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Biomedical subjects

J M Salander

Publications and source records attributed to J M Salander.

29 records · Page 2Linked to original sources
PubMed1983

Percutaneous transluminal balloon angioplasty of the iliac artery for contralateral ischemia.

The cases of three patients with lower extremity ischemia from ipsilateral iliac artery occlusion and contralateral iliac artery stenosis are presented. Planned treatment was percutaneous transluminal angioplasty (PTA) of the contralateral iliac artery, rendering it an adequate donor vessel for subsequent femorofemoral bypass. Because of adequate collateral vessels across the pelvis, cross-femoral bypass was unnecessary following PTA. Current technology allows simultaneous intraoperative PTA and femorofemoral bypass. We do not recommend this on the basis of our experience.

Aged↗
PubMed1983

The Matas/Soubbotitch connection.

The Southern Association for Vascular Surgery, as one of the recently developed major regional vascular societies, has recognized the outstanding accomplishments of one of the vascular pioneers in the United States, Rudolph Matas, by including his profile in the Association logo. Although the contributions in vascular surgery by Matas are well known by all who have an interest in vascular surgery, the contributions of V. Soubbotitch have not been recognized widely in the English-speaking world. Matas proclaimed in an International Surgical Congress in London in 1913 that Soubbotitch had achieved clinical success that was unparalleled by repairing injured arteries and veins. Soubbotitch, Senior Surgeon, Belgrade State Hospital, Serbia (now part of Yugoslavia) and a Lieutenant Colonel in the Serbian Army Reserve during the Balkan Wars (Serbo-Turkish and Serbo-Bulgarian) initiated one of the first clinical programs that emphasized repair, rather than ligation, of injured arteries and veins. Surgeons from the capitals in Europe visited his clinic to assist in this effort, and the 1913 presentation in London included the experience of managing 77 injured large blood vessels, which resulted in 32 vascular repairs--19 arteriorrhaphies and 13 venorrhaphies. It is ironic that nearly 40 years passed before similar successful efforts were achieved during the latter part of the Korean Conflict (1952 to 1953). In this brief review we emphasize the connection between two outstanding surgical pioneers who shared mutual interest in the repair of injured vessels and in international surgical exchanges, Matas and Soubbotitch.

History, 19th Century↗
PubMed1983

Etiologic factors for recurrent carotid artery stenosis.

Since 1966, 29 patients with recurrent carotid artery stenosis have been encountered. The mean (+/- SEM) internal between initial carotid endarterectomy and secondary presentation was 67.5 +/- 9.2 months (range 6 to 180 months). There was a disproportionate number of women with recurrent stenosis. The mean age at initial endarterectomy in patients with recurrent stenosis, 54.6 +/- 1.4 years, was significantly less (P less than 0.001) than that of all patients who had endarterectomy. To define the etiologic factors for recurrence, 21 of these patients were matched with case-control patients of the same age and sex who had undergone endarterectomy the same year but did not develop recognized recurrent stenosis. There was no significant difference in the incidence of hypertension, diabetes mellitus, coronary artery disease, bilateral carotid disease, other vascular operations, or family history for atherosclerosis in patients with recurrent stenosis compared to control patients. The indications for primary endarterectomy, angiographic distribution of disease, and operative details were similar in both groups. There was no difference in the incidence of regular, therapeutic aspirin ingestion following initial endarterectomy (52.5% in both groups). There was a striking difference in smoking habits. Ninety-five percent of patients with recurrent stenosis continued to smoke following initial endarterectomy, compared to 23.8% of control patients (P less than 0.001). Lipid fractionation studies were performed in both groups, and there were no significant differences in levels of cholesterol, triglycerides, high-density lipoprotein (HDL)-cholesterol, and total cholesterol/HDL-cholesterol ratio. Dose-response platelet aggregometry detected no differences between groups in the sensitivity of platelets to adenosine diphosphate (ADP), collagen, and epinephrine. Reoperation in patients with recurrent stenosis was associated with minimal morbidity, no deaths, and generally excellent results.

Anesthesia↗
PubMed1981

Heparin. Efficacy and safety after arterial operations.

Hemorrhage is the most serious side effect of heparin sodium use. Under several circumstances, one may need to administer heparin to patients who have had recent peripheral vascular operations. Avoiding an inordinate number of hemorrhagic complications is mandatory after such operations. Side effects appear to be minimized by administering heparin by continuous intravenous (IV) infusion. Nineteen patients with recent peripheral vascular operations were given heparin by continuous IV infusion. A known hemorrhagic complication developed in only one. The degree of hemorrhage was mild and did not necessitate cessation of treatment with heparin. None of the patients whose mean activated partial thromboplastin times were in the therapeutic range experienced thrombotic complications while receiving heparin.

Adult↗
PubMed1981

Perioperative heparin prophylaxis of deep venous thrombosis in patients with peripheral vascular disease.

Perioperative low dose heparin was administered to 24 patients who were compared with 19 control patients undergoing peripheral vascular surgical procedures. This prophylactic measure was ineffective in reducing the incidence of subclinical, postoperative deep venous thrombosis, as indicated by iodine-125 fibrinogen scanning. The data suggest that patients undergoing vascular surgery will not benefit from the routine application of this prophylactic regimen.

Fibrinogen↗
PubMed1981

Fibromuscular dysplasia of the internal carotid arteries. Clinical experience and follow-up.

Fibromuscular dysplasia of the internal carotid arteries is a rare condition that may cause transient ischemic attacks, stroke and death. The preferred method of treatment of symptomatic lesions is graduated dilatation. Over a six year period, we have dilated 18 lesions. During a follow-up period ranging from 13 to 70 months (mean: 48.3 months), none of the patients operated on has developed a stroke or "hard" ocular/neurologic symptoms in the territory of the artery/arteries operated upon. Additionally, no patient has developed a stroke related to the contralateral asymptomatic, and consequently unoperated, carotid artery. Five patients with global symptoms have not had either carotid artery dilated and none has developed transient ischemic attacks or stroke during a follow-up period ranging from 22 to 100 months (mean: 42 months). These data demonstrate that a rational plan of management is dilatation of lesions associated with hard ocular/neurologic symptoms and nonoperative management of asymptomatic patients and patients with global symptoms.

Adult↗
PubMed1981

Clinical results of lumbar sympathectomy.

Lumbar sympathectomy appears to be effect in relieving rest pain, particularly when the ankle: brachial systolic pressure ratio (ABR) is relatively high, i.e., greater than 0.35. The ABR seems to have less predictive value when advanced skin changes are present, and in such cases the extent of ischemic necrosis is probably the major determinant of outcome. A low, or even unrecordable ABR, does not remove all hope of a successful outcome. However, it makes success less likely and can be used as a guide in determining the risk: benefit ratio for individual patients.

Adult↗
PubMed1976

Perforated jejunal diverticulitis.

The 25th case of perforated jejunal diverticulitis is reported and all previous cases are reviewed. The mortality in this group of patients is 32%. Resection of the perforated segment with end-to-end anastomosis seems to offer the best chance of cure.

Abdomen, Acute↗