bluuebunny/crossref_metadata_2025_split huggingface dataset:
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 After 1 year, 10 patients had been withdrawn (9 ASA/DPM: 1 placebo) and 4 out of 26 grafts in the active group and 15 out of 37 in the placebo group had occluded ( P 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.
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.
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.
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.
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.
Laser Doppler Blood Flow Monitoring in Reconstructive Vascular Surgery: Case Studies
Authors: Svensson Henry , Bergqvist David , Takolander Rabbe 
Published: November 2007

Laser Doppler flowmetric (LDF) measurements were performed preopera tively and postoperatively in patients undergoing arterial reconstruction in the lower limb, and intraoperatively in patients undergoing abdominal aortic re construction. In 21 instances of successful arterial reconstruction in the lower limb, post operative LDF values from the skin of the foot were significantly higher than those obtained preoperatively. In 4 instances, depressed LDF values immedi ately after surgery clearly heralded thrombotic complications. In 5 patients operated upon for occlusive disease of the aorta, LDF values from the skin of one foot were significantly higher at the end of surgery than those obtained when surgery was started. In 2 cases of aneurysm, LDF values decreased but distal pulses were normal. In 2 of these 7 patients, intraoperative embolization was instantly detected. In 1 case of severe microembolization from an aortic aneurysm, a low and unchanged LDF value was recorded throughout the reconstructive procedure, indicating thrombosis of the microvasculature. These observations indicate that laser Doppler flowmetry is useful in recon structive vascular surgery to determine the patency of reconstructed vessels and also to detect thromboembolic complications during and after operation.
Primary Angiosarcoma of the Heart. A Case Report and Review of the English Literature
Authors: Allam Charles , Shikhani Alain , Slim Michel S. , Takla Lama J. , Malouf Joe F. 
Published: November 2007

Primary angiosarcoma of the heart is a rare tumor. In view of its variable clinical picture, the diagnosis is delayed and often difficult to establish without an open biopsy. In the majority of cases the tumor originates from the right atrium, metasta sizes early to distant sites, and carries a rapidly fatal outcome. The clinicopath ologic features and the methods of diagnosis for this highly malignant neoplasm are reviewed and a new case is reported.
Hemodynamic Study After Mechanical Dilatation of Femoral Arteriovenous Fistulas Constructed in Dogs
Authors: Rodriguez-Moran Manuel , Fernandez-Temprano José M. , Lozano Francisco , Cuadrado-Idoyaga Fernando , Serrano Eduardo , Gomez-Alonso Alberto 
Published: November 2007

Perioperative blood flow, blood flow velocity, arterial diameter, and venous diameter are factors with known influence in survival with arteriovenous fistu las (AVF). Twenty-four femoral AVFs were constructed in 12 dogs. The fistulas were randomly divided, and in half of them the vein and the artery were mechani cally dilated (in an extension of 23 cm) with a Fogarty or Foley catheter. After dilatation, perioperative blood flow, blood flow velocity, and arterial diameter were greater in the dilated group when compared to the nondilated group (p < 0.005, p < 0.005, p < 0.025 respectively). In the dogs reoperated at day 30, similar results were observed and also venous diameter was greater in the dilated fistulas (p < 0.05). In conclusion, simple mechanical dilatation of a long venous and arterial segment improved most of the factors that have influence in AVF patency and improved the maturation of the AVF vein. We believe that it would be useful for the construction of arteriovenous fistulas in uremic patients.
Early and Late Results in the Surgical Treatment of Phlegmasia Cerulea Dolens
Authors: Alemany José , Marsal Teresa 
Published: November 2007

