Vascular surgeryPub Date : 1977-09-01DOI: 10.1177/153857447701100506
D R Jackson
{"title":"Reconstructive procedures in the management of occlusive arterial disease.","authors":"D R Jackson","doi":"10.1177/153857447701100506","DOIUrl":"https://doi.org/10.1177/153857447701100506","url":null,"abstract":"newer graft conduits and techniques are constantly being advanced by researchers. This paper discusses standard approaches to occlusive peripheral arterial disease distal to the aorto-coronary bypass area. I will not discuss the etiology of the disease processes involved nor the subjects of embolectomies, acute traumatic lesions, or aneurysms (except for the thoracoabdominal aneurysm which is often involved with occlusions in the visceral vessels as","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 5","pages":"308-20"},"PeriodicalIF":0.0,"publicationDate":"1977-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100506","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11817418","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}
Vascular surgeryPub Date : 1977-09-01DOI: 10.1177/153857447701100501
D E Strandness
{"title":"Diagnostic considerations in occlusive arterial disease.","authors":"D E Strandness","doi":"10.1177/153857447701100501","DOIUrl":"https://doi.org/10.1177/153857447701100501","url":null,"abstract":"<p><p>The diagnostic approaches to the problem of occlusive arterial disease have been reviewed. The history and physical examination are most useful in establishing the diagnosis, localizing the most proximal level of the arterial involvement, and categorizing the patient's stage of disease. Functional evaluation of limb blood pressures and flow velocity at rest and after exercise provide useful data for estimating the degree of the arterial involvement, and this information can be used as the baseline for evaluating the effects of therapy.</p>","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 5","pages":"271-7"},"PeriodicalIF":0.0,"publicationDate":"1977-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100501","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11817411","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}
Vascular surgeryPub Date : 1977-07-01DOI: 10.1177/153857447701100404
J R Lemoine, K M Moser
{"title":"Radiolabelled fibrinogen and impedance plethysmography in the diagnosis of deep venous thrombosis.","authors":"J R Lemoine, K M Moser","doi":"10.1177/153857447701100404","DOIUrl":"https://doi.org/10.1177/153857447701100404","url":null,"abstract":"From the Pulmonary Division, Department of Medicine, University of California, San Diego, School of Medicine. Pulmonary embolism continues to be an important cause of death particularly for the in-hospital patient.’ Most thrombi responsible for such events originate in the lower limbs. The clinical diagnosis of such deep-venous thrombosis (DVT) remains notoriously unreliable. Early recognition would permit prompt, appropriate therapy with heparin and hopefully prevent embolization of large clots to the lungs. Recently, two diagnostic aids have become available which offer promise in the early detection of DVT-the radiolabelled p25 fibrinogen test (RLF) 2-4 and impedance plethysmography (IPG).&dquo;7 The theory, methodology and results of these procedures are reviewed briefly in this paper.","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 4","pages":"216-8"},"PeriodicalIF":0.0,"publicationDate":"1977-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11819159","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}
Vascular surgeryPub Date : 1977-07-01DOI: 10.1177/153857447701100408
F S Mishkin
{"title":"The advantages and limitations of radionuclide techniques in the patient with vascular disease an overview.","authors":"F S Mishkin","doi":"10.1177/153857447701100408","DOIUrl":"https://doi.org/10.1177/153857447701100408","url":null,"abstract":"Radionuclides have been used to objectively assess the circulation for a half century (1). Techniques employing radioactivity were developed to provide true tracers which do not affect the process being measured. Radionuclides provide a unique sensitivity with the ability to detect and quantitate several thousand molecules. Ultimately, this inherently quantitative ability may prove most useful. Relative distribution of activity and hence relative blood flow can be readily determined using particles which are completely trapped by the capillary bed during a single circulatory transit (2). Actual quantitative measurements of flow per unit weight can also be determined either by measuring clearance of intraarterial injection of a diffusible indicator such as","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 4","pages":"261-70"},"PeriodicalIF":0.0,"publicationDate":"1977-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11819161","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}
Vascular surgeryPub Date : 1977-07-01DOI: 10.1177/153857447701100407
M E Siegel
{"title":"Radionuclide assessment of peripheral arterial disease.","authors":"M E Siegel","doi":"10.1177/153857447701100407","DOIUrl":"https://doi.org/10.1177/153857447701100407","url":null,"abstract":"The use of radioactive tracers in the diagnostic and prognostic evaluation of the patient with peripheral arterial disease has produced clinically useful information. Their application has provided a means by which: (1) The regional distribution of perfusion at the level of the microcirculation, under various stresses, has provided objective evidence of diffuse small vessel disease; (2) The determination of graft patency can be simply and repeatedly performed; (3) The relative perfusion of &dquo;ischemic&dquo; ulcers can be determined and utilized to prognosticate their healing potential; (4) The presence of arteriovenous shunts can be verified and quantified; and (5) The skin perfusion pressure can be determined and utilized to assess the healing potential of surgical amputations.","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 4","pages":"241-60"},"PeriodicalIF":0.0,"publicationDate":"1977-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11819160","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}
Vascular surgeryPub Date : 1977-07-01DOI: 10.1177/153857447701100402
R M Carroll, H B Rose, J Vydon
