bluuebunny/crossref_metadata_2025 huggingface dataset:
The Sutureless Microanastomosis
Authors: Gestring Gidon F. , Lerner R. , Requena Ramiro
Published: November 2007

It has recently become clinically feasible to extract highly concentrated fibrinogen from the patient's own blood. In combination with commercial thrombin this fibrinogen/thrombin compound can be used as tissue adhesive, hemostatic agent and intravascular embolizer. In this presentation the authors describe a new end-to-side and side-to-side microanastomosis using this autologous "fibrin glue" (Fibrinkleber) in stead of suture material. The advantages of the new technique consist of:

• Simplicity

• Greatly reduced OR time

• Increased patency rate

• Can be done without operating microscope
Pulmonary Embolism as a Complication of Transfemoral Arteriography
Authors: Yasuno Masao , Kawamura Osamu , Onodera Tomoya , Kawata Reiji , Matsunaga Yoshinori , Mori Akio , Inoue Kiyoshi
Published: November 2007

We studied 60 consecutive patients to determine the incidence of pulmonary em bolism after transfemoral arteriography by comparing prearteriography lung perfusion scans with those obtained 1 day after arteriography. Nineteen patients (32%) demon strated new perfusion defects in the postarteriography lung scan. There was no signifi cant difference in regard to the incidence of pulmonary embolism with or without right heart catheterization. We believe that the source of emboli was from the leg vein thrombosis which was produced due to manual groin compression or compression from a sandbag and extended periods of bed rest after arteriography. Our data suggest that pulmonary embolism is a more common complication of transfemoral arteriography than previously appreciated.
Superior Vena Cava Syndrome in Behçet's Disease
Authors: Dündar Semra , Yazici Hamza
Published: November 2007

Behget's disease was first defined by a Turkish dermatologist of the same name, as a trisymptom syndrome which manifested itself with aphthae in the mouth, genital exul cerations and iridocyclitis with hypopyon. 1 Later, some other features have been attributed to this syndrome, namely skin changes, joint involvement, obstruction of arteries or veins, and infection of sterile injection sites.2-16 Some other rare findings have been also noted in Behqet's disease. Aphthae, genital exulcerations, eye lesions and skin changes are the major lesions. If a patient has three of the major lesions or two major + two minor lesions; the disease is considered to be complete in his case. According to the information we now have, the basic pathological disorder in Behget's disease is vasculitis. Thrombosis in the great veins and arteries, and aneurysms, are frequently noted. The majority of the cases, when they first come to the doctor, suffer from superior vena cava obstruction.

Superior vena cava obstruction is usually diagnosed easily. This causes the appear ance of many collateral veins over the anterior chest wall, the dilation of neck veins, and the growth of edema of the chest, neck and face. In the majority of superior vena cava syndromes noted in the literature, malignancy is pinpointed as the cause, while, occa sionally, benign lesions are also winnowed out to be the culprit.27,31

The aim of this work was to present the review of the last fourteen years' etiology of the superior vena cava syndromes in our hospital, and to attempt to find out how many of them were caused by Behçet's disease. As a result, it was found that Behget's disease is the second cause of superior vena cava syndrome, after malignancy. It is known that Behçet's disease is most frequently diagnosed in Turkey, Japan and Greece, so perhaps this result is not surprising for Turkey. 7,26 What's more, it is also probable that Behçet's disease might be the underlying cause in most of the cases dubbed "due to unknown reasons." To ascertain this properly, a careful case history and complete physical examination are compulsory.
Transaxillary Resection of the Cervical Rib
Authors: Jannelli Fedèle I. , Puccio Francesco , Tombolini Giorgo , Cavarra Gaetano
Published: November 2007

We describe our experience with transaxillary cervical rib resection. The surgical technique, which is always easy to carry out and without complications, is described. Radiological check-ups have shown that by this approach the cervical rib can be removed almost entirely.
Hypotensive Blood Flow in Six Millimeter and Eight Millimeter PTFE Arterio-Venous Fistulas
Authors: Forman Mark , Doscher William , Stein Theodore , Wise Leslie
Published: November 2007

PTFE grafts of 6 mm and 8 mm internal diameter are the most commonly used sizes for dialysis access. Hypotension is a common cause of thrombosis in this type of arteriovenous fistula. In the animal model, stasis develops in both sizes equally during hypotension despite the theoretical advantage of lower resistance in the 8 mm graft. This indicates that internal graft diameter is not significant for prevention of stasis in dialysis access grafts at physiological and hypotensive BP levels.
Two-Dimensional Echocardiographic Evaluation of Right Ventricular Function in Acute Myocardial Infarction
Authors: Arvan Stephen
Published: November 2007

Twenty-five patients with acute myocardial infarction, 15 inferior wall (IWMI) and 10 anterior wall (AWMI), were studied using two-dimensional echocardiography (2DE) and blood pool scan to evaluate the accuracy of 2DE for measuring right ventricular function. Fractional shortening (FS) of the minor axis of the right ventricle in the apical four chamber view (A4C) and subcostal four chamber view (S4C) for AWMI patients was higher as compared to the control group (41.8± 11 vs 27±9 and 46±8 vs 27±7 respectively). FS of the minor right ventricular axis for isolated IWMI subjects in the same views was not significantly different from the control population (32±7% vs 27±9% and 34± 13 vs 27±7% respectively). However, patients with an IWMI complicated by right ventricular infarction (RVI) had a significant depression of FS of the minor axis as compared to the control group in both the A4C and S4C views (8±5% vs 27±9% and 18±7 vs 27±7% respectively). FS of the minor axis in only the A4C view correlated . well with the corresponding blood pool scan ejection fraction (EF) for the entire infarction group (r=.69, p<.001). Long axis FS was not significantly different from controls for the IWMI and AWMI group and the correlation with the blood pool scan EF was poor (r= .32 and r=.09 respectively). Surface area of the right ventricle in the A4C view was increased in four of six patients with RVI and six of six patients with blood pool scans.

