Biomedical subjects

Artur Ruciński

Publications and source records attributed to Artur Ruciński.

10 recordsLinked to original sources

PubMed2006

[The surgical treatment of thoracic outlet syndrome].

UNLABELLED: In this paper the surgical treatment of thoracic outlet syndrome (TOS) is presented. MATERIAL AND METHODS: The investigation of 74 patients treated for vascular complications of the TOS the Paget-Schroetter syndrome and postthrombotic syndrome (27 patients), as well as upper limb ischemia and/or the subclavian artery aneurysm (14 patients) and for neurological complications of the TOS (33 patients) was performed. In case of venous thrombosis the treatment consisted of thrombolytic therapy and decompressive procedures that included transaxillary first rib resection and other surgical procedures that excise different anomalies in the region of the thoracic outlet. In case of complications associated with compression of the subclavian artery the operation consisted of resection of the first rib and accessory osseous and muscular pathological elements using supraclavicular and/or infraclavicular approach with implantation of vascular bypass were performed. In the neurological syndrome of TOS the operation consisted of transaxillary first rib resection and other surgical procedures that excise different anomalies in the region of the thoracic outlet. The therapy results were estimated with use of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire of the American Academy of Orthopedic Surgeons. RESULTS: In case of venous complications the thrombolytic therapy was successful in all cases the restoration of complete patency was obtained. In all patients first rib was resected via transaxillary approach. The DASH questionnaire revealed the full return of upper limb function in most of patients. Improvement was obtained the in the cases with postthrombotic syndrome. In case of upper limb ischemia the improvement of blood flow was obtained after the subclavian-brachial bypass implantation (5 patients). In this group the DASH score showed return to full activity. In case of subclavian artery aneurysm surgery (9 patients) the DASH scale revealed worsening of limb function in 4 patients during the follow-up period. In the neurological syndrome of TOS the restoration of complete activity of limb was observed. The DASH scale revealed worsening of limb function in 4 patients during the follow-up period. CONCLUSIONS: The optimal therapy of vascular complications is multimodal treatment (thrombolysis or reconstructive vascular procedure with decompressive surgery). The surgical treatment of neurological TOS halts degradation of brachial splice. The decompression of neurovascular bundle in vascular TOS should include the first rib resection in each case.

Blood Vessel Prosthesis Implantation↗

PubMed2004

[Immunosuppression in the treatment of vascular prosthesis infection with arterial transplantation].

AIM: The purpose of this study is to evaluate the use of immunosuppression in treatment of prosthetic graft infections with arterial transplantation. MATERIAL AND METHODS: In this paper 29 cases of the massive aorto-ilio-femoral graft infection treated by the replacement of infected prosthesis with arterial homograft are presented. The arterial allograft was stored with application of cold ischemia method in preservation solution at 4 degrees C. During the follow up period the patients were divided into two groups: group received immunosuppressive regimen after surgery (n = 16) and group without immunosuppression (n = 13). The Duplex-Doppler ultrasound, the scintigraphy with use of Technetium-labeled leukocytes, bacteriological and antigenic examination and blood levels of Cyclosporin A were used in the diagnostic trial of infection and of the healing process of the homograft. In both groups there was performed evaluation of arterial wall by using the scanning electron microscopy. RESULTS: In the group with immunosuppression no complications due to the homograft's wall degradation and deficiency of cell mediated immunity in infections were noticed. In the group without immunosuppression there were observed complications related to the impairment of the allograft wall: in 3 cases--the graft rupture, in 2 cases--the graft true aneurysm and homograft thrombosis in 3 cases. CONCLUSION: The use of immunosuppression in transplantation of artery produces increase in survival rate and improves function of arterial graft.

Adult↗

PubMed2004

The use of synthetic vascular prosthesis in the surgical treatment of secondary aorto-duodenal fistulas.

