bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seat-Belt Dissection and Thrombosis of the Abdominal Aorta — A Case Report
Authors: Almazán Arturo , Ramos Manuel , Estella Rafael , Marin Antonio , González-Orús José Maria , Gómez-Alonso Alberto 
Published: August 2008

Aortic injury is very rare in blunt abdominal trauma, but dissection and thrombosis of the aorta from a seat belt is exceptional and could be explained by the joint action of opposing forces. Anatomically, the lesions could go from aor tic wall hematoma to complete rupture. The authors describe a case of acute presentation with loss of both femoral pulses and signs of lower limb ischemia due to circumferential dissection of the intima at the aortic bifurcation and secondary thrombosis. Small bowel rupture was associated. The patient did well with bowel resection and simple suture of the intimal tear.
Age as High-Risk Factor in the Treatment of Abdominal Aortic Aneurysm
Authors: Noppeney T. , Raithel D. 
Published: August 2008

During the last thirty years, a distinct increase in the frequency of operative treatment of abdominal aortic aneurysm (AAA) has been caused by the overall increase in AAA, its more frequent diagnosis, progress in intensive care, and technical developments in vascular surgery. The mean age of the patients has risen over the same time to sixty-nine years. An analysis of the authors' patients with AAA reveals that resection of an aneurysm and interposition of a prosthesis represent nowadays, even in high- risk patients, the therapy of choice.
Femoropopliteal Laser Angioplasty: Initial Clinical Results with Large Probes as "Sole Therapy"
Authors: Rosenthal David , Wheeler William G. , Seagraves Annette , Lamis Pano A. , Jones Michael 
Published: August 2008

Laser-assisted balloon angioplasty has been shown to be effective in the treatment of superficial femoral artery (SFA) occlusive disease. In order to avoid the inherent trauma of balloon angioplasty, 30 patients underwent laser angioplasty of the SFA as "sole therapy." Laser angioplasty was performed using a laser coupled to a 600 micron fiber and a 3.5 mm probe (22-28 watts). Fourteen patients had laser angioplasty for claudication and 16 for limb salvage. The initial success rate was 83% (25/30) (lesion length 2-14 cm). In follow-up extending to nine months, 84% (21/25) of laser angioplastied SFAs have remained patent. By avoiding the disruptive effect on the arterial wall architecture caused by balloon angioplasty, while at the same time ablating and vaporizing more atheromatous material with larger laser probes, the long-term patency rates of laser angioplasty as sole therapy may prove to be superior to those of laser- assisted balloon angioplasty.
Comparison of Penile:Brachial Index and Pelvic Angiogram
Authors: Haynes Daniel F. , Lewis Ronald W. , Balkin Peter W. , Rice Janet C. , Kerstein Morris D. 
Published: August 2008

After an initial evaluation indicating potential vasogenic impotence, 27 pa tients were identified as having had both penile:brachial index (PBI) and pelvic angiography done. All patients had also undergone psychiatric and hormonal evaluation, as well as nocturnal penile tumescence monitoring. If the PBI was consistent with vasogenic impotence (≤ 0. 7), an angiogram was performed. Twenty-one patients were found by angiogram to have impaired arterial inflow on at least one side, yielding a prevalence of 84%. Angiogram findings, in rela tion to PBI for each side, demonstrated that 30/49 (61%) sides had impaired inflow. Of the 24 patients for whom bilateral data were available, 9 (38%) had impaired inflow to both sides, while 12 (50%) had impaired inflow on only one side. Of these 21 patients who had impaired inflow, 16 (76%) had lesions of the internal pudendal artery or more proximally. Of the 30 sides with impaired inflow, 24 (80%) had lesions proximal to the internal pudendal artery, 1 (3%) had a lesion of the common penile artery, and 11 (37%) had lesions of the penile arteries either dorsal or deep. Vascular disease may be missed by the PBI by singling out arteries other than the deep artery of the penis. The PBI has an important role in assignment of patients to angiography; at the 0.6 threshold, especially, PBI is shown to be a specific tool with a high positive predictive value in this patient population. The significant number of arterial lesions demonstrated in these patients lends sup port to a broader role for angiography in evaluation of men with impotence.
Carotid Resection for the Elongated Internal Carotid Artery
Authors: Wandschneider W. , Veit F.H. , Hollaus P. , Raynoschek H. , Denck H. 
Published: August 2008

