PubMed Health⌕ Search

Biomedical subjects

J R Allenberg

Publications and source records attributed to J R Allenberg.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Femoro-crural bypass--orthotopic].

From 1980 to 1988 248 femoro-distal bypass procedures were performed in anatomical position for limb salvage due to peripheral artery disease. Bypass material strongly influenced bypass patency rate. The analysis showed a highly significant difference between venous and prosthetic grafts over a period of 3 years (p less than 0.0001). Use of the composite jump craft technique increased patency rates after 3 years to 58%, which is close to that of vein bypasses (63%). Use of prosthetic bypass material alone achieved a patency rate of only 38%. It is concluded that technically more difficult procedures such as the composite jump graft technique are superior to prosthetic bypasses.

Arterial Occlusive Diseases↗
PubMed1989

[The radiologic diagnosis of inflammatory aneurysms].

An inflammatory aneurysm is defined as a nonbacterial special type of atherosclerotic aneurysm. The macroscopic characteristics are: a porcelaneous appearance, excessive thickening of the aortic wall, and perianeurysmal adhesions. Chronic inflammatory infiltrations, which are localized in the adventitia, can be found via microscopy. Six of forty-three patients with abdominal aortic aneurysms were found to have an inflammatory aneurysm at operation. In a retrospective study, we examined the sonographic, computed tomographic and angiographic appearance of inflammatory aneurysms. Only with computed tomography can thickening of the aneurysmal wall be demonstrated; angiography does not have this capacity and can only find an inflammatory aneurysm in particular cases.

Angiography, Digital Subtraction↗
PubMed1987

[Surgical therapy of radiation-induced arterial vascular damage].

Late complications following adjuvant or curative radiotherapy become clinically more evident with increasing duration of the observation period. Atherosclerotic disease secondary to radiation therapy is a rare complication. This is a report on 10 such cases requiring reconstructive vascular surgery between 1980 and January 1986. Previous radiotherapy was performed for malignancies in 9 patients and for thyroiditis in one patient. The time interval between radiation and onset of symptoms due to radiation induced atherosclerotic disease was on average 19.5 years (5-37 years). In order to reduce wound and graft infection to a minimum the extra-anatomical position of the graft was preferred. There was no major morbidity nor mortality postoperatively. During the mean follow-up of 22 months (1-63 months) one late graft occlusion was observed. Our results show that vascular reconstruction of radiation induced atherosclerotic disease is possible. Reconstructive surgery is clearly indicated for patients who underwent previous curative therapy for malignant disease.

Aged↗
PubMed1985

[Acute renal failure caused by renal artery occlusion. A surgical disease picture].

Out of 66 reconstructive operations of the renal arteries from 1980 to July 1984, 5 operations have been performed after a total occlusion of the renal artery. 3 patients were admitted with acute renal failure, all of them had a solitary kidney. The diagnosis could only be established by renographic examination, therefore a renal arteriography should be one of the first diagnostic procedures. Preexisting collateral vessels maintained a minimal blood flow of the kidney, the interval between the onset of the first symptoms and the operative revascularisation was between 24 hours and 5 days. Even if the ischemic tolerance time of the kidney exceeds 30-60 minutes, it does not necessarily lead to total organ damage because of those preexisting collateral vessels. On all 3 patients the renovasculary reconstruction was successful.

Acute Kidney Injury↗
PubMed1985

[Significance of hemodynamic sequelae of aortic ligation in infrarenal aneurysms of the abdominal aorta].

The operative mortality in abdominal aortic aneurysm repair is in large part attributable to a high incidence of myocardial infarction. This is a result of cardiovascular instability during aortic cross-clamping and declamping in patients with coexistent coronary artery disease. Therefore cardiodynamics (pulmonary arterial wedge pressure, PAWP; cardiac index, CJ) were studied in 31 patients during abdominal aortic aneurysm surgery. 12 patients (control) with a PAWP mean of 8 mmHg preoperatively showed impaired cardiac function after declamping and a significant fall in arterial pressure. 19 patients were volume loaded to a PAWP greater than 12 mmHg and the cyclo-oxygenase inhibitor Aspirin was given preoperatively. This resulted in improved cardiac performance with no fall in arterial pressure after declamping. Optimal volume loading and cyclo-oxygenase inhibition have the ability to prevent adverse hemodynamic responses to aortic clamping and declamping. Maintenance of optimal cardiac performance will reduce cardiovascular complications and postoperative mortality in abdominal aortic aneurysm repair.

Aged↗
PubMed1984

[Indications for surgery of carotid artery stenosis with contralateral carotid occlusion].

