Limb-salvage by femoro-distal bypass and free muscle flap transfer.

Objectives: To evaluate the feasibility and long-term outcome of distal arterial reconstruction combined with free muscle flap transfer for patients who would otherwise have undergone major amputation.

Methods: Between 1996 and 2001, 27 reconstructions using autologous vein were performed in 25 patients. Seventeen of these patients had diabetes mellitus.

Experimental comparison of four methods of end-to-side anastomosis with expanded polytetrafluoroethylene.

Background: Four established techniques of distal end-to-side anastomosis (direct anastomosis, Linton patch, Taylor patch and Miller cuff) were compared to investigate the local distribution of anastomotic intimal hyperplasia. The study aimed to elucidate whether mechanical factors or flow alterations are mainly responsible for the improved patency rates reported for vein cuff interposition techniques in infrainguinal arterial reconstructions using prosthetic graft material.

Methods: Thirty-two expanded polytetrafluoroethylene (ePTFE) femoropopliteal bypass grafts were implanted in 16 sheep using the four anastomotic techniques.

External beam radiation for prevention of intimal hyperplasia in peripheral arterial bypasses.

Purpose: Neointimal hyperplasia is one of the limiting factors in infrainguinal prosthetic vascular grafting. We conducted a pilot study to assess the possible role of radiotherapy for the prevention of this proliferating cellular process.

Methods And Materials: Ten patients (7 men, 3 women; median age: 73 years) suffering from critical leg ischemia were treated by infrainguinal revascularization using 6-mm polytetrafluoroethylene.

Streptococcus pneumoniae mycotic aortic aneurysm after allogeneic bone marrow transplantation.

Background: Streptococcus pneumoniae (SP) is a common cause of community-acquired pneumonia and accounts for up to 30% of all cases of pneumonia. Patients with chronic graft-versus-host-disease (GvHD) after allogeneic bone marrow transplantation (BMT) have a high susceptibility to SP infections. So far, mycotic aneurysm resulting from SP has not been reported after BMT.

Fluid dynamics, wall mechanics, and oxygen transfer in peripheral bypass anastomoses.

Intimal hyperplasia at vascular anastomoses seems to be promoted by altered flow conditions and stress distributions within the anastomotic region. In order to gain deeper insight into postoperative disease processes, and subsequently, to contribute to the development of improved vascular reconstructions, detailed studies, also on local flow dynamics and related mass transport and wall mechanical effects, are required. In context with in vivo studies, computer simulation based on casts of femoro-popliteal bypasses implanted into sheep were performed to analyze the flow dynamics, the oxygen transport, and the wall and suture mechanics in anatomically correct bypass configurations related to three established surgical techniques and resulting geometries (conventional type anastomosis, Taylor-patch and Miller-cuff anastomoses with venous interposition grafts of different modifications).