A series of 408 patients with acute thrombosis in the iliofemoral area was operated on over the last fourteen years. The operative indication and prognosis depend on localizing the origin and duration of the thrombus. We differentiate among three type of thrombosis: iliofemoral, sapheno-femoro-iliac, and femo roiliac. The duration of the thrombi varied from three to thirty days. In the first and second type, there is a great danger of pulmonary embolism. In such cases, operative treatment is indicated. In the third type of thrombosis, the confluent point is ascendingly obliterated. There is little danger of pulmonary embolism, for the peripheral pressure is not raised. Intraoperative prophylaxis for embo lism by means of a balloon catheter placed contralaterally is not necessary. Of this group, 284 patients were followed up over a period of one to fourteen years. Good results were seen following thrombectomy of type I and II throm bosis. The third type of thrombosis showed worse results. In type I and II thrombosis, fibrinolysis can easily cause pulmonary embo lism, for the peripheral venous pressure is high, but in thrombosis of the third type, the danger of pulmonary embolism is relatively small. The results of fi brinolysis in this ascending type are better than the results of surgery.
Restenosis After Carotid Endarterectomy
Authors: Buche M. , Schoevaerdts J.C. , Jaumin P. , Ponlot R. , Chalant Ch. H. 
Published: November 2007

Fifty endarterectomies of the internal carotid artery have been performed on 43 patients from March, 1984, to December, 1985. There were no perioperative or hospital deaths. The permeability of the operated vessel was confirmed by Doppler or angiography in every case. All patients received aspirin 100 mg/day and dipyridamole 400 mg/day post operatively and all were examined for follow-up. Routine Doppler examination of the carotid artery was performed at frequent intervals. At long-term follow-up, 4 patients had died. None of these deaths could be linked to a neurologic deficit. Three restenoses due to intimal hyperplasia were discovered at follow-up between the eighth and twelfth months. The three re stenoses were successfully reoperated. Because the risk of carotid artery restenosis appears to be real, routine fol low-up with Doppler examination is required. Suspicion of restenosis is an indi cation for control angiography. If restenosis is severe, a reoperation is warranted.
Chemodectoma of the Vagus Nerve—A Case Report
Authors: Tawfik Omar M. 
Published: November 2007

Chemodectomas are tumors of the "paraganglion" system. They arise in many different parts of the body. This is a report of a chemodectoma that arose within the sheath of the vagus nerve and was successfully excised. The different locations where chemodecto mas have been reported in the literature are listed.
Argon Laser-Assisted Peripheral Angioplasty
Authors: Diethrich Edward B. , Timbadia Ela , Bahadir Ilhan , Coburn Kathy , Zenzen Sharon 
Published: November 2007

Pioneered several years ago by cardiologists and interventional radiologists, laser-assisted angioplasty for the ablation of occlusive atherosclerotic lesions in the peripheral and coronary circulations is now entering the domain of the vas cular surgeon, who has the ability to progress beyond the limitations of the percutaneous approach. In the initial 38 patients undergoing 51 lower extremity laser angioplasty/ balloon dilatation procedures for peripheral vascular occlusive disease, pedal pulses were restored in 32 (63%) limbs. The tandem procedure failed in 16 (31%); however, when improvement was assessed objectively by postoperative ankle/arm index evaluation, a positive outcome was achieved in 72 % of the patients. Three (6%) patients required femoral-popliteal bypass after balloon- related arterial dissection was identified. Although laser angioplasty can successfully open occluded arteries, new in traoperative angiographic equipment compatible with laser angioplasty and a variety of incrementally sized laser probes will facilitate refinement of the tech nology and enhance its application.
Changes in Paracardiac Lymph Nodes in Portal Hypertension
Authors: Aboul-Enein A. , Arafa Sobhy 
Published: November 2007

Because of their proximity to the coronary vein and thoracic duct, the para cardiac lymph nodes are liable to develop both venous and lymphatic conges tion. The authors studied morphologic changes in the paracardiac lymph nodes in patients with portal hypertension. Paracardiac lymph nodes were obtained during surgery from 40 volunteer patients with esophageal varices due to schistosomal portal hypertension (29 nonbleeders, 11 bleeders). Paracardiac lymph nodes from 10 volunteer patients having surgery for correction of incisional hernia served as controls. The main histologic difference found in this study was the lower incidence of necrosis in nonbleeders. This indicates the possible role played by inadequate lymphatic drainage of the excessive lymph produced by the congested varices- bearing area in the bleeder.
Patent Ductus Arteriosus in Arabs
Authors: Raffa Hassan 
Published: November 2007