In a retrospective study the course of 69 patients of the Surgery Department of the University of Heidelberg (66 men, 3 women, mean age 60 years) with carotid artery stenosis with contralateral carotid occlusion has been reported. 10% of the patients with carotid artery stenosis had a contralateral occlusion. Corresponding to the side of occlusion most patients had a preoperative neurological stage IV (55%, 19% stage II, 26% stage I) and corresponding to the side of stenosis most patients had a stage I (57%, 28% stage II, 4% stage III, 12% stage IV). In addition to the stenosis the occlusion had been operated on in 7 patients, in 5 of them the revascularisation was not possible. In 88% the arteriotomy could be closed using a venous patch and in 97% a intraluminal shunt was used. All operations were done under general anesthesia. The early lethality rate was 10%, in one patient a postoperative neurological deficit occurred. The late mortality rate was 21%, in 5% a new neurological deficit could be found (n = 57, mean follow-up: 3.0 years). In relation to the preoperative neurological stage corresponding to the side of stenosis the highest mortality rate was found in patients with stage IV. In a separate analysis of two periods (1962-1978 and 1979-1981) it can be demonstrated that the high early mortality rate is nearly entirely found in the first period with a low operative frequency. In the second period 1979-1981, 33 carotid endarterectomies in patients with contralateral occlusion were operated with a mortality rate of 3%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1977

[Experimental coronary bypass operation: distribution of myocardial blood flow early and after one year].

In 10 dogs a stenosis greater than 75% of the left circumflex coronary artery is induced (Ameroid) in the course of 40 days. Within 1 hour after coronary artery bypass operation (n = 6) maldistribution of myocardial blood flow (MBF), consisting of a subendocardial perfusion deficit, is improved but not completely abolished. One year after coronary bypass operation (n = 4) MBF and its endo/epi-distribution is normal. Bypass flow and its flow profile are useful indicators of MBF and its intramyocardial distribution only when coronary dilation is induced.

Animals↗
PubMed1977

[Myocardial blood flow distribution immediately following experimental aortocoronary bypass and 1 year postoperatively].

A 75--90% stenosis of the left circumflex coronary artery (CCA) was induced over a period of 40 days in 11 mongrel dogs. Coronary blood flow and the distribution of myocardial blood flow (MBF, tracer-microspheres) was measured at rest and after maximal coronary dilatation in 8 dogs before and within 1 hour after coronary bypass. In 3 dogs these measurements are performed 1 year after bypass op. During coronary stenosis distribution of myocardial blood flow in the area supplied by the CCA was unhomogeneous, the subendocardium receiving less. Within 1 hour after opening the graft, MBF to the subendocardium was improved but the unequal distribution not completely abolished. One year after bypass op, however, the quantity and distribution of MBF appear to be normal although revascularized myocardium was perfused in part via coronary collaterals.

Animals↗
PubMed1977

[Hormone concentrations in thyroid gland tissue and plasma in autonomous thyroid adenomas with and without thyrostatic pretreatment].

The thyroid hormone concentrations of T2, T3 (and the inactive R-T3) were determined in thyroid tissue of 20 patients with autonomous adenomas. High concentrations were found in scintigrafically decompensated adenomas without preoperative thyrostatic treatment. Decompensated adenomas after thyrostatic treatment, compersated adenomas and a group of 9 euthyroid goiters showed no difference in tissue-concentrations of T4 and T3. The amount of tissue-R-T3 seems to be lowered in autonomy. The plasma-concentration of T3, which was intraoperatively elevated in the venous effluent from decompensated adenomas without thyrostatic treatment, was significantly lower in the blood draining decompensated adenomas after thyrostatic treatment as well as compensated adenomas.

Adenoma↗
PubMed1976

Experimental coronary artery bypass operation. Myocardial blood flow, ventricular performance and regional myocardial function.

Myocardial blood flow and ventricular function was studied in seven dogs with chronic myocardial ischemia before and after coronary bypass grafting. Restoring blood flow in an area of 25% of the anterior wall of the left ventricle did not significantly improve overall ventricular function. Assessment of intramyocardial pressure as an index of regional myocardial function revealed a consistent enhancement of myocardial contraction at rest, and under pharmacological stress of the heart.

Animals↗
PubMed1975

[Regional myocardial blood flow and left ventricular function in critical coronary stenosis and after coronary artery bypass grafting in the dog (author's transl)].

In 7 mongrel dogs myocardial ischemia is produced by means of an ameroid constrictor placed on the left circumflex coronary artery (CCA). Myocardial blood flow (MBF) is diminished by 56% in an area of 25% of the anterior wall of the left ventricle. A decrease in dp/dtmax suggests a small depression of left ventricular function. After bypass operation the slight changes in EDP, dp/dtmax and Vmax indicate no significant improvement of total ventricular function. MBF increases from 42 +/- 10 ml/100 g/min to 67 +/- 21 ml/100 g/min (p smaller than 0.02) in the area supplied by the bypass. In this region intramyocardial pressure rises significantly suggesting improvement of regional myocardial function.

Animals↗
PubMed1975

[Effect of coronary bypass surgery on myocardial pressure and ventricular function in the dog].

In 7 dogs a severe stenosis of the left circumflex coronary artery (CCA) is produced in the course of 18 days. The influence of myocardial revascularization on left ventricular function and on intramyocardial pressures in the areas supplied by the CCA and by the left anterior descending coronary artery is studied. Neither under control conditions nor during acute left ventricular pressure load does opening a bypass graft between the carotid artery and CCA induce a significant change in total ventricular function (dp/dtmax, Vmax, left ventricular enddiastolic pressure). However, immediately after opening the graft intramyocardial pressure rises in the CCA area indicating a regional improvement of myocardial function.

Animals↗