European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
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to evaluate the use of endovascular occlusion in the treatment of arterial trauma. ⋯ this treatment modality is effective and safe in the treatment of penetrating trauma in selected patients.
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Eur J Vasc Endovasc Surg · Oct 1999
Comparative StudyElective repair of type IV thoraco-abdominal aortic aneurysms; experience of a subcostal (transabdominal) approach.
preoperative pulmonary function has been shown by univariate analysis to be an independent predictor of outcome following Crawford Type IV thoraco-abdominal aortic aneurysm repair. The aim of this study was to determine if outcome had been improved by the introduction of a subcostal approach for the elective repair of these aneurysms. ⋯ the introduction of a subcostal approach for type IV thoraco-abdominal aneurysm repair in selected "high risk" patients has been associated with an unacceptably high rate of complications requiring early re-operation. We feel that this relates to the problems inherent in the introduction of a new technique and reduced exposure in patients of inappropriate body habitus. The predicted benefit to pulmonary function is realised in shorter intubation times, but has not translated into earlier recovery or improved outcome. Operation duration and blood loss have not been significantly reduced. Based on these outcomes, we do not currently recommend the general adoption of this approach in all type IV repairs. We will continue to evaluate this approach in patients with poor pulmonary function and a suitable body habitus.
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Eur J Vasc Endovasc Surg · Jun 1999
Influence of the collateral function of the circle of Willis on hemispherical perfusion during carotid occlusion as assessed by transcranial colour-coded duplex ultrasonography.
to investigate the collateral potential of the circle of Willis with transcranial colour-coded duplex ultrasonography and common carotid artery (CCA) compression. ⋯ collateral flow from the basilar to the carotid territory is often hampered by non-functioning posterior communicating arteries. A non-functioning anterior communicating artery is rare. A complete collateral circulation provides better perfusion of the MCA during carotid occlusion as compared with collateral supply through only the anterior or the posterior communicating artery in the case of an incomplete circle of Willis.