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Thrombolytic treatment of venous thromboembolism. 静脉血栓栓塞的溶栓治疗。
Vascular surgery Pub Date : 1977-11-01 DOI: 10.1177/153857447701100601
V Gurewich
{"title":"Thrombolytic treatment of venous thromboembolism.","authors":"V Gurewich","doi":"10.1177/153857447701100601","DOIUrl":"https://doi.org/10.1177/153857447701100601","url":null,"abstract":"From the Vascular Laboratory, St. Elizabeth’s Hospital, Boston, Massachusetts. The objective of thrombolytic therapy is to accelerate the rate of clot lysis or to induce it when natural activation of the lytic system is inadequate. In deep vein thrombosis involving the lower extremities, reduction in the incidence of venous insufficiency is the major goal. Complete lysis of venous thrombi has been reported in 40%’ to 60%3 of streptokinase-treated patients, compared to about 10% of those treated with heparin. When thromboembolic occlusion involves other sites, such as the hepatic or renal veins or the pulmonary arteries, thrombolytic therapy may improve vital organ function or may even be life-saving. However it should be emphasized that the long-term clinical benefits of streptokinase or urokinase have not been proven. What has been demonstrated in clinical trials is that thrombolytic therapy is more effective than heparin in dissolving venous thrombi-1--5 and that these drugs significantly accelerate the rate of lysis of pulmonary emboli compared to heparin. 6","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 6","pages":"341-2"},"PeriodicalIF":0.0,"publicationDate":"1977-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100601","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11819163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Experience with fibrinolytic therapy of vascular occlusive disease. 有血管闭塞性疾病的纤溶治疗经验。
Vascular surgery Pub Date : 1977-11-01 DOI: 10.1177/153857447701100605
W L Warner
{"title":"Experience with fibrinolytic therapy of vascular occlusive disease.","authors":"W L Warner","doi":"10.1177/153857447701100605","DOIUrl":"https://doi.org/10.1177/153857447701100605","url":null,"abstract":"<p><p>1. There may well be a place for streptokinase therapy in selected patients with chronic arterial occlusion, but the emphasis should be on developing information on selection criteria. 2. Efficacy and safety have been established for the use of streptokinase in occluded AV cannulae, but this may be more of historical than contemporary importance. 3. Although more investigation is required to define the role of lytic therapy in retinal vascular occlusion and in the hemolytic uremic syndrome, the preliminary results are encouraging and merit further attention.</p>","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 6","pages":"364-72"},"PeriodicalIF":0.0,"publicationDate":"1977-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11819165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Heparin and vascular endothelium. 肝素与血管内皮。
Vascular surgery Pub Date : 1977-11-01 DOI: 10.1177/153857447701100602
H Engelberg
{"title":"Heparin and vascular endothelium.","authors":"H Engelberg","doi":"10.1177/153857447701100602","DOIUrl":"https://doi.org/10.1177/153857447701100602","url":null,"abstract":"From the Cedars-Sinai Medical Center, Los Angeles, California. Research evidence has accummulated to indicate that endogenous heparin functions in the repair of injured vascular endothelium and that the fixation of injected exogenous heparin at the endothelial surface, and the many beneficial effects of heparin at this site, would minimize the harmful effects of atherogenic and thrombotic factors. This subject has both physiologic and clinical significance. Physiologically it is pertinent that in various species there are numerous mast cells immedi-","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 6","pages":"344-8"},"PeriodicalIF":0.0,"publicationDate":"1977-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100602","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11819162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Considerations on venous thrombectomy. 静脉血栓切除术的注意事项。
Vascular surgery Pub Date : 1977-11-01 DOI: 10.1177/153857447701100609
A Senn, B Nachbur
