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Biomedical subjects

A Kusaba

Publications and source records attributed to A Kusaba.

At least 73 records · Page 4Linked to original sources
PubMed1981

Ultrasonic flow wave pattern as a prognostic indicator in peripheral arterial reconstruction.

A prognostic flowmetric study on 80 reconstructed arteries of the lower extremity was carried out to assess the flow wave patterns detected using a bidirectional doppler flowmeter. In 21 of 80 arteries, changes in the flow wave pattern were noted. For 10 of 21 affected arteries, an immediate arteriography revealed localized stenotic lesions at the distal anastomosis, in a short segment of the implanted autogenous vein graft or at the proximal host artery. Immediate repairs for the lesions were successfully performed by a minor surgery in 8 of 10 cases and the flow wave pattern reverted to normal. Two were not successful as the occlusion was complete before attempting the repair. The remaining 11 are now under conservative management as these patients refused further surgery. The ultrasonically driven flow wave pattern proved to be a useful indicator to assess the patency of the reconstructed peripheral artery to detect possible stenosis and thereby to take proper corrective measures and hence prevent a late occlusion.

Arterial Occlusive Diseases↗
PubMed1981

Absorbable suture materials for vascular anastomoses. Tensile strength and axial pressure studies using polyglycolic acid sutures.

This study attempted to evaluate how vascular healing itself is sufficient enough to provide adequate strength to autogenous vein grafts in small arteries without the use of nonabsorbable sutures. The absorbable suture, Dexon, was used in small canine femoral vein graft anastomoses over a two-month trial period with nonabsorbable Prolene as a control. Tensile strength and resistance to axial leak were measured. Results show that Dexon had 93 per cent of the tensile strength of Prolene immediately; 76 per cent at 14 days, 111 per cent at 21 days, and 110 per cent at 30 days, and 124 per cent at 60 days as an average for all suture lines. The per cent mean resistance to leakage that Dexon had compared to Prolene for all suture lines was 102 per cent at seven days, 97 per cent at 14 days, 107 per cent at 21 days, and 97 per cent at 30 days. There is no evidence of aneurysms, suture line disruptions, dilations, or infections of any anastomoses. Our ultimate conclusion is that the integrity of small autogenous vein graft is dependent on healing rather than on the permanent strength of the suture material and that Dexon maintains vascular integrity long enough to permit this healing to occur.

Absorption↗
PubMed1981

Experimental study of the influence of porosity on development of neointima in Gore-Tex grafts: a method to increase long-term patency rate.

The objective of this study was to evaluate the controlled microscopic development and fate of the neointima of Gore-Tex graft pretreated with multiple regular perforations, compared to nonperforated controls. Gore-Tex grafts (each 7 cm x 8 mm), perforated at regular 2 mm intervals with a special needle (0.8 mm internal diameter) for one half the length, with the remaining half kept intact, were implanted in 37 canine abdominal aortas in an end-to-end fashion. Standard untreated Gore-Tex grafts, of identical size, were similarly implanted in ten as controls. The perforated portion of the artificially treated Gore-Tex grafts demonstrated early neointimization at one week, the presence of fibroblasts and developing vasovasorum at 4 weeks, and complete endothelialization at 12 weeks. In contrast, the unperforated portion of implanted grafts demonstrated delayed endothelialization, requiring 24 weeks for complete development. Untreated controls demonstrated incomplete healing of the central luminal portion of the graft, with reddish thrombi still present at 24 weeks. Our study demonstrated that the poor development of neointima persists in the central portion of standard Gore-Tex controls in the last postoperative period, while pretreatment with multiple small perforations significantly hastens the development of a smooth neointima.

Animals↗
PubMed1980

A case of a developmental anomaly of the femoral artery: persistent sciatic artery.

A case of a persistent sciatic artery in a 68-year-old farmer, showing symptoms of acute arterial occlusive lesion of the right lower limb is presented. The persistent sciatic artery was joined to the internal iliac artery proximally and to the popliteal artery distally. The anomalous artery was occluded by atheromatous thrombi. The superficial femoral artery was hypoplastic and terminated in the descending genicular artery at the midthigh level. A successful bypass was performed between the common femoral artery and proximal popliteal artery utilizing a woven teflon graft.

