Treatment Of Ischemic Disease Research Articles

Angiography of the Femoral Bifurcation

Evaluation of the origin of the deep femoral artery is important in planning treatment of ischemic disease of the lower extremity. While arteriography in the ipsilateral anterior oblique projection will adequately demonstrate the femoral bifurcation in 91% of cases, the posterior oblique projection will be necessary in 9%. Selection of the most useful oblique projection can be done by studying the AP arteriogram.

An objective assessment of common femoral endarterectomy and profundaplasty in patients with superficial femoral occlusion.

Common femoral endarterectomy with profundaplasty has become accepted as a useful operation in the treatment of ischemic arterial disease which is the result of superficial femoral occlusion. However, objective assessment of its long-term postoperative hemodynamic effects has not been reported. This study determines the effect of this operation on the resting pressure index, the walking distance on the treadmill, the fall in postexercise ankle pressure, and the recovery time. Measurements were made just before operation and 1 month later in 20 patients with severe claudication and superficial femoral occlusion. Sixteen patients were available for follow-up at 1 year. These patients were matched according to the resting pressure index to another group of 20 patients with superficial femoral occlusion followed up conservatively. The results indicate that common femoral endarterectomy with profundaplasty improves the distal perfusion pressure and, by inference, flow, which provides strong objective confirmation of the clinical impression that this operation is of value and help in determining its place in the management of severe lower limb ischemia.

HYPERBARIC OXYGEN IN CARDIOVASCULAR DISEASE. POTENTIAL USAGES AND HAZARDS.

In summary, hyperbaric oxygenation produces remarkable physiologic increases in oxygen transport to body tissues. However, potential benefit from hyperoxygenation in the treatment of ischemic disease appears dependent upon the presence of a partially intact capillary circulation. Improved means for prevention of oxygen toxicity and better technics of oxygen delivery to specific sites are required, if hyperbaric oxygenation is to fulfill present hopes for therapeutic application.