FS of the minor axis in the A4C view correlated well with right ventricular function and was accurate in identifying those patients with an RVI. FS of the long axis was not a reliable measurement for evaluating right ventricular function. Surface area determination of the right ventricular cavity did not prove to be a sensitive index of right ventricular function in addition.
ATP, Creatine Phosphate and Glycogen Content in Human Myocardial Biopsies: Markers for the Efficacy of Cardioprotection During Aorto-Coronary Bypass Surgery
Authors: van der Vusse Ger J. , Coumans Will A. , van der Veen Erik , Drake Angela J. , Flameng Willem , Suy Raf
Published: November 2007

Measurements of the myocardial content of ATP, creatine phosphate and glycogen provide a sensitive marker of the effect of inevitably global ischemia on myocardial tissue during aorto-coronary bypass surgery and give insight in the efficacy of various cardioprotective techniques. Continuous aortic cross clamping for performance of the distal anastomoses with multidose St. Thomas cardioplegia did not result in significant changes in the myocardial ATP, creatine phosphate and glycogen content. In contrast, hypothermic intermittent crossclamping resulted in a significant reduced tissue content of these markers of myocardial ischemia.
Posttraumatic Dissection of the Iliac and Femoral Arteries
Authors: deSantos Luis Alonso , Bilbao Jaureguizar José Ignacio , Hochman Lyone F. , Rubio Pedro A.
Published: November 2007

The following article describes a case of posttraumatic iliac artery dissection that extended into the femoral artery. The incidence of isolated iliac artery aneurysms is discussed, as well as complications and treatment of these rare entities.
Fulminant Hepatic Failure After Open Heart Surgery: A Case Report
Authors: Morishita Yasuo , Taira Akira
Published: November 2007

Reports on fulminant hepatic failure after open heart surgery are very few. We recently experienced a 38-year-old female with fulminant hepatic failure accompanying encephalopathy after open heart surgery, and possible etiology of this syndrome was discussed.

The patient having undergone open mitral commissurotomy for mitral stenosis died on the 27th postoperative day following the postoperative course of a fulminant type of liver failure. No other possible causes of hepatic dysfunction were identified except slight preoperative disturbance in liver function probably due to congestion.

We conclude that preoperative congestive heart failure may cause a fulmi nant type of liver dysfunction after open heart surgery.
The Management of Abdominal Aortic Salmonellosis
Authors: Todd George J.
Published: November 2007

Infection of the abdominal aorta by Salmonella organisms is a rare but com monly fatal condition. Successful man agement depends on rapid diagnosis, ag gressive surgical intervention, extra- anatomic vascular reconstruction and antibiotic therapy.

A review of the surgical literature re veals 25 cases of Salmonella aortitis with only five survivors. Pre-operative death from aortic rupture is common and post operative death due to graft infection is to be anticipated if a prosthesis is placed in the normal retroperitoneal location.

A successfully managed case is pre sented with a three year follow-up. Therapy consisted of aneurysm resection, axillobifemoral bypass and a six week course of antibiotics. The status of the oversewn aortic stump has been followed at yearly intervals by means of the in travenous digital subtraction angiogram. No aneurysmal dilatation of the aortic stump has occurred during the three year follow-up and the extra-anatomic recon struction has remained patent without the need for thrombectomy. Important con siderations in the operative and post operative management are discussed.
The Early Development of Post Traumatic Aneurysm
Authors: Absoud E.M. , Nash J.R. , Harrop S.N. , Morgan W.J.
Published: November 2007

Two examples of post traumatic aneurysm developing within two weeks of injury are reported to draw attention to the early development of this condition. A method is described for the management of scalp aneurysm.
A Prospective Randomized Study to Examine the Effect of Aspirin Plus Dipyridamole on the Patency of Prosthetic Femoro-Popliteal Grafts
Authors: Goldman Mark , McCollum Charles
Published: November 2007

When prosthetic materials are used in arterial reconstruction patency rates are less favourable due to the formation of platelet thrombus on the luminal surface. As platelet inhibitory drugs may reduce the rate of platelet accumula tion on such grafts, a randomised, double blind study has been undertaken to assess the effect of Aspirin and Dipyridamole on the patency of prosthetic fe moropopliteal bypass grafts. Drug or identical placebo therapy was started two days pre-operatively in 53 patients undergoing femoropopliteal bypass using either Dacron or Polytetrafluorethylene. Follow-up was for at least one year or until first occlusion, with patency assessed objectively. In the 28 patients on placebo cumulative patency by life table was 36% by 12 months compared to 67% on ASA/DPM (P < 0.05). In 37 patients with PTFE grafts, ASA/DPM en hanced one year patency from 50% to 80%. This drug combination therefore reduces prosthetic graft thrombosis in patients and must now be considered the standard against which new drugs should be compared.
Characteristic Association of Congenital Arterio-Venous Fistulas and Segmentary Arterial Fibrodysplasia: Monomelic Angiodysplastic Syndrome
Authors: Gessaroli M. , D'Addato M. , Stella A.
Published: November 2007

The clinical, arteriographic and histological study of 5 cases of monomelic congenital arterio-venous fistulas proposes some findings about their pathoge netic thesis.

