Physiologic surgery for lower limbs filarial lymphoedema

This study is an expansion of previously undertaken early surgical trials to test the efficacy of lymphnodovenous shunts [LNVS] for the treatment of filarial lymphoedema of the lower limbs. LNVS was carried out in fifteen patients suffering from lower limbs filarial lymphoedema over a 3.5 years period, after failed previous conservative therapy. Mean follow-up was 13.7 months. Eleven patients had benefit from this type of physiologic surgery as judged by regular postoperative limb circumference measurements, radio- isotope lymphoscanning and incidence of recurrent cellulitis or lymphangitis. The lymphnodovenous shunt [LNVS] represents an appealing therapeutic option in properly selected cases of [secondary] filarial lymphoedema of lower limbs. Larger series and longer follow- up are awaited to further confirm the durable efficacy of such procedure in a most challenging problem in vascular surgery

Management of post-arterial catheterization lower limbs ischemia

Thirty one cases of iatrogenic acute lower limbs ischemia following diagnostic or therapeutic arterial catheterization were referred to and managed by the vascular surgery team, Ain Shams University Hospital, over a two year period. Thrombosis, spasm [with or without thrombosis], dissection, traumatic arteriovenous fistula and perforation were the common clinico-pathologic presentations. Surgical interference was resorted to in 21 cases [67.7%] while a conservative policy was followed in the rest [32.3%]. The different clinical settings are reviewed and the results are discussed in this study

Doppler examination and venous pressure measurement in deep venous thrombosis: value and limitations

Thirty-four with a clinical picture of deep venous thrombosis presented to the outpatients clinic at El-Demerdash and Ain-Shams Specialized Hospital during the period from February 1985 to November 1988. They were all subjected to Doppler assessment and venous pressure recording as well as venography. The Doppler findings correlated to a certain extent with the radiological pictures. The results of this study indicate that in absence of sophisticated vascular lab equipment, Venous Doppler examination combined with pressures measurement, even without plethysmography, could be a reasonable non- invasive substitute to venography in cases of deep venous thrombosis