[Approach in the treatment of combined aorto-iliac and femoro-popliteal lesions]. / Welke houding aannemen bij de behandeling van gekombineerde aorto-iliacale en femoro-popliteale letsels.

Recognition of the hemodynamic importance of aorto-iliac and femoro-popliteal stenoses or occlusions is essential for correct vascular reconstruction. Non-invasive examinations, arteriography, pressure- and flow-measurements add their value to clinical judgment and surgical experience. Practical guides are given to decide for one-level-reconstruction, concomitant or delayed two-stage-repair, or a combination of balloon-dilation together with arterial reconstruction.

[Contribution of femoral hemodynamics (intra-arterial velocity, pressure) in indications for vascular reconstruction in ischemia of the lower limbs. Preliminary study]. / Apport de l'hémodynamique fémorale (vitesse, pression intra-artérielle) dans les indications des reconstructions vasculaires pour ischémie des membres inférieurs. Etude préliminaire.

The choice of the best operative procedure in vascular reconstructions for ischemic lower limbs, is mainly guided by clinical experience and by arteriography. Doppler wave analysis and femoral artery pressure measurements are new diagnostic tools. In those difficult cases of multiple-level-disease, the intra-operative measurement of the femoral artery pressure proved to be an important step for the operative decision.

[Organization and activities of microsurgery in Belgium]. / Organisation et activités de la microchirurgie en Belgique.

Answering the question of indications and organisation in microsurgery in Belgium, a report is given of the microsurgical activities around the country. The benefit of the multicentered activity is stated and the necessity of a more pronounced organisation for emergency microsurgery is stressed.

Iatrogenic chylothorax. Etiologic and therapeutic considerations, with presentation of two clinical cases.

A case of mediastinal sclerosis after radiotherapy is presented as a curiosity in iatrogenic etiologies of chylothorax. After 7 weeks of conservative treatment, an operative pleurodesis was successful. In a second clinical case, the hazardous intra-thoracic coagulation of the chyle is illustrate. Etiology and therapeutic mangements of iatrogenic chylothorax in the literature are briefly reviewed.

Review of 1,375 cases of vascular reconstruction for ischemic disorder of the lower limbs Statistical analysis of late postoperative thromboses with evaluation of the effect of an anti-platelet agent[tauthor's transl)]. / Réflexions et commentaires concernant 1.375 cas de reconstruction vasculaire pour troubles ischémiques des membres inférieurs. Analyse statistique des thromboses tardives avec évaluation de l'effet d'un agent antiplaquettaire

The authors are presenting 1.375 cases of arterial reconstruciton of the lower limbs, those patients having undergone 1.562 operatons between 1963 and 1974. Although mention is made of long-term postoperative morbidity (false femoral aneurysm, infection, amputation), the study is mainly centered on the problem of late thromboses, calculated in percentages per year and classified according to the time lapse since the initail operation. Comparison is made between the percentages before and after 1972. Since 1972, Dipyridamol, an anti-platelet agent, has been administered systematically to all vascular reconstructions of the lower limbs. The action of this type of drug on the platelet adhesivenss is briefly treated. In this respect the numbers calculated suggests a decrease of about 25 % in the numbers of late thrombosis, all other treatment remaining unchanged for the past 11 years. In conclusion, operative indication and surgical skill remain primordial in this type of surgery. However, the anti-platelet treatment, associated with fat-free diet, no tobacco, vasodilators or anticoagulants, seems to bring a further guarantee to permeability of arterial reconstructions.