bluuebunny/crossref_metadata_2025_split huggingface dataset:
Familial Incidence of Abdominal Aortic Aneurysms
Authors: Speziale Francesco , De Santis Francesco , Giannoni Maria Fabrizia , Massimi Gregory J. , Brait Cristina M. Chaves , Fiorani Brenno , Flaishman Isac , Fadda Gian Franco , Fiorani Paolo 
Published: November 2007

The rupture of an abdominal aortic aneurysms (AAAs) is associated with a mortality rate exceeding 50%. To reduce this figure it is necessary to increase the frequency of early diagnosis and elective surgery. Screening the general population for occult AAAs has proven cost ineffective. Only by identifying high-risk subgroups will screening programs be improved. The aim of this report was to investigate by ultrasonography the prevalence of previously unknown aortic dilatations among first-degree relatives (parents, siblings, and children) of patients operated on for AAAs.Ninety-one (52.6%) of the 173 living first degree-relatives of 51 patients who underwent AAA resection were submitted to an aortoiliac ultrasonographic examina tion to establish aortic diameter and morphology. There was at least 1 first-degree relative with an AAA (multiplex family) in 10 families (19.6%) before ultrasound screening. With ultrasound a previously unknown infrarenal aortic dilatation was detected in 14 subjects (9 men/5 women; 10 siblings and 4 children) of 12 different families. Specifically, these aortic dilatations consisted of 10 AAAs (diameters ranged from 2.6 to 4.3 cm) and 4 aortic blebs. These occult aortic dilatations were located in 50% of cases in the lower third of the infrarenal abdominal aorta. The cumulative incidence of multiplex families was 35.3%. This study suggests a familial tendency to have an important etiologic role in the formation of AAAs. Family screening of, above all, male siblings older than forty-five years will help identify occult AAAs and reduce the mortality rates associated with their rupture.
External Valvuloplasty of the Saphenofemoral Junction
Authors: Zamboni Paolo , Gasbarro Vincenzo , Marcellino Maria Grazia , Murgia Anna Paola , Feo Carlo , Liboni Alberto , Donini Ippolito 
Published: November 2007

Thirty-five patients (32 women, 3 men, mean age thirty-four years old) underwent external valvuloplasty of the saphenofemoral junction (EV-SFJ). The surgical rationale of this operation is the evidence, in the first stage of primary varicose disease, of a normal valvular apparatus in a dilatated phlebosclerotic vein wall. EV-SFJ restores valve function by correcting vein wall dilatation. EV-SFJ was performed under local anesthesia and, in the last 10 cases, with intraop erative angioscopy This examination confirms the presence of a complete apparatus of the terminal and of the subterminal long saphenous valves and allows the intraoperative control of the correction of vein wall dilatation. Follow-up was from five to fifty-seven months (average forty-two months).
Improvement of Spinal Cord Electrical Activity with Lazaroid (U74006F) During Operations on the Thoracic Aorta: Evaluation of a Novel Lipid Peroxidation Inhibitor
Authors: Olah Andreas , Cernaianu Aurel C. , Gaprindashvili Teimuraz , Cilley Jonathan H. , Neuwirth Michael M. , Ansari Nasarin , DelRossi Anthony J. 
Published: November 2007

Reperfusion injury may contribute to spinal cord damage after cross-clamping of the thoracic aorta (AXC). Tirilazad (U74006F), a potent free radical scavenger and lipid peroxidation inhibitor, has proven to be beneficial in ischemia/reperfusion models. The authors investigated the efficacy of U74006F in preventing paraplegia following forty-five minutes of normothermic AXC distal to the origin of the left subclavian artery. Thirty-two mongrel dogs were assigned to receiving either vehicle as pretreatment (control, n = 7) or 1.5 mg/kg U74006F (group II, n=7) or 3 mg/kg U74006F (group III, n = 10) infused into the descending aorta distal to the clamp for twenty minutes during reperfusion, or 3 mg/kg U74006F IV as pretreatment twenty-five minutes before the onset of ischemia (group IV, n = 8). Mean proximal (BPpr) and distal (BPdx) aortic pressures and somatosensory evoked potentials (SEP) were measured at baseline and at minutes 2, 5, 7, 10, 15, 30, and 45 after AXC. SEP and neurologic outcome (Tarlov criteria) were assessed twenty-four hours postprocedure. There was no difference between BPpx or BP dx and their counterparts in the U74006F-treated animals and the control. SEP returned faster in all treatment groups when compared with controls. However, the neurologic outcome did not differ among groups. The authors conclude that although U74006F did not improve the neurologic outcome, it had a positive effect on the recovery of electrical activity of the spinal cord following transient ischemia. This suggests that the injury to the spinal cord induced by AXC is caused, in part, during reperfusion.
Limb Salvage With H.E.L.P (Heparin-induced Extracorporeal LDL Precipitation) In Peripheral Arterial Disease (PAD)
Authors: Lechner P. , Walzl M. , Walzl B. , Lechner H. , Cesnik H. 
Published: November 2007

