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Biomedical subjects

D E Strandness

Publications and source records attributed to D E Strandness.

At least 217 records · Page 12Linked to original sources
PubMed1980

Flow disturbances following carotid endarterectomy.

Noninvasive flow dynamics in 69 carotid arteries following endarterectomy were studied. By using three parameters which measure either changes in velocity or disturbed flow, 49 per cent of the arteries demonstrated flow abnormalities consistent with a 50 per cent, or greater, reduction in diameter in at least two of the three measured parameters. Of the 31 arteries which underwent more than one postoperative study, progression of the flow abnormality was suggested by changes in the velocity ratio in 20 arteries, maximum velocity in 15 arteries and the fractional broadening term in 25 arteries.

Blood Flow Velocity↗
PubMed1979

Noninvasive testing vs clinical evaluation of arterial disease. A prospective study.

In a prospective clinical study involving 458 diabetic patients, the results of noninvasive testing procedures were compared with the findings obtained by clinical evaluation. The results of the study showed that nearly one third of the patients who gave no history of intermittent claudication were found to have arterial disease when tested. One fifth of the patients with what were considered normal physical examination results had abnormal results by noninvasive testing. When history and physical examination prove ineffective for obtaining a diagnosis of arterial disease, the use of noninvasive devices effectively rules out or confirms the presence of hemodynamically significant arterial obstruction. Not only can simple, noninvasive testing methods greatly increase the accuracy of clinical diagnosis for the presence of arterial disease, but the baseline data obtained can serve as objective indexes to follow the natural history of the disease.

Adolescent↗
PubMed1979

Venous capacitance and outflow in the postoperative patient.

Venous capacitance and outflow were measured in a series of 50 unselected patients undergoing a variety of general surgical procedures. Studies done prior to operation and the morning after demonstrated a fall in capacitance and outflow that was related to the degree of ambulation. Fully ambulatory patients demonstrated no changes. Males under the age of 40 were unchanged regardless of the type of operation or degree of ambulation. It is likely that the observed changes reflected a reduction in arterial flow but alterations in venous tone cannot be ruled out.

Adolescent↗
PubMed1979

A prospective evaluation of oculoplethysmography and carotid phonoangiography.

With oculoplethysmography, conclusions are drawn regarding the state of internal carotid artery disease by measurements based upon pressure and flow in the eye, a location far removed from the site of the disease. Thus, many potential variables including ocular disease, vessel wall properties, intracranial atherosclerosis and collateral flow may affect the results. Although oculoplethysmography was quite accurate in detecting occlusion of the internal carotid artery, the identification of a high grade stenosis was much less precise. Furthermore, it could not distinguish between stenosis and occlusion, making angiography necessary for accurate diagnosis. In this study, oculoplethysmography, either alone or in combination with carotid phonoangiography, was not of sufficient accuracy to recommend its use as part of a noninvasive evaluation of carotid artery occlusive disease.

Angiography↗
PubMed1979

Hemodynamic studies before and after extended bypass grafts to the tibial and personeal arteries.

Thirty-ones limbs of 29 consecutive patients undergoing bypass grafts to the tibial or peroneal arteries were studied. Twenty-five limbs had ischemic rest pain with or without localized gangrene, and six had incapacitating claudication. The mean segmental pressure indices were upper thigh, 1.16 +/- 0.36; above knee, 0.71 +/- 0.30; below knee 0.51 +/- 0.23; and ankle, 0.28 +/- 0.21. Indices at the ankle were significantly lower (P less than 0.005) than those obtained from limbs that were candidates for simple femoropopliteal bypass. Three grafts failed immediately (initial patency rate of 90%). In the surviving grafts, ankle pressures rose from 39 +/- 26 to 145 +/- 29 mm Hg, and the ankle pressure index increased from 0.27 +/- 0.20 to 1.03 +/- 0.15 mm Hg. Consistent with these hemodynamic changes, all patients but one initially were relieved of their symptoms, and all ischemic lesions were treated successfully. Thirteen grafts failed subsequently (21 days to 34 months). Compared with preoperative values, ankle pressures after failure were either increased or unchanged in 75% of these limbs. Early occlusion could not be predicted on the basis of a low preoperative pressure index. During follow-up, impending graft failure was detected by a fall in ankle pressure in three patients and successfully prevented.

