bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Angioplasty For Left Coronary Ostial Stenosis in Takayasu's Disease — A Case Report
Authors: Raffa Hassan , Mimish Laith , Al-Ibrahim Khalid , Rustom Magd 
Published: August 2008

Surgical angioplasty of the left main coronary artery for severe ostial stenosis in a thirty-five-year-old oriental woman suffering from Takayasu's disease was performed by use of an onlay autologous pericardial patch through an anterior aortotomy approach. This procedure was performed to reestablish a physiologic antegrade coronary arterial flow and to avoid use of internal mammary arteries, which have little flow in Takayasu's disease, or the saphenous veins, which can also be involved in the inflammatory process. The procedure also avoids a lengthy, time-consuming triple coronary artery bypass procedure and the use of saphenous veins, which are prone to certain slow or rapid attrition. Total clinical improvement with disappearance of angina and return of the patient to NYHA functional class I with normal treadmill exercise response was immediately obtained. Angiographic restudy six months after the surgical angioplasty revealed excellent results with complete wide patency of the ostium. This represents the first report in the world literature of surgical angioplasty of a left main coronary arterial ostial stenosis in Takayasu's disease.
Experimental Study of Cerebral Vasospasm Induced by Serotonin and Oxyhemoglobin in Subarachnoid Hemorrhage
Authors: Kun Jiang , Li Shao Hua  , Bao Yao Dong  
Published: August 2008

To clarify the mechanism of cerebral vasospasm induced by serotonin (5-HT) and oxyhemoglobin (OxyHb), the authors studied the roles of vasoactive pros taglandins (PGs) and free radicals in the cerebral vascular wall of rabbits. At first, they measured the 5-HT level in whole blood plus cerebrospinal fluid (CSF) and in platelet-rich plasma (PRP) plus CSF by fluorescence following the incubation at 37°C for zero to six days. The 5-HT in whole blood plus CSF did not significantly diminish for up to five days (p < 0.05), but in PRP plus CSF it markedly decreased within twenty-four hours (p < 0.01). The authors prepared 49 rabbits, divided into four groups: a nontreated (control) group and three groups treated with 5-HT, with OxyHb, and with free radical scavengers plus OxyHb, respectively. After treating the vessels with 5-HT or OxyHb, they measured levels of 6-keto-PGF1α and thromboxane B2 (TXB2), the stable metabolites of prostacyclin (PGI2) and TXA2, respectively, with PGE2 in vessels by radioimmunoassay. Vascular lipid peroxidation (LPO) was also measured by fluorescence. In the nontreated group, the level of 6-keto- PGF1α was significantly higher in the basilar vessels than that of any peripheral vessels (p < 0.01). In the group treated with 5-HT, 5-HT contracted both basilar and femoral arteries, but there was no significant change in levels of 6-keto-PGF1α, TXB2 , PGE2, and LPO. Vasospasm induced by 5-HT is not specific to the cerebral artery and does not depend on PGs and LPO. In the group treated with OxyHb, however, OxyHb induced severe vasospasm in the basilar vessel alone, where LOP was highly increased (p < 0.01) and 6-keto-PGF1 α markedly decreased (p < 0.01), but there was no significant change in TXB2 and PGE2. OxyHb did not induce femoral arterial spasm. But the LPO content was increased (p < 0.01), and there was no change in the levels of 6-keto-PGF1α, TXB2, and PGE2. These results disclose that cerebral vasospasm induced by OxyHb may depend on the high level of PGI2, a vasodilator, in the vascular wall. When various free radical scavengers were mixed with OxyHb, only manni tol, which is a hydroxy radical scavenger, could inhibit cerebral vasospasm in duced by OxyHb and elevate the level of 6-keto-PGF1α in the arterial wall. Therefore, the mechanism of cerebral vasospasm induced by OxyHb depends on the hydroxy radical, which inhibits PGI2 metabolism.
Hip Claudication—Its Pathophysiology and Treatment
Authors: Iwai Takehisa , Sato Shoji , Sakurazawa Kenichi , Muraoka Yukihiko , Inoue Yoshinori , Endo Mituo 
Published: August 2008