Heparin-induced extracorporeal LDL precipitation (H.E.L.R) is based on the fact that lipoproteins and fibrinogen are precipitated at a pH value of 5.12 in the presence of heparin. The elimination of excess fibrinogen from the patient's blood leads to a marked improvement in microcirculation, followed by an increased oxygen supply to the tissue. This permits performance of limb-saving surgical procedures instead of mutilating amputations. Ten patients suffering from far-advanced peripheral arterial disease (PAD) were submitted to 10 H.E.L.P. treatments each instead of undergoing amputations. Surgery could be limited to the removal of necrotic tissue only Wound-healing was uncompro mised in all the patients, and the H.E.L.P. treatment was free of side effects.
Endoluminal Placement of PTFE Graft-Stent Devices in a Canine Model
Authors: Back Martin R. , Kopchok George E. , White Rodney A. , White Geoffrey , Yu Weiyun , Wilson Samuel E. 
Published: November 2007

Endovascular placement of stents lined with prosthetic vascular graft materials offers promise in the treatment of dissections, aneurysms, and atherosclerotic occlusive disease. This study reports the development of and initial experience with polytetraflu oroethylene (PTFE) graft-stent devices endoluminally deployed in canines. Each iliac artery in 6 heparinized dogs received a 6-mm-diameter tubular PTFE graft mounted on either an 8 mm Palmaz stent (PS) or a metallic-ringed graft attachment device (GAD). The graft-stent devices were introduced from the femoral artery through a 14 Fr delivery catheter. Positioning and balloon expansion of the graft-stent devices were aided by fluoroscopic and intravascular ultrasound (IVUS) assessment. Animals were studied acutely (n = 2) or at weeks 1, 2, 4, or 8 after placement. No interval anticoagulation was used. All 6 PTFE-PS devices remained patent. Two of 6 PTFE-GAD devices occluded (at two and four weeks, respectively) owing to initial inadequate deployment. Nonoccluding thrombus was present in an additional 2 PTFE-GAD devices (acute and at one week, respectively) and in 2 PTFE-PS devices (at one week and two weeks, respectively). Complications included groin hematomas in 2 animals (at one week and two weeks, respectively) caused by the large traumatic delivery catheter. Endoluminal placement of PTFE graft-stent devices is feasible. Accurate assessment of deployment by IVUS, reduction of delivery catheter size, and improved graft-stent design are required.
Foot Venous Pressure Measurement in Patients with Varicose Veins
Authors: Matsuda Hitoshi , Ota Toshiaki , Okada Masayoshi 
Published: November 2007