Two hundred patients with patent ductus arteriosus (PDA) underwent sur gery for either triple ligation and transfixation (183 patients = 91.5%) or divi sion and suture (18 patients = 8.5%). The patent ductus arteriosus was an isolated lesion in 163 patients (81.5%) and combined with other cardiac anoma lies in 37 patients (18.5%). Advanced pulmonary hypertension (> 50 mmHg), even in the pediatric age group, was seen in 70 patients (35%). Familial PDA occurred in 6 patients, and 38 patients were born at a high- altitude area (> 4000 feet). Recanalization occurred in only 1 patient (0.5%) owing to initial faulty tech nique using umbilical tape instead of strong silk for ligation of the PDA. Only 2 patients with complex congenital anomalies died (mortality rate of 1%). The peculiarities, presentation forms, and surgical results in Arab patients with PDA are discussed in this paper.
Incomplete Hemisphere Ischemic Model in the Dog Produced by Electrocoagulating Several Major Intracranial Arteries
Authors: Weigou Jiang , Shaoqing Li 
Published: November 2007

An obstacle in stroke research is lack of a suitable animal model; therefore, there is an apparent need for an experimental model of ischemia that resembles as closely as possible what is observed in human beings. The authors used soma tosensory evoked potentials (SEPs) and histologic examination to evaluate the practicability and reliability of an incomplete ischemic model of the brain in dog after observing the circle of Willis of dog. Incomplete cerebral hemisphere is chemia was produced by electrocoagulating various vessels from the circle of Willis. After occlusion, there was a precipitous decrease in the amplitude of cerebral cortical components. The majority of neurons at the sixth hour after occlusion became swollen and some were shrunken. This study shows that the model is a useful one that has the advantages of high rates of successful ischemia and prediction of its size and location, and it is suitable for intracranial microvasosurgical and pathophysiological research in cerebral ischemia.
Acute Abdominal Conditions Induced by Anticoagulant Therapy—Case Reports
Authors: Stanton Paul E. , Watson Scott , Laucirica Rodolfo , Vo Nghia N. , Yee Edward S. 
Published: November 2007

Hemorrhage after oral anticoagu lant administration is a well-recog nized hazard of therapy, and hemorrhagic complications may oc cur in 10-40% of patients. Usually these complications are minor, but se rious bleeding has been reported in from 2-10% of patients on prolonged anticoagulant therapy. Some hemorrhagic complications may be manifested as an acute ab dominal process that may result in unnecessary surgery. The process is most commonly seen in the form of intestinal obstruction produced by hemorrhage into the bowel wall, ad jacent mesentery, or retroperitoneal structures. The authors present 7 cases of se rious abdominal anticoagulant com plications and review the Western literature on this perplexing prob lem.
The DRG Prospective Payment System, Age, Resource Consumption, and Outcome for Peripheral Vascular Surgical Patients
Authors: Munoz Eric , Borrero Edgar , Goldstein Jonathan , Mulloy Katherine , Chang John , Wise Leslie 
Published: November 2007

The federal Medicare DRG pro spective payment system as entered its sixth year, with no major adverse effect so far on American health care regarding either access to or quality of surgical care. The authors ana lyzed hospital resourc consumption and outcome by age for peripheral vascular surgical patients from Ja nuay 1, 1985, through March 31, 1986, at a large academic medical center using the DRG format. Total costs (exclusive of MD fees) for the 211 peripheral vascular surgical pa tients studied were $2,933,623. Mean hospital cost per patient, hospital length of stay, percent of outliers, and mortality were higher for pa tients seventy-five years of age and over as compared with younger pa tients. DRG case-mix index and the number of procedures per patient was also higher for these older pa tients. This study demonstrated that un der prospective payment systems (ie, DRG reimbursement) financial risk was higher for patients seventy-five years of age and over, as were hospi tal length of stay, the number of pro cedures per patient, and mortality. These data suggest that current DRG reimbursement may provide finan cial disincentives to treat elderly pe ripheral vascular surgical patients. As government continues to decrease DRG hospital payment for these pa tients relative to hospital costs, both their access to and quality of surgical care could be jeopardized in the fu ture.