Results found: 3

Number of results on page

Search results

Sort By:

Limit search:

The importance of blood flow volume in the brainsupplying arteries for the clinical management – the impact of collateral circulation

100%

Elwertowski M., Leszczyński J., Kaszczewski P., Lamparski K., Sin Yee Ho S., Gałązka Z.

Journal of Ultrasonography

2018

vol. 18

issue 73

112-119

Aim: An assessment of increased compensatory blood flow in the brain-supplying arteries in patients with significant carotid artery stenosis. Materials and methods: Doppler ultrasound was performed in 218 patients over 60 years of age to evaluate both the degree of brain-supplying artery stenosis as well as the blood flow volume balance in all vessels supplying the brain: the internal carotid artery, the external carotid artery and the vertebral artery. The control group included 94 patients with no stenosis in the extracranial segments and no neurological manifestations, in whom blood flow values were calculated (the internal carotid artery – 290 mL/min, the external carotid artery – 125 mL/min, the vertebral artery – 80 mL/min); the total mean blood flow in the brain-supplying arteries was 985 mL/min. A 33% increase in blood flow was considered compensatory. In addition to the control group, 30 patients with asymptomatic stenosis of less than 50% and 12 patients after endarterectomy with mean blood flow of 920 mL/min and 960 mL/min, as well as two groups of particular interest to us, i.e. 38 patients with no compensatory blood flow increase despite significant stenosis (>50%) with mean blood flow of 844 mL/ min and 44 patients with similar stenosis and with compensatory blood flow increase up to 1174 mL/min were included in the analysis. Results: Comparison of the two groups showed several significant differences: increased blood flow (118% vs. 86% of the norm) in patients with compensated stenosis, an increased number of asymptomatic patients (70% vs. 37%) and a threefold increase in the number of patients with occlusions (15 : 5) in the group of patients with increased blood supply to the brain. Conclusions: All potential blood-supplying vessels, including the external carotid artery, are involved in brain tissue perfusion in some of the patients with significant stenosis. Determining the degree of compensation may have an important impact on the indications for surgical treatment, which will make a valuable contribution to the current criteria (asymptomatic/ symptomatic patients).

Cel pracy: Ocena wpływu kompensacyjnego wzrostu przepływu w naczyniach dogłowowych u chorych z istotnymi zwężeniami tętnic szyjnych. Materiał i metoda: U 218 chorych powyżej 60. roku życia wykonano rozszerzone badanie ultrasonograficzne z opcją dopplera w celu oceny zarówno stopnia zwężenia naczyń dogłowowych, jak i bilansu objętości przepływu we wszystkich głównych naczyniach doprowadzających krew do mózgu: tętnicy szyjnej wewnętrznej, tętnicy szyjnej zewnętrznej i tętnicy kręgowej. Grupę kontrolną stanowiło 94 pacjentów bez zwężeń naczyń w odcinkach przedczaszkowych oraz bez objawów neurologicznych, u których obliczono normy przepływu w naczyniach (tętnica szyjna wewnętrzna – 290 ml/min, tętnica szyjna zewnętrzna – 125 ml/min, tętnica kręgowa – 80 ml/min); całkowity przepływ w naczyniach dogłowowych wynosił u nich średnio 985 ml/min. Za kompensacyjny wzrost uznano zwiększenie przepływu o 33%. Poza grupą kontrolną analizie poddano 30 pacjentów z bezobjawowymi zwężeniami poniżej 50% i 12 osób po endarterektomii ze średnimi przepływami 920 ml/min i 960 ml/min, a także dwie szczególnie interesujące nas grupy: 38 pacjentów bez kompensacyjnego wzrostu przepływu pomimo istotnych (>50%) zwężeń ze średnim przepływem 844 ml/min oraz 44 chorych z kompensacyjnym wzrostem przepływu do 1174 ml/min przy podobnych zwężeniach. Wyniki: Porównanie dwóch grup wykazało kilka istotnych różnic: większy przepływ (118% vs 86% normy) u chorych ze skompensowanymi zwężeniami, większą liczbę chorych bezobjawowych (70% vs 37%) oraz trzykrotnie więcej chorych z niedrożnościami (15 : 5) w grupie pacjentów ze zwiększonymi przepływami domózgowymi. Wnioski: Wszystkie naczynia mogące doprowadzić krew do mózgu, w tym tętnica szyjna zewnętrzna, u części chorych z istotnymi zwężeniami biorą udział w zapewnieniu perfuzji tkanki mózgowej. Określenie stopnia kompensacji może w istotny sposób wpłynąć na wskazania do leczenia zabiegowego, co stanowi cenne uzupełnienie dotychczasowych kryteriów (pacjenci bezobjawowi/objawowi).

