[Endovascular exclusion of abdominal aortic aneurysm].

Objective: To explore the indications, methods, manipulations, and problems of endovascular exclusion of abdominal aortic aneurysm (AAA).

Method: Under general anesthesia and dynamic supervision of DSA, an endovascular exclusion with a stent-graft complex of 11.0 cm x 2.

[Possibilities and limits of ambulatory operations in vascular surgery: demands and reality].

The requirements for day-case a-v fistula surgery are an effective out-patient clinic, adequate surgical and anaesthesiological equipment and a thorough patient selection for the planned operation. For surgical reasons, only 87 cases (8.1%) out of the 1068 a-v fistula operations carried out had to be admitted to a ward.

[Alternative mechanical autotransfusion. Hemofiltration vs. hemoseparation].

The effect of haemoconcentration of shed blood from operative field during vascular surgery by either centrifugation (cell separation, n = 10) or haemofiltration (n = 10) was investigated. Interest in this in-vitro-study was focused on the quality of the blood concentrated. Various parameters were measured in the patient (before onset of anaesthesia), and in the blood after suction from operative field: 1.

Occlusion of the brachial artery by thrombus dislodged from a traumatic aneurysm of the anterior humeral circumflex artery.

The successful treatment of a brachial artery occlusion caused by a chronic embolizing aneurysm of the anterior humeral circumflex artery is described. In the case of embolizing axillary artery aneurysms, the best therapy is resection of the aneurysm followed by distal thromboembolectomy and vascular reconstruction by a saphenous vein segment. Prosthetic material should be reserved as a second choice.

[Effective autotransfusion thanks to cooperation].

A 61-year-old female patient scheduled for major vascular surgery had several diseases, including cardiovascular, pulmonary, renal and hepatic insufficiency. Prior operations--major vascular surgery, strumectomy--had led in most cases to severe bleeding complications owing to a known inherited thrombopathia. Therefore, it was questionable whether an operation would be possible at all.

[Quality of life after surgical interventions--vascular surgery].

Vascular surgery is primarily a reconstructive discipline that contributes appreciably to the patient's quality of life (QL) by improving many organ and system functions. The definition of QL includes a variety of specific and very individual aspects. The postoperative evaluation of QL must be based on the one hand on hard data and common clinical parameters, and, on the other, on the individual feeling of the patient, who compares preoperative sequelae and postoperative functional improvement.

[Bypass spanning the knee joint with synthetic prosthesis].

Synthetic tubes are the second choice for below-knee bypass materials. The ring-reinforced thin-walled Goretex-PTFE graft is an approved material which was tested in a multicenter study. The primary 3 years patency for below-knee femoral-popliteal bypass was 64%, for crural bypass 39%.

[Results of the surgical treatment of acute circulatory disorders of the leg caused by arterial embolism and arterial thrombosis].

232 patients with arterial embolism (E) and 103 with arterial thrombosis (T) were treated. Operative mortalities were 18.9% (E) and 11.

[Indications for the implantation of a vena cava filter].

Intracaval filter implantation is an alternative to surgical removement of the sources of pulmonary emboli. The indication for implantation of a Greenfield vena cava filter, which is the far advanced type, has to be a very narrow one, however. The two main indications are: recurrent emboli despite adequate anticoagulant therapy and contraindications to anticoagulation and no possibility for venous thrombectomy or thrombolytic therapy.

Buflomedil in arterial occlusive disease: results of a controlled multicenter study.

In a double-blind, randomised multicentre study buflomedil, a vasoactive substance, was compared with placebo in the treatment of 93 patients with chronic arterial occlusive disease. After a run-in period of four weeks the patients received either buflomedil (600 mg daily) or placebo over 12 weeks. The pain-free and the total walking distances improved significantly in both groups.

[Problems and limitations in reconstructing peripheral artery injuries].

Unlabelled: Between September 1975 and November 1982 we performed the repair on 75 injured peripheral arteries. In 57% a full restitution could be achieved, in 13% the extremity was saved with a resting functional deficit, in 20% an amputation was required, 10% had a lethal outcome. - Causes of failure are: 1) prolonged ischemia, 2) insufficient primary repair, 3) associated peripheral vascular lesions, 4) local and general revascularisation syndrome.

[Vascular surgical treatment of chronic leg ischemia in patients over 70--choice of procedure and results].

Vascular reconstructions were performed in 322 patients over 70 years of age. The indications for operation of 372 lower extremities were: chronic occlusive disease with rest pain or gangrene in 94 percent and intermittent claudication in only 6 percent. The operative mortality rate was 10.

[Doppler ultrasonic measurement for diagnosing carotid occlusions and stenoses (author's transl)].

Doppler ultrasonic measurements were performed in 74 patients suffering from cerebrovascular disorders. Flow direction was determined in the supratrochlear artery by using a directional Doppler sonographic instrument according to the method of Keller et al. 15 patients presented, unilateral or bilateral, with a flow reversal (i.

[Complications of arterial reconstructions below the knee for chronic vascular occlusion (author's transl)].

From 1967 to 1976 49 reconstructions were undertaken in the area distal of the art. poplitea: 30 femoral-crural bypasses, 12 TEA und 7 orthogradic desobliterations. Complications until clinical demission were reviewed.

[Clinical experiences with induced preoperative haemodilution in vascular surgery (author's transl)].

A procedure of haemodilution modified for the particular requirements of vascular surgery has been used on 90 hospital patients. 61% of the operations have been performed without using homologous blood. The method applied being clinically well tolerable, it the object of this study to find to what extent a measurable reduction of the loss of blood during the operation with consequently a reduction of the amount of homologous blood administered can be attained.