European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
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Eur J Vasc Endovasc Surg · May 1997
Meta AnalysisLocal versus general anaesthesia in carotid endarterectomy: a systematic review of the evidence.
To determine whether carotid endarterectomy under local anaesthesia is safer and as effective as under general anaesthesia. ⋯ Non-randomised studies suggest potentially important benefits from performing carotid endarterectomy under local anaesthesia. However, these studies were seriously flawed and can only be hypothesis generating. The results must be confirmed in large well-designed randomised trials before any recommendations on the use of local anaesthetic can be made.
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Eur J Vasc Endovasc Surg · May 1997
Discriminative microcirculatory screening of patients with refractory limb ischaemia for dorsal column stimulation.
(1) To determine the proportion of patients with critical limb ischaemia refractory to invasive treatment that can be successfully treated by dorsal column stimulation (DCS), and (2) to identify potential responders to DCS by a simple test that is sufficiently predictive to limit the need for a prolonged trial stimulation period. ⋯ DCS is a rewarding therapeutic option in selected patients with critical limb ischaemia. delta tcpO2 appears to reliably predict response to DCS and may obviate trial stimulation in most cases.
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Eur J Vasc Endovasc Surg · Apr 1997
Changes in platelet count, coagulation and fibrinogen associated with elective repair of asymptomatic abdominal aortic aneurysm and aortic reconstruction for occlusive disease.
Mortality and morbidity following aortic surgery, particularly repair of ruptured abdominal aortic aneurysm (AAA), is frequently associated with the development of coagulopathy. ⋯ Patients undergoing elective repair of AAA demonstrate similar, albeit less dramatic, changes in platelet count to those we have previously reported in patients undergoing repair of ruptured AAA. Aortic clamping leads to platelet sequestration and thrombocytopenia in the early postoperative period. Later, patients develop hyperfibrinogenaemia and thrombocytosis which may persist for several weeks. Similar changes are seen in patients undergoing aortic surgery for occlusive disease. These changes may represent a hypercoagulable state that predisposes these patients to thrombotic complications.
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Eur J Vasc Endovasc Surg · Mar 1997
Case ReportsA prospective study of the effect of limb-threatening ischaemia and its surgical treatment on the quality of life.
To assess the quality of life after treatment for limb-threatening ischaemia. ⋯ The treatment of limb-threatening ischaemia should aim to maintain pre-morbid lifestyle, an aim which is best achieved by limb-salvage. The patient's own expectations and needs have a major bearing on the choice of therapy.
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Eur J Vasc Endovasc Surg · Jan 1997
Compartment syndrome and fasciotomy in vascular surgery. A review of 57 cases.
To investigate the occurrence of compartment syndrome and the results of fasciotomy in vascular surgical patients. ⋯ Compartment syndrome is usually related to acute ischaemia and rarely following elective vascular surgery. Subcutaneous fasciotomy does not always ensure sufficient decompression of all four lower leg compartments. Complications related to fasciotomy are rare.