At the Seraphimer Hospital the main interest in the vascular surgical basic research has been microangiography, clinical physiological diagnostic methods, isotope clearance techniques and metabolic changes in ischemic tissues. Clinical vascular surgical research has mainly been reconstructive arterial surgery in patients with ischemic gangrene, deep femoral artery reconstruction, treatment of arterial embolism and the use of sympathetic blocks. Walking exercises have been supervised by physiotherapists and all patients have been recommended to stop smoking. Anticoagulants have been reserved for prophylactic treatment of patients who postoperatively still have other critical stenoses. Regular post-operative examinations have been performed at the vascular surgical out-patient department.

Arterial Occlusive Diseases↗

PubMed1980

Varicose veins. Do not do phlebography unnecessarily; preserve the great saphenous vein!

Phlebography should be performed only on special indications, chiefly for the diagnosis of thrombosis. A non-invasive method such as venous plethysmography is valuable in assessing deep venous insufficiency. Local exstirpation of varices and perforants and percutaneous paired sutures round superficial varices are recommended instead of stripping, as the saphenous vein may be needed for arterial reconstruction in risk groups, e.g. all male smokers. Peripheral arterial pulsations should always be checked to ascertain that the symptoms are not due to arteriosclerotic occlusion.

Humans↗

PubMed1978

Practical considerations of the vascular surgical "out-patients".

Continuity in vascular patient control is important. Physiological methods useful in diagnosis and follow-up of vascular surgical out-patients are discussed. Measurement of systolic blood pressure in the big toe gave good assessment of their peripheral perfusion pressure and helped in selecting patients for vascular reconstruction. Walking capacity was measured on a treadmill together with simultaneous ECG. We recommended that all our patients stop smoking.

Aged↗

PubMed1978

Reconstruction of the deep femoral artery.

Deep femoral artery reconstruction was performed on 54 extremities. Best results were obtained in patients with severe rest pain and minor ischemic ulcerations. Intermittent claudication generally did not improve significantly. The mean operative flow to deep femoral artery was 170 mg/min. and the increase in peripheral pressure 20 mm Hg.

Amputation, Surgical↗

PubMed1978

Sympathetic blocks.

The results of permanent chemical block of the lumbar symmpathetic chain in patients with inoperable vascular conditions, treated during the three-year period 1973--1975 is presented. The results show that, when unsuitable patients have been rejected by their poor response to continuous local aneasthetic blocks, good results with permanent phenol blocks are attainable. These are mainly in patients whose presenting symptom is pain at rest. The complication-rate was low.

Adult↗

PubMed1977

A case of severe compression of the coeliac artery.

A man, aged 42 years, presented as an emergency with a history of stabbing upper abdominal pain, nausea and diarrhoea of two weeks' duration. Apart from abnormal transaminase and alkaline phosphatase values, the routine clinical and laboratory examinations did not reveal any abnormality. As the abdominal pain increased in severity, particularly in association with eating, and projectile vomiting supervened, aortography was carried out and showed severe stenosis of the coeliac axis, involving about 1 cm of the artery. At operation a thick fibrous band, which originated from the median arcuate diaphragm, was seen to constrict the point of origin of the artery and to compress the vessel against the aorta. The band was divided, whereupon the coeliac artery immediately showed strong pulsations and adequate filling. Microscopic examination of the fibrous band revealed, among other structures, those characteristic of a ganglion. The symptoms disappeared after operation.

Adult↗

PubMed1974