{"title":"Considerations on venous thrombectomy.","authors":"A Senn,&nbsp;B Nachbur","doi":"10.1177/153857447701100609","DOIUrl":"https://doi.org/10.1177/153857447701100609","url":null,"abstract":"From the Clinic of Thoracic and Cardiovascular Surgery, University of Bern, Bern, Switzerland. We are all aware of the problems that arise from deep venous thrombosis: pulmonary embolism, invalidating postphlebitic syndromes a real social problem in the chronic stage, and loss of life and limb in the acute phase. Prevention of thrombosis is to be aimed at by all means. When venous thrombosis is established, all the therapeutic measures have to be applied: anticoagulation, elevation, and bandaging to avoid the above-mentioned complications. But the conservative methods alone cannot achieve the real goal of therapy. That goal is to reopen the main venous channels and thus to restore unimpeded venous backflow. Disobliteration of the obstructed veins can only be achieved by fibrinolysis or surgical thrombectomy, and therefore we favor","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 6","pages":"391-4"},"PeriodicalIF":0.0,"publicationDate":"1977-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11819087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Selecting the therapeutic alternative for rehabilitating patients with occlusive arterial disease. 动脉闭塞性疾病患者康复治疗方案的选择。
Vascular surgery Pub Date : 1977-09-01 DOI: 10.1177/153857447701100507
L W Friedmann
{"title":"Selecting the therapeutic alternative for rehabilitating patients with occlusive arterial disease.","authors":"L W Friedmann","doi":"10.1177/153857447701100507","DOIUrl":"https://doi.org/10.1177/153857447701100507","url":null,"abstract":"From the Department of Rehabilitative Medicine, Nassau County Medical Center, East Meadow, New York Choosing a therapeutic plan for a patient with occlusive arterial disease is clearly one of the vital functions of the physician and surgeon. That decision and the care which flows from it are the reasons the patient consults us. He does not consult us for the diagnosis, or to participate in our research or training programs. The criteria upon which our decision must be based depend first upon the complaints of the patient, then upon the patient’s general health, the state of the medical and surgical art, and the patient’s wishes concerning the disposition of his life and body. The decision must be based not upon what we are technically capable of doing and have a personal interest in doing, but on what we ought to do. An example of the latter deciding whether to reimplant a limb after severance by trauma. In most cases, even though we now have the techniques and the technical skill to perform the reimplantation, it is my experience that to do so is usually not in the patient’s best interests. There are four criteria by which to judge success in medical treatment.","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 5","pages":"321-32"},"PeriodicalIF":0.0,"publicationDate":"1977-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100507","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11817421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
What constitutes proper evaluation for the patient with intermittent claudication? 如何对间歇性跛行患者进行适当的评估?
Vascular surgery Pub Date : 1977-09-01 DOI: 10.1177/153857447701100502
R Lennihan, M Mackereth
{"title":"What constitutes proper evaluation for the patient with intermittent claudication?","authors":"R Lennihan,&nbsp;M Mackereth","doi":"10.1177/153857447701100502","DOIUrl":"https://doi.org/10.1177/153857447701100502","url":null,"abstract":"Intermittent claudication is a well-recognized clinical entity with characteristic complaints and findings. The patient describes exertional leg discomfort brought on by a short walk. Calf, thigh, or hip muscles may be involved. The pain subsides during a brief rest and the individual can walk again. Peripheral pulses are reduced or absent, but otherwise the leg seems quite normal. On the basis of these simple features, a physician can readily establish the diagnosis of arterial insufficiency which for all practical purposes is due to atherosclerosis. Atherosclerosis itself is a manifestation of aging with involvement that may appear localized. Yet the disease process is often generalized with coronary, cerebral, or hypertensive manifestations. What, then, constitutes a proper evaluation for the patient with intermit-","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 5","pages":"278-90"},"PeriodicalIF":0.0,"publicationDate":"1977-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100502","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11817412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical treatment of vertebral artery insufficiency in patients with diagnosis of multiple sclerosis. 诊断为多发性硬化症的患者椎动脉功能不全的手术治疗。
Vascular surgery Pub Date : 1977-09-01 DOI: 10.1177/153857447701100508
S A Hurvitz