Adult↗
PubMed1979

Detection of carotid occlusive disease by ultrasonic imaging and pulsed Doppler spectrum analysis.

Ultrasonic imaging of the cervical carotid arteries by ultrasonic arteriography and duplex scanning combined with pulsed Doppler spectrum analysis were investigated in a series of patients undergoing arteriography. By using the ultrasonic image as a guide for precise placement of the pulsed Doppler sample volume, the characteristics of blood flow at points of interest in the carotid arteries could be determined. Audible analysis of the Doppler signal permitted correct diagnosis of 23 of 26 (88%) high-grade stenoses or occlusions with ultrasonic arteriography and 24 of 26 (92%) with duplex scanning. Spectrum analysis of Doppler signals obtained with the duplex scanner detected all of the 22 high-grade stenoses. Spectral abnormalities of a lesser degree also were detected in 18 of 23 vessels (78%) with atherosclerotic plaques which should not have reduced cerebral blood flow. These techniques permit the accurate detection of and the distinction between high-grade stenoses and occlusion, as well as the identification of many plaques which are not large enough to affect intracranial hemodynamics.

Arterial Occlusive Diseases↗
PubMed1978

Aortoiliac reconstruction in patients with combined iliac and superficial femoral arterial occlusion.

Despite revascularization of the common femoral--profunda femoris system, many patients fail to obtain satisfactory relief from claudication or rest pain. Clinical observations were compared with objective physiological data in 54 technically successful aortoiliofemoral reconstructions for multilevel disease. Nine of 28 operations (32%) for claudication and five of 26 operations (19%) for ischemia at rest had poor results. While the average ankle pressure index (API = ankle blood pressure/arm blood pressure) rose from 0.52 +/- 0.03 (SEM) to 0.81 +/- 0.03 in limbs treated successfully for claudication, it changed insignificantly in those with an unsuccessful result (0.58 +/- 0.04 to 0.61 +/- 0.04). When ischemic symptoms were relieved, API rose from 0.23 +/- 0.04 to 0.55 +/- 0.03 but increased only from 0.22 +/- 0.09 to 0.40 +/- 0.02 in limbs with insufficient improvement. Preoperative thigh pressure index (TPI) in claudicating limbs with poor results (0.96 +/- 0.05) differed little from that in limbs with good results (0.92 +/- 0.05); nor was the TPI of ischemic limbs with poor results (0.83 +/- 0.13) significantly greater than that in limbs with good results (0.60 +/- 0.05). Neither the TPI nor the thigh to ankle pressure gradient was of value in predicting which extremities would respond poorly to aortoiliofemoral reconstruction.

Adult↗
PubMed1977

Doppler ultrasound in vascular surgery.

Doppler ultrasound was first introduced into the study of arterial and venous disorders in 1966. The devices currently used in clinical practice are continous wave systems which, in their simplest form, are pocket-sized units. Instruments with the capability of distinguishing the direction of flow are also available. The signal may be processed for audio use, or an analogue recording can be made of the Doppler frequency shift. The described clinical information will, in large part, dictate the type of equipment used.

Acute Disease↗
PubMed1977

DVT or not DVT?

Explore the source record for details and available documents.

Humans↗
PubMed1976

Extremity necrosis caused by indwelling arterial catheters.

Four patients sustained tissue due to indwelling catheters, three of which were in radial arteries and one of which was in the dorsalis pedis artery, In one of the patients, septic thrombosis was demonstrated. The risk of such complications can be minimized by precannulation evaluation of the arterial circulation of the extremity, by proper care of the catheter when in place, and by careful observation for clinical evidence of infection, ischemia, and other treatable problems.

Aged↗