The association of arterial fibroplasia and congenital arterio-venous fistula is seen as caused by hemodynamic alteration and particularly by the embryoge netic changes which occur simultaneously.

These observations suggest the presence of a syndrome with characteristic monomelic anomalies.
Clinical Experience Using Blood Potassium Cardioplegia in valve-Surgery With Prolonged Aortic Cross-Clamp Times
Authors: Morishita Yasuo , Taira Akira
Published: November 2007

The efficacy of cold blood potassium cardioplegia during aortic cross-clamp ing time longer than 150 minutes was evaluated in 27 patients with cardiac valvular surgery at Kagoshima University Hospital from August, 1978, to June, 1983. Ischemic intervals ranged from 150 to 241 minutes with a mean of 173 minutes.

Cardiac-related hospital death occurred in two patients (7.4%); one died of massive intrathoracic bleeding in a case with aortic and mitral regurgitation due to infectious endocarditis, and the other was due to an immobilized valve of the implanted aortic prosthesis. Although the patients with aortic cross-clamping time of more than 150 minutes were obviously in more serious condition by preoperative assessments than the patients with aortic cross-clamping time less than 150 minutes, there was no significant relationship between the length of cross-clamping time and cardiac-related hospital death or the occurrence of postoperative low-output syndrome.

These findings suggest that cold blood potassium cardioplegia provides ex cellent myocardial protection during aortic cross-clamp times longer than 150 minutes.
Comparative Study of the Arterial and Venous Segmental Circulation in the Human Spleen
Authors: Rendina E. , Pescarmona E. , Marinozzi G.
Published: November 2007

The authors have studied the vascular organization of the human spleen with particular regard to the relationship between the arterial and venous segmental circulation. Sixty fresh adult human spleen obtained at post-mortem were stud ied. After anatomical dissection of the splenic vessels at the hilus, in a group of thirty spleens (group I) the injection of radioopaque material (Lipiodol Extraf luid) was performed and angiograms were taken. In a second group of thirty spleens (group 2) epoxy resins of different colours (Biodur E 20) were injected in the splenic vessels and corrosion-casts obtained. By means of these methods the presence of a segmental vascular organization in the human spleen was evi denced ; every main splenic vascular segment, both arterial and venous, was independent and no visible anastomoses took place. In addition, there were complete correspondence of the arterial and venous segments, which were su perimposable since each arterial segment had the same limits as the correspon dent venous one. A parallel distribution of the arterial and venous segmental branches provided a further demonstration that each main splenic vascular seg ment may be considered as a real independent morphological unit. These ana tomical findings support the fact that partial splenectomies can be considered in a variety of pathological conditions, as an alternative to total splenectomy, par ticularly in young patients.
Subclavian Steal Syndrome. Correction by Transthoracic or Extraanatomic Repair
Authors: Schlosser V.
Published: November 2007

Proximal subclavian artery stenosis may cause severe disturbances of cere bral blood supply well known as subclavian steal syndrome.

On the other hand subclavian artery stenosis may produce problems of the perfusion of the arm. But in the presence of a well established collateral circula tion with reversal flow in the ipsilateral vertebral artery the reduced perfusion of the arm in the presence of proximal subclavian artery stenosis seldom re quires operative treatment.
A Tridimensional Study of Microcirculation in Skeletal Muscle
Authors: Gaudio E. , Pannarale L. , Marinozzi G.
Published: November 2007

The authors used a microcorrosion cast technique to study the microvascular bed of skeletal muscles in the rat.

They also tried to clarify the differences, in this respect, between fast twitch and slow twitch muscles. For this purpose they studied as fast twitch muscles, the tibialis anterior muscle and the pectineus muscle and, as a slow twitch mus cle, the soleus muscle.

Thanks to the peculiar technique used, they were able to distinguish differ ent sections of the microvascular bed.

They also found astonishing differences between the capillary networks in the soleus and tibialis anterior muscles, on the original bases of peculiar charac teristics of the capillary network in the soleus.
Myocardial Protection With Combined Selective Profound Hypothermia and Hyperkaliemic Cardioplegic Arrest In Aortic Valve Replacement
Authors: Wellens F. , Deuvaert F. , Depaepe J. , Primo G.
Published: November 2007

To analyse the results of combined profound myocardial hypothermia and cardioplegic hyperkalemic arrest for aortic valve replacement a series of 100 consecutive patients undergoing isolated or combined aortic valve replacement was reviewed.

There was no operative or early postoperative mortality, only one patient presented with low cardiac output syndrome.

Inotropic support was used in 8, vasodilator therapy in 4 and external pacing in 8 instances. Reoperation for bleeding occurred twice. Postpericardiotomy syndrome was present in 7 patients; requiring surgical drainage in 2. Conduc tion defects ( > 48 H) were present in 3 and supraventricular arrhythmias in 15 patients successfully treated with medical therapy in 5 and D.C. countershock in 10.