Acute Disease↗
PubMed1980

Venous reconstruction by endvenectomy with temporary arteriovenous fistula for stasis syndrome of lower extremity: experimental and clinical studies.

Effect of the temporary arteriovenous fistula on venous reconstruction for stasis syndrome of the lower extremity was studied experimentally and clinically. The canine iliac vein was replaced with an autogenous vein graft in which the intimal surface was roughened by scrubbing with sponge. A temporary arteriovenous fistula which was closed surgically three or four weeks later was created between the femoral vessels. The patency rate for twenty-one grafts was 80.9 per cent for one to thirty-six weeks (mean 8 weeks), in contrast to complete failure in the control group in which no arteriovenous fistula was created. Adequate healing of the luminal surface of the grafts were experimentally demonstrated by light microscopic examination and en face silver staining of the endothel-like cells with the aid of patent arteriovenous fistula for three weeks. This procedure was clinically applied in four patients with stasis syndrome of the lower extremities. Good function of the reconstructed venous segments in three of four patients was observed for the last 3 to 8 years after the operations. A looping technique using 2-0 monfilament nylon around the fistula devised by us was very helpful to make easy the shunt closure later. Open endvenectomy with a temporary arteriovenous fistula is believed to be an acceptable approach for segmental chronic occlusive lesion in the iliac vein.

Adolescent↗
PubMed1980

Long-term results of reconstructive surgery for aorto-iliac arterial occlusive lesions.

We report a review of 215 reconstructions for aorto-iliac arterial occlusive lesions, involving 156 patients. At 13 years, the cumulative patency rate of 158 aorto-femoral or aorto-iliac dacron synthetic bypass prostheses was 71.6 per cent as compared to 52.7 per cent at 5 years for 22 blunt endarterectomies and 47.4 per cent at 6 years for 35 axillo-femoral bypass prostheses. Of the 158 synthetic bypass prostheses, the cumulative patency rate at 13 years was 85.1 per cent in cases with no occlusive involvement of the peripheral arteries, significantly higher (p less than 0.03) than the 39.3 per cent patency rate at 7 years in cases in which associated femoro-popliteal occlusive lesions were not treated. At 12 years, the patency rate was 53.2 per cent in cases in which associated femoro-popliteal occlusive lesions were treated during the same reconstructive intervention, i.e. markedly higher (p less than 0.08) than in patients in whom the degree of outflow in the distal vessels was poor. Our findings indicated that, in order to achieve a satisfactory long-term patency rate, it is important to treat associated occulusive lesions in the femoro-popliteal arteries.

Adolescent↗
PubMed1980

Long-term results of reconstructive surgery for femoro-popliteal arterial occlusive lesions.

A retrospective review of 156 reconstructions performed for femoro-popliteal arterial occlusive lesions in 141 patients was carried out in terms of the reconstructive procedure and the degree of out-flow in the distal vessel. The cumulative patency rate for 95 autogenous vein grafts was 60.7 per cent at 12 years and higher than the 27.4% patency rate for 50 endarterectomies (p less than 0.001). All of 11 synthetic bypass prostheses failed with late thrombosis within 3 years after operation. The cumulative patency rate in cases with good distal run-off vessel and those with fair distal run-off vessel were 77.1% at 11 years and 57.3% at 12 years, respectively, and these values were significantly superior to 10.3% in cases with poor distal run-off vessel. The patency rate for 41 in situ grafts was 72.2%, being superior to 65.5% for 42 free grafts.

Adolescent↗
PubMed1980

Comparative study on the fibrinolytic activity of pseudointima in varying types of autovein grafting.

Three types of autovein grafting procedures have been commonly employed for peripheral arterial reconstruction, that is, non-reversed, reversed and in-situ autovein grafting, and these procedures were comparatively studied in dogs to assess the best one for grafting. In the fibrinolytic activity of the internal surface of the grafts, as measured by standard fibrin plate method and Todd's fibrin slide technique, the in-situ autovein graft showed the highest activity, 139.5% in the mean, followed by 18% (mean) in the reversed autovein graft and 5.2% (mean) in the nonreversed autovein graft. The extent of fibrous proliferation of the pseudointima was least in the in-situ graft followed by the reversed and the non-reversed graft. These results suggest that preservation of the vasa vasorum is the most important factor to minimize fibrous proliferation of the graft pseudointima and to maintain high fibrinolytic activity on the internal surface of the graft. Consequently, the in-situ autovein grafting appears to be the most suitable method to ensure peripheral arterial continuity following surgical reconstruction.