Hip claudication (HC) is a comparatively rare symptom in patients with chronic arterial occlusive disease. Although the role of the internal iliac artery (IIA) is important in the occurrence of HC, the relationship between HC and the IIA collateral system with the external iliac artery and the superior rectal artery is not clear and is possibly very complex. During the past three years 15 patients who presented with HC, and 3 patients who presented with bilateral IIA occlusion without HC, were studied. In all patients angiography revealed variable IIA occlusive changes. The pressure in the bilateral profunda penis arteries was measured and was found to correspond well with the angiographic findings. The superior rectal arterial flow was examined transrectally with a Doppler probe developed by the authors. In addition to the main arterial recon struction (bifurcated synthetic grafting 8 cases, femorofemoral crossover or fe moropopliteal bypass 6 cases, etc.), direct IIA reconstruction was performed in 13 IIAs (8 patients) with good results. HC was removed in 2 of the 3 femorofe moral crossover bypass cases. Their study suggests that many variations of hip claudication exist. The pe nile brachial pressure index in HC patients was 0.3±0.13 or less. Bilateral IIA occlusion cases with no HC were found to be getting blood via the superior rectal artery. It was also observed that there were to a certain extent independ ent supplies to the hip and genitalia, for elevation of the penile pressure was seen on the IIA repair side. In some cases, without IIA repair, the rich blood plexus to the pelvic organs via the iliac circumflex and others provided complete relief from hip claudication.
Postoperative Thrombus Formation in the False Lumen Following Surgical Repair of Aortic Dissection
Authors: Yada Isao , Satoh Tomoaki , Wada Kiyoto , Mizumoto Tohoru , Shimono Takatugu , Takeuchi Yoshihiro , Hiraiwa Takane , Shinpo Hideto , Tanaka Kuniyoshi , Yuasa Hiroshi , Kusagawa Minoru 
Published: August 2008

During the period 1980 to 1990, 65 patients with aortic dissection underwent surgical treatment. The authors have mainly been using the entry closure proce dures to enclose the false lumen with thrombus for dissecting aortic aneurysm. The survival rate was 75%. In 36 long-surviving patients who have been able to be followed up postoperatively, angiography and/or computed tomography (CT) with contrast enhancement was used to evaluate the aortic and any resid ual false lumen during a mean follow-up of sixty months. Complete thrombotic closure of the false lumen was obtained in only 5 cases; 18 of the remaining 31 patients have developed almost complete thrombus for mation, and only local remaining false lumens were noted. In the other 13 pa tients (36%), an extensive residual false lumen was observed, mainly in the patients with an aneurysm of larger diameter where the preoperative CT im ages showed the false lumen to be larger than the true lumen, indicating the requirement for extensive aortic graft replacement or secondary operation.
Aneurysm of the Portal Vein: Case Report and Review of the Literature
Authors: Hiekata Tomizo , Hinata Saburo , Takei Hiroshi , Kamata Satoshi , Shinagawa Toshihito 
Published: August 2008

The authors present a case of a sixty-nine-year-old woman who had a saccu lar aneurysm of the extrahepatic portal vein measuring 5 cm in diameter. The aneurysm was excised safely without complications. Microscopically, the aneu rysmal wall showed extremely thin portions with media consisting of only a few layers of muscle bundles. Etiology was considered to be congenital. Eighty cases have been reported in the world literatures including 40 cases presented in Japanese. Fatal complications such as rupture and perforation have been reported in 1 case, and portacaval shunt has been recommended as a surgical treatment of choice for symptomatic patients to avoid thrombosis in the aneurysm, rupture, or portal hypertension. On the basis of the experience ob tained from the presented case, however, the authors consider that a large sac cular extrahepatic portal vein aneurysm had better be excised to avoid potentially fatal complications.
The Role of Reconstructive Surgery in the Management of Renal Artery Lesions—Case Reports
Authors: Del Gaudio Antonio , Faenza Alessandro 
Published: August 2008

In the past, the management of strictures of the renal arteries relied mainly on reconstructive surgery using prostheses or venous grafts. Today, these meth ods are being shelved in favor of transluminal percutaneous angioplasty, espe cially in high-risk cases or in patients with only one kidney (case report). After reviewing the long-term results of 75 consecutive patients submitted to surgery for renal artery strictures (30 reconstructed with prostheses and 45 with venous grafts), the authors maintain that there is still a place for this type of surgery in particular situations such as the two long-term complications re ported (case reports).
Skin Flux and Histology in Venous Hypertension
Authors: Laurora Giuseppe , Pizzicannella Giuseppe , Cesarone Maria Rosaria , Fisher C. , Belcaro Giovanni , Nicolaides A.N. 
Published: August 2008

Skin blood flux and the venoarteriolar response have been studied by laser- Doppler flowmetry (LDF) in 20 postphlebitic limbs and in 20 normal limbs. Histology was also studied with punch biopsy specimens in postphlebitic limbs and in 4 randomly selected, normal volunteers. Skin flux was increased and the venoarteriolar response decreased in all postphlebitic limbs. Also in all patients an apparent increase in the number of capillaries was observed. They appeared dilated and tortuous, and the thick ened capillary wall was surrounded by a pericapillary halo composed of pro tein, neutral polysaccharides, hemosiderin, and fibrin. In conclusion, measurements with LDF differentiate between normal and postphlebitic limbs, corresponding to the histologic finding of an altered capil lary system. Therefore, LDF is useful for defining the degree of microan giopathy due to venous hypertension.
Correction of Superficial Incompetence with Selective Saphenous Vein Repair (SSVR)
Authors: Belcaro G. 
Published: August 2008

The aim of this study was to evaluate, in a prospective, five-year follow-up study, selective saphenous vein repair (SSVR) (combined use of plication of the incompetent saphenofemoral junction [SFJ] and selective ligature of incompe tent veins). The effects of SSVR were evaluated by ambulatory venous pressure measurements refilling time (RT) and color duplex to detect the number of incompetent venous sites. From a group of 400 consecutive patients studied for venous incompetence 54 subjects were randomized in an SSVR and a control group. Criteria of inclusion were SFJ incompetence with presence of valve cusps and incompetence of two to five venous sites in the territory of the long saphenous. After five years 22 patients in the SSVR group and 21 in the control group completed the study. SSVR increased RT (p < 0.02), and the number of incom petent sites was decreased after five years (p < 0.02). In the control group RT was shorter and the number of incompetent sites increased (p < 0.05) after five years. In conclusion SSVR appears to be an effective, physiological treatment with good long-term (five-year results) on incompetence and on the prevention of new incompetent sites.
The Effect of Atrial Pressure Changes and Cardiac Nerves on Plasma Atrial Natriuretic Peptide Levels
Authors: Okcu Nihat , Kocak Hikmet , Derya Onuk M. , Gündogdu Mehmet , Bakan Ebubekir , Yilmaz Arif , Basoglu Ahmet , Ates Azman , Ayse Pac F. 
Published: August 2008

The authors researched the association between plasma atrial natriuretic peptide (ANP) levels and atrial pressure changes and cardiac nerves in 14 dogs. The dogs were divided into two groups, each group containing 7 dogs. In the second group, cardiac denervation was performed. Left atrial pressure was in creased by creating partial mitral obstruction in both groups. In the second stage, after atrial pressures were decreased to previous values, the dogs were bled. Eventually, atrial pressures were decreased below the normal value. Plasma ANP levels and right and left atrial pressures were determined in all stages. It was concluded that ANP was released from the atria by a direct effect of stretching of the atrial wall and that there was no specific effect of cardiac nerves on ANP release.
Cryopreserved Allografts for Limb Salvage
Authors: Trotter Michael C. , Painter Max W. , Casini Michael P. , Ilabaca Patricio A. 
Published: August 2008

Over a nineteen-month period, 17 patients (8 men, 9 women) underwent revascularization for limb salvage with cryopreserved saphenous vein allografts when autogenous saphenous vein was not available and prosthetic material was felt to be inappropriate. Their mean age was sixty-seven years. Risk factors included hypertension (88%), diabetes mellitus (63%), cigarette smoking (44%), and hypercholesterolemia (44%). All patients had multiple previous vascular operations including coronary artery bypass grafting (3.9 procedures per pa tient). Indications for operations were rest pain (8), ischemic necrosis (3), or both (6). All cryopreserved allografts were obtained from the same procurement source and prepared by a standardized protocol. Combinations of prosthetic material and cryopreserved allograft were used to make composite grafts (5 cases) when adequate length of autogenous saphenous vein was not available. Upper limb veins were not utilized. All patients received antiplatelet therapy or were anticoagulated postoperatively. Current follow-up is two to fifteen months. There were 1 death and 3 major amputations (including the 1 patient who died) in the postoperative period. Fol low-up noninvasive vascular studies were obtainable in 13 patients whose limb was salvaged; 71 % of assessable grafts were patent. Cryopreserved saphenous vein allografts provide a viable option for a selected group of patients when autogenous saphenous vein is not available.
Peripheral Pseudoaneurysms in a Third World Country
Authors: Babar S.M.A. 
Published: August 2008

