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Biomedical subjects

D W Oller

Publications and source records attributed to D W Oller.

28 records · Page 2Linked to original sources
PubMed1977

An alternative approach to lesions in the proximal segments of the brachiocephalic arterial system.

Tolerance of a cerebral hemisphere to permanent interruption of the ipsilateral carotid artery or to prolonged operative clamping of this vessel, can be determined preoperatively by a noninvasive technique combining the use of the ocular pneumoplethysmograph with compression of the proximal part of the common carotid artery. This technique is essential for the management of proximal lesions of the brachiocephalic arterial system to avoid the use of bypass grafts and to permit a supraclavicular approach rather than thoracotomy or a median plane sternotomy.

Adult↗
PubMed1975

Elective carotid artery resection.

A retrospective study of carotid artery resection disclosed a 64% mortality when resection was performed on an emergency basis, as compared with 14% when the surgery was undertaken electively. This concurs with other studies that have demonstrated increased survival rates when elective carotid artery resection has superseded carotid artery rupture, and reemphasizes the need for a more accurate means of predicting individual tolerance for loss of the carotid artery. Use of the ocular plethysmograph (OPG) is proposed as a simple and accurate means of evaluating the adequacy of collateral hemispheric blood flow to compensate for a potentially resectable carotid artery. Eleven patients have been evaluated using this technique. Nine were predicted to successfully tolerate carotid artery resection, while intolerance was predicted for the remaining two. Four of the nine patients have undergone resection of the artery with no neurologic sequelae to date.

Aged↗
PubMedDate not supplied

Noninvasive diagnosis of carotid occlusion by ocular pneumoplethysmography.

An ocular pneumoplethysmograph was devised to measure the systolic pressure in the ophthalmic artery and to obtain calibrated pulse volume changes from the ocular globe, with simultaneous recording from both eyes. The instrument is self-contained and portable. It can be applied by paramedical personnel, and the graphic recording is readily interpreted by the physician. It has proved to be 100% accurate in noninvasively detecting unilateral carotid occlusion or preocclusive stenosis. This technique, when combined with carotid compression, has been shown to be most valuable in assessing the tolerance of a cerebral hemisphere to proximal carotid occlusion. It was used to evaluate a wide variety of carotid arterial lesions. Elective carotid resection without graft replacement and urgent and elective carotid ligations were performed, based on the preoperative prediction that such procedures would be tolerated without neurological injury. The instrument and the technique of its application are simple, safe, and accurate.

Animals↗