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Biomedical subjects

A S Chilvers

Publications and source records attributed to A S Chilvers.

18 recordsLinked to original sources
PubMed1984

Axillofemoral bypass in poor risk patients with critical ischaemia.

While there is an abundance of information about the results of axillofemoral grafting in the North American literature there is little published data from this country. This may reflect a reluctance on the part of British surgeons to use the technique. In the years 1976-1981 we have performed 30 axillofemoral bypasses in 27 patients to alleviate critical ischaemia of the lower limb. Grafts were inserted to bypass aortoiliac occlusive disease in patients too old or too ill for an intra-abdominal operation. Thirty-three limbs were at risk of major amputation, 10 because of gangrene and 23 because of rest pain. Operative mortality was nil and complications were few. Only 38% of grafts remained patent for 2 years but results in terms of limb salvage were satisfactory. Only 3 major amputations were necessary and this confirms our view that the operation is a valuable alternative to intra-abdominal reconstruction in poor risk patients.

Adult↗
PubMed1982

Umbilical vein graft for lower limb ischaemia.

Over a two-year period 30 patients in a British district general hospital had human umbilical vein grafts (Meadox Medical) inserted for severe lower limb ischaemia. There were no perioperative deaths but 6 patients subsequently died from their atherosclerosis. The cumulative patency rate at one year was 70%. Five patients suffered immediate graft failure and all required amputation. Failures were due to inappropriate case selection and early technical inexperience with handling the graft.

Aged↗
PubMed1975

Comments on operations for lower limb lymphoedema.

Good results have been obtained from surgical operations for lymphoedema of the lower limbs using skin flaps with a blood supply to cover the muscles following reduction of swollen subcutaneous tissue. The Charles operation using free skin grafts for cover is reserved for tropical elephantiasis or patients with local skin in bad condition. A variety of other procedures of physiologic intent have given disappointing results and been abandoned. The results of 74 operations are reviewed with a view to improving still further the results. The mortality rate was nil and there were only minor complications.

Humans↗
PubMed1970

Methods for the localization of incompetent ankle perforating veins.

A test for localizing incompetent ankle perforating veins uses an injection of fluorescein into a vein on the dorsum of the foot, with subsequent scanning of the leg under ultraviolet light. The test was found to be 96% accurate, and to be simple, safe, and cheap. It is considered to be particularly suitable for assessing legs with very early changes and with recurrent varicose veins.

Ankle↗
PubMedDate not supplied

Operations for lymphoedema of the lower limbs. A study of the results in 108 operations utilizing vascularized dermal flaps.

The results of operations for lymphoedema of the lower limbs have been reviewed. In experienced hands the results are very satisfactory. Modifications of the buried dermis flap operation of Thompson have been found to give the best results in patients where the local skin has been in good condition. The chief complication has been the occurrence of localized areas of necrosis, chiefly at the edges of the flaps. It has not been a serious complication but has sometimes prolonged the stay in hospital. It has been associated with haematoma formation. Methods of avoiding this and other complications are discussed in order to improve results still further. There have been no serious complications and no deaths in this series.

Humans↗
PubMedDate not supplied

Ruptured abdominal aortic aneurysm treated by ligation of the aorta and an axillobifemoral bypass.

Although a few elderly patients do survive operation for a ruptured aortic aneurysm mortality in patients over 70 years of age is very high. An alternative operation to conventional Dacron replacement of the aorta has been devised. This involves occlusion of the infrarenal aorta and iliac arteries with large plastic clips and insertion of a Dacron axillobifemoral graft. Eight patients with a mean age of 71 years were so treated. Half of them left hospital alive. We consider the results justify further use of this operation in selected patients.

Aged↗