For the evaluation of the severity of varicose veins, foot venous pressure (FVP) measurements utilizing manual calf compression were applied to 52 limbs with varicose veins (group V) and 12 limbs of healthy volunteers (group C). Group V was divided into three groups: group V1 comprising 37 limbs without stasis syndrome, group V2 comprising 9 limbs with pigmentation, and group V3 comprising 6 limbs with preulcerative or ulcerative skin change. First, comparison of manual calf compression with the toe-stand test was performed, wherein a higher reproducibility was revealed for subjects undergoing manual calf compression. Also, a lower ambulatory venous pressure (AVP) and a higher percentage of FVP drop (%drop = [pressure at rest-AVP]/pressure at rest) was obtained with manual calf compression, confirming that this method apparently emptied the calf venous pool. Based on these findings, FVP at four seconds after compression (4SP) and its ratio of increase (4SR% = [4SP - AVP] / [pressure at rest - AVP]) were instituted by use of this method, in addition to AVP, % drop, and 50%/90% of calf-refilling times (RT50/RT90). When the values of the four groups were compared, differences were insignificant between groups C and V1, while significant differences were found between groups V2 (continued on next page) (Abstract continued) or V3 and groups C or V1 in all parameters examined. The number of abnormal limbs that had values beyond the ranges for group C increased from group V1 to group V3. Such abnormalities were best revealed by 4SR% and RT50. In the postoperative FVP measurements of 17 limbs, all parameters of all limbs were restored to the normal range, except for % drop of 4 limbs, and 4SR%, RT50, and RT90 of 1 limb. Based on these findings, all parameters examined in this study were considered to be sufficient for the evaluation of the severity of varicose veins. In particular, 4SR% and RT50, which reflect venous reflux in the early venous refilling phase, were the best diagnostic parameters. The usefulness of FVP measurement utilizing manual calf compression and the significance of the early phase of venous refilling in the varicose veins limbs were confirmed.
Ruptured Abdominal Aortic Aneurysms
Authors: Masclans Joan R. , Planas Mercè , Bermejo Begoña , Serra Joaquim , Porta Isabel , Sobregrau Rafael , de Latorre Francisco J. 
Published: November 2007

A study of 80 patients with ruptured aortic aneurysms admitted over an eight-year period to the Intensive Care Unit of the authors' hospital was undertaken. All the information was introduced to a data base and processed for statistical treatment by use of a software program. Most patients admitted to the emergency room presented diffuse or localized abdominal pain. An abdominal mass was present in 40% of the cases. Hypotension was usually present with shock in 20% of the patients. The diagnosis was confirmed essen tially by computerized axial tomography. In 27% of the patients, operation was under taken based on clinical grounds only. Sixty-seven percent of the patients showed one or more complications. Acute renal failure (51%), sepsis (31%), acute respiratory insuffi ciency (20%), mesenteric ischemia (13%), coagulopathy (11%), and neurologic compli cations (11%) were the most often encountered. The mortality rate was 42.5%; shock was the most common cause of death, and mesenteric ischemia was the second.
The Vasa Vasorum in the Abdominal Aorta of the Dog
Authors: Pisco João Martins , Correia Miguel , Esperança Pina José Antònio , de Sousa Luis Aires 
Published: November 2007

The authors studied the distribution of the vasa vasorum in the abdominal aorta of the normal dog and following surgically created aortic stenosis. Twelve dogs with normal aorta and 6 dogs with surgically created stenosis in the abdominal aorta were used. The dogs with aortic stenosis were sacrificed at two, four, and six weeks after creation of the stenoses. The vasa vasorum network was evaluated by the Spalteholz technique, microan giography, histology and scanning electronic microscopy (SEM). In the normal aorta there is in the adventitia a network of vessels from which arise arterioles that extend up to the outer third of the media. At the stenotic zone there is interruption of the vasa vasorum and proliferation on each side of the stenosis up to 5 mm. The authors conclude that the effect of revascularization techniques on vasa vasorum of surgically created stenosis should be analyzed at least 5 mm away from the stenosis.
Long-Term Results of Simultaneous Carotid Endarterectomy and Coronary Artery Revascularization in Patients with Unstable Angina and Cerebrovascular Insufficiency
Authors: Vassilidze Teimouraz , Cernaianu Aurel C. , Gaprindashvili Teimuraz , Gallucci John G. , Cilley Jonathan H. , Grosso Michael A. , DelRossi Anthony J. 
Published: November 2007