In this paper the methods with synthetic vascular prosthesis used in surgical treatment of the secondary aorto-intestinal fistula are presented. 10 cases of 22 patients treated in the years 1993-2003 for secondary aorto-intestinal fistulas as a complication of vascular prosthesis infection are analysed. In all patients the abdominal CT, scintigraphy with technetium 99m labeled leucocytes and endoscopy were performed. The patients underwent the operation of infected dacron prosthesis' replacement with silver/collagen coated prosthesis or extraanatomic bypass (subclavian to femoral). To close the intestinal fistula the duodenectomy with gastroenterostomy was performed or the duodenum was sutured and protected with the use of pedicled omentum. In 4 patients extraanatomic subclavian-femoral of polytetrafluoroethylene (PTFE) bypass was used. In these cases the intestinal surgery was composed of the partial duodenectomy with fistula excision and duodenal stumps formation followed by antecolic gastrojejunostomy with the Braun's enteroanastomosis and pyloroplasty. In this group 2 patients (50%) died in the follow up period. There were two extraanatomic bypass thromboses in the 30 days follow up and one amputation (25%). The infected vascular prosthesis was replaced with silver/collagen coated prosthesis in the 6 patients. In these cases duodenal fistula was closed with two layers of stitches and additionally protected with pedicled fragment of the greater omentum, which was sewn on the duodenum. In this group 1 patients (16.7%) died in the follow up period. In one case (16.7%) in 9 months after operation reinfection od silver prosthesis was observed. There were no significative differences (p = 0.45) in terms of early mortality between both group of patients. The treatment of the fistula is a difficult and hazardous surgical procedure, results of which are unpredictable.

Adult↗

PubMed2004

Use of mesh fibrous dressing covered with fibrin glue (TachoComb) in hemostasis after vascular anastomoses in the groin.

We present in this paper application of haemostatic device TachoComb onto bleeding after vascular anastomosis of dacron vascular prosthesis (branch of aortobifemoral or bypass aortofemoral) with common femoral artery in the groin. Hemorrhagic complications have influence onto clinical status of operated patients. Haemostatic TachoComb dressing was applied at 30 cases and results were compared to control group consist of 25 cases, in which gas compresses were applied. Mean loss blood in group I with the usage of TachoComb was statistical characteristic (p < 0.003) smallest than in group II. Also mean time of hemostasis was shortest than in group II (p < 0.01). We proved that use of TachoComb limits bleeding from suture line connecting artery with vascular prosthesis.

Anastomosis, Surgical↗

PubMed2004

[Presence of Chlamydia pneumoniae in the carotid artery].

UNLABELLED: There is growing experimental evidence that Chlamydia pneumoniae is a risk factor and contribute to the development of atherosclerosis of carotid artery. This process might cause stenosis of carotid artery and TIA or stroke. AIM: Aim of this study was to evaluate the frequency of Ch. pneumoniae infection in carotid artery stenosis patients and in control group-healthy artery from multiorgan donors. MATERIAL AND METHODS: From each of 84 patients undergoing carotid endarterectomy the samples were analyzed by nested PCR for Ch. pneumoniae DNA. Furthermore we determined DNA Ch. pneumoniae in carotid artery from 20 multiorgan donors. RESULTS: In control group-healthy artery the PCR for Ch. pneumoniae was negative in all samples. Ch. pneumoniae was detected in 57 patients (67.85%) with symptomatic carotid artery stenosis, however in 27 patients (32.15%) the PCR test was negative. CONCLUSIONS: We did not observe infection of Ch. pneumoniae in healthy carotid artery-control group. We noted great frequency of infection in patients with stenosis of carotid artery. Patients with stenosis of carotid artery can be candidates to antibiotic therapy, which can slow down the progression of artery stenosis.

Adult↗

PubMed2004

[Incidence of factor VII and C3 in vascular anastomosis].

