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Biomedical subjects

I Tonković

Publications and source records attributed to I Tonković.

At least 19 recordsLinked to original sources
PubMed1997

Treatment of upper limb nerve war injuries associated with vascular trauma.

During a 4-year period, in the Departments of Plastic Surgery and Vascular Surgery at the Clinical Hospital Centre in Zagreb, 151 upper limb nerve injuries caused by war weapons were treated using microsurgical procedures, and 119 patients have been assessed. Among them, 44 patients with 58 nerve injuries had associated arterial injuries. It is of great importance that peripheral nerve as well as vessel injuries should be considered in all extremity war wounds. Every effort should be made to perform immediate revascularization of a damaged artery, as this is the best guarantee for long-term arterial patency. Reconstruction with autologous vein has been the method of choice for arterial war injuries. Injured peripheral nerves, at the time of vascular repair, were marked and left for secondary reconstruction. Primary repair of such injuries was contraindicated because it was impossible to determine the exact proximal and distal extent of injury. Functional results were obtained in only 44.8 per cent of cases with concomitant nerve and arterial war injuries, an outcome that could be explained by insufficient vascularization at the site of nerve repair (using both mechanisms of graft revascularization), as well as proximal levels of injury and extent of nerve damage, which resulted in long nerve defects.

Adolescent↗
PubMed1996

Arteriovenous fistula of the internal mammary artery (combat injury): transcatheter intravascular coil occlusion.

A case of arteriovenous fistula of the left internal mammary artery occluded by Gianturco coil is reported. A 26-year-old male suffered multiple explosive injuries. Right heart failure developed postoperatively. Digital subtraction angiography demonstrated arteriovenous fistulas between the left internal mammary artery and left subclavian and innominate veins. Considering previous multiple surgical interventions and severe general condition of the patient, both arteriovenous fistulas were successfully occluded by transcatheter placement of a Gianturco coil.

Adult↗
PubMed1995

[Epidural anesthesia in vascular surgery in patients with chronic obstructive lung disease].

Epidural anaesthesia was determined in 29 patients with chronic obstructive pulmonary disease. Lidocaine 2% for vascular procedures such as embolectomy from the arteriae femoralis and arteriae poplitea was used as an anesthetic in 12 patients and 0.5% bupivacaine for aortobitemoral or femoropopliteal bypass in 17 patients. Thus possible complications in patients with obstructive chronic pulmonary disease were avoided as well as prolonged mechanical ventilation and endotracheal intubation. With the postoperative application of local anesthetic through a catheter into the epidural space, spontaneous breathing and good analgesia was achieved. Preoperatively all patients were administered bronchodilators, expetorants and they stopped smoking.

Anesthesia, Epidural↗
PubMed1993

Military vascular injuries in Croatia.

A single-centre experience of military vascular injuries in the recent conflict in Yugoslavia is reviewed. From 1 April to 13 December 1991, 1020 casualties were admitted to the Surgical Clinic at the Teaching Faculty of the University in Zagreb, Croatia. A total of 120 injured blood vessels in 76 patients were treated in the department of vascular surgery. Casualties were transported to the hospital after treatment by forward surgical facilities. The transportation time ranged from 3 to 18 (mean 7) h. The most common injuries were to the popliteal artery (12.5%) and brachial veins (10.0%). After segmental resection, arterial and venous revascularization with saphenous vein graft interposition was the preferred option. Twenty-six fasciotomies were performed because of compartment syndrome. Indications for six amputations included sepsis, deep vein thrombosis and extensive myonecrosis. Concomitant bone fractures were stabilized by an external fixator in 90.4% of cases. Vascular injuries were repaired before orthopaedic stabilization. Completion arteriography was used to delineate concomitant distal lesions.

Adolescent↗
PubMed1978

[Surgical reconstructive treatment of blood vessels in the popliteal region].

Severe occlusive disease frequently includes the popliteal artery and origin of the trifurcation vessels with reconstruction of one or more of the crural arteries. We made femorocrural bypass 23 times. Our indications for operation continue to be relief of pain or salvage of extremity. Of the 23 grafts during of one year period block recurred in 8 patients. Five times we made amputation and good results we had in 15 patients. In one patient we used Gore-tex prosthesis with succses in 4 month period.

Adult↗