Thirty-four patients underwent resection of the internal carotid artery (ICA) because of symptomatic elongation; 61.8% had suffered a stroke and 38.2% transient ischemic attacks (TIA). There were no asymptomatic patients; 35.3% were operated on for stenotic plaques without manifest elongation in preopera tive angiography but developed ICA kinking after endarterectomy. There was no mortality and no permanent neurologic deficit during the perioperative per iod. Within a follow-up interval with a mean of seventeen months there was 1 ipsihemispherical stroke (2.9%); in another asymptomatic patient duplex sono graphy revealed low-grade carotid stenosis. Thus 92% of the 35 patients who were followed up showed normal neurologic and sonographic findings during follow-up. The authors concluded that their technique of ICA resection, especially the use of an intraluminal shunt, is a safe method yielding satisfactory long-term results. Attention should be paid to the possibility of ICA kinking following local endarterectomy.
Vein Valve Graft for Primary Femorosaphenous Incompetence
Authors: Ananthakrishnan N. , Srinivasan K. , Hadke N.S. , Govind Krishna S.R. , Srivastava K.K. 
Published: August 2008

Primary femorosaphenous incompetence (FSI) is a rare cause of venous stasis and ulceration and is conventionally managed by ligation of the saphenofemoral junction with or without stripping of the long saphenous vein (LSV). The authors present here 9 patients with FSI documented by phlebography who were managed by the alternate procedure of vein valve graft from the basilic vein to the long saphenous system to restore competency of the femorosaphenous (FS) junction . This procedure has hitherto not been tried for primary varicosity of the LSV. There was cosmetic improvement in all patients. Chronic ulcers in 5 patients seen preoperatively remained healed during a follow-up period of one to five years. There was symptomatic improvement of heaviness of the limb in 5 of 6 patients . Phlebography at one year postoperatively showed competency of the FS junction in all 9 patients and graft patency in 8 of 9 patients. This procedure has the added advantage of preserving the LSV for future use in arterial bypass surgery and avoids complications like saphenous nerve injury and lymphatic disruption associated with stripping of the LSV.
The Popliteal Approach: A New Approach to Percutaneous Laser-Assisted Angioplasty
Authors: Stagg Samuel J. , Chaisson Gary , Ladd William R. , Murray Gary , Pharo Wayne , Fudge Tommy , Abben Richard , Couvillon Michael A. , Allie David , Walker Craig M. 
Published: August 2008

"Hot-tip" laser angioplasty has been proven safe and effective in treating periperal vascular disease. There is, however, a group of patients with lesions or occlusions at the origin of the superficial femoral artery (SFA) that are difficult to approach from a standard antegrade femoral approach. The authors have developed a new retrograde popliteal approach that allows laser angioplasty to be performed percutaneously in these patients; 51 consecutive cases have been treated and followed up for more than one year. There were 40 cases with lesions greater than 9 cm long (Group A), while 11 cases had lesions less than 9 cm long (Group B). The mean lesion length was 15 cm. The initial success rate was 32 of 51 cases (63%): 24 of 40 cases (60%) in Group A and 8 of 11 cases (73%) in Group B proved successful. A three-month follow-up showed that clinical patency was 100% in initially successful cases (32 of 32 cases overall, 24 of 24 cases in Group A, and 8 of 8 cases in Group B). A twelve-month follow-up showed clinical patency in 20 of 32 initally successful cases (63%); 14 of 24 cases (58%) in Group A and 6 of 8 cases in Group B (75%) remained patent at twelve months. The authors conclude that the popliteal approach to laser-assisted angioplasty is a safe and effective method of treating lesions at the origin of the SFA that could not be treated with any other percutaneous approach. One-year follow-up results in these patients are encouraging.
Echocardiographic and Color Flow Doppler Features of Bioprosthetic Valve Degeneration
Authors: Alam Mohsin , Rosman Howard S. 
Published: August 2008

