Infrainguinal percutaneous transluminal angioplasty [PTA] for limb salvage

Infrainguinal PTA is progressively increasing as a treatment modality for limb salvage. To evaluate its technical success, complications and clinical effectiveness up to 6 months, the results of 43 selected patients with limb threatening ischemia treated over the period from March 1996 to September 1999 were reviewed. All procedures were done in the operating room. Technical success of PTA with optional stenting was 83.7% [36/43] and 83.3% [30/36] of the successful interventions resulted in a significant clinical improvement. Six months follow up of 21 patients showed that clinical improvement was maintained for all patients originally treated for ischemic ulcers or gangrene, but for only 22.3% [2/9] of patients originally treated for rest pain. In infrainguinal PTA is a simple alternative in selected patients with critical limb ischemia. Procedure related complications are minimal, manageable and does not affect a subsequent bypass if needed

Chronic unclassified arteritis, a non-arteriosclerotic arterio-occlusive disease with a distinct clinicohistopathological entity

9 patients with characteristic clinical and histopathological features which are different from the known types of arteritis in literature were described. All the patients were non-diabetic males [mean age = 42.2 years]. The commonly affected arterial segment was the ilio-common femoral and the femoro-popliteal segments, with otherwise angiographically healthy arterial tree. Angiographically normal run-off arteries were always present. Operatively, the arteries has a fleshy thick wall which was rather friable with a variable degree of periarterial fibrosis. Immunohistopathological findings included a thick internal and external elastic lamina with variable patterns of chronic inflammatory cell infiltration and immune deposits of IgG and complement [C3] mainly

Value of intravenous streptokinase in treating femoral arterial thrombosis after pediatric cardiac catheterization

In order to evaluate the role of intravenous streptokinase in treating femoral arterial thrombosis after pediatric cardiac catheterization and its role in obviating vascular surgical thrombectomy, intravenous streptokinase in a loading dose of 1000 units/kg followed by an infusion at a rate of 1000 units/kg/hour was given to infants and children who developed femoral arterial thrombosis, after cardiac catheterization, not responding to 24 hours of adequate heparinization. A total of 520 consecutive children were catheterized between September 1989 and December 1992 at the Cardiology Department of Ain-Shams University. Out of the 520 patients, 240 patients had transarterial studies. Eighteen of these children had percutaneous balloon aortic valvuloplasty [PBAV] and 14 had percutaneous balloon coarctation angioplasty [PBCA]. There were 34 patients [14.1%] out of the total 240 patients who had a cool, pulseless extremity after catheterization. Nine patients [26.5%] improved with continued heparinization alone. The remaining 25 patients who did not respond to 24 hours of continuous heparinization, were treated with streptokinase and constituted the subjects of this study. In all of the 25 patients treated with streptokinase, except one 12-year-old female who underwent successful surgical femoral arterial thrombectomy, normal pulsations returned equal to those in the contralateral leg. Follow-up of 10 patients showed that the arterial pulsations in 50% of those treated with streptokinase were diminished as proven by Doppler vascular studies. Streptokinase is definitely effective in treating femoral arterial thrombosis not responding to heparinization after arterial catheterization, thus obviating the need for surgical thrombectomy in the majority of cases