The clinical results confirm that this simple myocardial protection technique provides an excellent myocardial preservation for all patients operated for sin gle or combined aortic valve replacement.
Tortuous Vessels Simulating Aneurysms in the Right Neck
Authors: Siu K.F. , Wei W.I. , Wong J.
Published: November 2007

Ten patients presenting with a pulsatile mass in the right lower neck were investigated for suspected aneurysms of either the right common carotid artery or subclavian artery. Arch aortogram performed in eight patients showed that these were tortuous vessels, but not aneurysms, at the bifurcation of the innomi nate artery. These patients have distinct clinical features, the recognition of which should allow a confident diagnosis to be made without arteriography.
Atrial Fibrillation Secondary to Withdrawal of Beta-Blocker Therapy in General and Vascular Surgery
Authors: Bass Aryeh , Mohr Raphael , Adar Raphael
Published: November 2007

Withdrawal of beta-blocker treatment due to circumstances connected with general and vascular operations was the cause of rapid atrial fibrillation in 5 of 6 patients in whom this complication occurred within one year. Three illustra tive cases are described. The arrhythmia was resistant to digoxin and verapamil and was controlled only after beta-blocker treatment was resumed. The mech anism of this phenomenon is discussed and a regimen for prophylaxis and treat ment is suggested. Increased awareness of this syndrome by general surgeons should reduce the incidence of this complication.
Autologous Arterial Reconstruction in the Treatment of Renal Artery Stenosis
Authors: Turini Damiano , Selli Cesare , Carini Marco , Rosi Paolo
Published: November 2007

Renal revascularization was performed using the internal iliac artery in 25 patients. The causes for arterial damage were fibrodysplasia in 19 cases, athero sclerosis in 5 and aneurysm in one. Simple autotransplantation was performed in 10 cases, and ex-situ repair with subsequent autotransplantation in 15. Mean postoperative followup was 5.2 years; renal volume, evaluated with planimetry in IVP, was improved in 65% of the cases. Sixty-eight percent of the patients were cured from hypertension, 28% improved and 8% remained unchanged.
Acute Ischaemia of the Upper Limb Due to Irradiation Arteriopathy
Authors: Bainbridge Edward Thomas , Ashton Frank
Published: November 2007

A case is described of spontaneous brachial artery thrombosis occurring 37 years after irradiation of the elbow. Though irradiation arteriopathy is well recognised, this appears to be the first published example of involvement of the more distal arterial supply to the upper limb. Despite successful by-pass, is chaemic contracture gradually developed, emphasising the need for urgent re- vascularisation of the ischaemic upper limb.
Descending Thoracic Aortic Laceration: Report of Six Patients and a Review of the Surgical Treatment
Authors: Rees J. Richard
Published: November 2007

During a seven year period the author has treated six patients who had sus tained traumatic aortic transection. Observations regarding these patients are presented as well as a review of the literature concerning the surgical treatment of this entity.
The Association of Sudden Onset of Symptomatic Hemorrhoid Disease, Impotence, and Aortic Thrombosis in a 43 Year Old Man Following Minor Trauma
Authors: Chapman James E. , Bennett William E.
Published: November 2007

The sudden onset of symptomatic hemorrhoid disease in a 43 year old man heralded infrarenal aortic thrombosis after a minor fall. He developed a classic Leriche Syndrome and required aortic thrombectomy and aorto-bifemoral grafting. The unusual presentation is explained by the collateral circulation and arteriograms demonstrating this point are presented. It was felt that the pres ence of pre-existing sub-occlusive iliac disease predisposed this patient to aortic thrombosis and a successful outcome followed surgical treatment.
Management of Effort Thrombosis with Low-Dose Streptokinase
Authors: Webb Gordon L. , Kerstein Morris D.
Published: November 2007

A 51-year-old female presented with axillary-subclavian vein effort throm bosis. The treatment modality was low-dose constant-infusion streptokinase, followed by heparin and coumadin. Near-total resolution of the pathology and symptoms resulted. There were no adverse events secondary to streptokinase.
Role of Arteriography in the Management of Giant Cell Lesions of Bone
Authors: Yadav S.S.
Published: November 2007

Arteriography performed in 45 giant cell lesions of the bone has proved useful in the evaluation and enbloc resection at various sites. Arterial displace ment and exact assessment of the extension of the tumour have been observed in most of the cases. A biplane arteriogram gave a correct evaluation of the intra and extra osseous extent of the lesion and the positioning of the major feeding arteries, making the enbloc resection adequate and easy. The investigation has been of a great help in modifying the treatment and the surgical approaches.
Cannulation of Arteriovenous Fistulas for Hemodialysis
Authors: Rubio Pedro A. , Farrell Edward M.
Published: November 2007

In patients undergoing hemodialysis for chronic renal failure, improper can nulation technique increases the likelihood of hemorrhage and extrinsic throm bosis. The risk is minimized when the dialysis needle is inserted parallel (rather than perpendicular) to the skin.
The Influence of Platelet Inhibition on the Patency of Femoro-Popliteal Dacron Bypass Grafts
Authors: Donaldson D.R. , Salter M.C.P. , Kester R.C. , Rajah S.M. , Hall T.J. , Sreeharan N. , Crow M.J.
Published: November 2007

Neointimal hyperplasia and thrombosis initiated by platelet activity may contribute to the failure of femoropopliteal Dacron bypass grafts. We have therefore undertaken a randomised prospective double blind trial comparing the efficacy of a combination of acetyl salicylic acid (ASA) 330 mg and dipyrida mole (DPM) 75 mg three times daily, with placebo in maintaining the patency of femoropopliteal Dacron bypass grafts implanted to relieve disabling claudica tion. Patients received either ASA/DPM or placebo commencing pre-opera tively and continuing for 12 months. Seventy-three double velour (Microvel) grafts in 65 patients were studied, 38 grafts in the placebo group and 35 grafts in the active group. The following were measured pre-operatively and at 3, 6, 9 and 12 months postoperatively: maximum walking distance (MWD); ankle/bra chial systolic pressure index (ABSPI); graft patency; platelet adhesion and ag gregation; template bleeding time; ASA and DPM levels. After 1 year, 10 patients had been withdrawn (9 ASA/DPM: 1 placebo) and 4 out of 26 grafts in the active group and 15 out of 37 in the placebo group had occluded ( P < 0.05 Chi square test).

We conclude that inhibition of platelet function by the use of a combination of ASA and DPM improved the patency rate of femoropopliteal Dacron bypass grafts.
Acute Post Traumatic Fusiform Aneurysm of the Proximal Left Internal Carotid Artery: A Case Report
Authors: Posevitz Laszlo , Bafitis Harold , Schatzman Earl R.
Published: November 2007

Aneurysms of the extracranial portion of the internal carotid artery are not common, but certainly constitute a definite threat to life. Congenital defects, infection, atherosclerosis, local inflammation of the arterial wall, and some times trauma, are among the various causes of aneurysm formation. Symptoms vary with size and anatomical position of these aneurysms; often symptomology is delayed in onset. A case of a young female with a single isolated fusiform aneurysm at the origin of the left internal carotid artery, secondary to trauma (attempted strangulation), is herein reported. Presentation, clinical observa tions, management methods, and the relevant literature on the subject is re viewed.
Late Collateralization of Coronary Arteries From a Previously Non-Functioning Internal Mammary Artery Implant: A Case Summary
Authors: McKelvie Robert S. , Tanser Paul H. , Stolberg Harald O.
Published: November 2007

A case of severe atheromatous coronary artery disease underwent bilateral internal mammary artery (I.M.A.) implantation for relief of angina pectoris. Thirteen months later one I.M.A. had anastomosed with the native coronary circulation while the other, while patent, provided no collateral flow. Because of recurrent angina, recatheterization at 13 years post-I.M.A. revealed both I.M.A. collateralizing the native coronary arteries in which significant progres sion of atherosclerosis had occurred. The mechanism of this late collateraliza tion is most likely due to progression of coronary artery occlusion.
Stenotic Intimal Thickening of the External Iliac Artery: Illness of the Competition Cyclists? Report of Two Cases
Authors: Mosimann R. , Walder J. , Van Melle G.
Published: November 2007

Two top class cyclists, 23 and 24, complained of intermittent acute claudica tion at maximal effort due to a stenotic endofibrosis of the external iliac artery. Symptoms disappeared after endarterectomy and venous patch arterioplasty. This pathology is probably the consequence of repeated and long continued haemodynamic stress acting on the external iliac artery which would be respon sible, in certain subjects, for an exaggerated bend due to the sitting position of the competitor. High cardiac output and adaptive hypertension must also be of importance.
Greenfield vena Caval Filter: St. Joseph's Hospital Experiences
Authors: Ketterhagen James P. , Sauter Kendall E.
Published: November 2007

Since the first vena caval filter was inserted at St. Joseph's Hospital in 1979, 18 similar procedures have been performed. A review of these cases was con ducted in which the indications for and site of insertion, associated diagnostic and radiographic studies, complications, and mortality were summarized.

The data reveal a mortality rate of 11 %, owing primarily to the use of the filter in hemodynamically unstable patients with massive pulmonary emboli. This figure suggests that vena caval filters should only be used as a truly pro phylactic measure, limiting the indications for insertion to failures of or contra indications to anticoagulation, as well as possible consideration as prophylaxis in high risk patients or those with "free floating" thrombus above the inguinal ligament.

Such failures of anticoagulation and complications of overtreatment can be minimized through an understanding of the variable response to anticoagulants and the recognition of the need for accurate, frequent monitoring of anticoagu lant therapy.
Role of Internal Jugular Vein Patch Following Carotid Endarterectomy: A Case Report
Authors: Kerstein Morris D. , Godin Michael S.
Published: November 2007

Five patients, two of whom were diabetic, all of whom were smokers with heart disease, with an average age of 61.2 years, underwent internal jugular vein patch angioplasty after carotid endarterectomy because of extensive nar rowing of the internal carotid artery. The patients were followed for a mean of 32 months post-operatively, with no evidence of recurrent stenosis or symptoms.
The Healing of the Thin-Walled Expanded Polytetrafluoroethylene Vascular Graft
Authors: Takenaka Kenji , Mohsen Kholoussy A. , Yang Yeng , Kodellas Lambros , Matsumoto Teruo
Published: November 2007

The objective of this experiment was to investigate the healing of thin-walled reinforced expanded polytetrafluoroethylene (PTFE) vascular graft (thin graft) .

