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F G Buskens

Publications and source records attributed to F G Buskens.

35 records · Page 2Linked to original sources
PubMed1992

Femoropopliteal arterial reconstruction with intraoperative iliac transluminal angioplasty for disabling claudication: results of a combined approach.

Seventeen patients with disabling claudication resulting from multilevel arteriosclerotic disease were treated by combined intraoperative iliac transluminal angioplasty and femoropopliteal arterial reconstruction. Clinical improvement or total relief of ischaemic symptoms was observed in 15 out of 17 patients. Iliac pressure gradients were reduced with balloon dilatation to < 2 mmHg in all cases. The mean (+/- S.D.) resting ankle-brachial systolic pressure index increased from 0.42 +/- 0.14 to 0.87 +/- 0.21. Complications from intraoperative angioplasty were not encountered and no early graft failures were seen. The primary actuarial graft patency at 1, 2 and 5 years was 100, 88 and 67%, respectively. Combined intraoperative iliac transluminal angioplasty and femoropopliteal arterial reconstruction is a useful alternative to conventional surgical revascularisation in the treatment of selected patients with disabling claudication in the presence of multilevel arteriosclerotic disease.

Aged↗
PubMed1992

Effect of perioperative blood transfusion and cell saver on the incidence of postoperative infective complications in patients with an aneurysm of the abdominal aorta.

OBJECTIVE: To find out if there was an association between perioperative blood transfusion and the development of infective complications, and whether the use of the cell saver for autologous transfusion had any influence. DESIGN: Retrospective study. SETTING: University Hospital. SUBJECTS: 102 consecutive patients who had been operated on for aneurysms of the abdominal aorta. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: 32 of the 102 patients developed infective complications. Thirteen patients died (six after emergency and seven after elective operations). Nine died as a direct result of infection, one of intra-abdominal bleeding, one of necrosis of the colon, and two of cardiopulmonary complications. The incidence of infective complications was directly related to the number of units of blood transfused, being 0 when 0 or 1 was given; 11 (20%) when 2-4 units were given; 12 (55%) when 5-8 units were given; and 9 (69%) when the number was 9 or more. The cell saver had no influence on the incidence. Other factors associated with higher rates of infective complications were the insertion of a bifurcated prosthesis (p = 0.03), and emergency operation (p < 0.001). CONCLUSION: These results confirm the association between blood transfusion and the incidence of infective complications. It may be that more intensive use of the cell saver and preoperatively saved autologous blood could reduce the rate of infective complications.

Age Factors↗
PubMed1990

[Incidence, risk and operability of abdominal aortic aneurysm in the elderly patient].

The risks of operative treatment of abdominal aortic aneurysm are considerably smaller in elective circumstances than after rupture of the aneurysm. The risk of a ruptured aneurysm is higher than the indicated percentage in the literature, because this only reflects the operative mortality. Possibly almost 65% of the patients with a rupture of an abdominal aortic aneurysm die at home or during transport to the hospital. In the absence of valid contra-indications to surgery, elective operative treatment should be considered, also in the elderly patient.

Aged↗
PubMed1989

Diagnosis and management of the coronary-subclavian steal syndrome.

A patient is presented with recurrent angina due to a coronary-subclavian steal syndrome 3 years after left internal mammary to left anterior descending coronary artery bypass grafting. Myocardial ischaemia could easily be provoked by selective exercise of the left upper limb. Coronary angiography showed reversal of flow in the left internal mammary artery. Suggestions are given for prevention of the coronary-subclavian steal syndrome by identification of patients who are at risk of developing subclavian artery occlusive disease. Performance of coronary and brachiocephalic angiography is indicated in recurrence of angina in patients with internal mammary artery bypass grafts. Doppler spectral analysis may be a valuable technique for detection of a haemodynamically significant stenosis of the left subclavian artery. Carotid-subclavian bypass grafting is the procedure of choice for management of the coronary-subclavian steal syndrome.

Angina Pectoris↗
PubMed1986

Spinal cord injury following surgery for acute traumatic rupture of the thoracic aorta.

