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Biomedical subjects

C D Dossa

Publications and source records attributed to C D Dossa.

6 recordsLinked to original sources
PubMed1998

Superficial temporal artery aneurysms.

OBJECTIVE: We analyzed the data from our vascular registry to determine the cause, clinical features, and cost-effective management of this uncommon pathologic entity. DESIGN: Patients referred to the vascular surgery outpatient clinic of a tertiary referral center during the past 18 years were evaluated. SUBJECTS: The subjects were six male patients (14 to 32 years) referred for evaluation of a unilateral pulsatile mass over the temporal region of the head. INTERVENTION: Diagnosis of superficial temporal artery aneurysm was verified by loss of the aneurysm's pulse with compression of the ipsilateral proximal superficial temporal artery. All treated aneurysms were electively ligated and excised as an ambulatory procedure. RESULTS: The symptoms were resolved. No recurrences or other complications were seen. CONCLUSIONS: Although rare, a superficial temporal artery aneurysm should be considered when a temporal head mass is evaluated. This condition is almost always a result of blunt or penetrating head trauma. Clinical examination is sufficient to confirm the diagnosis. Simple elective ligation and excision of the aneurysm is curative.

Adolescent↗
PubMed1994

Acute aortic occlusion. A 40-year experience.

OBJECTIVE: To review a large experience with acute aortic occlusion (AAO) to better define the cause, clinical presentation, treatment, prognostic variables, and outcome. DESIGN: Retrospective review of 46 consecutive patients with AAO during a 40-year period. SETTING: A large urban tertiary care referral center in Detroit, Mich. PATIENTS: Adult patients with arteriographic and/or operative confirmation of acute occlusion of the abdominal aorta plus signs and symptoms of acute ischemia. INTERVENTION: Operative and nonoperative treatment of AAO. MAIN OUTCOME MEASURES: Mortality, morbidity, and long-term survival. Other variables measured included cause, risk factors, and effects of duration and severity of ischemia and treatment methods on outcome. RESULTS: Two primary causes were identified--embolism (65%) and thrombosis (35%). Heart disease and female gender were risk factors for embolism, while smoking and diabetes were risk factors for thrombosis. Severity of ischemia on presentation correlated better with outcome than duration of ischemia. The hospital mortality rate was 35% and morbidity, 74%, with no difference between the two groups. Recurrent arterial embolism occurred in 43% of patients with embolic AAO. Seventy-two percent of AAO survivors were alive 5 years after therapy. CONCLUSIONS: Acute aortic occlusion remains a serious vascular surgical emergency with significant morbidity and mortality, even when recognized promptly and treated appropriately. Nevertheless, survivors have a reasonable long-term outcome. Permanent anticoagulation is suggested in patients with embolic AAO to minimize a high incidence of recurrent arterial embolism.

Acute Disease↗
PubMed1994

Results of lower extremity amputations in patients with end-stage renal disease.

PURPOSE: The purpose of this study was to determine the impact of end-stage renal disease (ESRD) on the outcome of patients undergoing lower extremity (LE) amputation. METHODS: Hospital charts and vascular surgery registry data were reviewed for all patients who underwent LE amputation over a consecutive 56-month period. The results of 84 patients with ESRD (137 amputations) were compared with 375 patients (442 amputations) without ESRD. RESULTS: Hospital mortality rate was significantly greater in patients with ESRD than patients without ESRD, 24% versus 7% (p = 0.001). Patients with ESRD undergoing minor amputations had mortality rates three times greater than patients without ESRD undergoing major LE amputations. In patients with ESRD requiring bilateral or unilateral above-knee amputation hospital mortality rates were 43% and 38%, respectively. In addition, patients with ESRD were seven times more likely to undergo bilateral amputation than patients without ESRD over a mean follow-up period of 17 months. No kidney transplant patients died after amputation. CONCLUSION: ESRD has a profound negative impact on morbidity, mortality, and survival rates after LE amputation. Attempts at prevention of amputation with aggressive foot care and patient education in this high-risk group should be the focus of therapy.

Adult↗