Serial echocardiographic and color flow Doppler studies were performed in 38 mitral and aortic bioprosthetic valves. In the ensuing three to four months of follow-up, 7 patients developed clinical, angiographic evidence of severe valve regurgitation due to structural valve degeneration. Analysis of ultrasound studies revealed that increased thickness of the cusp by echocardiography and presence of mild to moderate color flow Doppler regurgitation preceded clinical regurgi tation in 5 and 4 bioprostheses respectively. In conclusion, echo and cardiac Doppler features of thickened and/or regur gitant valves are markers for degenerating bioprostheses and these features usually precede clinical dysfunction.
Allogenic, Multidonor In Vitro Endothelialization of Small Diameter PTFE Grafts in Baboons
Authors: Fasol Roland , Zilla Peter , Preiss Petra , von Oppell Ulrich , Odell John , Reichart Bruno 
Published: August 2008

The early effect of allogenic in vitro endothelialization was assessed in small- diameter vascular prostheses. Cryopreserved and pooled venous endothelial cells (ECs) from 13 baboons of similar blood group were used for confluent in vitro endothelialization of fibrin glue-coated polytetrafluoroethylene vascular grafts. Bilateral femoral interpositions (12 cm) of experimental and control grafts were subsequently implanted into a separate group of 18 male baboons with the same blood group as that of the pooled cells. After sixteen days of implantation the patency rate of grafts of the endothelialized group was similar to that of the control group (55.6% vs 61.1%, p>0.1). Scanning electron microscopy revealed that 44.4% of experimental grafts were completly free of endothelium, while the remaining grafts showed a moderate mean EC coverage of 34.4 17.1%. These remaining ECs were found mainly as small islands densely covered by leukocytes. The majority of these white cells resembled granulocytes, although adherent lymphocytes were also regularly observed. Since surface morphology does not explain the mechanism of EC loss, further experiments must elucidate this question. If rejection is found to be the primary cause for this cell loss, the use of major histocompatibility complex (MHC) matched EC subpools might be considered.
Loss of Tachyphylaxis and Increased Sensitivity to Angiotensin II in Experimental Vein Grants
Authors: O'Donohoe Martin K. , Radic Zeljko S. , Stein Adam D. , Schwartz Lewis B. , McCann Richard L. , Hagen Per-Otto 
Published: August 2008

Intimal hyperplasia and atherosclerosis have been implicated in the pathophysiology of vein graft failure. Several recent studies have also reported alterations in the vasoreactivity of vein grafts. These alterations in vasoreactivity could contribute to vein graft spasm and lead to graft occlusion. This study examined the vasomotor responses of experimental vein grafts to angiotensin II, the most potent natural vasoconstrictor known. The right carotid artery was divided and bypassed in 12 rabbits with use of the right external jugular vein. The left external jugular vein was used as a control. Eight vein grafts and jugular veins were harvested after fourteen days and 4 vein grafts after twenty-eight days. Segments of vein graft and control vein were mounted under isometric tension in an organ bath, and the dose response curves to angiotensin II obtained. On day 14, the response of the jugular veins was triphasic, while the respnse of the vein grafts was sigmoidal. The vein grafts were hypersensitive to angiotensin II. The ED50 was reduced from 8.4 ± 2.5 x 10-6 M in the jugular veins to 1.62 ± 0.24 x 10-8 M in the vein grafts (p < 0.005). The maximal response to angiotensin II was also increased from 342 ± 24 mg in the jugular veins to 558 ± 108 mg in the vein grafts on day 14 (p < 0.05). There was no significant difference in either the ED50 or the maximal response of the vein grafts on day 14 or 28. Tachyphylaxis (desensitization with repeated doses of agonist) was observed in the jugular veins but not in the vein grafts. The results show that experimental vein grafts are hypersensitive to angiotensin II, with either single or repeated exposure. This increased vasoreactivity to angiotensin II may have important clinical implications, particularly when vein grafts are used in patients with renovascular hypertension.
Surgical Treatment of Postinfarct Ventricular Tachycardia—Seven Years of Experience
Authors: Renzulli A. , D'Onofrio A. , Glenville B.E. , Naik S. , Bourke J.P. , McComb J.M. , Campbell R.W.F. , Hilton C.J. 
Published: August 2008

