Aorto-iliac reconstruction without arteriography.

Background: Duplex imaging has been shown to be as accurate as arteriography in detecting hemodynamically significant aorto-iliac stenosis or occlusions.

Methods: Review of the duplex scan and arteriogram reports for all primary aorto-iliac reconstructions performed during an 18-month period was undertaken. Deviations from the preoperatively planned procedure were determined.

Major vascular injuries during laparoscopic procedures.

Background: Major vascular complications following laparoscopic procedures are rare, with only 20 cases reported in the literature.

Patients And Methods: The cases of 4 patients who sustained 5 vascular injuries during laparoscopic procedures between June 1991 and May 1994 are presented, and previously reported cases in the literature are reviewed.

Results: All injuries occurred during pelvic laparoscopy (2 diagnostic procedures, 1 tubal ligation, and 1 hernia repair).

Ruptured abdominal aortic aneurysm. The Tacoma experience.

The Tacoma, Washington surgical experience with 37 consecutive patients with ruptured abdominal aortic aneurysms seen over a 5 year period has been reported. The overall survival rate was 38 percent. The development of shock before initiation of surgery was a common finding and portended a poor prognosis.

Thoracic esophageal and tracheal injury following blunt trauma.

A 20-year-old man injured in a motor vehicular accident sustained a nonpenetrating double blowout injury of the upper thoracic esophagus. A simultaneous membraneous rupture of the trachea occurred. Treatment was by operative primary closure.

In situ cold perfusion of kidneys for transplantation. An experimental and clinical evaluation.

Cadaver kidneys from donors who have sustained cardiac standstill are often unsuitable for transplantation due to prolonged warm ischemic time. In an attempt to increase the salvage rate of these kidneys, the efficacy of in situ intra-aortic cold perfusion in producing immediate function of allografted kidneys was assessed in the nonheart beating canine model. In the first experiment, kidneys harvested after cardiac standstill and immediate intra-aortic cold perfusion were demonstrated to function equally as well as kidneys harvested "optimally.