Library

X
feed icon rss

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Electronic Resource
    Electronic Resource
    Is venous duplex imaging an appropriate initial screening test for patients with suspected pulmonary embolism? (1996)
    Springer
    Annals of vascular surgery 10 (1996), S. 220-223 
    Details
    ISSN: 1615-5947
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Noninvasive tests for deep venous thrombosis (DVT) are helpful in evaluating patients with suspected pulmonary embolism (PE) who have non-high-probability ventilation/perfusion (V/Q) lung scans. Based on the enthusiasm for these noninvasive tests, venous duplex imaging (VDI) has evolved as the initial screening test for patients with clinically suspected PE in some centers. This study evaluates the utility of VDI as the initial test in a diagnostic algorithm for patients with suspected PE. A total of 306 consecutive patients who underwent VDI as the initial screening test for clinically suspected PE during the past 24 months were reviewed; 121 patients were subsequently evaluated with V/Q scans and 20 underwent pulmonary arteriography. VDI demonstrated DVT in 10% (23/216), with 7% (22/306) having proximal DVT and 3% (9/306) having isolated calf DVT. In 25 patients with unilateral leg symptoms, DVT was found in 40% (10/25); however, among the 281 without unilateral leg symptoms, results of VDI were abnormal in only 5% (15/281). V/Q scans were obtained in 40% (121/306), with only 16% (19/121) of scans showing a high probability of PE. DVT was found in 25% (5/19) of patients with high-probability V/Q scans and in 25% (26/102) with non-high-probability scans. In patients with clinically suspected PE the incidence of detectable infrainguinal DVT is low. VDI appears to be a reasonable initial screening test in patients with clinically suspected PE and unilateral leg symptoms. However, in patients without unilateral leg symptoms, the diagnostic yield is low and an alternative diagnostic approach appears justified.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02001885
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    The Contributions of Arterial and Venous Volumes to Increased Cutaneous Blood Flow during Leg Compression (1998)
    Springer
    Annals of vascular surgery 12 (1998), S. 182-186 
    Details
    ISSN: 1615-5947
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100169900138
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    The hemodynamics of venous ulceration (1992)
    Springer
    Annals of vascular surgery 6 (1992), S. 1-4 
    Details
    ISSN: 1615-5947
    Keywords: Venous insufficiency ; venous ulceration ; air-plethysmography ; hemodynamics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Venous ulceration is the result of progressive chronic venous insufficiency, the pathophysiology of which is complex and incompletely understood. Ambulatory venous hypertension in this disease has been well-documented; however, relatively little attention has been directed toward other parameters of venous function. This study evaluates a spectrum of hemodynamic variables and the degree to which they are altered in patients with venous ulceration, and correlates ambulatory venous pressure (AVP) with the noninvasive estimate of this parameter. Air-plethysmography was used to evaluate 36 ulcerated extremities from 30 patients with chronic venous disease and 80 asymptomatic extremities from 54 patients. This technique measures the functional venous volume (VV), assesses valvular function [Venous Filling Index (VFI)], evaluates the efficiency of the calf muscle-pump [Ejection Fraction (EF)], and provides an estimation of ambulatory venous pressure [Residual Volume Fraction (RVF)]. In addition, AVP's were recorded in 13 asymptomatic extremities from 10 patients and 16 ulcerated extremities from 14 patients with chronic venous disease. Significant differences existed between the two groups for all of the hemodynamic parameters. Ulcerated extremities had greater venous volumes, displayed marked deterioration in valvular competence and calf musclepump function, and showed significant ambulatory venous hypertension compared to the asymptomatic group. Additionally, the relationship between RVF and AVP appeared linear, with a correlation coefficient of 0.87. Air-plethysmography currently provides the most complete evaluation of venous hemodynamics and should improve our understanding of the pathophysiology of chronic-venous disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02000658
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Microcirculatory Compensation to Progressive Atherosclerotic Disease (1997)
    Springer
    Annals of vascular surgery 11 (1997), S. 49 -53 
    Details
    ISSN: 1615-5947
