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Biomedical subjects

F J Veith

Publications and source records attributed to F J Veith.

At least 325 records · Page 18Linked to original sources
PubMed1981

Superficial femoral and popliteal arteries as inflow sites for distal bypasses.

In a series of limb salvage bypass to the popliteal and infrapopliteal arteries, the superficial femoral and popliteal arteries were used preferentially to provide inflow if these vessels were no more than minimally diseased proximal to the site of bypass origin. Cumulative life-table patency rate at 6 years for popliteal bypasses was 66% for 290 cases originating from the common femoral and 81% for 60 cases originating from the superficial femoral and popliteal arteries (P greater than 0.1). Infrapopliteal bypass patency rate at 5 years was 50% for 129 cases originating from the common femoral artery and 58% for 79 cases originating more distally (P greater than 0.25). When vein grafts alone were considered, patency rates were still not influenced by the site of origin of popliteal and infrapopliteal bypasses. Only 1 of 32 failures of a bypass with a distal origin could have been caused by proximal progression of disease. Because of these findings and multiple advantages that result from using arteries distal to the common femoral for bypass inflow, preferential use of the superficial femoral and popliteal arteries for this purpose is recommended in appropriately selected patients.

Adult↗
PubMed1981

Long-term survival of murine allogeneic bone marrow chimeras: effect of anti-lymphocyte serum and bone marrow dose.

Graft-vs-host disease (GVHD) and failure of donor stem cells to engraft permanently are two major obstacles to successful bone marrow transplantation. We evaluated the effect of a single large dose of anti-lymphocyte serum (ALS) on mice receiving various numbers of H-2 incompatible bone marrow cells. Most animals receiving lethal total body irradiation (TBI) and allogeneic marrow died within 45 days due to GVHD, A/J (H-2a), CBA/J (H-2k), and DBA/1J (H-2q) mice that were given ALS 6 to 24 hr before TBI and C57BL/6 (B6, H-2b) bone marrow 24 hr after irradiation survived in good health for more than 200 days. This result compared quite favorably with mice that received anti-Thy 1.2 and C-treated B6 bone marrow (90% survival at 100 days, 50% survival at 200 days). Engraftment of the allogeneic marrow was dose dependent. At 100 days after TBI, about 30% of the A/J mice given 2 x 10(6) bone marrow cells were complete chimeras, i.e., donor H-2 antigens could be detected on greater than 85% of the peripheral blood mononuclear leukocytes of these mice. However, at a dose of 1 x 10(7) B6 bone marrow cells, 95% of the A/J mice were complete chimeras. Spleen and bone marrow from B6 leads to A/J chimeras and B6 leads to CBA chimeras were unable to induce lethal GVHD in TBI-treated mice that were syngeneic to the recipient. However, these cell preparations caused lethal GVHD in third party mice indicating that the lack of alloreactivity was specific to the strain in which the unresponsiveness was originally induced.

Animals↗
PubMed1981

Femoropopliteal bypass to the isolated popliteal segment: is polytetrafluoroethylene graft acceptable?

In a series of 148 polytetrafluoroethylene femoropopliteal bypasses performed for limb salvage, 33-month life-table cumulative patency rates for grafts inserted into an isolated popliteal artery segment (91% +/- 5%) were not significantly different from those inserted into a popliteal segment with angiographically better runoff (78% +/- 5%). Similarly, below-knee reconstructions had 3-year patency rates (86% +/- 6%) that were not significantly different from those for bypasses inserted into the popliteal artery above the knee (79% +/- 6%). One clear disadvantage of the isolated popliteal artery segment as a site for distal insertion of the bypass was the increased incidence of limb loss despite a patent reconstruction. This was particularly frequent in diabetics with extensive foot gangrene or infection and could be avoided by a secondary extension of the bypass to a patent distal leg or foot artery.

Aged↗
PubMed1980

Wound infections after transplant nephrectomy.

Wound infections after transplant nephrectomy were analyzed retrospectively. When prophylactic antibiotics were not used, 20% of the closed nephrectomy wounds became infected. Eighty-one percent of the infections were due to staphylococcal organisms. Wounds containing a preexisting focus of infection or those reoperated on more than once within a month prior to nephrectomy are at such high risk for infection that these wounds should be left open for secondary healing. With the use of prophylactic cefazolin sodium, in the immediate preoperative and postoperative period, no wound infections have occurred in 18 closed transplant nephrectomy wounds.

Cefazolin↗
PubMed1980

Three year experience with expanded polytetrafluoroethylene arterial grafts for limb salvage.

Polytetrafluoroethylene grafts were used for 175 femoropopliteal reconstructions with a cumulative 3 year life table patency rate of 77%. Reoperation for early or late failure was required in 27 patients to achieve this patency rate. If these 27 failures were calculated as nonpatent grafts, 3 year patency would be 62%. Thirty month life table patency rates were 94 and 91% for polytetrafluoroethylene axillofemoral and femorofemoral bypasses, respectively. Twenty-two polytetrafluoroethylene axillopopliteal bypasses were performed because of infection in the groin, previously failed reconstructions or unavailability of femoral vessels due to disease. The 2 year life table patency rate was 69%, with nine of the grafts patent for more than 1 year. Forty polytetrafluoroethylene bypasses to arteries at the ankle or in the foot resulted in a 2 year life table patency rate of 48%. Thus, polytetrafluoroethylene grafts show early promise as a vascular prosthesis. Although further study will be required to define the exact role of this new arterial substitute, it already can facilitate the performance of otherwise difficult or impossible limb salvage procedures.