This preliminary report of an ongoing prospective trial that began in 1986 describes 95 peripheral pseudoaneurysms excluding intracranial and cardiac aneurysms. The majority of these aneurysms were located in the upper limbs. Firearm injury was the main cause, and the author found a high incidence of concomi tant neurological lesions. Relevant investigations included Doppler flow studies, arteriography, and electrophysiologic assessment for neurologic lesions. Where neurologic involvement, such as brachial plexus (BP) lesion, was present, a rad ical one-stage neurovascular reconstruction, after excision of the aneurysm, was undertaken. This usually involved sural nerve grafting for nerve defects. Long saphenous vein (LSV) was the most common vascular conduit used, but the author has also used cephalic vein and synthetic grafts in selected cases. The early results have been very good with respect to revascularization and amelioration of symptoms, but the reattendance rate of the patients under fol low-up was very poor. Although the limited early review of the results of both vascular and nerve grafts has been very satisfactory, these findings cannot be statistically generalized. The author found lack of patient education, peer bias, and poverty to be the main reasons for the poor follow-ups and delayed refer rals. His approach has been surgically aggressive to provide reliable improve ment within a short period of time.
Beneficial Effects of Prostacyclin on Pulmonary Function During Heparin Reversal with Protamine
Authors: Küçükaksu Deniz Süha , Katircioğlu Salih Fehmi , Saydam Gül , Bozdayi Mithat , Mavitas Binali , Tasdemir Oguz , Bayazit Kemal 
Published: August 2008

This study was planned to show the beneficial effects of prostacyclin (PGI2) on pulmonary function after heparin reversal with protamine. Twenty-eight patients entered the study. Half of these patients received prostacyclin, whereas the other patients did not. N-acetyl glucosaminidase (NAG) level was 37.6 ± 4.7 pmoL/mL in the con trol group and 19.7 ± 3.8 pmoL/mL in the PGI2 group (p < 0.001) five minutes after protamine administration. Leukotriene B 4 (LTB4) level was 118 ±13.7 pmoL/mL in the control group and 56 ± 13.8 pmoL/mL in the PGI2 group (p < 0.001). Alveolar-arterial oxygen difference was 69± 15 mmHg in the con trol group and 58 ± 11 mmHg in the PGI2 group (p < 0.05). As a result of this study it was concluded that PGI2 reduced the toxic mani festations of heparin-protamine complex and improved the pulmonary gas ex change.
Surgical Management of Evolving Capillary Hemangiomas in Childhood
Authors: Seccia Antonio , Salgarello Marzia 
Published: August 2008

On the basis of a large series of cases, the authors define and illustrate the characteristics of evolving capillary hemangiomas (ie, congenital vascular capil lary lesions that do not undergo spontaneous regression after the first eight to ten months of life), focusing on how they evolve and the ensuing need for early treatment. The progressive growth and expansion in the cutaneous-subcutaneous (and at times muscular) district is due to the dilation and confluence of capillaries and progressive formation of confluent cavities resulting from the breaking of the interlacunar septa and from endothelial proliferation. The authors point out the sites most frequently involved: lips, eyelids, and cheeks, with considerable repercussions on the cosmetic-functional unit. The clinical aspects are also discussed, especially in relation to the location and de velopment of a single lesion, as well as the diagnostic and therapeutic aspects of the disorder. Special attention is paid to surgical treatment, which must obviously be con servative and must be designed as a multistep procedure so as to avoid useless mutilation and make sure that the scar tissue due to the surgical sclerosis will contribute to the reduction of the angiomatous lesion.
Percutaneous Antegrade Popliteal Artery Approach for Infrapopliteal Angioplasty: Case Report and Technical Note
Authors: Oliva Vincent , Blais Christian , Echave Vincent , Abdulnour Elias 
Published: August 2008

Infrapopliteal angioplasty was performed using percutaneous antegrade catheterization via the popliteal artery; this was done in a sixty-five-year-old patient suffering from lower limb ischemia, with an occluded superficial femo ral artery. The purpose of the procedure was to improve the distal runoff, prior to femoropopliteal bypass surgery. The technique is fully described.
Aortic Aneurysm Repair in Patients with Coronary Heart Disease: Strategy for Diagnosis and Treatment
Authors: Schlosser Volker , Fraedrich Gustav , Schindler Michael , Fasol Roland 
Published: August 2008