In order to study pathogenesis of vascular prosthesis healing process the following experiment was designed. 16 dogs underwent implantation of unilateral straight aorto-femoral teflon (PTFE, polytetrafluoroethylene) by-pass. After 6 months all dogs were killed, dissected and vascular prostheses with margin of adjacent aorta and femoral artery were collected for further study. Areas of proximal and distal anastomosis were examined immunohistochemically. Presence of coagulation factor VII, and C3 complement factor were studied. The obtained results were analyzed statistically by means of t-Student test. Factor VII as well C3 were found in areas of both proximal and distal anastomosis. Concentration of all two substances in proximal and distal anastomosis was compared. No statistically valid differences in factor VII concentration in proximal and distal anastomosis were found, whereas amounts of C3 factor as well as degree of extracellular matrix infiltration were markedly higher in distal anastomosis.

Anastomosis, Surgical↗

PubMed2004

The treatment of subclavian artery compression with the use of ringed polytetrafluoroethylene vascular prostheses.

UNLABELLED: In this paper the treatment of arterial complications of the Thoracic Outlet Syndrome (TOS) is presented. The investigation of 14 patients treated in the Department of Vascular, General and Transplantological Surgery of the Wroclaw Medical University for arterial complications of the TOS (as upper limb ischemia and/or the subclavian artery aneurysm in 14 patients) was performed. In case of complications associated with compression of the subclavian artery the operation consisted of resection of the first rib and accessory osseous and muscular pathological elements using supraclavicular and/or infraclavicular approach with implantation of externally supported ringed vascular polytetrafluoroethylene bypass (PTFE) were performed. The therapy results were estimated with use of The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire of American Academy of Orthopedic Surgeons. RESULTS: In case of upper limb ischemia the improvement of blood flow was obtained after the subclavian-brachial bypass implantation (5 patients). In this group the DASH score showed return to full activity. In case of subclavian artery aneurysm surgery (9 patients) the DASH scale revealed worsening of limb function in 4 patients during follow-up period. The optimal therapy of vascular complications is the multimodal treatment (reconstructive vascular procedure with decompressive surgery). The decompression of neurovascular bundle in vascular TOS should include the first rib resection in each case.

Adolescent↗

PubMed2003

The treatment of massive prosthetic grafts infections with the use of silver/collagen coated dacron vascular prosthesis.

In this paper the use of silver-coated medical prosthesis of massive aorto-bifemoral and ilio-femoral dacron graft infection with hemorrhage is presented. To solve this problem in situ replacement was attempted using silver-coated dacron vascular prosthesis more resistant to infection. 9 patients with this therapeutic method is reported. Although positive clinical effect was obtained, the scintigraphy and Duplex Doppler Ultrasound of implanted graft revealed its infection. In our opinion therefore application of silver-coated medical prosthesis should be very cautious and limited to the critical states.

Antibiotic Prophylaxis↗

PubMed2003

Intraoperative hemostasis during kidney transplantation and the use collagen mesh dressing covered by fibrin glue (TachoComb).

In this paper we present influence of use of haemostatic dressing TachoComb, onto bleeding from surface of transplanted kidney. Kidney transplantation (KTX) seems to be main method of treatment of terminal renal failure. Enlarging number of KTX results in growing frequency of intra and postoperative complications. Hemorrhagic complications can impact clinical status of recipient and graft function. Haemostatic dressing was applied at 29 cases. Control group in which only gas compresses were used consisted of 25 patients. It was proved, that use of dressing from collagen mesh covered by fibrin glue TachoComb, after kidney transplantation diminished parenchymal bleeding and time necessary to get complete hemostasis.

Aprotinin↗

PubMed2002

[Bilateral chemodectoma--a case report].

Chemodectoma is exceptionally rarely tumor comes from the parasympathetic part of nervous system. Cases description first of all concern multiple, single tumors localized on the neck, occasionally somewhere else. Tumors expansion in internal carotid vein aperture or in ear provoke serious complications from cranial nerves paralysis to cerebellum lesion. In this paper authors present a case of bilateral chemodectoma. Surgical treatment has required--not only simple tumor excision but also internal carotid artery reimplantation.

Adult↗