In 12 dogs (30-35 kgm), a 4 cm segment of each common iliac artery was excised and replaced with an equal length of PTFE vascular graft, 6mm internal diameter. Standard graft was used on one side and thin graft on the other. Dogs were sacrificed at intervals up to 12 weeks.

Pannus extension started at both ends after the first week. The degree of pannus extension and pannus thickness showed no difference between both grafts at each interval. It was covered by a monolayer of endothelial-like cells as seen by scanning electron microscopy. Anastomotic hyperplasia and the growth rates of endothelialization measured from the proximal anastomosis were simi lar.

No significant difference was noted in the healing between the thin-walled and standard PTFE vascular grafts for up to 12 weeks.
Management and Follow-up of Descending Aortic Dissection
Authors: Folon L. , Jacquemart J.L. , Dautrebande J. , Jaumin P. , Goenen M.
Published: November 2007

The management of 25 consecutive patients with descending aortic dissection is reported.

Nineteen patients had medical therapy and 6 needed early surgical correc tions. Indications for early surgery are outlined. Nineteen patients were dis charged and 6 died in-hospital. The actuarial survival is 76% at 11 months and 50% at 4 years.

The authors describe the factors susceptible to influence early and late out come.
Anatomical Snuffbox Versus Radial Styloid Process as the Location of Choice for Hemodialysis Arteriovenous Fistula: A Retrospective Analysis
Authors: Bogers A.J.J.C. , Derksen-van Daatselaar D. , Rijksen J.F.W.B.
Published: November 2007

A retrospective analysis was performed to investigate the effectivity of snuff box and radial styloid arteriovenous fistula as access procedures for mainte nance hemodialysis.

Taken into account that men were considered significantly more often suit able to construct a snuffbox fistula, we found no differences in effectivity be tween the two locations in arterialization of forearm veins and suitability for hemodialysis treatment.
Chronic Intravascular Hemolysis Following Cardiac Replacement With the St. Jude Medical Prosthesis: Comparative Study With the Bjork — Shiley Prosthesis
Authors: Paolini Giovanni , Fabbrizzi Fabrizio , Cristofani Renza , Borzoni Giancarlo , Giordani Roberto , Lucchetti Amalia , Salvatore Leonardo
Published: November 2007

This study compares 153 patients with SJM prosthetic valves and 37 patients with Björk-Shiley valves for evidence of intravascular hemolysis and analyzes the degree of hemolysis by position (mitral or aortic), diameter, number of pros theses and duration of implant.

The hematological status of all the patients was assessed by the following laboratory tests: hemoglobin concentration, serum lactatedehydrogenase (LDH), red blood cells count (RBC) , reticulocytes, serum iron, serum haptoglo bin, hemosiderinuria and schistocytes count.

The results of laboratory tests and the characteristics of implant were com pared by the Pearson X2 for qualitative variables and by the analysis of covari ance, using the regression approach, for continuous variables.

This study indicates a significantly higher degree of hemolysis in the St. Jude Medical group as shown by LDH and haptoglobin values which are the most reliable sources revealing qualitative hemolysis.

The relationship between hemolysis, duration of implant, diameter, number and position of the prostheses, inside the SJM group, shows significance only between hemolysis and number of prostheses.

Furthermore, the data show a higher degree of hemolysis in the mitral posi tion for SJM prosthesis and in aortic position for Björk-Shiley (B-S) prosthesis.

The explanation for this difference may be the turbulent flow of regurgitant leakage at the pivots recesses in the SJM valve which is higher in the mitral position where there is the maximal pressure gradient and the asynchronous closure of the two leaflets.

The authors conclude that, in spite of the higher degree of hemolysis shown by the SJM prosthesis, there is no reason to revaluate its use because no case of clinically significant hemolytic anemia was observed in this study.
The Non-Invasive Substitute "Valve" Operation by Technique II in Chronic Venous Insufficiency of the Lower Limb
Authors: Psathakis Nikolaos D. , Psathakis Dimitrios N.
Published: November 2007

The substitute "valve" operation by Technique II using a silicone tendon designed to produce a valve-like mechanism on the popliteal vein is described. The results obtained in 55 limbs with chronic venous insufficiency due to reflux in the deep veins have been assessed by phlebography and by measurements of ambulatory venous pressure before and one week after the operation; 23 limbs were followed up two years after the operation. Clinical improvement in 50 of 55 limbs was associated with reduction in the ambulatory venous pressure and with phlebographic evidence of a functioning "substitute valve." After using the Doppler ultrasound the abolition of the popliteal reflux in 11 limbs after substi tute valve operation by Technique II was studied; they had had a marked popli teal reflux and a high ambulatory venous pressure before the operation.
Arterial Stenosis, Aneurysm and Soft Tissue Tumor— A Rare Combination: A Case Report
Authors: Schlosser Volker , Adler P. , Riese K.H.
Published: November 2007

Percutaneous transluminal angioplasty (PTA) is nowadays, 20 years after the first publication by Dotter, an accepted part of the therapeutic scheme of arterial occlusive disease treatment.

Reocclusion and restenosis following PTA occur quite frequently, aneu rysms, however, in the area of treatment are extremely rare. A pertinent obser vation is reported here because of its clinical and pathogenic pecularity.
Vascular Compromise in Experimental Colonic Anastomoses
Authors: Foster M.E. , Brennan S.S. , Leaper D.J.
Published: November 2007

Successful anastomotic healing depends upon adequate tissue blood flow. More than one in ten colonic anastomoses leak causing death in one-third of patients.

