Crural Bypass Surgery in Case of Critical Ischemia: Technical Aspects and Results.

Background Crural bypass surgery is one of the last options to salvage the leg. Compared to arterial reconstructions of more proximal localization patency rates are generally less good. The aim of this retrospective study was to answer the question if crural bypass surgery is justified.

Abnormal Venous Dilatation other than Typical Varicose Vein, Rare Encounters.

Varicose vein, one of the common vascular illnesses is usually a disease in lower limb. This is due to reflux of blood from deep venous system to superficial venous system. Rarely, this disease can also happen in veins in different location.

Creation of an Arterialized Cephalic Vein as Autologous Bypass for Below-Knee Reconstruction in Critical Limb Ischemia.

Two cases of below-knee bypasses using an arterialized cephalic vein (CV) are presented. Both patients had critical ischemia, but no greater or lesser saphenous veins (LSVs) were usable. According to ultrasound, the CVs were thin but regularly positioned.

Initial Experience of Complex Peripheral Bypass Surgery at Dhulikhel Hospital, Kathmandu University Hospital.

Peripheral arterial disease is seemingly silent yet is a major pubic health problem with limb threatening and life threatening consequences. This condition can initially be asymptomatic and gradually may progress to intermittent claudication and finally to critical ischemia. When conservative management is not sufficient and there is option of surgical management, peripheral bypass surgery is an established modality of treatment of peripheral arterial disease.

Intervention for access-induced ischemia: which option is the best?

Introduction: Access-induced ischemia is a rare but important surgical complication with potentially devastating long-term results. The question remains which therapeutic option is the best for the different forms of ischemia.

Method: A review of the literature concerning access-induced ischemia (classification, treatment) was performed; furthermore, our own experience of more than 300 cases with ischemia was discussed.

Continuous irrigation as a therapeutic option for graft infections of the groin.

Background: Wound infections following vascular procedures occur in 1-7 % of patients and can lead to severe problems including amputation and death. There are no established treatment options for this complication. The aim of our study was to introduce continuous irrigation as a new treatment technique.

The value of duplex ultrasound in the prediction of brachial dialysis access induced ischemia syndrome (DAIIS).

Purpose: Dialysis access induced ischemia syndrome (DAIIS) is a serious complication of Vascular Access (VA) surgery. It mainly occurs in brachial VA. The aim of this prospective study was to ascertain whether early detection of DAIIS following brachial VA is possible, enabling immediate therapy.

Late sequelae of retained foreign bodies after world war II missile injuries.

A number of people injured during the second world war harbour foreign bodies such as grenade splinters or bullets in some part of the body. Most of these metal fragments remain clinically silent. Some of them, however, may cause delayed complications.

Ischemic monomelic neuropathy: a rare but important complication after hemodialysis access placement--a review.

The creation of a vascular access for hemodialysis is a frequently performed procedure. Ischemic monomelic neuropathy (IMN) is a rare, but important complication of hemodialysis access (HA) procedures, which can lead to severe and nonreversible limb dysfunctions. Therefore, in any case of postoperative neurological malfunction, immediate neurological investigations should be undertaken.

Proximalization of the arterial inflow (PAI) in patients with dialysis access-induced ischemic syndrome: first report on long-term clinical results.

Purpose: Proximalization of the arterial inflow (PAI) is a promising technique which was introduced several years ago as a treatment option for patients with dialysis access-induced ischemic syndrome (DAIIS). In our institutions we have been performing PAI since 2003 and have seen positive clinical results. The aim of this prospective survey is to present the long-term results of PAI.

Proximalization of the arterial inflow: new treatment of choice in patients with advanced dialysis shunt-associated steal syndrome?

Dialysis-associated steal syndrome (DASS) is a potentially devastating complication. As a new surgical technique, proximalization of the arterial inflow (PAI) has been described recently to be of good effect in case of DASS. As there has not yet been much general familiarity with this technique, our aim with this prospective study was to establish its indication for a special group of patients who developed advanced DASS (finger necrosis) following autogenous hemodialysis access (HA).

Dialysis shunt-associated steal syndrome with autogenous hemodialysis accesses: proposal for a new classification based on clinical results.

Background: Dialysis-associated steal syndrome (DASS) is a multifactorial complication. There are several therapeutic options, although because of the lack of research decisions for certain procedures are often made individually. The aim of this retrospective survey was to propose a new classification for DASS, including therapeutic recommendations, to make standardized procedures easier.

Dialysis shunt-associated steal syndrome (DASS) following brachial accesses: the value of fistula banding under blood flow control.

Background: Dialysis shunt-associated steal syndrome (DASS) is a rare complication of hemodialysis access (HA) which preferably occurs in brachial fistulas. Treatment options are discussed controversially. Aim of this study was to evaluate flow-controlled fistula banding.

Frequency of transient ipsilateral vocal cord paralysis in patients undergoing carotid endarterectomy under local anesthesia.

Background: Especially because of improvements in clinical neurologic monitoring, carotid endarterectomy done under local anesthesia has become the technique of choice in several centers. Temporary ipsilateral vocal nerve palsies due to local anesthetics have been described, however. Such complications are most important in situations where there is a pre-existing contralateral paralysis.

[Therapy and course of disease in spontaneous esophageal perforations].

Introduction: Esophageal perforations occur spontaneously or as a complication of endoscopic procedures. Especially in spontaneous perforation there is ongoing debate regarding the best treatment options.

Methods: 24 patients that were treated at two surgical centers (University Halle, City-hospital Bielefeld) after spontaneous esophageal perforations between 1996 and 2005 were analysed retrospectively.

[Primary operative gastrostomy or percutaneous endoscopic gastrostomy (PEG) in progressive oesophageal carcinomas? A case report on abdominal wall metastases following PEG].

Introduction: Percutaneous endoscopic gastrostomy (PEG) is a safe and easy procedure used to provide enteric nourishment in patients with non-operable, constricting, malignant tumors of the oropharynx or esophagus. However, as a late complication, the development of abdominal wall metastases have been described, the mechanism of which is controversially.

Patients And Methods: We describe two cases in which abdominal wall metastases developed 9 and 14 months, respectively, following PEG.

[Therapeutic results after papilloduodenal injuries following ERCP].

Introduction: Our goal was to compare operative vs. conservative therapeutic strategies after injuries following ERCP.

Methods: Eight patients with ERCP-induced injuries were surveyed retrospectively.

Comparison of questionnaire-based and serological screening for natural latex allergy in children with neurogenic bladder dysfunction.

Objective: We evaluated the prevalence of sensitization to natural latex in children with congenital neurogenic bladder dysfunction by patient history and serological examinations.

Method: 50 consecutive children aged from 6 months to 17 years were included into the study which comprised questionnaires of patient and family histories, serological screening tests for common inhalational allergens (CAP SX1), and determination of total serum immunoglobulin E (IgE) and of latex-specific serum IgE by solid-phase immunoassays.

Results: 5 children had a history of allergic reactions to natural latex; a history of atopic disposition or allergic reactions other than to latex was present in 16 children.