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- Bowald, S, et al.
(author)
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Pulmonary microembolism during and after aortic cross-clamping in heparinized and non-heparinized pigs.
- 1980
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In: Acta chirurgica Scandinavica. - 0001-5482. ; 146:5, s. 351-6
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Journal article (peer-reviewed)abstract
- The occurrence of pulmonary microembolism after aortic clamping and declamping was investigated in 21 young pigs. The prophylactive effect of heparin was also examined. Eight animals were heparinized, while 13 did not receive heparin. In 15 pigs the plasma concentration of fibrinogen was determined before, during and after clamping of the aorta. External detection of 51Cr-labelled platelets and 125I-labelled fibrinogen was performed. Lung tissue from these animals was homogenized and analysed for radioactivity. Specimens were taken from the lungs of all animals for morphological investigation. A significant decrease in plasma fibrinogen concentration was noted during the aortic clamping in non-heparinized animals. Morphological studies of lung tissue revealed numerous fibrin/platelet thrombi, leukocyte and platelet aggregates, atelectases and bleedings. In homogenized lung tissue, areas with elevated radioactivity were found, indicating fibrin/platelet entrapment. No such changes were seen in pigs pretreated with heparin. It was found that pulmonary microembolism occurs frequently after aortic clamping if heparin is not given at an early stage of the procedure.
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- Karacagil, Sadettin, et al.
(author)
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Comparative analysis of patency, limb salvage and survival in diabetic and non-diabetic patients undergoing infrainguinal bypass surgery
- 1995
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In: Diabetic Medicine. - 0742-3071 .- 1464-5491. ; 12:6, s. 537-541
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Journal article (peer-reviewed)abstract
- In 92 diabetic and 175 non-diabetic patients undergoing 336 femoropopliteal or femorodistal bypass procedures, 1- and 3-year cumulative life-table patency, limb salvage, and survival rates were comparatively analysed. The peroperative mortality rate was significantly higher in diabetic patients (5% compared to 1.4%, p < 0.001). The cumulative graft patency rates were 61% at 12 months and 46% at 36 months in diabetic patients compared to 64 and 52% in non-diabetic patients. Significantly better patency rates were observed in limbs with good runoff compared to limbs with poor runoff in both groups. The limb salvage rates at 3 years were 70% in diabetic patients and 62% in non-diabetic patients. The survival rate at 3 years was significantly lower in diabetic patients, 62% compared to 86% in non-diabetic patients. Diabetic patients with poor runoff demonstrated a significantly lower survival rate after 36 months compared to diabetic patients with good runoff (48% and 74%, respectively). The results of this study demonstrate that the early and intermediate patency and limb salvage rates are similar in diabetic and non-diabetic patients. On the other hand the survival rate in diabetic patients, especially in those with poor distal runoff, is significantly lower than non-diabetic patients.
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- Karacagil, Sadettin, et al.
(author)
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Influence of twist on vein and PTFE graft hemodynamics : an ex vivo experimental study
- 1997
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In: Panminerva Medica (Testo stampato). - 0031-0808 .- 1827-1898. ; 39:2, s. 95-99
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Journal article (peer-reviewed)abstract
- OBJECTIVE: In an ex vivo infusion model, the effect of different factors affecting the critical level of twist in vein and PTFE grafts was analysed. SETTING: University Hospital, Department of Surgery. EXPERIMENTAL DESIGN: Saline perfusion of grafts with various diameter and length under constant high (90 ml/min) and low (50 ml/min) flow rates against various peripheral resistance was performed. MEASURES: The pressure changes in the grafts were measured at increasing increments of twisting. RESULTS: The critical level of twist appears to be dependent on the diameter, length, stretching, status of peripheral resistance, amount of volume flow and the type of graft material, varying between 90 to more than 360 degrees. In vein grafts critical twisting appeared earlier with a decrease in diameter, shortening in length, high peripheral resistance, high flow rate and stretching. PTFE grafts especially with external spiral support were resistant to twist. CONCLUSIONS: These data suggest that the critical level of graft twist is dependent upon multiple factors and moderate or even high grade twist with especially externally supported PTFE grafts regardless of length and long mobilized vein grafts do not lead to hemodynamic changes. On the other hand total cessation of flow occurs at lower degrees of twist in stretched, short vein grafts.
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