The results of surgery for postischemic drug-resistant ventricular arrhythmias (VA) are still controversial. The operative mortality in the literature ranges between 10% and 40% because of selection of patients. The authors reviewed their experience at Freeman Hospital where all patients with drug-refractory ventricular tachycardia (VT) or ventricular fibrillation (VF) underwent surgical treatment regardless of left ventricular function (LVF) and of time from infarction and operation. Between March, 1981, and March, 1988, 65 patients [53 men, 12 women aged thirteen to seventy-five years (mean fifty-four)] underwent surgery. All of them had a previous myocardial infarct (MI). Mean preoperative ejection fraction was 28% ± 11, and 32 % had single-vessel, 44 % double-vessel, and 24% triple-vessel disease. In 16 surgical treatment was undertaken on an emergency basis. All had intraoperative mapping based on activation sequence or, when this was not possible (noninducible VT/VF), on analysis of fragmented potentials. LV endocardial resection was performed in 64 patients. Heart transplant (HTx) was necessary in 1. Associated procedures were aneurysmectomy in 40 patients (62%), multiple cryoablation in 13 (20%), encircling ventriculotomy in 8 (12%), right ventricular endocardial resection in 1, coronary artery bypass grafting in 43 (66%), mitral valve replacement in 5 (8%), and closure of postinfarct ventricular septal defect (VSD) in 2. The operative mortality was 26% (17 patients}. The main cause of death was left ventricular failure, 13 (20%). The mortality was higher in patients with previous anterior MI 15/49 (31%) and in emergency operations 9/16 (56%). The follow-up ranged between four and forty months (mean twenty-two months) with 6 late deaths (2 arrhythmia related). In 11 patients (17%) postoperative arrhythmic episodes were observed, but only in 6 (5 drug controlled, 1 without therapy) was there recurrence of preoperative arrhythmia. Surgery for life-threatening VA allows good long-term results for relief of arrhythmias. Perioperative mortality is still high in unselected patients; it depends mainly on the preoperative LVF. HTx in cases with very depressed LVF is an option, but in the majority of patients in this group it was contraindicated.
Measurement of the Lumen Diameter in Vessels and Grafts: A New in Situ Method
Authors: Al-Ali Jassem , Inacio Jorge , Strömberg Lennart , Swedenborg Jesper 
Published: August 2008

A method and an equipment for measuring lumen diameters of vessels and vascular grafts in situ in experimental and clinical situations have been designed and tested on animals. The measurements were performed with a balloon catheter inserted in the lumen of the vessel. Saline was injected into the balloon, which increases in size spherically. The relationship between the hydrostatic pressure in the balloon, the volume of the injectate and the diameter of the balloon was registered and processed by a computer. The diameters were recorded graphically and digitally. The method and the designed equipment showed good precision. The meas uring procedure is not time consuming and the equipment is easy to handle.
Myocardial Response to Pretreatment with L-Carnitine in Patients with Cardiac Valve Replacement
Authors: Sunamori Makoto , Nakagawa Tetsuro , Fujisawa Shigeki , Suzuki Akio 
Published: August 2008

Twenty-one patients undergoing mitral valve replacement (MVR) with either isolated or combined valvular procedure were investigated to determine the ef fect of randomized and prospective administration of L-carnitine (car) chloride on myocardial function. Carnitine chloride (1800 mg/day, for seven consecu tive days just prior to MVR) was given orally to 9 patients (car-treated group) who were compared with 12 car-untreated patients (control group) subjected to the same procedure. Valve replacement was performed using the Bjork-Shiley mechanical prosthesis in aortic and mitral position and bioprosthesis in tricuspid position in both groups under cardiopulmonary bypass (CPB) associated with cold potassium-magnesium cardioplegia and systemic hypothermia. Preopera tive and intraoperative clinical profile (age, functional class, duration of aortic clamp and CPB, and level of hypothermia) was well matched in both groups. Free, short-chain acyl, long-chain acyl, and total Car were measured in the papil lary muscle excised adjacent to the free wall of the left ventricle at the time of valvular surgery. Heart rate and mean arterial pressure did not differ between the two groups. Cardiac index was 3.44 ± 0.08 and 3.82 ± 0.13 L/m2/min in the control and car-treated groups, respectively, (p < 0.05). Dobutamine (DOB) infusion rate was 8.55 ± 0.73 and 5.57 ± 0.95 μg/kg/min in the control and car-treated groups, respectively (p < 0.05). Left ventricular stroke work index (LVSWI)/DOB ratio was 4.50 ± 0.65 and 8.16 ± 1.72 g*m/m 2/beat/unit of DOB, in the control and car-treated groups, respectively (p < 0.05). Long-chain acyl carnitine was 0.224 ± 0.031 and 0.460 ± 0.096 nmoL/mg noncollagenous protein in the control and the car-treated groups, respectively (p<0.05). LVSWI/DOB ratio was well correlated with long-chain acyl carnitine in the tis sue, r = 0.74, n = 18, p<0.001. These findings suggest that pretreatment with L-carnitine chloride appears to be effective in improving myocardial function in the early phase of reperfu sion following surgery and that long-chain acyl carnitine may play a key role in the enhancement of carnitine-meditated mitochondrial metabolic process.
Cryopreserved Trachea—A New Arterial Conduit: Early Hemodynamic and Radiographic Performance
Authors: Laub Glenn W. , Muralidharan S. , Daliosio Connie , Perritt Alison , Jiang Gu  , Fernandez Javier , Pollock Samuel , Adkins Mark S. , McGrath Lynn B. 
Published: August 2008

