Improved outcome after rupture of abdominal aortic aneurysm over an 18-year period.

The purpose of the study was to analyze changes in in-hospital mortality of patients with ruptured abdominal aortic aneurysm (RAAA) during an 18-year period. A retrospective analysis of 246 patients with RAAA in the years 1987-2005 was performed. The patients were divided into groups that consisted of 111 patients treated in the years 1987-2000 (group I) and 135 patients treated in the years 2001-2005 (group II).

Increased risk of the abdominal aortic aneurysm in carriers of the MTHFR 677T allele.

Abdominal aortic aneurysm (AAA) presents itself as a progressive dilation of the abdominal aorta, leading--if untreated--to rupture. It is a common disease of the elderly, with a complex etiology. Several genetic, biochemical and environmental factors are recognized as relevant for the pathogenesis of AAA.

Renovascular hypertension - simultaneous aortic and renal artery reconstruction.

Despite the enormous progress that has been madein the fields of vascular surgery and intensive care, reconstructive surgery of renal arteries in the presence of arteriosclerosis of the abdominal aorta remains a serious therapeutic problem and is associated with a high rate of complications. The purpose of this study was to analyze the results of treatment of patients with renovascular hypertension and so-called difficult aorta. Surgery was carried out in 68 patients with a critically stenosed renal artery and severe arteriosclerosis of the abdominal aorta.

Steady-state pharmacokinetics of indobufen enantiomers in patients with obliterative atherosclerosis.

Steady-state pharmacokinetics of indobufen (INDB) enantiomers administered as racemic INDB (rac-INDB) tablets and bleeding time were studied in patients. Two-hundred mg INDB tablets (Ibustrin) were administered twice daily for 7 days to obliterative atherosclerosis patients. Enantiospecific reversed phase (RP) HPLC with UV detection (lambda = 275 nm) was used for determination of INDB enantiomers in serum of patients.

Sutureless intraluminal graft for repair of high abdominal aortic aneurysm.

The aim of our study was experimental and clinical assessment of bifurcated grafts with ring on its main branch made of the same polyester as the prosthesis. This type of prosthesis facilitates quick anastomosis with the aorta through tying the aortic wall on the ring using a polyester tape. Experimental studies carried out on 18 pigs demonstrated good healing up of such a graft.

The mechanical properties of fresh and cryopreserved arterial homografts.

Objectives: To assess the effect of cryopreservation on the elasticity and compliance of arterial allografts.

Materials And Methods: Iliofemoral segments of arteries and veins harvested from multiorgan donors were divided into two groups: fresh-control, tested for 24 hours after harvesting, and cryopreserved in liquid nitrogen after pretreatment with 20% dimethylsulphoxide and stored for an average time of 22 days. Vessel wall elastic properties were evaluated from the stress-strain relationship in a specially designed test cell fixed to the Instron Universal Testing Machine.

[The importance of excision of the first thoracic rib and accessory cervical rib in the treatment of deep venous thrombosis of the upper extremities].

This paper presents 15 cases of deep venous thrombosis of the upper extremity as a complication of previously asymptomatic thoracic outlet syndrome. The diagnosis was based on clinical examination and phlebography. To achieve prompt recanalisation of the vein streptokinase was used.

[Allogenic arterial transplants as aorto-iliaco-femoral vascular replacement in prosthesis infection].

From June 1996 to February 1998 10 patients with aorto-femoral graft infection were treated in our department. In all cases infected vascular grafts were removed and in situ cryopreserved arterial allograft was inserted. Two patients died on the 1st and the 17th postoperative day due to septic shock or heart infarction.

[Aneurysm of the vertebral artery as a tumor of the neck].

The authors described a case of vertebral artery aneurysm, basing on their own experience and literature. The clinical course, diagnostic difficulties and treatment were discussed. There is presented an aneurysm of the vertebral artery coexistent with rheumatoid cervical spine disease.

Clinical and morphological aspects of Buerger's disease.