Axillary Artery↗
PubMed1980

Percutaneous transluminal dilation in renal transplant arterial stenosis.

Twelve hypertensive patients underwent percutaneous transluminal dilation (PTD) for relief of arterial stenosis complicating renal allotransplantation. Two patients underwent repeat PTD for recurrent stenosis and hypertension. Six patients had end to end anastomosis of the donor renal artery to the recipient hypogastric artery; four of six PTDs were successful. Six patients had end to side anastomosis of the donor renal artery to the recipient external iliac artery; seven of eight PTDs, including one of two repeat PTDs, were successful. Prior to PTD, all patients were using several antihypertensive medications. Following successful PTD, the mean blood pressure dropped from 184 +/- 15/118 +/- 9 to 133 +/- 13/89 +/- 11 mm Hg (P < 0.001) and remained at that level for up to 15 months (average followup 9 months) with decreased or no antihypertensive medications. Since surgical correction of arterial stenosis occurring after renal transplantation is difficult and may endanger the graft, PTD should be the first interventional therapy.

Adult↗
PubMed1980

Percutaneous transluminal angioplasty in renal transplant arterial stenosis for relief of hypertension.

Seven hypertensive patients underwent percutaneous transluminal angioplasty (PTA) for relief of arterial stenosis complicating renal allotransplantation. Four had end-to-end anastomosis of the donor renal artery to the recipient hypogastric artery; all PTA's were successful. Three patients had end-to-side anastomosis of the donor renal artery to the recipient external iliac artery; 2/3 PTA's were successful. Prior to PTA, all patients were using several antihypertension medications. Following successful PTA, the mean blood pressure fell from 190 +/- 10/120 +/- 5 to 132 +/- 16/86 +/- 9 mm Hg (p less than 0.01) and remained at that level for up to six months (average follow-up 2.85 months) with decreased or no antihypertension medications. Since surgical correction of arterial stenosis is difficult and may endanger the transplant kidney, PTA should be attempted first.

Adult↗
PubMed1980

Popliteal artery branches: percutaneous transluminal angioplasty.

Percutaneous transluminal angioplasty of the branches of the popliteal artery was performed in six patients, two of whom also had femoropopliteal angioplasty. Dilatation was performed with catheters ranging from 5.5 to 7 French. None of the popliteal branch dilatations was performed with an inflated balloon. Excellent dilatation, as documented by angiography and Doppler ultrasound pressure recordings, was obtained in four cases and moderate and slight improvement in one case each. Two of the four patients with excellent results had prompt healing of toe amputations and are doing well at 19 and 22 months after angioplasty. In the other two patients with excellent results, below-knee amputation was necessary despite patency of the dilated segment in one. In the other patient with initially excellent results, reocclusion occurred 4 months after angioplasty. In the patients who had moderate and slight improvement on angiography and in distal pressures, no significant clinical course change occurred. No patient had clinical deterioration after angioplasty and no significant complications occurred.

Aged↗
PubMed1980

Management of sepsis involving expanded polytetrafluoroethylene grafts for hemodialysis access.

The incidence and management of infections in 80 polytetrafluoroethylene (PTFE) grafts is reviewed. In a follow-up period of 12 to 30 months, the overall incidence of infection was 19%. In functioning grafts the majority of infections occurred after dialysis puncture or reoperation. With appropriate management, by incision, drainage, and packing of wounds with povidone-iodine solution, it was possible, even in the face of positive blood cultures, to treat four of five localized infections successfully without loss of graft function. Prophylactic antibiotics may be useful in reducing the high incidence of infection associated with secondary operations.

Aneurysm↗
PubMed1980

Management of early and late thrombosis of expanded polytetrafluoroethylene (PTFE) femoropopliteal bypass grafts: favorable prognosis with appropriate reoperation.

In a series of 175 polytetrafluorethylene (PTFE) femoropopliteal bypasses for limb salvage, nine thrombosed within the first montha after operation and 22 thrombosed from 1 to 23 months after operation. With reoperation (four simple thrombectomies and five graft extensions) all nine early closures are patent 3 to 27 months (mean 16 months) later. Four of the late thromboses did not jeopardize the limb, and viability has persisted 4 to 14 months. Eighteen of the late thromboses placed the limb in jeopardy. Appropriate reoperation after preoperative angiography restored graft patency for 2 to 27 months in 14 of 18 cases. Six grafts were patent more than 1 year after reoperation. The operations performed for late thrombosis were incision and patch angioplasty for intimal hyperplasia (25%), graft extension for distal disease (42%), and simple thrombectomy when no cause of thrombosis was identified (33%). These findings justify an aggressive approach with appropriate reoperations when PTFE femoropopliteal bypasses thrombose in the early or late postoperative period. Important additional limb salvage can thereby be obtained.

Blood Vessel Prosthesis↗
PubMed1980

Technique for occluding the surpaceliac aorta through the abdomen.

A technique for occluding the supraceliac aorta through the abdomen is described. Although the procedure must be carried out without visual control, it can be accomplished safely and rapidly. It is recommended for use in patients in whom previous operations or disease processes make dissection of the infrarenal aorta without prior proximal control difficult and dangerous.

Aorta, Abdominal↗