The benefits of vaso-active agents in intestinal ischaemia has been previously reported. In this study isoxuprine and nifedipine were administered to rats un dergoing colonic anastomosis in normal and ischaemic bowel and the effect on healing was noted. Similarly the effect of intestinal obstruction on colonic blood flow was measured using a laser Doppler flowmeter.

Although both isoxuprine and nifedipine appear to improve early healing, Nifedipine may actually impair the later stages as collagen content is signifi cantly reduced at seven days. Intestinal obstruction significantly reduced co lonic blood flow in proximal bowel after three days and flow took longer to recover in this segment than in the distal collapsed colon.

Adequate tissue perfusion is a pre-requisite for normal healing.
Axillo-Femoral Bypass
Authors: Chang John B. , Chan Florence
Published: November 2007

Axillo-femoral artery bypass has been an alternative extra-anatomic bypass procedure for aorto-iliac occlusive disease since its introduction in 1963. This extra-anatomic bypass has been used in special conditions where the conven tional aorto-femoral bypass is not possible because of intra-abdominal sepsis or extremely high operative risk for aortic procedure. In order to have reasonable long-term patency report, retrospective review is done on a patient undergoing axillo-femoral artery bypass grafting performed between 1976 to 1981. Twenty- eight axillo-unifemoral bypasses and 43 axillo-bifemoral bypasses were per formed in this period. Fifty percent of the patient population had multiple risk factors. Arteriosclerotic heart disease was found in 41 %, central nervous system problem and stroke were found in 31%. Twenty-five percent of the patients were diabetic. Five-year patency rate of axillo-bifemoral bypass graft was 75%. Axillo-unifemoral bypass had a five-year patency of 33%. Axillo-unifemoral bypass with femoral-distal bypass had a five-year patency rate of 6 to 8%. Ax illo-bilateral femoral bypass with femoral-distal bypass had 56.2% of a five- year patency. Overall, five-year patency, without thrombectomy was 60%.
Ascending Aorta to Bilateral Common Femoral Artery Bypass Grafting for Thrombosis of the Aorta: Case Reports
Authors: Schwartz Richard L. , Rice Philip L.
Published: November 2007

Thrombosis of the abdominal aorta is a recognized entity most commonly due to embolic occlusion of the bifurcation, the presence of an abdominal aortic aneurysm, or the presence of distal aortic occlusive disease. The approach to the embolic occlusion is generally under local anesthesia with balloon embolectomy. We have treated two patients with thrombosis of the aorta secondary to severe aorto-iliac disease, and a third patient with thrombosis of the aorta who had a prior aneurysmectomy and multiple abdominal procedures for pancreatic dis ease. These patients were referred late in the course of their aortic thrombosis and had established lines of demarcation at the abdominal level. To effect rapid establishment of lower extremity circulation and to avoid the intra-abdominal problems associated with re-operative procedures, we utilized the ascending aorta to bilateral common femoral bypass as an alternative mechanism to estab lish prompt vascular integrity. The procedure may be accomplished by the mid sternal splitting approach and utilization of a low porosity dacron prosthesis which is then tunneled subcutaneously into the common femoral area without difficulty. The operative procedure requires less than two hours for the immedi ate establishment of blood flow, and the post-operative convalescence in the hospital is five to seven days. This procedure is easily performed by surgeons dealing with major cardiothoracic procedures and can be utilized as an alterna tive to other more lengthy procedures when rapid establishment of lower ex tremity perfusion is desired in acute aortic thrombosis.
Aneurysm of Saphenous Vein Graft of the Common Carotid Artery: A Case Report and Review of Literature
Authors: Chung Jey J. , Watkins James E. , Nguyen Duy D. , Kim Jin
Published: November 2007

Aneurysmal failures occurring in vein grafts inserted into arterial systems generally occur relatively soon after placement. We describe, however, this rare complication in a saphenous vein graft to the common carotid artery 15 years postoperatively.
Celiac Artery Compression Syndrome: Report of a Case and Review of Current Opinion
Authors: Tribble Curtis G. , Harman P. Kent , Mentzer Robert M.
Published: November 2007

The celiac artery compression syndrome (or median arcuate ligament syn drome) is characterized by postprandial abdominal pain, an epigastric bruit, and arteriographic evidence of significant extrinsic compression of the celiac artery. Although the concept of extrinsic compression of vessels is well estab lished in vascular surgery, the existence of the celiac artery compression syn drome has been a matter of controversy. A patient relieved of celiac artery compression and postprandial pain is presented. A review of the controversy and an approach to evaluating patients suspected of having this type of com pression is outlined.
Congenital Arteriovenous Fistula of the Renal Vessels: An Exceptional Cause of Congestive Heart Failure in the Elderly: A Case Report
Authors: Mestres Carlos A. , Igual Alberto , Murtra Marcos
Published: November 2007

The case of a 74-year-old male patient with an arteriovenous fistula of the renal vessels, considered to be congenital in origin is presented. Clinical symp toms included those of congestive heart failure but there was no hypertension. The possible pathogenetic mechanisms are discussed and a literature review is also performed, focusing attention on the fact that this is an exceptional cause of congestive heart failure in the elderly.
Vascular Graft Infection with Candida Albicans: Case Report
Authors: Weber Frederick H. , Wilson Mary E.
Published: November 2007

