P. Zukowski

Military Institute of the Health Services, Warszawa, Masovian Voivodeship, Poland

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Publications (8)5.3 Total impact

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    ABSTRACT: A false aneurysm is rare and underdiagnosed complication of intracranial hemorrhage. Objective of the study was to point out diagnostic imaging signs of false aneurysm and to determine frequency and diagnostic significance of these signs. Cerebral arteriography performed in our center from November 2007 to September 2010 revealed the false aneurysm in 8 patients (4 male, 4 female, mean age was 38 years). During the same angiographic procedure 6 patients were treated by endovascular embolization using coils, mixture of Histoacryl and Lipiodol or Onyx (liquid embolic material). Authors retrospectively analyzed preprocedural studies (computed tomography, magnetic resonance imaging) and angiographic findings to identify signs specific to false aneurysm. Computed tomographic findings that are not specific but should raise suspicion of the false aneurysm include: enlargement of parenchymal hematoma dimensions, unusual or delayed evolution of hematoma and spot sign associated with acute hematoma expansion. More specific signs can be revealed in digital subtraction angiography that shows a globular shaped neckless aneurysmal sac, delayed filling and emptying of contrast agent and stagnation of contrast with regard to the head position. Although preangiographic imaging studies findings in patients with false aneurysms are not specific, they should lead to angiographic validation, especially enlarging parenchymal hematoma and atypical hematoma evolution. Digital subtraction angiography makes it possible to diagnose the lesion and to use endovascular embolization techniques, which are currently the method of choice for treatment of pseudoaneurysms.
    No preview · Article · Dec 2011 · European journal of radiology
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    ABSTRACT: The aim of our report is description of the first in Poland translumbar cannulation of vena cava inferior used as an alternative vascular access for hemodialysis in 62 years old patient without further access for hemodialysis and no access for peritoneal dialysis.
    No preview · Article · Apr 2008 · Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego
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    ABSTRACT: Vascular injuries of the thoracic inlet and mediastinum present formidable difficulties in terms of exposure and management. The majority of patients with gunshot wounds to the thoracic aorta and brachiocephalic vessels do not reach the operating room alive, but those who do present unique problems for thoracic and vascular surgeons. In such cases, operative repair must be individualized and often must depend on experience with other elective cardiovascular procedures. This report details the management of a patient suffering wound to the superior thoracic region from a low-velocity hunting shotgun, involving superficial (skin and muscles) and deep tissues (heart and descending aorta). Some of the difficulties inherent in managing such an injury are discussed.
    No preview · Article · Jan 2008 · Acta Angiologica

  • No preview · Article · Sep 2006 · European journal of pain (London, England)
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    ABSTRACT: Background. Authors introduced ways and results of treatment operating patients with spinal metastases, treated in Orthopaedic Clinic of Central Military Hospital in years 1993-2002. Material and methods. In introduced period in Clinic 54 patients was treated with spinal metastases. 37(68,6%) was treated surgical and 17(31,4%) conservatively. In Clinic following indications were established to operating treatments: pathological fracture of vertebrae, growing neurological symptoms, as well as uncompromising pain in conservative treatment. Advancement of neoplasmatic disease and very bad prognosis was most important contraindication to operating treatment. Following operating method treatments: posterior stabilization by Harrington method and stabilization by transpedicular screws. Percutaneous vertebroplasty was applied. Results. In Frankel scale following results were noted down: in front of operation E-5, D-23, C-7, B-2, A-0, after operation E-8, D-24, C-5, B-0, A-0. Conclusions. Authors affirm, that operation treatment in choose cases is only effective way of supply patients with spinal metastases.
    No preview · Article · Apr 2003 · Ortopedia, traumatologia, rehabilitacja
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    ABSTRACT: Over the last few years, subclavian artery pseudoaneurysm (SAP) has been a more and more frequent cause of patients' hospitalization and not only in surgical wards. These aneurysms appear as a result of trauma, especially by means of transport. The great variety of clinical symptoms sometimes cause diagnostic problems and demand the use of different methods of diagnostic imaging. In this article, we present the etiology and clinical symptoms as well as the modern methods of diagnostics and treatment of these cases.
    No preview · Article · Jan 2003
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    ABSTRACT: Background: The symptoms of celiac trunk stenosis appear very seldom, but in every case a diagnosis pointing in the direction of the existence of external compression of this vessel is required. Among a few causes of celiac trunk stenosis, the most frequent is extrinsic compression by the median arcuate ligament of the diaphragm. Stenosis of the celiac trunk caused by median arcuate ligament was described for the first time by Dunbar in 1965 and this syndrome of symptoms due to the compression of this vessel was named "Median Arcuate Ligament Syndrome" (MALS). The aim of this study was the angiographic evaluation of the character and degree of celiac trunk stenosis among patients with clinical signs of functional stenosis. Material and methods: From January 2001 to the end of 2003 we performed angiographic examinations on 78 patients with clinical signs of functional celiac trunk stenosis. There were 53 women and 25 men with a mean age of 42 years (range 15 to 78 years). Results: The angiographic examinations showed signs of celiac trunk stenosis due to external compression among all patients. 34 patients (43.6%) had a typical functional stenosis in different stages shown only during the exhaust respiratory phase. In the remaining 44 cases (56.4%), the signs of compression were demonstrated during both respiratory phases but the stenosis was growing in the exhaust phase. 32 patients (41%) had a critical stenosis, more than 90% a luminal narrowing. Among 28 patients (35.9%) we had a stenosis between 75-90% and 18 patients (23.1%) had a stenosis between 50-75%. All these data relate to the exhaust phase. Conclusions: 1. Only the angiographic examination is the final diagnostic procedure explaining the doubtful cases of celiac trunk stenosis. 2. All diagnostic procedures must be executed in both respiratory phases. 3. On the basis of angiographic examination we can qualify the character of stenosis, but not always, unambigously, its cause. 4. Extrinsic compression by the median arcuate ligament of the diaphragm is the most frequently appearing cause of functional celiac trunk stenosis.
    No preview · Article · Jan 2003
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    ABSTRACT: Background: The purpose of the study was to evaluate endovascular treatment in patients with stenosis and occlusions of iliac arteries. In 98% of the cases, ischaemical changes in lower limbs are caused by atherosclerosis. In 1.5% of the cases, ischaemic changes are caused by inflammation, fibromuscular dysplasia, and compression syndrome. Stenosis and occlusions are primarily found in femoral arteries and, less frequently, in iliac arteries. The PTA often remains the sole method for treatment of high risk patients. Material/Methods: From 1998 to 2002, 50 PTAs of iliac arteries with high pressure balloons and stents implantation were performed in 36 cases. Results: Technically, the treatment proved successful in 96% of the cases. In four patients, complications such as occlusion of the femoral and axillary artery, peripheral thrombosis, and haematoma into the site of the femoral artery puncture occurred. The follow-up results were as follows: 75-90% of permeable arteries after 3 years and 70-80% after 5 years. The results are comparable with those after surgical treatment. Conclusions: Early and follow-up results are very good due to anatomical structure of iliac arteries. Treatment is highly effective in patients with Io and IIo of ischaemic changes. The PTA results are analogous to those after surgical treatment. The endovascular treatment is the only method in patients from the high risk group.
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