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: venoarterial reflex (VAR) restricts arterial inflow, and avoids an excessive rise in capillary pressure. This study tests the hypothesis that there is microcirculatory compensation to atherosclerotic disease of increasing severity. Foot skin perfusion (FSP) was measured in 100 limbs with a laser Doppler placed on the plantar aspect of the great toe. Limbs were categorized as normal (n= 31) with an ankle brackial index (ABI) ≥ 0.96, claudicants (n= 42) ABI 0.5–0.86, and critical ischemia (n= 27) with an ABI 〈*leq〉 0.49 or a pulse volume recording consistent with severe peripheral vascular disease and symptoms of rest pain or tissue loss. Segmental Doppler pressures and pulse volume recordings were performed prior to laser Doppler measurements. Subjects with clinical signs or symptoms of chronic venous insufficiency were excluded. The resting foot skin perfusion was measured in the horizontal and dependent position, with the patient supine and sitting. Comparisons within categories were done using Wilcoxon matched pairs signed rank test and between groups with Mann–Whitney U test for unpaired data. Differences were considered significant if they exceeded the 95% confidence level (p value 〈*leq〉0.05). Resting supine skin perfusion was similar between nondiabetic normals and claudicants and diabetic normals and claudicants. There was a significant decrease in the foot skin perfusion (mean FSP ± SEM) in the normal limb with a change from the supine (7.8 ± 2.2 ml/min/100 g) to the dependent (2.8 ± 0.6 ml/min/100 g) position indicating an intact VAR. This was absent in 33% of the limbs with claudication. Limbs with critical ischemia demonstrated an increase in FSP with dependency (supine 4.0 ± 1.0 ml/min/100 g) versus dependent (8.4 ± 1.8 ml/min/100 g) and was present in both diabetic and nondiabetic limbs. Microcirculatory compensation occurs early in atherosclerotic limbs. Although supine FSP is similar in normals and claudicants, a greater percentage of claudicants demonstrate a loss of the VAR. Critically ischemic limbs have increased FSP in the dependent position. These observations indicate that there are microcirculatory alterations in limbs with claudication and assist in explaining why patients with ischemic rest pain obtain relief and develop edema with dependency.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100169900009
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 5
    Electronic Resource
    Electronic Resource
    Duplex Venous Imaging: Role for a Comprehensive Lower Extremity Examination (2000)
    Springer
    Annals of vascular surgery 14 (2000), S. 73-76 
    Details
    ISSN: 1615-5947
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100169910013
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 6
    Electronic Resource
    Electronic Resource
    Free vascularized tissue transfer for limb salvage in peripheral vascular disease (1990)
    Springer
    Annals of vascular surgery 4 (1990), S. 244-254 
    Details
    ISSN: 1615-5947
    Keywords: Free tissue transfer ; peripheral vascular disease ; limb salvage ; ischemia ; diabetes mellitus ; occlusive disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In patients with tissue necrosis, higher limb salvage rates can be accomplished with free tissue transfers performed by a vascular and plastic surgeon team. We treated 10 patients with severe ischemic soft tissue defects in their legs with radical debridement and free tissue transfer alone (two patients) or after revascularization (eight patients). Arteriography was performed to plan revascularization to evaluate bypass results, and to identify appropriate recipient vessels for free tissue transfer. Soft tissue defects treated with free tissue transfer included nonhealing amputation sites in five patients and proximal skin and muscle necrosis in the remaining patients, one of which resulted in an exposed in-situ graft in one leg. One patient underwent a distal bypass specifically to provide arterial inflow for free tissue transfer, whereas seven other patients received free tissue transfers following bypass due to persistently nonhealing wounds. The remaining two patients had diabetes mellitus with necrosis near a major joint with nonhealing amputation sites. Free tissue transfers were taken from the latissimus dorsi in six patients, and from the gracilis, rectus abdominis, rectus femoris, and scapula flaps in other patients. Recipient vessels for free tissue transfers were the external iliac artery (one patient), saphenous vein bypass grafts (two patients), popliteal artery (one patient), posterior tibial (three patients), and dorsalis pedis vessels (three patients). Eight of the 10 flaps were viable at follow-up (four months-six years), with a mean follow-up of 20 months. One patient underwent above-knee amputation 15 months after operation and one underwent below-knee amputation three years later due to central flap necrosis. The remainder achieved functional limb salvage allowing patients to resume ambulation. Vascular surgeons should consider free tissue transfer in patients with nonhealing soft tissue defects following optimal revascularization to further extend our ability to salvage the threatened limb.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02009452
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 7
    Electronic Resource
    Electronic Resource
    The piezoelectric pulse sensor device: A prospective evaluation (1994)
    Springer
    Annals of vascular surgery 8 (1994), S. 367-371 
    Details
    ISSN: 1615-5947