{"title":"Surgical treatment of vertebral artery insufficiency in patients with diagnosis of multiple sclerosis.","authors":"S A Hurvitz","doi":"10.1177/153857447701100508","DOIUrl":"https://doi.org/10.1177/153857447701100508","url":null,"abstract":"<p><p>Nine patients with signs and symptoms of vertebral-basilar artery insufficiency and with the diagnosis of multiple sclerosis experienced partial restoration of lost neurologic function with the revascularization of ischemic tissue of the hindbrain by an operation to correct partial extraluminal obstruction of the proximal segment of the first part of the vertebral artery. The selection of patients is dependent on preoperative angiography of the aortic arch with visualization of the vessels of the neck, the vertebral and the carotid arteries. There was no mortality and no significant morbidity among these patients.</p>","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 5","pages":"333-9"},"PeriodicalIF":0.0,"publicationDate":"1977-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11817422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Tube graft replacement of the suprarenal aorta with implantation of the superior mesenteric artery. 用肠系膜上动脉植入术置换肾上主动脉。
Vascular surgery Pub Date : 1977-09-01 DOI: 10.1177/153857447701100505
P A Rubio, F J Reul
{"title":"Tube graft replacement of the suprarenal aorta with implantation of the superior mesenteric artery.","authors":"P A Rubio,&nbsp;F J Reul","doi":"10.1177/153857447701100505","DOIUrl":"https://doi.org/10.1177/153857447701100505","url":null,"abstract":"<p><p>The superior mesenteric artery was successfully implanted to a tube graft replacement of the suprarenal abdominal aorta after a gunshot wound. Although injuries to the abdominal aorta carry a high mortality, adequate management and prompt operation can reduce the mortality rate. In cases like this one the ingenuity of the surgeon is at stake, because arterial anastomoses are not always possible to their natural origin. Death from aortic injuries is most commonly caused by hemorrhage and exsanguination, so appropriate measures must be taken as soon as the diagnosis is made to avoid this possibility. Also, patients should not be hypotensive for any long time, so transfusion should be timed carefully, especially when the aortic clamps are being removed.</p>","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 5","pages":"304-7"},"PeriodicalIF":0.0,"publicationDate":"1977-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100505","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11817417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Aortic and iliac graft fistulae. 主动脉和髂移植物瘘管。
Vascular surgery Pub Date : 1977-09-01 DOI: 10.1177/153857447701100503
D C Jackson, W M Thompson, I S Johnsrude
{"title":"Aortic and iliac graft fistulae.","authors":"D C Jackson,&nbsp;W M Thompson,&nbsp;I S Johnsrude","doi":"10.1177/153857447701100503","DOIUrl":"https://doi.org/10.1177/153857447701100503","url":null,"abstract":"<p><p>Sixteen patients with aortic and iliac graft fistulae were diagnosed from a series of over 886 abdominal aortic reconstructive operations. A preoperative diagnosis was established in 12, eleven by radiographic studies. Angiography and barium intestinal studies were the most helpful. The two most important features in diagnosis are a high index of suspicion and an aggressive radiographic approach.</p>","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 5","pages":"291-8"},"PeriodicalIF":0.0,"publicationDate":"1977-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11817426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Cystic adventitial disease of the popliteal artery. 腘动脉囊性外膜病。
Vascular surgery Pub Date : 1977-09-01 DOI: 10.1177/153857447701100504
J Lau, H S Kim, R Carcia-Rinaldi
{"title":"Cystic adventitial disease of the popliteal artery.","authors":"J Lau,&nbsp;H S Kim,&nbsp;R Carcia-Rinaldi","doi":"10.1177/153857447701100504","DOIUrl":"https://doi.org/10.1177/153857447701100504","url":null,"abstract":"A 35-year-old man was admitted to the Ben Taub General Hospital for evaluation of increasing claudication of the right leg. His symptoms had begun a year before admission and had progressed to the point where he required crutches to walk. He had no history of trauma to his right leg, denied claudication of all other extremities, and had no symptoms of cardiac disease or cerebrovascular insufficiency. Physical examination was normal except for absent popliteal and distal pedal pulses in the right leg. The right foot was cooler than the left. Translumbar aortography revealed a normal aorta and iliac arteries. The","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 5","pages":"299-303"},"PeriodicalIF":0.0,"publicationDate":"1977-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100504","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11817416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
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