Ind icati ons for Percu ta neous Transluminal An giopl asty From the Surgeon 's Point ofView. H . DENCK. With 2 Figures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 324

52 . Indicat ion s for Percutane ou s Transluminal An giopl asty: Th e Nephrologist's View .E . Lu x and D . SEYBOLD. With 1 Figure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327

53. In dications for Percutaneous Transluminal An giopl asty: Th e An giolo gist's Point ofView. W. SCHOOP .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 332

x Co nte nts

XIII. Percutaneou s Transluminal Angioplasty Today and in the Future

54 . Per cut an eou s Transluminal A ngioplasty: Stat e of the Art and Fu ture Per spectives.A . BOLLINGER, E. SCHNEIDER, U. KUHLMANN, G. POULIADISan d U. BRUNNER . . . . . . . 335

55. T ran slu minal A ngioplas ty : Result s and Future O ut look. C. T . DOTIER . . . . . . . . . . . . 337

Appendix

56 . Tran slum inal Angioplas ty : A Co mp rehensive , Chronological Bibliography 1964 -1 982 .C. T. DOTI ER and E. J. R UBLE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339

Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363

List of Collaborators

J. E. ABELE

K. AMPLATZ

K. BACHMANN

C. F . BARKER

H. BAUMRUCK

G.BERGER

H. D. BERKOWITZ

W . BLii,TTLER

G ISELA BOLLE

A. BOLLINGER

U. BRUNNER

W .-D. B USSMANN

GABRIELE CAPPIUS

W. R. C ASTANEDA-ZUNGIA

R. F. COLAPINTO

CORNELIA DEMMER

H. D ENCK

G. D ILBAT

C . T. D OTTER

MEDI-TECH INC. 480 Pleasant St., P.O .B. 7407 , Watertown,MA 02 172 USA

Depart men t of Radiology, University of Minnesota Hospitals,420 Delaware Street S.E ., Minneapolis, MN 55455 USA

Medizinische Poliklinik , Universitat Erlangen -Niirnbe rg, D-8520Er langen

De partment of Surgery, Hospital of the University of Penn syl­vania, 4 Silverstein, Philadelph ia, PA 19 104 USA

Physikalisch-technische Priifanstalt fur Radiologie und Elektr o­medizin. Allgemein es Krank enh aus, Alserstr. 4, A-1190 Wien

Neurologisch-psychi atri sche Klinik, Neuroph ysiologische Abt ei­lung, Klinikum Niirnb erg, Flurstr. 17, D- 8500 Niirnberg

Hospital of the University of Pennsylvania, 4th Floor SilversteinPavilion , 3400 Spru ce Street , Philadelphia. Pa. 19104 USA

Praxis fiir GefiiBerkranku ngen, Eisengasse 2, CH-8008 Ziirich

Radiologisches Zent rum, Diagnostische Abteilung, Klinikum Niirn­berg, Flurstr. 17, D- 8500 Niirnbe rg 91

Department fiir Innere Medizin, Poliklinik, Angiologische Abtei­lung, Universita tsspita l, Ramistr . 100, CH-8091 Ziir ich

Abteilung fiir Periphere Vasku lare Chirurgie, Chiru rgie B, Uni ­versitatsspital, Ramistr. 100, CH-809 1 Ziirich

Zentrum de r Inneren Medizin, Abteilung fiir Kardiologie, Klinikumder J. W. Goeth e-Universitat, Theodor-Stern-Kai 7, D-6000Frankfurt/M. 70

Aggerta lklinik, D-5250 Engelskirchen

Department of Radiology, University of Minnesota Hospitals,420 Delaware Stree t S.E., Minneapolis, MN 554 55 USA

Toront o Gene ral Hospitals, 101 College Street , To ront o, On t.M5G IL7 Canada

Aggertalklinik, D-5250 Engelskirchen

Krankenh aus der Stadt Wien- Lainz, I. Chirurgische Abt eilun g,Wolkersbergenstr. I, A-11 30 Wien

Radiologisches Zentrum, Diagnostische Abt eilun g,Klinikum Niirn­be rg, Flurstr. 17, D-8500 Niirnberg 9 1

University of Or egon , Health Sciences Cente r, Departm ent ofDiagnostic Radiology, Portl and, Oregon 9720 1 USA

