European journal of vascular surgery
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The authors present their experience in cerebral monitoring during carotid surgery by surveillance of the clinical status of the patients. The operation was performed using loco-regional anaesthesia and employing a temporary shunt in those cases with cerebral ischaemic symptoms at clamping. In the 212 operations performed, no complication due to inadequate monitoring or complications related to coronary disease or respiratory insufficiency were observed.
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Case Reports
Intrahepatic leiomyosarcoma of the inferior vena cava with extension into the right atrium.
We present a case of leiomyosarcoma of the intrahepatic inferior vena cava extending into the right atrium, that has been successfully palliated by removal of the obstructing tumour under conditions of full cardiopulmonary bypass and circulatory arrest. Lesions of this kind have previously thought not to be amenable to surgery. Although resection was incomplete, successful palliation may be achieved facilitating this technique.
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A 35-year-old drug abuser inadvertently injected adulterated heroin into her left femoral artery and presented with critical ischaemia of her left leg. Treatment with intravenous Iloprost, a stable prostacyclin analogue, combined with Heparin, produced a dramatic improvement in her circulation within 4 h.
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The effects of intra-arterial injection of Temazepam are described in 11 drug abusers admitted over a 6 month period. All patients suffered severe ischaemia, and injection into the radial artery invariably resulted in tissue loss leading to amputation. The pathogenesis and options for treatment are discussed.