[A case of thrombosed popliteal artery by method of endovascular pulse spray thrombolysis in the process of multiple fractures of tibia]. / Przypadek zespolowego leczenia zakrzepu tetnicy podkolanowej metoda dotetniczej, pulsacyjnej trombolizy, w przebiegu wieloodlamowego zlamania kosci goleni.

A case of team-treated thrombosed popliteal artery caused by blunt limb trauma with open tibia fracture is presented. Thrombosed artery was treated by endovascular pulse-spray method using Angiomed catheter. Implementation of this method allowed us to dissolve thrombus and to retrieve arterial circulation in the limb. In our opinion this procedure was an alternative for traditional surgery. After revascularisation of the limb orthopedic operation on fractured bones was performed using Zespol technique.

[Studies of fibromuscular hyperplasia of vascular anastomosis]. / Badania nad hiperplazja wlóknisto-miesniowa zespolenia naczyniowego.

The aim of this study was to present a retrospective analysis of occurrence, diagnosis, methods and treatment results in patients treated because of thrombosis of vascular anastomosis. Authors have tried to make and experimental model of hyperplasia of vascular anastomosis and verify a possibility of stop hyperplasia application by an optimal dose of dexamethasone. They also have evaluated an efficacy of Doppler color ultrasonography to make an early diagnosis of stenosis of vascular anastomosis.

[Pseudoaneurysm after anastomosis of a prosthesis with the femoral artery]. / Tetniaki rzekome w zespoleniu protezy z tetnica udowa.

One of the complications of femoral artery synthetic prostheses are anastomotic aneurysms. In 1985-1993, 38 patients were treated for anastomotic aneurysms. Diagnosis was based on clinical and ultrasound examinations. A retrospective analysis has shown an occurrence of fever in 12 patients, and superficial pus oozing in 10 patients. Bacteriological cultures of intra-operatively collected specimens were positive in 25 patients. An infection with staphylococci was predominating. Repeated reconstructive surgery was performed within 6 months to 5 years after the primary one, mean 1.6 years. Aneurysm with the segment of prosthesis was excised and replaced by a fragment of new prosthesis (26 patients) or the vessel after excision of aneurysm was sutured with additional sutures on the whole anastomosis circumference (6 patients). On 7 patients bypass grafting was performed with ligation of vessels supplying anastomotic aneurysm. In all patients flow drainage was used. Positive result of re-operation was achieved in 21 (68.4%) patients. Limb was amputated in 10 cases (26.3%), and 2 patients (5.3%) died. An analysis of the treated patients showed an important role of the anastomotic infection in the anastomotic aneurysms formation. The treatment should include prolonged antibiotic therapy prior to the operation. In case of reoperation possible infection should always be considered.

[Experimental studies on the effect of dexamethasone on development of anastomotic vascular wall hyperplasia]. / Badania doswiadczalne wplywu deksametazonu na rozwój rozrostu sciany zespolenia naczyniowego.

In order to determine the effect of anti-inflammatory treatment with dexamethasone on the development of vascular anastomosis hyperplasia, experimental studies were performed in dogs. The animals received synthetic vascular graft implanted into the carotid artery and were given dexamethasone. Group I--control was given no dexamethasone, while group II received it in dose 0.2 mg/kg daily and group III in dose 0.4 mg/kg daily. The follow-up time ranged from four to eight weeks. Then the grafts were taken and subjected to morphological examination. The experiments carried out demonstrated that dexamethasone administered in dose 0.4 mg/kd daily inhibited the development of hyperplasia and delayed healing-in of the vascular grafts.

[Methods and results of treating late thrombosis of vascular grafts caused by fibromuscular lesions of vascular anastomosis]. / Metody i wyniki leczenia póznych zakrzepów przeszczepów tetniczych spowodowanych zmianami wlóknisto-miesniowymi zespolenia naczyniowego.

In the years 1989-1991 at the I Chair and Department of Surgery, II Faculty, Medical Academy in Warsaw, 56 patients were treated with vascular graft thrombosis. The studies involved patients in whom thrombosis developed between 3 and 24 months after the operation. Hyperplasia of the vascular anastomosis was the cause of the occlusion. The purpose of the work was determination of therapeutic methods and results. It was found that hyperplasia led to vascular graft occlusion in some patients even with very good early results. The treatment of thrombosis should be surgical. The methods giving the best results were thrombectomy and angioplasty of distal anastomosis or graft exchange.