XII

S. DOWI NSKY

M ARI ANNE ERNSTING

W. F ASSBINDER

K .FENDLER

B. J . O . FI EBACH

E. F INGE RHUT

N .FoULLO N

D. B. FREIMANN

H . GAlLER

A. GA LLINO

G . G . G EYSKES

R. GHISLA

Z. G LOCK

T. GOD ULA

R. GROSSE-VORHOLT

A. R. GR ONTZIG

P. GROTZMACHER

M . H AERT EL

I-I. H ARTJ ES

C. R. H ATCHER

H. H ESS

R. HOPF

L. HORVATH

J. W. H URST

I. ILL ES

H .INGRISCH

List of Collaborators

Zentrum der inneren Medizin, Abteilun g fiir Kardiologie, Klinikumder J. W. Goethe-Universitat , Th eodor-Stern -Kai 7, D-6000Frankfurt/M . 70

Rad iolog isches Zentrum, Diagnostische Abteilung , Klinikum Niirn­berg , Flurstr. 17, D-8500 Niirnberg 91

Zentrum der Inneren Medizin, Abteilung fiir Kardiologie, Klini­kum der J. W. Go eth e-Univ ersitat , Th eodor-Stern-Kai 7, D-6000Frankfurt/M. 70

Radiologische Klin ik, H-7643 Pecs

Zentrale Strahlendiagnostik und Neuroradiologie, Stad tische Kli­niken Dui sburg, Zu den Rehwiesen 9, D-41 00 Dui sburg 1

Aggert alklinik , D-5250 En gelskirchen

Aggertalkl inik fiir Gcfatlk rankheiten, D-5250 Engelskirch en

Department of Radiology, Presbyterian- Un iversi ty of Pennsyl­vania, Medical Center, 51 North 39 th Street, Philadelphia , PA19104 USA

Rad iologisches Zentrum , Ab t. Diagnostik, Klinikum Niirnberg,Flurst r. 17, D-8 500 Niirnberg

Medi zinische Universitatsklinik, Inselspital , CH-30 I0 Bern

Department of Nefrology, University Ho spital, Catharijnesingel101, NL-3500 CG Utrecht

Universitatskinderklinik, Inselspital . CH -30 I0 Bern

Medi zinische Universitatsklinik, 1nselspi tal , CH-3 0 I0 Bern

Stadtische Kliniken Duisburg, Ge riatri sche Klinik, Zu den Reh­wiesen 9, D-41 00 Duisburg I

Rad iologisches Zentrum, Diagnostische Ab tcilung, Klinikum Niirn­berg, Flurstr. 17, D-8500 Niirnberg 91

Emory University School of Med icine , Department of Medicine,1364 Clifton Road , N.E. , Atlanta, Georgia 30322 USA

Zentrum der Inneren Medizin , Abteilun g fur Kardiologie, Klinikumder J. W. Goethe-Universitat , Th eodor-Stern-Kai 7, D-6000Frankfur t/M. 70

Institut fur Radiologie, Kantonsspital, CH-9000 St. Gallen

Rontgendiagnostisches Zentralins titut , U niversi ta ts-Klinikum Es­sen , Hufelandstr. 55, D-4300 Essen I

E mory Un iversity School of Med icine , Departm ent of Medicine,1364 Clifton Ro ad , N.E ., Atlanta, Georgia 30322 USA

Medi zinische Poliklinik der Univ ersit at Miinch en , Pettenkofer­str. 8a, D-8000 Miinch en 2

Zent rum der inn eren Med izin , Abteilung fiir Kardiologie, Klinikumder J . W. Goethe-Universitat , Theodor-Stern-Kai 7, D-6000Fra nkfurt/M. 70

Radiologische Klinik , H-7643 Pees

Emor y University School of Med icine, Department of Med icine,1364 Clifton Ro ad , N.E., At lant a, Georgi a 30322 USA

Radiologische Klinik, H-7643 Pees

Rad iologische Klinik und Poliklinik der Universitat Miinchen,Polikl inik, Pettenkoferstr. 8a , 8000 Miinchen 2

