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Biomedical subjects

R Takolander

Publications and source records attributed to R Takolander.

At least 73 records · Page 4Linked to original sources
PubMed1985

Ischemic intestinal complications after aortic reconstructive surgery.

The cases of bowel ischemia following aortoiliac reconstructive surgery during a 5-year period were analyzed. The incidence of the complication was 1.5%. Two of the six patients had ischemia of both small and large bowel. The various secondary operations are described. Three of the patients died. A characteristic and consistent finding was profound thrombocytopenia, which was significantly more pronounced than in a control series. The pathogenesis is multifactorial.

Aged↗
PubMed1985

Reconstruction of the external carotid artery.

Reconstruction of a stenotic external carotid artery associated with occlusion of the ipsilateral internal carotid artery is described in four cases. In two of them there was also a significant stump of internal carotid artery following the occlusion, and the stump was oversewn at the reconstructive operation. All four patients improved after the operation. Two still required medication which, however, had been ineffective preoperatively but now was beneficial. Reconstruction of the external carotid artery is indicated in patients with ipsilateral occlusion of the internal carotid artery and symptoms of artery-to-artery embolization.

Aged↗
PubMed1984

Reversible renal insufficiency after percutaneous transluminal angioplasty (PTA) of renal artery stenosis.

Three patients developed reversible renal insufficiency after successfully performed PTA at the same time as their hypertension was beneficially influenced. The main cause of this complication probably is toxic effects of contrast medium in combination with the temporary occlusion of the renal artery during the PTA of kidneys with previously damaged parenchymal and impaired perfusion. During the phase of renal insufficiency contrast medium retention in the renal cortex was noted at computed tomography.

Acute Kidney Injury↗
PubMed1984

Percutaneous transluminal angioplasty of arteriosclerotic lesions in the pelvis and lower extremities.

The experience of percutaneous transluminal angioplasty (PTA) in 66 patients (71 stenoses) with arteriosclerotic lesions in the pelvic and lower extremity arteries is reported. The PTA was technically successful in 70 stenoses. Complications were seen in eleven patients. The follow-up time was 19 months (2-44). The frequency of recurrencies was clearly related to the location of stenosis, the more distal the lesion the higher the recurrency rate. The immediate roentgenologic result had no prognostic value to protect recurrencies. To conclude PTA is an alternative to surgery in patients with short stenoses in the iliac arteries, but very strict indications should be used when lesions are localized below the inguinal ligament.

Adult↗
PubMed1984

Arteriosclerosis in popliteal artery trifurcation as a predictor for myocardial infarction after arterial reconstructive operation.

The frequency of myocardial infarction and mortality within 30 days after lower limb vascular reconstruction, in relation to the extent of atherosclerotic lesions in the trifurcation of the popliteal artery, have been retrospectively analyzed in 158 consecutive patients reconstructed in the aortoiliac region and 239 consecutive patients undergoing femorodistal bypass. Among the patients without trifurcational disease (TFD) none had myocardial infarction develop postoperatively, as compared with four of the 50 patients with TFD in the aortoiliac series (p less than 0.05) and 18 of the 174 patients with TFD in the femorodistal series (p less than 0.05). In nine instances, the cause of death was myocardial infarction. The strong correlation between postoperative myocardial infarction and the presence of TFD, may be due to a direct correlation between coronary artery disease and TFD. The finding is of practical importance in the selection of treatment for patients with circulatory disorders of the lower limbs. The finding facilitates the preoperative identification of patients liable to have myocardial infarction develop. Indications for operation can be made more stringent and optimal intraoperative and postoperative monitoring can be instituted.

Acute Kidney Injury↗
PubMed1984

Extraanatomic vascular reconstruction in patients with aorto-iliac arteriosclerosis.

During an 11-year period 117 extraanatomic reconstructions were made for aorto-iliac arteriosclerosis; 36 axillofemoral and 81 femorofemoral crossover bypasses. The patients were old and had several factors making them poor risks for surgery. Axillofemoral grafts were more often used in patients with malignant disease. Postoperative mortality was 10% without difference between the two types of reconstruction. Both early and late complications were significantly more frequent in patients with axillofemoral bypass. Reoperations for occlusion and symptoms from the donor side also were significantly more common among axillofemoral patients. Life table analysis showed a higher survival and patency rate among patients with crossover grafts.

Aged↗
PubMed1983

Ureteral obstruction as a complication in aorto-iliac reconstructive surgery.

Two cases of ureteral obstruction secondary to aorto-iliac reconstruction with bifurcation aortic grafts are described. Twenty-eight cases have been called from the literature and analysed. There seem to exist two types of aetiology regarding this complication: development of heavy localized fibrosis, and mechanical compression owing to the ureter having been placed behind the graft. Symptoms are often diffuse, but after operative treatment the prognosis seems good. The actual incidence of this complication is not known.

Aged↗
PubMed1983

Renal failure as a complication to aortoiliac and iliac reconstructive surgery.

A retrospective analysis has been undertaken of 17 patients among 221 who developed renal failure after aortic and/or iliac reconstructions because of occlusive disease (incidence 8%). In two renal artery occlusion was causing anuria, in the others tubular necrosis was considered to be responsible. This complication is multifactorial and factors of importance may be: operative trauma, haemorrhagic and other postoperative complications with reoperations, age and preoperative angiography. The patients with postoperative renal failure were older, the preoperative serum creatinine slightly higher, operation time longer and intraoperative haemorrhage greater than in patients without postoperative renal failure. Renal insufficiency after aorto-iliac reconstruction is a symptom with poor prognosis, the mortality being significantly higher (35%) than among the 204 patients without renal failure (2.0%). No simple dominating risk factor has been found in this material.

Adult↗
PubMed1981

Aortic occlusion following blunt trauma of the abdomen.

Blunt injuries to the abdominal aorta with initial survival are rare. Two cases of blunt aortic occlusion are reported: one with acute abdominal symptoms and leg ischemia and one with delayed intermittent claudication. The first patient died 9 days postinjury with possible sepsis and bronchopneumonia. The second presented with delayed symptoms 9 years postinjury: fibrous thickening of the intima, a dense, fibrous band around the aorta and left renal vein. After a Dacron graft from the descending thoracic aorta to the external iliac arteries the patient recovered and is employed full time.

Adult↗
PubMed1981

Renal transplantation in patients with endstage diabetic nephropathy.

Eighty-six renal transplantations were performed in 69 patients with endstage diabetic nephropathy. Cadaveric kidneys were used in 77 of the transplantations. Most of the patients had severe retinopathy. Patients with severe cardiopathy and neuropathy were not accepted for transplantation. After one year 61% of the patients were alive, after three years 43%, all except one with functioning graft. The quality of life of the survivors was acceptable, only two requiring nursing care. It is concluded that renal transplantation in patients with diabetic nephropathy is justified in selected patients.

Adult↗
PubMed1976

Repair of skin and soft tissue loss of the lower leg with cross-leg flaps.

Forty patients with severe leg injuries associated with skin or soft tissue loss were treated. Cross-leg flaps were used. The flaps healed well. Special attention was paid to the pre- and postoperative periods of disability of the patients. The former were very long (37.7 months) compared to the latter (10.5 months) which ceased when the patient became fit for work.

Child↗