[Posttraumatic carotid-petrosal arteriovenous fistula].

Exclusive petrosal drainage of traumatic parasellar fistulae is uncommon (carotid-petrosal fistula). In the reported case successful treatment was achieved by muscle embolization and ligature of the ipsilateral internal and external carotid arteries.

The influence of limb elevation, examination technique, and outflow system design on venous plethysmography.

The effect of limb elevation and the design of the thigh cuff outflow system on venous capacitance and venous outflow, as determined by strain gauge plethysmography, was reviewed in a group of normal limbs without evidence of deep venous thrombosis. We improved the reliability of plethysmography in evaluating venous outflow, particularly in the early period after cuff deflation, by using uniform leg elevation, large diameter outflow tubing, and single rather than simultaneous limb examinations. Based on this experience, an optimum technique of examination emphasizing precise limb elevation, sequential limb examination and proper design of the cuff outflow system was used to evaluate 21 patients with acute venous thrombosis.

The physiology of venous claudication.

The hemodynamic features of venous claudication are presented in a patient with chronic occlusion of the iliac vein. Exercise results in a marked venous volume overload, particularly in the thigh, which leads to pain. The syndrome develops in patients with isolated iliac vein occlusion and patent, competent veins distal to the inguinal ligament.

Venous capacitance and outflow in the postoperative patient.

Venous capacitance and outflow were measured in a series of 50 unselected patients undergoing a variety of general surgical procedures. Studies done prior to operation and the morning after demonstrated a fall in capacitance and outflow that was related to the degree of ambulation. Fully ambulatory patients demonstrated no changes.

The reproducibility of the treadmill walking test for claudication.

Two standard treadmill walking tests were carried out one week apart upon 117 patients with stable claudication. Although total walking time achieved was reproducible, there was a highly significant delay in the onset of pain during the second test. Absolute limb pressures, determined by Doppler, were reproducible for the group as a whole, although individual variation could be significant.