This study assessed the outcome of 11 consecutive high-risk patients (8 men, 3 women) with symptomatic, high-grade (greater than 70%) bilateral carotid stenosis and left main or triple-vessel disease with unstable angina undergoing emergency simultaneous carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) revascularization. Seven patients presented with crescendo unstable angina and 4 had type III postinfarc tion unstable angina. All were symptomatic for cerebrovascular insufficiency. Six patients had left main and 5 patients had triple-vessel disease aside from bilateral carotid lesions. There were 8 men and 3 women, (mean age 69.1 ± 3.9 years). The mean preoperative end-diastolic pressure and ejection fraction were 17.2 ±2.4 mm Hg and 35.3 ±6.9%, respectively. Sequential reconstruction of the carotid artery was followed by CABG with an average number of 3.1 ± 0.3 grafts per patient. One patient had additional aortic valve replace ment and 1 had an automatic implantable cardioverter defibrillator implanted. There was no operative mortality. The overall neurologic complication rate was 27.3% (3 of 11). One patient developed perioperative myocardial infarction and 1 other had respira tory failure. Mean postoperative hospital stay was 24.4 ±4.8 days. Within one year postoperation, 1 patient died. Two patients had contralateral CEA owing to recurrent transient ischemic attack. The five-year probability of survival was 89%. Our data show that simultaneous CEA/CABG in patients with high-risk coronary and cerebrovascular insufficiency may result in low mortality; however, a relatively increased incidence of short- and long-term morbidity is expected.
Effect on Thrombolysis and its Complication of Graft Occlusion and Specific Risk Factors
Authors: Ikeda Yasuharu , Wada Hiroya , Rummel Mark C. , Field Charles K. , Bhatnagar Pankaj K. , Khoury Paul A. , Wilson Audrey R. , Kerstein Morris D. , Matsumoto Teruo 
Published: November 2007

The objective of this study was to correlate the initial outcome of thrombolytic therapy in patients with specific risk factors who presented with an occluded synthetic graft. Seventy-seven angiographically documented occluded synthetic grafts were treated with urokinase. All patients presented within thirty days of occlusion. The cases were investi gated according to specific risk factors: smoking (SM), hypertension (HT), coronary artery disease (CAD), and diabetes mellitus (DM). A high number of occlusions occurred in patients had a history of heavy smoking (84.4%). Complete thrombolysis was achieved in 46 of 77 (59.7%) graft occlusions. Thirty-eight of 65 (58.5%) occlusions in patients who smoked, 29 of 47 (61.7%) occlusions in patients with HT, 22 of 36 (61.1%) occlu sions in patients with CAD, and 18 of 25 (72.0%) occlusions in patients with DM were completely lysed. When comparison was made between the specific risk factors, no signif icant difference was found in complete lysis. Forty-seven complications occurred in 31 (40.3%) of 77 cases. One patient (1.3%) suffered from a fatal intracranial hemorrhage. No significant increase in complications was seen when the various risk factors were compared. In conclusion, no relation was observed between the initial success rate with throm bolytic therapy and multiple risk factors in patients with arterial graft occlusion.
Carotid Endarterectomy: A Nine-Year Review of Procedures Performed in a Community Hospital
Authors: Holliday H. Joseph 
Published: November 2007

This review was conducted to compare the results of carotid endarterectomy in a community hospital with those of the same surgery performed in larger medical centers. In all, 166 carotid surgeries were performed over a nine-year period by the same surgeon. There were no operative or perioperative deaths. The operative stroke rate was 1.2%. No other significant complications were noted. Recurrence requiring a second surgery was noted in 1 patient. These results compare favorably with those of larger institutions and support carotid endarterectomy in a smaller community hospital. ,
Inferior Vena Caval Filter Placement Without Preoperative Venacavography
Authors: Mirande Raul A. , Mirande Karri K. , Liu Terrence , Baker William H. 
Published: November 2007

Despite the emergence of noninvasive studies as the gold standard of venous diagnosis, many authors still insist upon formal preoperative venacavograms prior to insertion of an inferior vena cava (IVC) filter. Conversely, the authors employed only preoperative nonin vasive venous examinations and intraoperative fluoroscopy in 123 consecutive (IVC) filter placements of either the Greenfield filter (n=66) or the LGM (Vena Tech) device (n=57) by the surgical service. They reviewed the patients' intraoperative and postop erative hospital courses to identify complications that could have been avoided by obtaining preoperative contrast venacavograms. Twenty-one intraoperative complications or untoward events occurred in 17 patients, 1 of which could definitely have been prevented by preoperative venograms. These included: unrecognized internal jugular thrombus or web (3), neck hematoma (2), partial filter opening (2), obliquely placed filters (2), requirement of multiple venous insertion sites (5) or conversion to an open procedure (2), premature filter discharge into iliac veins (2), unrecognized IVC thrombus requiring a suprarenal filter (1), placement of a Vena Tech filter inverted (1), and development of hemodynamic instability requiring inotropic support (1). Two patients (1.6%) suffered clinically apparent inferior vena caval occlusion and 4 (3.3%) had recurrent pulmonary emboli after filter placement. There were 18 deaths (14.6%), 14 of these within the thirty-day postoperative period (11.4%). None had evidence that the IVC filter or recurrent thromboembolic events led to their demise. In this retrospective review, the authors identified 1 intraoperative (unrecognized IVC thrombus) and no postoperative complications that could have been prevented by obtaining a preoperative contrast venacavogram. They conclude that noninvasive preop erative venous evaluation coupled with intraoperative fluoroscopy is adequate for the safe placement of inferior vena caval filters.
Early Diagnosis and Repair of Popliteal Artery and Vein Injuries Occurring During Arthroscopy of the Knee
Authors: Fogerty Mary D. , Hines George L. , Sutaria Maganlal 
Published: November 2007

