Vascular complications after 725 kidney transplantations during 3 decades.

Among 725 renal transplantations, the most common vascular complication was arterial stenosis, which was observed in 23 patients (3.17%). The majority of 20 (6.49%) arterial stenoses appeared in our initial experiences when we routinely used end-to-end renal graft to internal iliac artery anastomoses. A significant reduction in this incidence (0.72%) was achieved by introducing end-to-side anastomoses of the renal graft artery to the external or common iliac arteries. Intractable hypertension or impaired renal function in 14 patients (60.87%) with arterial stenosis demanded treatment. Patch angioplasty was more successful than other methods. The limited possibilities of conservative treatment of arterial hypertension at that time were the main reason for this frequent surgical repair. Among other vascular complications, the most serious were 12 episodes of arterial bleeding in 10 patients. Five kidneys were lost because of ruptured arterial anastomoses. In 6 patients, the common or external iliac artery was ligated as to achieve hemostasis with acute arterial insufficiency of the lower extremity in 4 patients. One patient required leg amputation, whereas 2 underwent extra-anatomic bypass procedures and 1 died because of hepatic failure. The majority of vascular complications occurred in the initial period of our transplantation practice. However, in spite of progress in diagnostic and treatment options, vascular complications may cause considerable clinical problems.

Variations of the great arteries in the carotid triangle.

The variations of the common carotid artery, as well as of the external and internal carotid arteries, are described. During anatomic dissection on adult cadavers, we investigated the variability of appearance of 40 carotid arterial systems. Special consideration was given to the topographic relations such as the level of the bifurcation of the common carotid artery, the relationship between the external and internal carotid arteries, and the origin of the great collateral branches. Special attention was paid to the origin of the superior thyroid artery. In this article the practical importance of these variations is stressed.

Work conditions as risk factors for varicose veins of the lower extremities in certain professions of the working population of Rijeka.

This research aims to establish the effect of working conditions on the appearance of varicose veins. The epidemiological study was carried out on 1,324 examinees, 530 males and 794 females, employed in 5 highly represented groups of professional activities in Rijeka (catering, trade, light industry, heavy industry and finances). The data were collected by survey and clinical examination. Varicose veins were more prevalent in the trade than in the office workers (odds ratio (OR) = 2.08; 95% confidence interval (CI) = 1.31-3.31), and more prevalent in catering industries than in the office workers (OR = 1.56; 95% CI = 1.001-2.43). chi 2-testing suggested that standing in the workplace (OR = 1.35; 95% CI = 0.95-1.92), weight handling while working (OR = 1.29; 95% CI = 1.01-1.64) and working indoors (OR = 1.61; 95% CI = 1.02-2.53) were risk factors for varicose veins. By multiple logistic regression, the following risk factors were isolated in the total population: female sex (OR = 1.92; 95% CI = 1.37-2.67), workplace (OR = 0.89; 95% CI = 0.78-0.99), age (OR = 1.05; 95% CI = 1.03-1.07), body mass index (OR = 1.04; 95% CI = 1.01-1.07) and family history of the disease (OR = 1.99; 95% CI = 1.55-2.57).