Coronary heart disease, specifically myocardial infarction, represents the major risk factor for patients undergoing surgical repair of their abdominal aortic aneurysm. About 75% of all patients in the series of 285 cases were without any signs or symptoms of coronary heart disease. Nevertheless, 21.8% of these patients required additional cardiologic screening in order to assess a possible suspected coronary heart disease, which made urgent coronary angiography necessary in 4.6% of all the patients. Furthermore, 7.3% of all the patients required percutaneous transluminal coronary angioplasty (9=3.15%) or coronary artery bypass grafting (12=4.2%) prior to their scheduled aneurysm operation. Owing to this concept of careful preoperative assessment of adjacent coronary risk factors in patients with aortic aneurysms, the overall morbidity and mortality has dropped from 7.6% to 3.1% over the last ten years.
Noninvasive Preoperative Evaluation of Carotid Atheroma: Echo-Color-Doppler Versus Duplex Scanning
Authors: Rizzo Salvatore , Cardia Giuseppe , Fullone Martinella , Regina Guido 
Published: August 2008

Seventy-two internal carotid arteries in 36 patients (33 men and 3 women) were examined by echo-color-Doppler with and without the insertion of the color function. Subsequently, within one month of the ultrasound evaluation, the 36 patients underwent digitalized angiography of the epiaortic truncus by arterial catheterization. Eight endarterectomies (EAs) of the internal carotid artery were performed on 7 patients (1 patient had surgery on both sides) who presented stenosis greater then 70% during angiography, and 2 patches of external carotid artery were performed. The authors have found no significant different (t test) between the perfect agreement of the echo-color-Doppler (87.5%) and the perfect agreement of the duplex scanning (79.1 %) (P=0.079). The difference between the two methods in underreading (P=0.144) or over-reading (P=0.160) the stenosis was insignificant. If only the third class of stenosis is considered (50-80%), the class where all the internal carotid arteries that underwent EA surgery are concentrated, the perfect agreement is significantly greater for echo-color-Doppler (79.4%) than for duplex scanning (67,65%) (P= 0.021). The authors believe that echo-color-Doppler facilitates the diagnosis of the lesion by means of the immediate identification of even minimal turbulence even though it offers the same possibility as duplex scanning for morphologic and structural study of the atherosclerotic plaque.
Predictive Value of Manual ECG-Monitored Exercise Test Before Abdominal Aortic or Peripheral Vascular Surgery
Authors: Kaaja Risto , Sell Henrik , Erkola Olli , Harjula Ari 
Published: August 2008

The value of manual ECG-monitored exercise test was studied in 58 patients (39 men and 19 women) with intermittent claudication scheduled for abdominal or peripheral vascular surgery. There was a high incidence of well-known risk factors (hypercholesterolemia, smoking, and hypertension) in men and women. History of coronary artery disease (CAD) was present in 29.3% of the patients. No correlation was found between patients with single or multiple stenoses in lower extremity arteries (angiography) and CAD. Ischemic response (ECG) to manual exercise testing was positive in 14 patients (24.1%), of whom 2 (14.3%) had major cardiovascular postoperative complications. Both died of acute myocardial infarction within fourteen days. They had slow recovery (thirty to sixty minutes) of the ST segment (0.3-0.6 mV). The authors conclude that manual exercise testing might reveal serious CAD in patients with severe occlusive peripheral arterial disease of the lower extremities. In cases with slow recovery of ischemic response to exercise, coronary bypass or angioplasty could be advantageous before major vascular surgery.
Rupture of an Aneurysm of the Internal Iliac Artery into the Rectum. Report on a Case with Favorable Outcome
Authors: Del Gaudio Giovanni-Alberto , Berardi Monica , Del Gaudio Antonio 
Published: August 2008

Although internal iliac artery aneurysms are uncommon, their timely recognition and surgical treatment are important since, like all other abdominal aneurysms, they tend to enlarge and rupture, often without warning, and the outcome is usually fatal. An aneurysm of the left internal iliac artery, in a seventy-six-year-old obese man, which ruptured into the rectum, was successfully treated by partial removal, distal aneurysmorrhaphy, and positioning of an aortofemoral prosthetic bypass.