RESUMO
291 patients were subjected to carotid endarterectomy from January 1985 to June 1992 in two Australian medical institutions. Of the 291 patients, perioperative stroke occurred in 22 (6.3%) after 347 operations (moderate 17 and severe 5). The 22 patients were studied with Doppler scan, angiography, reexploration and CT. Reexploration showed that 12 of 14 patients had thrombosis in the internal carotid artery at operation. The etiological factors for perioperative strokes included thrombosis at the operative sites in 14 patients (64%), cerebral embolism after operation in 4, clamping ischemia in 2, intracerebral hemorrhage in 1 and unknown cause in 1. Six patients (27%) recovered completely in 4 weeks, 10 (45%) had mild residual neurological deficits, 5 (23%) had moderate neurological deficits and 1 died 3 days after operation. Only 6 patients had permanent neurological deficits (6/347, 17%).
Assuntos
Transtornos Cerebrovasculares/etiologia , Endarterectomia das Carótidas/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Artéria Carótida Interna/cirurgia , Estenose das Carótidas/cirurgia , Feminino , Humanos , Complicações Intraoperatórias , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
Fifty-six patients with a ruptured abdominal aortic aneurysm presented to an acute general hospital over six years from 1968 to 1973. Twelve patients died before operation, while 19 of 44 patients (43%) survived replacement of the aneurysm with a Dacron graft. Patients aged under 70 years and not shocked on admission to hospital had the best chance of survival. It is suggested that survival rates can be significantly raised only by a decrease in the time between the onset of symptoms and an operation. A correct diagnosis may be made more often if it is remembered that the classical clinical triad of pain, shock and an abdominal mass is seen is less than half of the cases presenting to hospital.
Assuntos
Aorta Abdominal , Aneurisma Aórtico/cirurgia , Ruptura Aórtica/cirurgia , Fatores Etários , Idoso , Aneurisma Aórtico/diagnóstico , Aneurisma Aórtico/mortalidade , Ruptura Aórtica/diagnóstico , Ruptura Aórtica/mortalidade , Austrália , Prótese Vascular , Feminino , Seguimentos , Hospitais Gerais , Humanos , Masculino , Complicações Pós-Operatórias , Fatores de TempoRESUMO
Thirty patients with deep vein thrombosis of the legs of less than four days' duration were allocated at random to treatment with heparin, streptokinase, or Arvin under laboratory control. When the fate of the thrombi was assessed by objective techniques-phlebography and the (125)I-labelled fibrinogen test-the incidence of complete thrombolysis was greatest in the streptokinase group. Complications arose during treatment in each group but were least with Arvin. The natural history of the disease favours clinical but not always anatomical recovery.
Assuntos
Anticoagulantes/uso terapêutico , Heparina/uso terapêutico , Estreptoquinase/uso terapêutico , Tromboflebite/tratamento farmacológico , Peçonhas/uso terapêutico , Adulto , Idoso , Ensaios Clínicos como Assunto , Feminino , Fibrinogênio , Humanos , Radioisótopos do Iodo , Perna (Membro) , Masculino , Pessoa de Meia-Idade , FlebografiaAssuntos
Complicações Pós-Operatórias/prevenção & controle , Tromboflebite/prevenção & controle , Adulto , Colecistectomia , Ensaios Clínicos como Assunto , Vestuário , Colectomia , Terapia por Exercício , Feminino , Fibrinogênio , Gastrectomia , Hérnia Diafragmática/cirurgia , Humanos , Radioisótopos do Iodo , Masculino , Mastectomia , Pessoa de Meia-Idade , Tromboflebite/epidemiologia , Tromboflebite/etiologia , VagotomiaAssuntos
Estreptoquinase/uso terapêutico , Tromboflebite/tratamento farmacológico , Adolescente , Adulto , Idoso , Feminino , Febre/induzido quimicamente , Humanos , Infusões Parenterais , Isótopos de Iodo , Masculino , Pessoa de Meia-Idade , Flebografia , Estreptoquinase/administração & dosagem , Estreptoquinase/efeitos adversosRESUMO
Twenty-two patients who had an acute episode of thrombosis in the deep veins of the legs were studied by a new technique of ascending functional cinephlebography 6 to 12 months after the episode of thrombosis.If the condition was diagnosed within 36 hours and the thrombus was dissolved rapidly valve function was preserved. When diagnosis was delayed there was a very great risk of permanent damage to the valves.