Synthetic arterial conduits perform well in a vast range of applications; however, there are certain situations where these grafts are not ideal. In an ef fort to find a superior graft, the authors evaluated the use of rat tracheas as cryopreserved homograft arterial conduits. Twenty-four retired breeder Wistar rats received cryopreserved homograft tracheas as arterial grafts in the infrarenal abdominal aorta. After graft implan tation, the animals were allowed to recover and assigned to groups of 4 animals to be sacrificed at the end of one, two, three, six, twelve and twenty-four weeks. The animals were followed up clinically and then the grafts were evaluated hemodynamically, angiographically, and by gross histolog. Four animals (17%) died owing to ruptured aneurysmal grafts—1 in the two-week group, 1 in the six-week group, and 2 in the twelve-week group. One animal in the six week group had a patent but aneurysmal graft at the time of sacrifice. There were no pressure gradients, graft stenoses, or anastomotic strictures in any of the surviving animals. The authors conclude that the use of cryopreserved tracheal homograft as an interposition graft, while feasible, is associated with an unac ceptably high incidence of aneurysm formation.
A New Approach for Abdominal Aortic Aneurysm by a Ringed Y Graft
Authors: Kurata Satoru , Hongo Hiroshi , Furutani Akira , Kaneda Yosikazu , Sakai Hidenori , Kuroda Utaka , Nakayasu Kiyoshi , Esato Kensuke 
Published: August 2008

Nonsuture technique with ringed Y graft (RYG) was applied to 20 high-risk patients with abdominal aortic aneurysm (AAA). All showed marked arteri osclerotic changes. In 4 cases, there was no normal infrarenal segment of the aorta. Concomitant diseases were: chronic obstructive pulmonary disease in 6 pa tients, moderate renal failure in 6, heart failure in 6, gastric ulcer in 3, thoracic aortic aneurysm in 1, and ruptured AAA in 1. Five patients were more than eighty years old. The RYG method, except in the ruptured case, was evaluated (19 cases) by comparing age, size of aneurysm, operating time, blood loss, and aorta cross- clamping time with the conventional Y graft (CYG) method (21 cases). The mean age was 75 ± 1.7 years in the RYG group and 69 ± 1.5 years in the CYG group (p < 0.05). Sizes and operating times in the RYG group were identi cal with those in the CYG group. Mean blood loss was 755 ± 88 mL in the RYG group and 1204 ± 170 mL in the CYG group (p < 0.05). Aorta-clamping time was 37 ± 3.4 minutes in the RYG group and 56 ± 3.1 minutes in the CYG group (p < 0.001).
Arterial Reconstruction in the Lower Extremity by Means of Multiple Distal Anastomoses for Limb Salvage
Authors: Alemany J. 
Published: August 2008

Long femoropopliteal occlusions also involving the trifurcation are circum vented by means of femorodistal bypasses. Despite good function of the bypass, the result is occasionally disappointing in cases in which necroses on foot or lower leg have not regressed and have finally led to amputation. To optimize the perfusion of the lower leg, the author performed, between 1980 and 1990, a multilevel or multiple bypass on the lower limbs in 92 cases. By creation of several anastomoses in the lower leg and popliteal arteries, he at tained a better perfusion in the lower limb. His results show that multilevel reconstruction or bypass with multiple distal anastomoses in case of "limb salvage" achieves a statistically significant reduc tion of amputations.