List of Collaborators

K . W . J OHNSTON

M . KALTENBACH

J . W . K EIFER

G. KOB ER

M . K bHLER

A . KRNETA

E. KRbNERT

G. K OFFER

U. K UHLMANN

H. J. L EU

E . LbHR

E. Lux

F. M AHLER

W . P . T. M ALI

M . M ARTIN

G. M cLEAN

A . MOTA RJEME

N . M UZIKA

P. N ABAVI

B. NACHBU R

M . N ELL

O .OETLIK ER

F .OLBERT

W .OSTHEIM-DZEROWYCZ

T. P ALDEN

XIII

Department of Surgery, Toronto Gener al Hospital , Toronto, On t.M5G IL7 Canada

Zentrum der Inn eren Medizin, Abteilun g fur Kardiologie, Klini­kum der J. W. Goethe-U niversita t, Theodor-Stern-Kai 7, 0-6000Fr ankfurt /M. 70

St. Ann e's Hospital, 4950 W Thomas Street , Chicago, IL 60651,USA

Zentrum der Inneren Medizin, Abteilung fur Kardiologie, Klini­kum der J . W. Goethe-Uni versitat , Th eod or-Stern-Kai 7, 0-6000Frankfurt /M . 70

Aggert alklinik, 0-5250 Engelskirchen

Chirurgische Abteilung, Tiefenauspit al, CH-3004 Bern

Rad iologische s Zentrum, Klinikum Niirnberg, Abteilung Nuklea r­medizin, Flurstr. 17,0-8500 Niirnberg

Radiologische Klinik und Poliklinik der U niversitat Miinchen ,im Klinikum GroBhadern, Marchioninistr. 15, 8000 Miinchen 70

An giologische Abteilung des Departments fur Innere Mcdizin ,Poliklinik, Un iversitatsspital , Rarnistr . 100, CH-8091 Zurich

Institut fur Pathologie der Universitat Zurich, Kantonsspital ,Schmel zbergstr. 12, CH-809 1 Zurich

Rontgcndiagnostisches Zentralinstitut des Klinikums der Universi­tat Essen, Hufelandstr. 55, 0- 4300 Essen I

4. Medi zinische Klinik des Klinikums Niirnberg, Institut fiir Nephro­logie an der Un iversitat Erlangen-Num berg, Kontumazgarten14-18,0-8500 Niimber g

Medizinische Universitatsklinik, Inselspital Bern , CH-30 I0 Bern

Department of Ront gendiagnosis, University Hospital, Ca tha ­rijncsingel 101, NL-3500 CG Utrecht

Stadti sche Kliniken Dui sbu rg, Geri atri sche Klinik , Zu den Reh­wiesen 9, 0-4100 Dui sbur g I

Department of Radiology, Un iver sity of Pennsylvani a Hospital ,Philadelph ia, Pennsylvani a 19104, USA

St. Anne' s Hospit al, 4950 W. Th om as Street, Chicago, IL 6065 1USA

Rontgenstati on der I. Chirurg ischen Abteilung des Krankenhausesder Stadt Wien-Lainz, Wolk crsber genstr . I, A-1130 Wien

St. Ann e's Ho spital, 4950 W. Thomas Street , Chicago , IL 6065 1USA

Klinik fiir Thorax-, Hcrz-und Gcfalichiru rgie, Inselspit al. CI-I-30 I0Bern

Physikalisch -tc chni sche Priifan stalt fur Rad iologic und Elektro ­medi zin , Allgem eines Krank enhaus, A iserstr. 4, A-I 090 Wien

Un iversitats-Kinderkl inik , Inselspit al , CH-30 10 Bern

Krank enhaus der Stadt Wien-Lainz, Rontgenstation, Wolkers­bergenstr . 1, A- 1130 Wien

Ront gcn-Abteilung Hochrheinklinik, Ber gseest r. 57, 0-7880 BadSackingen

Aggcrtalklin ik, 0-5250 Engelskirche n

XIV

G. POULJADIS

P. PROBST

C. B. A. J. PUIJLAERT

G. R A AB

E VA-IRIS RICHT ER

H. RIEG ER

E. RING

B. ROBERTS

E . ROSSI

F .-J. ROTH

E NID J . R UBLE

J. H . J . RUIJS

R. R UMINSKY

D. R UMMEL

N. D. SCHER ER

M. SCHLUMPF

INGEBORG SCHMIDTKE

R. SCHMITT-ROTH

E . SCHN EIDER

W. SCHOEPP E

W . SCHOOP

A. SCHRIJVERS

F .SEUTER

D. SEYBOLD

W . SEYFERTH

List of Collaborators

Rontgendiagnostisches Zentralinstitut, Universi tat sspital , Rami­str. 100, CH-8091 Zurich