From 1970 to 1985, 49 patients were operated for traumatic aortic rupture (TAR) in 2 university hospitals. Protection of distal ischemia was performed 31 times with a left heart bypass (LHB), 5 times with a heparin coated shunt and, 13 times using simple aortic cross-clamping combined with pharmacological vasodilatation. Total mortality was 17 out of 49, 5 during and 12 after the operation, 2 of them being directly related to systemic heparinization during LHB. In the LHB and shunt groups there was one postoperative paraplegia out of 35 patients, while 4 from the 13 patients operated without a shunt developed paraplegia. If risk factors such as long cross-clamping time, hypotension, extensive laceration of the inner curvature of the aorta, or cross-clamping of the aortic arch at a high level are anticipated, LHB or the shunt technique must be considered to avoid paraplegia. A repair without a shunting procedure should be limited to those cases in which the individual surgeon believes that he can do the operation within 30 minutes aortic cross-clamping time.

Adult↗
PubMedDate not supplied

Home parenteral nutrition via arteriovenous fistulae.

Vascular access for home parenteral nutrition was achieved with arteriovenous fistulae during an average 14.3 months in seven patients. Two Cimino fistulae and six bovine grafts were used. The only complication was bovine graft thrombosis which occurred in six instances despite anticoagulant therapy. Thrombectomy could successfully be performed in three graft thrombosis. Considering complication rates arteriovenous fistulae are valuable alternatives for central venous catheters in long-term parenteral nutrition at home.

Adolescent↗
PubMedDate not supplied

[Organization of emergency health services in disasters].

Since 1982 the St. Radboud hospital, Nijmegen, has a contiguity plan for peace-time disasters which describes the way to deal with great numbers of patients of traffic-, environmental- or industrial-calamities. The function of the commander, the separate hospital services, the medical and nursing triage team and administrative services are clearly delineated. Also is indicated how to organise communication between hospital, municipality, police and fire-brigade. The plan also provides possibilities for information towards press and relatives of the victims.

Disaster Planning↗
PubMedDate not supplied

Traumatic rupture of the thoracic aorta.

The experience in the surgical treatment of traumatic rupture of the thoracic aorta is discussed. Twenty-two patients were seen from 1970 to 1980. They were divided into three groups, according to delay between injury and aortic repair: 1 degree emergency group: 16 patients; 2 degree delayed group: 3 patients; 3 degrees chronic group: 3 patients. All patients had a widened mediastinum and the aortography confirmed the diagnosis. In the first group four patients died before surgery could be started and four after aortic repair from 10 days to 6 seeks postoperatively. In the second and third group all patients survived. Of 22 cases, 21 ruptures were located at the aortic isthmus and 1 at the aortic arch. Many patients had various other injuries, skeletal, abdominal or cerebral. All, but one patient, were operated with the aid of a partial pulsatile left heart bypass to avoid cerebral hypertension and cardiac overload, and to prevent kidney and spinal cord ischemia. One patient was operated, according to the method of Crawford, with blood pressure controlled with nitroprusside. We have not observed in our patients paresis or paraplegia after surgery. The hospital mortality of the surgical treated patients was 34% in the emergency group and 0% in the delayed and chronic group. Surgical treatment is essential in emergency situation, as a complete rupture may be fatal and repair of the chronic post-traumatic false aneurysm is advocated, as their prognosis is unpredictable.

Aorta, Thoracic↗
PubMedDate not supplied

Iliac artery stenosis after kidney transplantation.

In human kidney transplantation hypertension and renal dysfunction are common complications. Diagnosis of vascular involvement may frequently be necessary. Although iliac artery stenosis is a rare complication after renal transplantation, it can be the cause of hypertension and renal dysfunction. Because colour duplex scanning is a repeatable non-invasive technique, it may provide a useful tool in establishing a diagnosis of iliac artery stenosis in patients with hypertension and/or renal dysfunction. We present four cases of iliac artery stenosis in kidney allograft recipients. Colour duplex scanning was used in these patients to detect and localize the stenosis. Quantitative analysis of Doppler spectra was used to compare the Doppler spectrum waveforms obtained from both femoral arteries and from the kidney allograft arteries of these patients with the normal range. This normal range was determined from Doppler spectra obtained in a control group of 21 kidney allograft recipients. Clinical data, arterial DSA, and the outcome of treatment were used to validate colour duplex findings in the patients with iliac artery stenosis. Quantitative analysis of Doppler spectra showed differences between the femoral artery on the affected side and the contralateral side outside the normal range. In three patients the iliac artery stenosis was located proximal from the anastomosis with the kidney allograft artery and in these three patients Doppler parameters obtained from the allograft artery were also outside the normal range. In one patient the stenosis was located distally from the anastomosis with the kidney allograft artery. In this case Doppler spectra from the kidney allograft artery were within the normal range.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