Animals↗
PubMed1979

Flow wave form analysis in vascular surgery.

An analysis of 82 limbs subjected to femoropopliteal bypass grafting demonstrated that electromagnetic flow wave forms of the reconstructed vessel are a reliable indicator in predicting the outcome of surgery. On the basis of this knowledge, postoperative follow-up study of patients who had undergone reconstructive surgery was carried out. Early occult occlusive lesions were detected in 5 of 56 limbs examined, and 3 of these patients underwent successful reoperation with satisfactory restoration of blood flow. Follow-up study using flow wave form analysis is a useful method of detecting occult changes in arteries and leads to early treatment.

Adult↗
PubMed1978

A new surgical approach to extensive arterial occlusion of lower extremity--femoro-popliteal open endarterectomy with arteriovenous shunt.

A revascularized surgery for extensive arterial occlusive lesions of the lower extremities, namely open endarterectomy of the occluded femoro-popliteal artery with arteriovenous shunt, was devised. The procedure is specially indicated to the extensive arterial occlusion of the lower extremity for which the conventional reconstructive vascular surgery is not applicable. The patency of the reconstructed femoro-popliteal arteries are ensured by virture of an arteriovenous shunt and newly developed collaterals from the reopened genicular network is expected to provide effective blood flow to peripheral parts. From 1967 to 1975, this procedure was applied to 59 extremities in 53 patients, all of whom had extensive arterial occlusion from the femoral artery to the periphery with impending ulcer and severe rest pain. Fourty-five out of 59 extremities had remarkable improvement of the ischemic symptoms and signs at the time of discharge. Long-term effectiveness was shown in 34 out of 59 extremities or 58 per cent.

Arterial Occlusive Diseases↗
PubMed1977

A multiclinic double-blind trial of pyridinolcarbamate and inositol niacinate in ischemic ulcer due to chronic arterial occlusion.

A double-blind multiclinic trial compared the efficacies of pyridinolcarbamate and inositol niacinate in the patients with the ischemic ulcer due to chronic arterial occlusion. A thrice-daily dose of 1.5 g of pyridinolcarbamate or 1.2 g of inositol niacinate was given at random to the patients during cold seasons, and the effectiveness of treatment was assessed mainly on the basis of the clinical course of the ischemic ulcer and the rest pain. The patients were classified into 4- and 6-week groups. Beneficial results were recorded in 16 of 32 cases (50.0%) of the 4-week pyridinolcarbamate group, and in 24 of 42 cases (57.1%) of the 4-week inositol niacinate group. In the 6-week group favorable results were observed in 54 of 79 cases (68.4%) on pyridinolcarbamate, and in 36 of 74 cases (48.6%) on inositol niacinate. Although sympathectomy is currently indicated for these ischemic lesions, long-term treatment with pyridinolcarbamate is recommended on the basis of the finding that the 6-week treatment appears superior to the 4-week treatment and also to the 6-week treatment with inositiol niacinate.

Adolescent↗
PubMed1976

Abdominal aneurysm with aortoduodenal fistula.

Two patients having the abdominal aneurysm with aortoduodenal fistula were treated surgically, but graft infection occurred. One patient died about 6 months after and the other about one year after the operation due to massive hemorrhage from the postoperative aortointestinal fistula. The difficulties in the treatment of the aortoduodenal fistula were discussed.

Aorta, Abdominal↗
PubMed1976

Effect of 4-hydroxypyrazolo[3,4-d]pyrimidine (allopurinol) administration of growth of Ehrlich tumor cells.

Effect of the administration of 4-hydroxypyrazolo([3,4-d]pyrimidine (allopurinol) on the growth of Ehrlich ascites tumor cells was investigated in an in vivo system. Oral administration of allopurinol (0.1% in diet) suppressed the growth of both ascites and solid types of the tumor after the implantation of Ehrlich tumor cells in mice. The inhibitory action depended on the dose but was lost repidly when the administration was interrupted. Possible mechanisms involved in the inhibitory effect of allopurinol on tumor growth were briefly discussed.

Allopurinol↗