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 · Nov 1995
The role of the circle of Willis in carotid occlusion: assessment with phase contrast MR angiography and transcranial duplex.
To study the collateral pathways recruited after occlusion of the internal carotid artery (ICA), and to evaluate its influence on the impairment of hemispheric blood flow supply and development of low flow infarcts. ⋯ These data suggest that even though ICA occlusion may occur without cerebral damage, collateral blood supply is not enough to maintain normal hemispheric perfusion. The ACoA may be a key collateral pathway as a non-functioning ACoA is associated with an increased risk of developing low-flow infarcts.
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Eur J Vasc Endovasc Surg · Jul 1995
Randomized Controlled Trial Clinical TrialA randomised, clinical study of the effect of low-dose dopamine on central and renal haemodynamics in infrarenal aortic surgery.
To determine whether dopamine prevents deterioration of central haemodynamics and renal function in aortoiliac surgery. ⋯ Peroperatively, dopamine counteracted depression of left ventricular function. The increased ERPF at the first postoperative clearance in the dopamine group indicates either improved peroperative haemodynamics or a synergistic effect between dopamine and epidural sympathetic blockade. Dopamine also improved diuresis and natriuresis.
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Eur J Vasc Endovasc Surg · May 1995
Randomized Controlled Trial Clinical TrialEffects of spinal cord stimulation (SCS) in patients with inoperable severe lower limb ischaemia: a prospective randomised controlled study.
This study was designed to test the hypothesis that spinal cord stimulation (SCS) improves limb salvage in patients with inoperable severe leg ischaemia. ⋯ SCS provided long-term pain relief but limb salvage at 18 months was not significantly improved by SCS in this rather small study. The results suggest that SCS may reduce amputation levels in patients with severe inoperable leg ischaemia and be most effective in patients without arterial hypertension.
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Eur J Vasc Endovasc Surg · Feb 1995
Multicenter StudyTrends in abdominal aortic aneurysms: a 13 year review.
To assess changing trends of abdominal aortic aneurysms 1979-1991. ⋯ The increasing incidence of abdominal aortic aneurysms may reflect better diagnostic methods, greater clinical awareness of the condition and increase in the proportion of elderly people in the population.
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Eur J Vasc Endovasc Surg · Feb 1995
Surgery for limb threatening ischaemia: a reappraisal of the costs and benefits.
To study the quality of life of patients following surgery for critical limb is ischaemia. ⋯ The mortality of this group of patients after six months was 24%. Forty-seven patients were available for quality of life assessment six months after initial intervention. Overall, amputation was more costly than successful revascularisation and limb salvage. Limb salvage resulted in greater mobility (p < 0.001) and better performance in self-care (p < 0.001) and lifestyle (p = 0.006), but produced more anxiety and depression (p = 0.04) than major amputation. A subgroup of patients who had major amputation after a failed limb salvage operation consumed a disproportionate amount of resources and, although their mobility was typical of amputees, their self-care and lifestyle scores were similar to those who had successful limb salvage. OBSTRUCTIONS: Limb salvage is attempted in up to 22% of patients for whom primary amputation may provide more expeditious rehabilitation with minimal impairment of their lifestyle performance.