International angiology : a journal of the International Union of Angiology
-
The venous system plays an important role in the determination of cardiac output and venous return. Venous tone is a property of the venous system which reflects the venous resistance and pressure. An increased venous tone caused by venoconstriction leads to an increased net capillary filtration by increasing the venous resistance and venous pressure. ⋯ The limbs of normal individuals that are at a high risk of developing varicose veins have an abnormal K(K = 1.33). This method is however invasive and we have developed a non-invasive method of calculating the elastic modulus <
> using air plethysmography. This method has shown a good reproducibility in 3 healthy volunteers examined and this technique can be used to study the effect of a phlebotonic agent on the venous tone in patients at high risk of developing venous insufficiency. -
A case of multivessel fibromuscular dysplasia involving the cervico-cephalic arteries, the right renal artery and the iliac arteries is reported. It was associated with reversible bilateral internal carotid arteries and vertebral arteries dissection, left thalamic infarct, right hemorrhagic cerebellar infarct, renovascular hypertension and intermittent claudication of the right lower limb. ⋯ Renovascular hypertension may foster the appearance of complication such as dissection of the arteries affected by fibromuscular dysplasia. In the case investigated the dissection of cervico-cephalic arteries was followed by spontaneous healing and a favourable neurological outcome whereas at the iliac arteries a rapid deterioration was observed.
-
Following replantation of complete or incomplete nonviable amputations of digits and hands, as well as microsurgical free tissue transfer, there is often a critical need for adjuvant therapy in order to restore sufficient venous drainage. In 24 out of 29 patients, venous insufficiency was successfully treated with the use of medicinal leeches. In a group of patients who had undergone replantation procedures (11 patients total), 9 patients (8 with digit and 1 with hand amputations) had venous drainage successfully restored with medicinal leeches, while in a group of patients who had free tissue transfers (18 patients total), 15 had the venous congestion treated successfully with leeches. The results indicate that medicinal leeches are a valuable, alternative method for the treatment of venous congestion in both replantation patients and those who have undergone free tissue transfer.
-
Comparative Study
The role of septic complications in aortic aneurysm surgery.
Out of 229 patients operated due to abdominal aortic aneurysms, 51 (22.3%) had prolonged (> 120 hours) postoperative intensive care stay. The mortality rate in this group was 27% representing 46% of the total mortality. ⋯ Reoperations, time for ventilatory support, incidence of renal failure and dialysis, gastrointestinal complications and mortality were all frequent in patients with septic postoperative complications as compared to those with non-septic complications, the latter mainly of cardiovascular origin. Signs of organ dysfunction should raise a suspicion of a septic complication and prompt insertion of diagnostic procedures and therapeutic interventions are necessary in order to minimize morbidity and mortality.
-
Paraplegia from spinal cord ischemia during thoracoabdominal aneurysm repair remains an unpredictable and unpreventable complication. In an effort to prevent spinal cord ischemia during aortic cross-clamping, preoperative angiographic localization of the blood supply to the spinal cord was performed in dogs. Sixteen animals underwent 60 minutes of thoracoabdominal aortic cross-clamping either without (control, n = 8) or with (shunted, n = 8) a selective shunt. ⋯ Spinal cord blood supply in dogs may be more segmental than previously believed. Technical problems in angiographic localization, spinal artery spasm, loss of spinal cord autoregulation or poor collateral circulation from the distal thoracic to the lumbar cord may also account for these results. Although shunting to aortic segments supplying the anterior spinal artery during thoracoabdominal aortic clamping may be attractive in humans, no benefit could be shown in this experimental model.