One-Centre Study Investigating a need for an immediate vascular surgery in patients over 80 years of age - comparison analysis of the results

84%

Pogorzelski R., Wołoszko T., Małek A., Szostek M., Jakuczun W., Toutounchi S., Macioch W., Leszczyński J., Skórski M.

Polish Journal of Surgery

2010

vol. 82

issue 5

267-271

According to the observation made by the study authors, every year there is an increasing number of patients advanced in years who require surgical management of their vascular disease. They constitute more than 4% of all patients. The similar situation is our medical centre, where the number of the hospitalisations of octogenarians increases with every subsequent year. In spite of many concomitant diseases we propose them immediate operation. Then it seems to be important a comparison two ways of treatment: immediate and elective ones.The aim of the study was evaluation of the results obtained in the treatment of vascular diseases requiring an immediate surgical intervention.Material and methods. In the years 2005-2007, there were 150 patients treated for arterial diseases. The group consisted of 87 men (58%) and 63 women (42%), with a mean age of 83.6. All the patients were divided into two groups: patients undergoing an elective surgery (n = 113), and those operated on immediately (n = 37). For both these groups was performed the comparison analysis, concerning the most important concomitant disorders, having an unquestionable influence on the final results of the operative treatmentResults. The comparison analysis of deaths, amputations, and hospitalisation period in the elective and immediate surgeries revealed the following: 5.3% vs 21.6% (p = 0.006), 7.9% vs 13.5% (p = 0.33), and 15.8 vs 9.8, respectively.Conclusions. Immediate vascular surgery is especially needed by older women. Culture and customs are the reasons for treatment delay in Poland, with its direct effects on the treatment results.

Anastomotic Aneurysms in the Groin - Results of Surgical Treatment

84%

Pogorzelski R., Wołoszko T., Szostek M., Macioch W., Leszczyński J., Jakuczun W., Małek A., Skórski M., Szostek M.

Polish Journal of Surgery

2007

vol. 79

issue 10

635-642

The aim of the study. The authors introduce single-center results of surgical treatment of 84 aneurysms in 79 patients. Anastomotic aneurysms belong to group of pseudoaneurysms which appear in places after vascular anastomosis.The most common location of this kind of pseudoaneurysm is the groin (85%). The next most common location is the proximal anastomotic place with the aorta or iliac common artery (12%), which constitutes from 1 to 5% of all vascular abnormalities. Usually, these need to be surgically treated.Material and methods. The authors present surgical treatment results of 79 patients with 84 pseudoaneurysms: 10 women (12.7%) and 69 men (87.3%) ranging in age from 44 to 81 years old, with an average age of 64.7 years old.The frequency of this pathology in all patients with vascular diseases treated in our Department was 1.6% and 7.7% in patients after surgical anastomosis in the groin. Eleven patients (13.9%) with aneurysm rupture and four (5.1%) with thrombosis and acute ischemia of the lower limb needed an emergency operation. The remaining 64 patients (81%) were operated on according to the plan.The most common operations were: vascular by - pass, secondary suture of anastomosis, and covering the lost part of the anastomosis with a patch. This treatment was used in 66 cases (84.5%), and 18 patients (22.8%) needed early secondary operation. 18 patients (22.8%) had a vascular prosthesis infection.Results. A good treatment result of anastomotic aneurysms was observed in 64 patients (81%).In 10 cases (12.7%), amputation was needed due to lack of blood recirculation in the limbs.Five patients died because of MODS due to vascular prosthesis infection.Conclusions. 1. The most important complication resulting in surgical treatment failure is vascular prosthesis infection and the progress of peripheral arteriosclerosis. 2. Distant vascular anastomosis dehiscence may show that the anastomosis was done using too much tension or that there were dakron physicochemical changes due to the aging process.

Refine search results

2 Polish Journal of Surgery

1 Journal of Ultrasonography

1 2018

1 2010

1 2007

3 Leszczyński J.

2 Jakuczun W.

2 Macioch W.

2 Małek A.

2 Pogorzelski R.

2 Skórski M.

2 Szostek M.

2 Wołoszko T.

1 Elwertowski M.

1 Gałązka Z.

1 Kaszczewski P.

1 Lamparski K.

1 Sin Yee Ho S.

1 Toutounchi S.

Search results

The importance of blood flow volume in the brainsupplying arteries for the clinical management – the impact of collateral circulation

One-Centre Study Investigating a need for an immediate vascular surgery in patients over 80 years of age - comparison analysis of the results

Anastomotic Aneurysms in the Groin - Results of Surgical Treatment