Background: Thirty-five patients with TAO and 35 with ASO have been studied. To determine differences between these two arterial diseases, we used clinical criteria, arteriographic and morphological methods. The peripheral (below the bifurcation of the popliteal artery) angiographic changes were found in TAO with 94% sensitivity, 94% specificity and with 96% of positive predictive value.

[The value of total contact casting in treatment of neuropathic foot ulcers in diabetic patients].

Neuropathic foot ulcers in diabetic patients pose great difficulties in treatment. Total contact casting is one of the available methods. It is thought to distribute the pressure evenly over the entire surface of the foot.

[Preoperative autotransfusion and hemodilution and its value in reconstructive vascular surgery].

Autotransfusion and haemodilution are the most safe and well known methods of blood protection in patients planned for vascular operations. During reconstructive vascular surgery autotransfusion with hypovolemic or normovolemic haemodilution were used. In the I group of patients hypovolemic haemodilution was done.

The value of quantitative bacteriological investigations in the monitoring of treatment of ischaemic ulcerations of lower legs.

The quantitative and qualitative bacteriological investigations of 63 patients were done on ischaemic ulcerations before reconstructive vascular surgery and at 7 day intervals after the operation. Among the isolated bacteria the most common were Gram positive (62.9%), especially Staphylococcus aureus.

[Bilateral carotid glomus tumor].

In 42 year-old patient operated on neck tumour chemodectomy was diagnosed intraoperatively. Due to the substantial size of the tumour the treatment was additionally radiated. During control examination, 2 months after the end of the treatment, a tumour was diagnosed on the neck.

Surgical management of abdominal aortic aneurysms in Poland. A multi-centre study.

Abdominal aortic aneurysm resections were performed on 941 patients between 1987 and 1991 in nine selected university vascular units in Poland. The aim of the study was (1) to determine how grave the problem of abdominal aortic aneurysms is in the main vascular centres in our country, (2) to evaluate the methods of management, (3) to trace the most common postoperative complications, and (4) to estimate results. Hospital mortality rate for 730 elective and urgent resections was 8.

C-reactive protein and alpha-1-acid glycoprotein in monitoring of patients with chronic arterial occlusion of the lower limbs.

C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP) levels were studied in the sera of 107 patients with chronic arterial ischaemia of the lower limbs. Depending on the degree of ischaemia, patients were divided into four groups: (i) intermittent claudication--20 patients; (ii) rest pain and ankle pressure above 50 mmHg--12 patients; (iii) rest pain and ankle pressure below 50 mmHg--25 patients; (iv) peripheral necrosis--50 patients. Reconstructive surgery was performed in 84 patients and primary major amputation in 23 cases.

Peripheral arteries of the extremities in acute ischemia.

Changes in peripheral arteries of the extremities during acute ischemia were examined in 108 patients with embolism and 18 with arterial injuries. All patients were divided into four degrees of ischemia due to our own original classification. It can be stated that patients with the first degree of ischemia presented patent peripheral arteries.

Morphological aspects of the aortofemoral graft thrombosis.

Sixty seven patients underwent aorto-femoral double velour grafting for aortoiliac occlusive disease and 38 patients were treated for recurrent lower limb ischemia following aortofemoral grafting. Apart from various clinical examinations the patients underwent angiography as well as the morphological investigation of specimens obtained from abdominal aortae, common femoral arteries and from grafts implanted into the aorto-femoral section. The examinations showed that diffuse intimal thickening may, in the course of atherosclerosis, convert itself into uncomplicated fibrous and further into complicated plaques impairing mainly graft outflow.

Morphological changes in femoropopliteal venous grafts.

Morphological examination of specimens obtained from 82 venous grafts implanted into the femoropopliteal section were done. Intimal oedema, necrosis of single smooth muscle cells and partial exfoliation of the endothelium with as occurrence of parietal thrombi may lead to early graft impatency. The late cause of stenosed inner diameter below 4 mm in the venous graft was in 14,6% the hyperplasia of the smooth muscle cells and collagen and elastin fibres in the intima, whereas in 4,9% the changes were defined as graft atherosclerosis.