This paper reports a patient with a pure Candida albicans vascular graft infection. Presentation was notable for the absence of systemic signs and symp toms of infection, minimal local tissue reaction, and a paucity of organisms in the initial pathologic specimen. The clinical course with multiple episodes of bleeding, the associated pathologic finding of vein necrosis, plus the repeated finding of yeast in tissue sections and in culture implicate the fungus as the cause of local pathology. This paper presents the patient, describes risk factors and possible mechanisms for infection, speculates on the reasons for the rarity of documented candida graft infections, and discusses the implications for patient management.
Inflammatory Aneurysms of the Abdominal Aorta
Authors: Brigham Robert A. , Youkey Jerry R. , Salander James M.
Published: November 2007

Inflammatory aneurysm of the abdominal aorta is an uncommon pathologic entity that presents a significant challenge to the vascular surgeon. Our experience with eight such patients forms the basis for this summary of the clinical presentation, radiologic findings and operative approach to this problem.
Left Atrial Pseudoaneurysm (A Left Atrial Catheter Complication): A Case Report
Authors: Pelias Anastasios J. , Naidech Howard , Lemole Gerald M. , DelRossi Anthony J.
Published: November 2007

Suture line pseudoaneurysms after cardiac surgery are usually associated with either infection or Marfan's syndrome. We present the first case of a pseudoaneurysm due to left atrial catheter after aortic and mitral valve replacements.
Colostomy Blood Flow Measurement by Laser Doppler Velocimetry — A Preliminary Report
Authors: Billings P.J. , Leaper D.J.
Published: November 2007

Laser Doppler velocimetry has been used to study colostomy blood flow. Eight patients were studied one week after fashioning of a colostomy and a further ten patients were studied at least nine weeks post-operatively. There was a significant difference in the blood flow between the two groups (p < 0.002). We conclude that laser Doppler velocimetry may be a useful technique for measuring colostomy blood flow.
Axillary Artery Injury in Erect Dislocation of the Shoulder (Luxatio Erecta): A Case Report
Authors: Morrison P.D. , Egan T.J.
Published: November 2007

Axillary artery damage from avulsion of the subscapular artery following erect dislocation of the shoulder—luxatio erecta—is described in an 11 year old child. Arterial repair was effected with an interposition vein graft. An associated brachial plexus injury was managed conservatively and it has now fully resolved. Luxatio erecta associated with vascular damage has been reported on at least two occasions in adults, but, as far as we can ascertain, not previously in childhood.
Popliteal Artery Entrapment Syndrome: Report of a Case
Authors: Badi Mustafa Hassan , Al-Awami Sayed Majed S. M. , El-Hassan Abdulla Yousif
Published: November 2007

This is a case report on popliteal artery entrapment in a 25-year-old Somali male, who presented with intermittent claudication of the right foot and calf. Angiography demonstrated occlusion and medial deviation of the right popliteal artery. This was treated by resection and arterial graft and correction of the anatomical anormality.
Combined Inguinal and Extraperitoneal Approach for Large Femoral Pseudoaneurysms: Case Reports
Authors: Vo Nghia M.
Published: November 2007

A combined inguinal and suprainguinal extraperitoneal approach is described for the surgical management of large (more than 7 cm in diameter) or high lying femoral pseudoaneurysms. The anastomosis was performed without tension and minimized turbulence and stress on the suture line. This approach facilitates surgical dissection and vascular control of the aneurysms.
Arteriovenous Fistula Involving the Anterior Tibial Artery Complicating Balloon Embolectomy — Case Study
Authors: Joseph  , Carter Paul
Published: November 2007

Arteriovenous fistula following use of the balloon catheter for arterial embolectomy has previously been reported between the profunda femoris artery and vein, between the posterior tibial artery and vein, and between the peroneal artery and vein. A case is here described of an arteriovenous fistula between the anterior tibial artery and its venae comitantes at midcalf level.
Splenic Artery Aneurysm: Current Perspective. Experience in a Community Medical Center
Authors: Ansari Azam , Helseth Hovald , Anderson Quentin M.
Published: November 2007

Splenic artery aneurysm (SAA) is a potentially lethal vascular disease second in frequency only to the intraabdominal aortic and iliac artery aneurysms. Even though first described in 1770, considerable controversy continues regarding its etiology, pathogenesis, and management. Recent clinicopathologic observations and surgical advances have done much to reduce the controversies and improve the prognosis.

The various aspects of diagnosis and management of SAA should be simpli fied and made familiar to all physicians, surgeons, and obstetricians because the disease entity is likely to be encountered in one form or the other at some time during their practice. Therefore, in this concise review we have discussed the current status of incidence, etiology, pathology, pathogenesis, diagnosis, man agement, and prognosis of SAA based on our and others' experiences.
Common Bile Duct Obstruction Secondary to an Aberrant Hepatic Artery: A Case Report
Authors: Stanton Paul E. , Haley Tony O. , Vo Nghia M.
Published: November 2007

Arterial anomalies are rare causes of biliary obstruction and are usually secondary to aneurysmal dilation. This case report demonstrates radiographi cally how an aberrant artery can cause biliary colic with extrinsic encroachment and eventually lead to narcotic addiction if not diagnosed early and treated appropriately.