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The goal of this prospective study of the piezoelectric pulse sensor device was to determine its technical applications and its ability to detect lower extremity occlusive arterial disease. Ten extremities (five volunteers) were evaluated to assess the ability to place the sensor in the correct anatomic position on a foot without a palpable pulse during cuff occlusion so that pulsatile flow would be detected following cuff deflation; its sensitivity as an end-point detector for pulsatile perfusion; and whether there is a linear qualitative pulse wave response with increasing perfusion pressures. Forty extremities (20 patients) with suspected occlusive arterial disease were studied to evaluate its capability of detecting perfusion as compared with the presence of a palpable pulse, an audible Doppler signal, and a foot volume waveform. The placement of the sensor on 10 normal limbs with temporary arterial occlusion resulted in a recordable waveform following cuff deflation in 100% of the dorsalis pedis arteries and in 10% of the posterior tibial arteries. The piezoelectric pulse sensor was as sensitive for detecting pulsatile perfusion as an audible Doppler signal and demonstrated a linear change in the waveform's amplitude and shape with incremental changes in perfusion pressure. In the 40-extremities with ankle/brachial indices ranging from 0.00 to 1.35, there was uniform agreement between pulse volume and Pulse Check waveforms. The piezoelectric pulse sensor is a sensitive method for monitoring lower extremity arterial perfusion when supplied by the dorsalis pedis artery; however, it is inadequate for the posterior tibial artery. This may be useful in monitoring revascularization procedures in the immediate postoperative period or monitoring the hemodynamic effectiveness of thrombolytic therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02132999
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 8
    Electronic Resource
    Electronic Resource
    Delayed rupture of an internal iliac artery aneurysm following proximal ligation for abdominal aortic aneurysm repair (1992)
    Springer
    Annals of vascular surgery 6 (1992), S. 537-540 
    Details
    ISSN: 1615-5947
    Keywords: Aneurysm ; iliac artery aneurysm ; abdominal aortic aneurysm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This is a report of a patient presenting with a contained rupture of an internal iliac aneurysm following proximal ligation after abdominal aortic aneurysm repair three years earlier. The patient presented with a large pelvic mass with symptoms of urgency, frequency, dysuria, tenesmus and fevers associated with anemia. Following evacuation of the aneurysm and direct suture ligation of the distal branches of the internal iliac artery, the patient's aortic graft was covered with omentum which also filled the pelvic cavity. The importance of proximal and distal control of aneurysms and/or the importance of complete luminal control of internal iliac artery aneurysms is emphasized by this case.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02000827
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 9
    Electronic Resource
    Electronic Resource
    The architecture of adventitial elastin in the canine infrarenal aorta (1991)
    New York, NY [u.a.] : Wiley-Blackwell
    The @Anatomical Record 230 (1991), S. 86-96 
    Details
    ISSN: 0003-276X
    Keywords: Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine
    Notes: Although the artery wall consists of three distinct layers, only the structures of the intima and media have been well characterized. The adventitia has generally been overlooked. Our examination focused on the organization of elastin and collagen which are the major components of this tunic. Canine infrarenal aortas were excised, stretched to their in vivo length, then pressure fixed in formalin. Transverse, longitudinal, and frontal sections were prepared with specific elastin and collagen stains. Areas of adventitia in these sections were examined with LM, and interconnections between collagen and elastin were photographed at various magnifications. Subsequently, the slides were fractured for attachment to SEM stubs, and the coverslips were demounted. The identical areas were then examined with SEM using the LM micrographs as a guide to identify elastin and collagen. Whole mount aortic ring preparations were digested in formic acid for 72 and 96 h at 45°C to confirm adventitial elastin architecture. The adventitia was organized in alternating lamellae of collagen and elastin. The elastin lamellae consisted of continuous sheets of elastin with a longitudinal fibrillar substructure. Finer circumferential elastin fibers were also identified. These attached to both longitudinal elastin and adjacent collagen lamellae. Collagen lamellae were arranged in broad corrugated bands of fibrils. The unique architecture of the adventitia may explain some of the visco-elastic properties of the aorta in both normal and pathologic states.
    Additional Material: 30 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/ar.1092300109
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...