{"title":"Noninvasive vascular testing in clinical practice.","authors":"R M Carroll, H B Rose, J Vydon","doi":"10.1177/153857447701100402","DOIUrl":"https://doi.org/10.1177/153857447701100402","url":null,"abstract":"Presented at the American College of Angiology, January 7, 1976, Palm Springs, Calif. Department of Radiology, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, California 90048. Noninvasive vascular testing has proven to be an important addition to the evaluation of the patient with suspected or documented vascular disease. The ability to determine the hemodynamic significance of stenotic or obstructive lesions in the arterial system has been aptly demonstrated through the efforts of Strandess and others. 1-3 The noninvasive nature of the testing and the reproducibility of the results allows for periodic evaluation to determine the progression of arterial disease. Angiography has been and continues to be the definitive test prior to the performance of arterial surgery. However, the morbidity and cost associated with angiography does not allow it to be a method of screening or repetitive evaluation of patients with vascular disease. In addition, angiography does not provide significant information regarding the dynamics of blood flow in obstructive disease.","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 4","pages":"201-4"},"PeriodicalIF":0.0,"publicationDate":"1977-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100402","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11819156","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}
Vascular surgeryPub Date : 1977-07-01DOI: 10.1177/153857447701100403
D E Strandness
{"title":"Invasive and noninvasive techniques in the detection and evaluation of acute venous thrombosis.","authors":"D E Strandness","doi":"10.1177/153857447701100403","DOIUrl":"https://doi.org/10.1177/153857447701100403","url":null,"abstract":"<p><p>There are a variety of noninvasive testing procedures which can be used to establish the diagnosis of acute venous thrombosis with a high degree of certainty. For prospective screening of patients at risk, only 125I-labelled fibrinogen is of value, but does have a false positive rate of 21%. Its greatest problem is that it must be given prior to the event and, furthermore, it is not accurate in the upper thigh or the region of the iliac veins. Doppler ultrasound, plethysmography and phleborheography are accurate methods of detecting thrombi which involve the major veins of the limb from the level of the tibial veins below the knee to the level of the iliac veins in the abdomen. If properly performed, the sensitivity and specificity should exceed 90% in experienced laboratories. Contrast phlebography remains the best method of demonstrating venous thrombosis but does have limitations with regard to costs, pain to the patient and the production of thrombosis in a small percentage of patients. Furthermore, if the injections are done at the foot level, at least 18% will have inadequate visualization of the iliac veins, a critically important venous segment. It use must be restricted to those situations in which the noninvasive tests are equivocal or the information is absolutely essential for a therapeutic decision.</p>","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 4","pages":"205-15"},"PeriodicalIF":0.0,"publicationDate":"1977-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11819157","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}
Vascular surgeryPub Date : 1977-07-01DOI: 10.1177/153857447701100405
E W Pollak
{"title":"The choice of test for diagnosis of venous thrombosis.","authors":"E W Pollak","doi":"10.1177/153857447701100405","DOIUrl":"https://doi.org/10.1177/153857447701100405","url":null,"abstract":"<p><p>Doppler ultrasound is the preferred screening test in asymptomatic patients with high risk for venous thrombosis. Radiographic phlebography leads to definitive diagnosis in most instances. Radionuclide angiography using 99mTc MAA with delayed images to detect particle entrapment in venous blood clots can be used when radiographic phlebography is contraindicated or impractical. To detect active thrombosis in patients with past venous disease, the serial fibrinogen uptake test is the method of choice. This method is also used to monitor the efficacy of anticoagulation therapy and to detect propagating thrombosis in patients failing to respond to anticoagulation, hopefully before massive lethal pulmonary embolism occurs. Radionuclide methods are contraindicated in pregnant women and children where non invasive methods are preferred. No completely satisfactory test exists for detection of hypogastric vein thrombosis. Among the methods currently being evaluated in the laboratory the ultrasound B-scan imaging, 99mTc MAA uptake test and 99mTc mAA venous scan offer the best possibilities for successful clinical application.</p>","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 4","pages":"219-25"},"PeriodicalIF":0.0,"publicationDate":"1977-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100405","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11769930","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}
Vascular surgeryPub Date : 1977-07-01DOI: 10.1177/153857447701100406
R C Verma, M M Webber, L Ramanna, J I Eisenman, L R Bennett
{"title":"Radionuclide venography and the role of radionuclides in the detection of venous disease.","authors":"R C Verma, M M Webber, L Ramanna, J I Eisenman, L R Bennett","doi":"10.1177/153857447701100406","DOIUrl":"https://doi.org/10.1177/153857447701100406","url":null,"abstract":"Until recently, the true incidence of venous thrombosis in the general population was difficult to determine. However, with the availability of noninvasive screening techniques, such data are now being gathered. The incidence of calf vein thrombosis, as measured by the fibrinogen uptake test in inpatient (medical and surgical) population, ranges from 30% to 60%.’ In carefully examined autopsy specimens, the incidence of deep vein thrombosis in the leg varied from 26% to 86%.’-’ 2","PeriodicalId":76789,"journal":{"name":"Vascular surgery","volume":"11 4","pages":"227-40"},"PeriodicalIF":0.0,"publicationDate":"1977-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/153857447701100406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11819158","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}