Injuries to the popliteal vessels during arthroscopic procedures of the knee are rare but may lead to amputation of the extremity. Early recognition and repair of such injuries is essential to avoid this complication. Two cases of patients who sustained injuries to the popliteal artery and vein during arthroscopy and were diagnosed and definitively treated within hours of the injury are reported. Both patients underwent urgent repair of the lacerated artery and vein and had good perfusion and function of the lower limb postoperatively. When the possibility of arthroscopic injury to the popliteal vessels exists, the diagnosis and treatment are straightforward. Early repair may avoid the disastrous complication of amputation of the affected leg.
Hemodynamically Significant Carotid Disease and Prophylactic Carotid Endarterectomy in CABG Patients—Impact on Perioperative Neurologic Events
Authors: Hines George L. , Scott William C. , Schubach Scott L. , Tyd Donna , Wehbe Ulla 
Published: November 2007

Perioperative neurologic deficits occur in 2-5% of patients undergoing isolated coronary artery bypass grafting (CABG). The effect of preexisting high-grade carotid artery stenosis, as determined by (1) the presence of a cervical bruit, (2) ocular plethysmog raphy (OPG), and (3) duplex scan, and the value of prophylactic carotid endarterectomy in preventing stroke, are uncertain. The hospital courses of 427 patients who underwent pre-CABG carotid duplex scan and coronary artery bypass (CAB) as the only cardiac procedure between April 1992 and June 1994 were reviewed (1) to evaluate the rela tionship between carotid stenosis and perioperative neurologic events and (2) to determine whether endarterectomy for high-grade lesions (80-99%) decreases the risk of perioperative cerebrovascular accident (CVA). There were 11 strokes (2.58%) in 427 patients, 4 CVAs occurred in 389 patients without significant carotid disease; 12 patients had total occlusion of one carotid artery and 4 of them developed a CVA (33.3%); 26 patients had a high-grade stenosis (80-99%) of one carotid artery. Twelve of these patients underwent either a pre-CABG carotid endarterectomy (CE) (5 patients) or simul taneous CE + CABG (7 patients). There were no neurologic events in this group. The 14 other patients with 80-99% stenosis did not undergo a CE. There were 3 CVAs and 1 transient ischemic attack (TIA) in this group. Seven of 11 CVAs (64%) occurred in 34 patients with either total or high-grade carotid disease (P < .0001 by Fisher Exact Test and Wilcoxin Rank Sum). Conclusions: (1) high-grade or total occlusion of a carotid artery is associated with significantly increased risk or perioperative neurologic events. (2) Carotid endarterec tomy appears to be protective. (3) A significant number (4 of 11) of neurologic events are due to causes other than carotid stenosis.
Descending Aortic Dissection in an Elderly Weight Lifter
Authors: Ciocca Rocco G. , Costibile Joseph P. , Graham Alan M. 
Published: November 2007

Acute aortic dissections are rare but not uncommon. The etiology of aortic dissections has been attributed to collagen abnormalities or systemic hypertension. Prognosis is predi cated on a timely diagnosis, location of the dissection, and appropriate intervention. Dissections of the aorta associated with weight lifting have been described and tend to involve the ascending aorta in young male weight lifters. This report describes the second reported descending aortic dissection associated with weight lifting. Aortic dissections associated with weight lifting are exceedingly rare; however, this entity may become more prevalent with an increase in exercise and cardiovascular condi tioning among all age groups.