[Acute limb ischemia after arterial surgery]. / Ostre niedokrwienie konczyn po operacjach tetnic.

The causes of acute limb ischaemia after reconstructive arterial surgery may include excessive peripheral resistance, considerable arterial blood pressure fall, technical error, separation of the intima, or embolization by dislodged thromboembolic material. The purpose of the work was and analysis of causes and results of treatment in the clinical material in the period 1988-1991. For acute limb ischaemia after arterial surgery 45 patients were treated. The main causes of ischaemia were: considerable blood pressure fall--10 patients, excessive peripheral resistance--11 patients, and embolization by dislodged thromboembolic material--11 patients. The obtained results are unsatisfactory and fraught with a great number of complications. Good result was obtained in 30 patients (66.6%), limb was amputated in 7 cases (15.6%), and eight patients died (17.8%).

[Evaluation of vascular prostheses made of carbon fiber]. / Ocena protez naczyniowych z wlókna weglowego.

The whole work was aimed at experimental estimation of the healing process in case of carbon fibre vascular prostheses implanted into the abdominal aorta of a dog. The tests applied to carbon fibre woven prostheses made in the USSR. All metrological and chemical tests were performed at the Knitting Industry Main Centre for Research and Development "Tricomed" in Lódz. Experimental examinations were performed on 12 dogs. Prostheses were implanted into dog's abdominal aorta "end to the end" with the help of threads type Mersilen 4-0 or Prolen 4-0. The dogs were observed for 53 to 121 days, i.e. their behaviour, condition of the postoperative wound and presence of pulse in the femoral arteries were taken into consideration. Upon the completion of the observation autopsy was performed. Thus obtained material was fixed in 9% formalin and next various dyeing methods were applied to it. During examination in autopsy no inflammatory reactions in the tissues adjacent to implanted prostheses were discovered. In each case there was a continuous and firm adhesion of prosthesis and neighbouring inferior caval vein. A newly developed so called "neoadventitia" in the lumen of the prostheses constituted a solid and uniform film covering the wall of the prosthesis. Haematoma in the nearabout of the prosthesis was found in two cases only. Close to anastomosis ordinary clusters of lymphocytes and numerous fibroblasts as well as collagen fibre between prosthesis plexus were discovered. On the basis of the examinations performed a conclusion could be drawn, i.e. the process of healing was followed by regular structure of new aorta walls together with well developed flexible and springy fibre and neglidgeble immunological reactions.

[Treatment of varicose ulcers with Codogard of Polish production]. / Leczenie owrzodzen zylnych goleni preparatem Codogard produkcji krajowej.

Synthetic skin CODOGARD produced by the Research and Development Centre of the Knitting Industry in Lódz was applied in 125 cases of the shank varicose ulcer treated in the Clinic of General Surgery of the Warsaw Medical Academy. Two different types of CODOGARD were used for evaluation: the first one without antibacterial dripping, and the second one with antibacterial dropping Sterinol. On the basis of achieved results it was established that CODOGARD was a successful medicine for the crus varicose ulcer. It causes faster cleaning away of the pus. It was observed that CODOGARD with Sterinol dripping was more effective. Taking into account the fact that the application of CODOGARD is easy, it should be widely used in surgical out patient's departments.

[Usefulness of Dallon prostheses for blood vessel reconstruction]. / Przydatnosc protez Dallon do rekonstrukcji tetnic.

Experimental and clinical results of the application of Dallon prostheses in vascular surgery are presented. Dallon prostheses are produced in the Medical Materials Department of the Research Development Centre of the Knitting Industry in lódz. They are contained in disposable radially sterilized wrappings. The experiments were performed on 17 mongrel dogs and the process of healing in was observed after three and six months. The process was similar to the healing in of other porous, synthetic prostheses. In 37 patients operated because of the artheromasia bypasses or vascular flaps of Dallon prostheses were implanted. The results of experimental and clinical research proved that the radially sterilized Dallon prostheses have similar properties like the prostheses produced be well known foreign firms, and are very useful in arterial reconstruction.