Radiologische Abteilung, Burgerspital, CH-4500 Solothurn

Department of Rontgendiagnosis, University Ho spital , Catha­rijnesingel 101, NL-3500 CG Utrecht

Medi zinische Poliklinik, Universitat E rlangen-Niirnberg, 8520Erlangen

Radiologisches Zentrum, Klinikum Niirnberg, Flurstr. 17, 8500Numberg

Aggertalklinik, D-5250 En gelskirchen

Department of Radiology, Uni versity of California, San Francisco ,California, USA

Department of Surgery, Hospital of the University of Pennsylvani a,4 Silver stein, Philadelphia, PA 19104 USA

Universitats-Kinderkl inik , Inselspital , CH-301 0 Bern

Aggertalklinik, D-5250 Engelskirchen

University of Oregon, Health Science Cente r, 3181 S.W . SamJackson Park Road, Portland, Oregon 9720 I USA

Department of Rontgendiagnosis, University Hospital, Catha­rijnesingel 10 I, NL-3500 CG Utrecht

Zentrum der Inneren Medizin, Abteilung fur Kardiologie, Klini­kum der J . W. Goethe-Universitat , Thcodor-Stern-Kai 7, D-6000Frankfurt/M . 70

Zentrum der Inneren Medizin , Abteilung fur Kardiologie , Klini­kum der J . W. Goethe-Universitat , Th eodor-Stern-Kai 7, D-6000Fr ankfurt/M . 70

Z entrum der inneren Medizin, Abteilung fur Kardiologie, Klinikumder J . W. Goethe-Universitat , Theodor-Stern-Kai 7, D-6000Frankfurt/M. 70

Angiologische Abteilung des Departments fiir Innere Medizin ,Poliklinik, Universitatsspital, Ramistr, 100, CH-8091 Zurich

Aggertalklinik, D-5250 Engelskirchen

2. Med . Klinik, Klinikum Niirnberg, Flurstr. 17, D-8500 Niirnberg

Department fur Innere Medizin , Universitatsspital , Ramistr . 100 ,CH-8091 Zurich

Zentrum der Inneren Medizin, Abt. fiir Kardiologie, Klinikum derJ . W. Goethe-Universitat, Theodor-Stern-Kai 7, D-6000 Fr ank­furt /M.70

Aggertalklinik, 0-5250 En gelsk irchen

Rontgendiagnostisches Zentralinstitut , Un iversitatsklinikum Es­sen , Hufelandstr. 55 , D-4300 Essen 1

SAYER AG, Institut fur Pharmakologie , Aprather Weg 18a ,D-5600 Wuppertal 1

4. Med . Klinik des Klinikums Niirnberg, Institut fur Nephrologiean der Universitat Erlang en-Ntirnberg, Kontumazgarten 14- 18,D- 8500 Niirnberg

Radiologisches Z entrum, Diagnostische Abteilung, Klinikum Nurn­berg, Flurstr. 17,0-8500 Numberg 91

List of Collaborators

D. SINAPIUS

R. K. SPENCE

C. TORRES

M . WEGENER

C. WEICHERT

P. W EIDMANN

H. P. J. W OSTEFELD

E. ZEITLER

C. L. ZOLLIKOFER

A. Z USKA

xv

Pathologisches Institut der Universitat Gottingen. Robert-Koch­Str. 40, D-3400 Gottingen

Department of Surgery, Cooper Medical Center, One CooperPlaza, Camden, NJ 08l 03 USA

Angiologische Abteilung des Departments fiir Innere Medizin ,Universitatsspital, Poliklinik, Ramistr. 100, CH-8091 Zurich

Aggertalklinik. D-5250 Engelskirchen

Riitgendiagnostisches Zentralinstitut. Universitats-Klinikum Es­sen , Hufelandstr. 55 , D-4300 Essen I

Medizinische Universitatsklinik, Poliklinik, Inselspital, CH-301OBern

Department of Rontgendiagnosis, St. Franciscus Hospital , Boer­haavelaan 25 , NL-4708 AE Roosendaal

Radiologisches Zentrum, Klinikum Niirnberg, Flurstr. 17, D-8500Niirnberg

Riintgendiagnostisches Zentralinstitut der Universitat Zurich ,Ramistr . 100, CH-8091 Zurich

St. Ann e's Hospital, 4950 W. Thomas Street, Chicago, IL 60651USA