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Biomedical subjects

P J Strutt

Publications and source records attributed to P J Strutt.

24 records · Page 2Linked to original sources
PubMed1988

Late results after femoral artery embolectomy.

A review of 100 femoral artery embolectomies performed on 88 consecutive patients during a 10-year period was conducted to establish immediate and long-term results. There were 48 (55%) male and 40 (45%) female patients. Ages ranged from 33 to 97 years (mean, 73 years). Local anesthesia was used in 84 (84%) cases. Fifteen (17%) patients died within 30 days of the procedure. Major limb amputation was required within 30 days of operation in 16 (16%) patients. Mortality rate in the group of patients needing early amputation was 50% compared with 11% for those who underwent successful embolectomy procedures (p less than 0.001). Current follow-up was established for all patients. Five-year and 10-year survival rates for the entire group were 40% and 35%, respectively. The most frequent causes of late death after femoral artery embolectomy were arteriosclerotic heart disease (26%), cerebrovascular accident (26%), and advanced carcinoma (21%). All 39 remaining survivors were located 8 to 126 months (mean, 48 months) after discharge to complete a questionnaire designed to assess quality of life and symptoms of vascular insufficiency. Thirty-five (90%) survivors were fully ambulatory and 27 (70%) lived in their own homes. Although early survival is decreased after femoral embolectomy, long-term survivors can be expected to live independently with excellent limb salvage and function.

Adult↗
PubMed1987

Late results of peripheral vascular surgery in patients 80 years of age and older.

During a seven-year period, 114 patients 80 years of age and older underwent 119 peripheral arterial procedures. There were 26 elective aortic reconstructions, nine ruptured abdominal aortic aneurysm (AAA) repairs, 33 femoropopliteal bypasses, 13 femorotibial bypasses, 21 femoral embolectomies, and 17 miscellaneous procedures. Early mortality, morbidity, and Goldman cardiac risk factors were determined by chart review. All 48 survivors returned for current noninvasive vascular examination and life-style assessment. Perioperative mortality after elective AAA resection was 4.3%, vs 78% after ruptured AAA. Perioperative mortality after infrainguinal bypass was nil. Five-year survivals after elective aortic and infrainguinal reconstructions were 54% and 30%, respectively. Of 18 patients studied 19 to 68 months after infrainguinal bypass, limb salvage was achieved in 83% and graft patency in 76%. Thirty-one long-term survivors (65%) were living at home. Only seven patients (15%) were confined to a wheelchair or were bedridden, and 28 (58%) were fully ambulatory. Peripheral arterial reconstruction in patients 80 years of age and older can be performed safely with excellent long-term survival and quality of life.

Aged↗
PubMed1987

Acute gastric dilatation after trauma.

During a 2-year period, 248 consecutive patients were admitted with multiple trauma. Acute gastric dilatation was documented in 67 (27%) patients by review of all admission roentgenograms. There were 51 (76%) males and 16 females. Ages ranged from 2 to 80 years (mean, 29.2 years). The incidence of acute gastric dilatation in children was 44% vs. 25% for adults (p less than 0.05). The mechanism of injury was motor vehicle accident in 45 (67%), agricultural accident in 8 (12%), fall in four (6%), bicycle accident in four (6%), and miscellaneous in six (9%). There were 38 orthopedic, 35 craniocerebral, 34 abdominal, 31 thoracic, 27 maxillofacial, and 14 spinal injuries. Injury Severity Scores ranged from 4 to 66 (mean, 23.5). Thirteen (19%) patients presented in shock and there were four (6%) hospital deaths. No death was attributable to gastric dilatation. Nasogastric tubes were placed in 41 (61%) patients and 26 were managed without tube placement. Complications associated with acute gastric dilatation included pulmonary aspiration in three (4%) patients, gastric hemorrhage in three (4%), gastrointestinal perforation in one (1%), and prolonged ileus in 12 (18%). In addition, gastric dilatation rendered abdominal examination difficult and delayed peritoneal lavage. Acute gastric dilatation after trauma is frequent in our rural trauma center. Early placement of a nasogastric tube in the absence of a clear contraindication is strongly supported in the management of multiply injured patients.

Acute Disease↗
PubMedDate not supplied

Routine invasive hemodynamic monitoring does not increase risk of aortic graft infection.

OBJECTIVE: To determine whether invasive hemodynamic monitoring resulted in an increased rate of aortic graft infection. DESIGN: Retrospective review with establishment of late follow-up. SETTING: Two referral teaching community medical centers. PATIENTS: Three hundred thirty consecutive patients who underwent elective aortoiliac (174), aortofemoral (91), or aortic tube (65) prosthetic graft placements during a 6-year period at the two institutions. All patients had percutaneous pulmonary artery catheter and radial artery cannula placement before surgery. Monitoring catheters were routinely removed within 72 hours. OUTCOME MEASURES: Early and late complications of catheter placement, perioperative morbidity and mortality, and late graft-related complications. RESULTS: Eighteen (5%) patients died in the perioperative period. Less than 2-year follow-up was possible in 67 patients. The remaining 245 patients were observed from 2 to 9 years (mean, 4.4 years). Graft infection was not identified in any patient. CONCLUSION: Routine invasive hemodynamic monitoring was not associated with an increase in the rate of prosthetic aortic graft infection.

Adult↗