Graft infection or graft reaction?

A perigraft reaction has been described that has been found to be free of infection, with a microscopic picture compatible to an immunologic-like reaction. Varied time intervals between onset of reaction and removal of tissue have allowed for a histopathologic staging. Note is made that four of the five grafts involved were external velour Dacron, with a question remaining as to whether the double velour stimulates an intensified hyperimmune response. Graft replacement by way of new uninvolved plains of tissue has not been necessary. Replacement with polytetrafluoroethylene through the same pathway resulted in prompt healing of wounds with no evidence of recurrent reaction.

Restenosis or occlusion after carotid endarterectomy: a survey with ocular pneumoplethysmography.

One hundred seventy-three carotid endarterectomies in 141 patients operated on during a 12-year period were surveyed both clinically and by ocular pneumoplethysmography (OPG)-Gee. Seventeen (12%) patients had positive OPG examinations. Three arteries (1.7%) demonstrated symptomatic recurrent stenosis in accord with earlier reports. An additional 8.1% of the operated arteries had asymptomatic recurrent stenosis. A total recurrence rate of 9.8% was found. Because of the considerable silent recurrence rate we have found, we recommend annual screening by OPG. Angiography and repeated endarterectomy are then used when appropriate.