PubMed · 8255959
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
D P de Bono. 1993. Chest pain, normal coronaries: whose problem?. https://doi.org/10.1093/qjmed%2F86.10.621
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Explore the source record for details and available documents.
BACKGROUND: Duplex imaging has been shown to be as accurate as arteriography in detecting hemodynamically significant aorto-iliac stenosis or occlusions. METHODS: Review of the duplex scan and arteriogram reports for all primary aorto-iliac reconstructions performed during an 18-month period was undertaken. Deviations from the preoperatively planned procedure were determined. The role of the duplex scan on procedure selection was assessed. RESULTS: Of the 54 patients identified, 13 had both duplex scan and arteriography (group I), 30 had only arteriography (group II), and 11 had only duplex scans (group III). Ten group I, 15 group II, and 9 group III patients had an occluded aorta or iliac artery. Two patients (3 anastomosis) required placement of the distal anastomosis on the common femoral rather than the external iliac artery as planned preoperatively. Both had been arteriogrammed. No group III patient required deviation from the preoperative plan. CONCLUSION: Aorto-iliac reconstruction can be performed without arteriography when a totally occluded aorta or iliac artery is identified by duplex scanning.
A 62-year old patient was admitted with a 24-hour history of ischemia in both legs caused by acute distal aortic occlusion and had had a total loss of sensitivity and motor function for 8 hours. Preoperative serum creatine phosphokinase level was 10,900 IU/ml. During aortofemoral reconstruction, both limbs were reperfused with a potassium-free, blood-cardioplegia-like perfusate. Fasciotomies were not necessary. After operation, maximal serum creatine phosphokinase levels remained below 10,000 IU/ml. Limb sensitivity and motor function were normal. Even for prolonged acute aortoiliac occlusion, a simplified controlled limb-reperfusion may preserve skeletal muscle and nerve function and prevent local and systemic complications caused by reperfusion damage.