Assuntos
Aneurisma/diagnóstico por imagem , Aneurisma/cirurgia , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/cirurgia , Abscesso Peritonsilar/diagnóstico por imagem , Abscesso Peritonsilar/cirurgia , Tomografia Computadorizada por Raios X , Artéria Carótida Externa/diagnóstico por imagem , Artéria Carótida Externa/cirurgia , Humanos , Lactente , Masculino , Exame Neurológico , Complicações Pós-Operatórias/diagnósticoRESUMO
Records of 76 patients who presented with ischemia of the upper extremity from 1966 to 1981 were reviewed. Patients were divided into three groups according to cause: Group 1, emboli from the artery; Group 2, ischemia after catheter injury; and Group 3, ischemia due to lesions of the axillary and subclavian arteries. Management varied among the three groups. Long-term anticoagulation therapy was helpful in Group 1 patients in preventing reembolization. Forty percent of patients with catheter-related trauma required angioplasty of some sort in addition to embolectomy. Management of Group 3 patients was most difficult and the results least acceptable (three patients required amputation). Management of this type of ischemia must be individualized; it should vary according to the underlying disorder.
Assuntos
Braço/irrigação sanguínea , Mãos/irrigação sanguínea , Isquemia/cirurgia , Doença Aguda , Anticoagulantes/uso terapêutico , Artéria Axilar/patologia , Cateterismo Cardíaco/efeitos adversos , Embolia/complicações , Embolia/cirurgia , Cardiopatias/complicações , Humanos , Isquemia/tratamento farmacológico , Isquemia/etiologia , Artéria Subclávia/patologia , Síndrome do Desfiladeiro Torácico/patologiaRESUMO
Thirty Goretex grafts of 6 mm internal diameter, 30 mu fibril length, 30 mg/cc density and 0.5 mm wall thickness were placed as end-to-side bypass grafts in canine femoral arteries. Handling characteristics, patency and healing properties were compared with autogenous jugular veins which were anastomosed into the opposing femoral arteries. Autogenous veins were easier to anastomose and they showed a patency rate of 87% over a 16 week observation period. The Goretex grafts had a 50% patency rate during the same period. Goretex grafts failed because of technical errors (9), graft kinks (5), infection (3) and neointimal fibrous hyperplasia (2). This canine model has previously been used to evaluate all currently available biologic and synthetic vascular grafts. Goretex grafts demonstrated the highest rate of technical failures, but the lowest incidence of neointimal fibrous hyperplasia when compared to other grafts previously tested in this model.
Assuntos
Prótese Vascular/normas , Artéria Femoral/cirurgia , Veias Jugulares/transplante , Animais , Cães , Artéria Femoral/patologia , Rejeição de Enxerto , Sobrevivência de Enxerto , Politetrafluoretileno , Transplante AutólogoRESUMO
Embolectomy was performed by the Trendelenburg method on one patient and with cardiopulmonary bypass on 10 patients during the period 1961 to 1975. The use of cardiopulmonary bypass permitted preoperative resuscitation, cardiorespiratory support during the operation, complete embolectomies to be performed and resulted in the survival of 4 of the 10 patients. There were 5 patients who suffered cardiac arrest prior to embolectomy. Three died intraoperatively, of which two died of left ventricular failure, and two others died postoperatively of brain damage indicating the need to proceed rapidly with the accurate diagnosis and treatment of massive pulmonary embolism. Following embolectomy, partial interruption of the inferior vena cava was performed and prevented recurrent pulmonary emboli and significant post-thrombotic sequelae in four patients. Another patient underwent caval ligation with significant sequelae.
