ISSN:0007-1323    

DOI:10.1002/bjs.1800691302

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800691303

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractThe effects of plasma lipid reduction on the progression of femoral atherosclerosis have been studied in 24 hyperlipidaemic patients with stable intermittent claudication. The patients were randomized into treatment or ‘usual‐care’ groups, the former receiving lipid‐lowering therapy by diet and drugs, and the latter no such treatment. Biplanar femoral arteriography was performed before and after a mean period of 19 months. In the treatment group plasma total cholesterol was decreased by a mean of 25 per cent and plasma triglyceride by more than 40 per cent. Plasma lipids were unchanged in the usual‐care group. Significantly fewer arterial segments showed detectable progression in the treatment group (P<0·01). In addition, the mean increment in plaque area (mm2per segment per year) in the treatment group was only 34 per cent of that in the usual‐care grou

ISSN:0007-1323    

DOI:10.1002/bjs.1800691304

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractThis study assessed the effect of femoro‐femoral bypass on penile perfusion and impotence. Twelve patients with femoro‐femoral grafts had Doppler pressure measurements and penile/brachial indices (PBI) recorded at both dorsal penile arteries, first with the graft open and then with the inflow portion of the graft temporarily occluded by manual external compression.Doppler pressure measurements and PBI did not change significantly in the dorsal penile artery on the donor (inflow) side of the graft when the graft was temporarily occluded. Patients who were potent both pre‐ and postoperatively (n ‐ 5) had no significant change in pressure or PBI on the recipient (outflow) side of the graft with graft occlusion. In those patients who experienced reversal of impotence following bypass (n = 4) the mean dorsal penile artery pressure on the recipient side decreased from 101 mmHg with the graft open to 30 mmHg with the graft occluded (P<0·05).Review of arteriograms revealed that patients most likely to experience increases in penile perfusion have either (a) recipient side common iliac artery occlusion and a patent internal iliac system which is perfused in a retrograde fashion or (b) recipient side proximal internal iliac occlusion with well‐developed collateral circulation between the profunda femoris and the distal internal iliac arterial systems.Femoro‐femoral bypass can increase penile perfusion and alleviate vasculogenic impotence in selec

ISSN:0007-1323    

DOI:10.1002/bjs.1800691305

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractProstaglandin E1has a strong vasodilator effect, it inhibits the aggregation of platelets and improves the microcirculation. The hormone is synthesized from arachidonic acid and 80–90 per cent is eliminated in the first transit of the pulmonary circulation. From 1 January 1978 to 30 June 1981 100 patients suffering from inoperable occlusion of the arteries of the lower limbs and facing amputation were treated with intra‐arterial PGE1by prolonged perfusion over an average period of 34 days. PGE10·1–0·2ng kg−1body weight min−1was administered. Forty‐even of 100 legs were saved; 22 of 29 patients suffering from diabetes requiring insulin had to undergo amputation, but only 1 of 18 patients suffering from thromboangiitis obliterans had to have an amputation. The results of treatment in the 52 cases of uncomplicated arteriosclerosis lie in between, with 18 amputations. The complications that followed treatment were haemorrhage, arterial thrombosis, infection and myco

ISSN:0007-1323    

DOI:10.1002/bjs.1800691306

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractThis review considers diagnosis and treatment of vasculogenic impotence. It describes current information related to normal mechanisms of penile erection and pathophysiology of organic impotence, methods of preoperative diagnosis, quantitative evaluation of penile blood flow and operative techniques to be employed in aneurysmal or occlusive aorto‐iliac disease. The importance of preserving internal iliac flow and neural fibres enervating the genitalia is stressed. Large vessel reconstructions have proved practical in maintaining or restoring normal erectile function, but at present reconstructions of isolated pudendal or penile artery occlusions are experimental. Medical therapy can be effective in certain marginal cases of small vessel occlusio

ISSN:0007-1323    

DOI:10.1002/bjs.1800691307

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractThe prevalence of symptomatic arterial disease of the lower limbs is 2 per cent of the population aged 45–60, but it has a relatively benign course, with 70 per cent of patients requiring no therapy. Of the numerous drugs used in the treatment of the disease, there is no evidence to suggest that antilipaemic drugs, anticoagulants, vasodilators or rheological agents confer any benefit to the patient. The initial use of antiplatelet drugs and prostaglandins has been disappointing despite the undoubted importance of the platelet/endothelial interaction in the aetiology of atherosclerosis. As it is unlikely that we can reverse advanced disease, this is hardly surprising. Long term use of these drugs may prevent deterioration in those patients with progressive disease, and controlled trials on this aspect of treatment are now required. Symptomatic relief in the claudicant may perhaps be obtained with naftidrofuryl and suloctodil and with the former in more severe ischaemia, but their use should not replace the beneficial effects of exercise and cessation of smokin

ISSN:0007-1323    

DOI:10.1002/bjs.1800691308

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractOne hundred and twenty‐four limbs in patients suffering from intermittent claudication were studied over 10 months. Changes in ankle pressure and treadmill exercise tolerance over the period were compared between two groups, one of patients who continued to smoke (group 1) and the other of those who gave up (group 2).Resting ankle systolic pressure fell in smokers' limbs by a mean of 10·2 mmHg (t = 3·56, P<0·001), and rose in those patients who stopped smoking by a mean 8·7 mmHg (P ‐ n.s.). Ankle pressures after exercise and maximum treadmill walking distance did not change in smokers but significantly improved in past smokers.Stopping cigarette smoking increased the chance of improvement in ankle pressure and exercise tolerance in intermittent claud

ISSN:0007-1323    

DOI:10.1002/bjs.1800691309

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractThe effect of local controlled cooling on the digital systolic blood pressure in the hand was studied in 25 healthy volunteers and 25 patients with Raynaud's syndrome.Arterial systolic pressure was indirectly measured using a digital cuff over the proximal phalanx and a photoplethysmographic probe over the digital pulp to detect pulsation. Pressures were measured after occlusion of the circulation (cuff at 180 mmHg) for 5 minutes with water circulating initially at 30°C and then at 10°C. An airfilled cuff was used simultaneously on a control finger. The digital systolic pressure at 10°C in the patients was significantly lower (P<0·001 Mann–Whitney U test) than in the normal volunteers whilst calculation of the percentage change in pressure induced by cooling the digit to 10°C allowed complete separation between both groups. The range in the controls was +2 per cent to −26 per cent and in the patients, −33 per cent to −100 per cent. The test gives reproducible results (coefficient of variation 5–11 per cent) and offers an objective method of identifying patients with excessive vasospasm due to a cold stimulus. It may prove useful in studying natural history and the effect o

ISSN:0007-1323    

DOI:10.1002/bjs.1800691310

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractDuring an 11‐year period, 80 transaxillary sympathectomies were performed on 51 patients (hyperhidrosis 24, Raynaud's syndrome 18, Buerger's disease 4, others 5).Bilateral procedures under one anaesthetic were performed in contrast with previous reports which advocated unilateral operations only. The advantages of the transaxillary route over other operative approaches are discusse

ISSN:0007-1323    

DOI:10.1002/bjs.1800691311

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY