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  • 1
    Electronic Resource
    Electronic Resource
    Usefulness of antiplatelet drugs in the management of heparin-associated thrombocytopenia and thrombosis (1991)
    Springer
    Annals of vascular surgery 5 (1991), S. 552-555 
    Details
    ISSN: 1615-5947
    Keywords: Heparin ; heparin-associated thrombocytopenia ; thrombocytopenia ; thrombosis ; antiplatelet drugs ; iloprost
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Heparin-associated thrombocytopenia and thrombosis is a severe complication of systemic heparin therapy. Its treatment is mainly based upon discontinuation of heparin therapy. However in some patients requiring emergency cardiac or vascular surgery, reexposure to heparin may be unavoidable. We report the management of two such patients by use of antiplatelet drugs for a vascular procedure. In the two cases, a combination of Iloprost, a stable prostacyclin analogue (1 to 2 ng/kg/mn) with aspirin and dipyridamole was shown to inhibit ex vivo the heparin-induced platelet aggregation. These antiplatelet agents were continued during the perioperative period. A successful vascular procedure was achieved with full heparinization without subsequent thrombocytopenia or thrombotic or hemorrhagic complications. This experience supports the hypothesis that heparin can be readministered early to patients with heparin-associated thrombocytopenia and thrombosis, provided antiplatelet therapy is given.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02015283
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Angioscopy-assisted valvuloplasty for primary deep venous valvular insufficiency (1996)
    Springer
    Annals of vascular surgery 10 (1996), S. 233-238 
    Details
    ISSN: 1615-5947
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Primary deep venous valvular insufficiency causes reflux syndrome. Angioscopy permits the surgeon not only to ascertain that venous valves have not been destroyed but to perform external valvuloplasty under visual control with the valves under pressure. We have performed angioscopy-assisted venous valvuloplasty in three men (mean age 36 years; range 30 to 38 years) and one woman (age 58 years). All four patients had class 3 disease (SVS/ISCVS classification). Descending phlebograms showed grade 3 reflux in one patient and grade 4 reflux in three patients. In all patients angioscopy-assisted valvuloplasty of the superficial femoral vein was combined with wrapping with a segment of polytetrafluoroethylene prosthesis, stripping of incompetent superficial veins, and subfascial ligation of perforating veins. Mean follow-up was 12 months (range 6 to 17 months). In three patients ulcers healed and did not recur; in the remaining patient nearly complete healing was obtained after skin grafting. In all patients ambulatory venous blood pressure improved significantly and venous filling time returned to normal (〉 15 seconds). At duplex ultrasonography and descending phlebography, no residual reflux was demonstrated. At final follow-up, all repaired valves were patent and competent. Our experience demonstrates that angioscopy-assisted venous valvuloplasty combines the accuracy of valvuloplasty by means of phlebotomy and the simplicity of external valvuloplasty and thus is preferred to either of these methods.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02001888
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Infection-Related Exposure of the Lower Anastomosis of Femorodistal Bypass: Salvage through Use of Pedicle Muscle Flaps (2000)
    Springer
    Annals of vascular surgery 14 (2000), S. 620-625 
    Details
    ISSN: 1615-5947
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Staphylococcus aureus in three cases, Pseudomonas aeruginosa in one case, and both in one case. Two patients were diabetics and one was undergoing corticosteroid treatment. The anastomosis was covered with a pedicle muscle flap fashioned from the extensor digitorum in four cases and the lateral head of the gastrocnemius in one case. Our results showed that anastomoses on the anterior tibial artery and dorsalis pedis artery are at higher risk for infection-related exposure but this complication can be treated using pedicle muscle flaps. This alternative should be considered before bypass removal or amputation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100169910112
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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