Search PubMed⌕ Search

Biomedical subjects

G D Perdue

Publications and source records attributed to G D Perdue.

At least 37 records · Page 2Linked to original sources
PubMed1980

Revascularization for severe limb ischemia.

Patients with rest pain or tissue necrosis (generally correlated with a tibial-brachial pressure index of less than 0.25) have a high probability of limb loss unless revascularization is done. These problems are usually associated with extensive and multiple segments of anatomical occlusive disease. A review of 359 patients with such problems indicates that revascularization was done in 86%, with initial success in 92% of patients. The durability of successful limb preservation proved good, with 90% of patients having a comfortable, useful limb to time of death or for one year or longer after operation. Cumulative patency rates were 90% at five years for aortofemoral reconstructions, 70% at five years for femoropopliteal bypasses, and 49% at five years for femorotibial grafts. Cumulative limb salvage rates were 93%, 81%, and 67% at five years in the same categories, respectively.

Adult↗
PubMed1980

Abdominal aortic surgery and horseshoe kidney.

Seventy cases, including the six reported here, of aortic operations in patients with horseshoe kidney were reviewed. Anomalous renal arteries were encountered in 42 (60%) of these patients. We concluded that accurate preoperative diagnosis and angiographic delineation of aberrant renal arteries facilitate preservation of renal blood supply. When accessory or anomalous arteries cannot be preserved in situ, they should be reimplanted into the aortic prosthesis. Symphysiotomy may improve operative exposure and when necessary is a safe maneuver.

Aged↗
PubMed1980

Impending aortoenteric hemorrhage: the effect of early recognition on improved outcome.

Aortoenteric hemorrhage is the result of enteric erosion and necrosis of aortic wall or anastomotic site. Mechanical or bacteriologic causes may occur singly or in combination. The temporal sequence is such that warning symptoms, often including back pain, fever, hemotochezia, and anemia, are present long before exsanguinating hemorrhage occurs. Vigorous diagnostic efforts, including gallium-67 citrate nuclear scan and computerized axial tomography, lead to a correct diagnosis. This allows planned semielective corrective operation before severe hemorrhage begins. The ideal operation consists of extra-anatomic revascularization, excision of the infected prosthesis, bowel repair with decompression, and sump drainage. Appropriate antimicrobial therapy should be continued until healing is complete. With aggressive diagnostic and therapeutic intervention according to this plan, marked improvement in survival and limb preservation can be anticipated in patients having this complication of aortic surgery. In this series, 15 of 18 patiets having operation recovered, though delayed limb loss occurred in two.

Adult↗
PubMed1980

67Ga scintigraphy in postoperative synthetic graft infections.

Postoperative infections of synthetic vascular grafts are seldom diagnosed by conventional radiographic methods, leading to high morbidity and mortality. Gallium-67 scintigraphy was included in the diagnostic evaluation of five patients with suspected vascular graft infections. Abnormal accumulation of the radionuclide around the graft was present in all of these patients who were later determined to have paraprosthetic infections. Gallium-67 citrate scintigrams seem to be diagnostically effective in the difficult problem of paraprosthetic infection.

Abscess↗
PubMed1979

Segmental aortic occlusion: An unusual lesion found in menopausal women.

A subgroup of patients with aortoiliac atherosclerosis are perimenopausal women in whom the lesions are confined to the midportion of the terminal aorta. The lesions occur in relatively small, though not hypoplastic, vessels, and it is speculated that the relatively small size of the terminal aorta functions as a long stenosis with resultant predisposition to atheroma formation. Other etiologic factors are not identified except for smoking. Endarterectomy results in satisfactory restoration of distal arterial flow. Recurrence has not been observed but the question exists as to whether replacement of the small segment with a larger prosthesis may be more appropriate in view of the possible etiology described.

Aortic Diseases↗
PubMed1979

Vascular access for cancer chemotherapy.

A persistent problem in caring for patients receiving long-term intravenous chemotherapy for cancer is the maintenance of access to the vascular system. At Emory University Hospital between January 1975 and December 1977, 48 cancer chemotherapy patients had upper-arm bovine arteriovenous fistulas created for vascular access. The heterografts were inserted from the distal brachial artery to the proximal brachial vein under local, regional block, or general anesthesia. Grafts were functioning satisfactorily in 81% of the subjects at the time of death or at termination of treatment. The mean duration of useful graft patency for the entire group was 4.6 months, with a range of 0 to 27 months. Thrombosis of the graft was the most frequently encountered complication; infection and bleeding occurred infrequently. Reoperation was required in 35% of grafts, of which one half were salvaged. No mortality was attributable to the operative procedures or to the presence of a chronic arteriovenous fistula.

Arteriovenous Shunt, Surgical↗
PubMed1978

Preoperative aortography before abdominal aortic aneurysmectomy?

A review of 100 consecutive patients undergoing abdominal aortic aneurysmectomy was made to assess the value and necessity of preoperative aortography. Comparison of arteriography with physical examination, plain roentgenograms and ultrasonography suggests that angiography is required only for evaluation of specific problems. Indications for the selective use of preoperative aortography are proposed.

Aneurysm↗
PubMed1975

Antibiotics as an aid in the prevention of infections after peripheral arterial surgery.

Patients having arterial reconstructive operations appear to have a comparatively high attack rate of hospital-acquired infections. A protocol for administration of antibiotic prophylaxis to such patients was designed to minimize major adverse effects while evaluating the effect on attack rate of hospital acquired infections. Short intensive therapy with an appropriate antibiotic during a period of time surrounding the operative procedure itself is emphasized. The attack rate of nosocomial infections declined from approximately 12 to approximately 3 per cent and wound infections occurred in only seven of 811 patients. Administration of antibiotics according to this protocol appears to reduce the expected attack rate of nosocomial infections.

Anti-Bacterial Agents↗
PubMed1975

The significance of elongation and angulation of the carotid artery: a negative view.

Many authors have postulated that angulation of the carotid artery is a cause of stroke and recommend corrective operation. Symptoms attributed to such lesions are often nebulous and unrelieved by the operation, and proof is lacking that unselected patients who have this condition have a risk of stroke exceeding operative risk. A review of 282 cerebral angiograms showed an incidence of elongation and potential angulation of 43 percent in children and 20 percent in adults. Acutal angulation was not found in children, however, and no child was suspected of having cerebral ischemia. Of 47 adults with potential angulation, 17 were suspected of having cerebral ischemia, the remainder having a variety of other lesions, such as tumors, aneurysm, and intracranial hemorrhage. Of the 17 having suspected cerebral ischemia, all had alternative explanations for their symptoms (hypertension, intracranial atherosclerosis), except one whose symptoms were completely inappropriate to the carotid distribution. A single patient had a completed stroke, demonstrable angulation, and only mild hypertension. Elongation and potential angulation of the carotid artery is common but usually coexists with other lesions. If the finding is postulated as the cause for neurologic morbidity the surgeon must be assured that symptoms are clearly neurologic, that no other cause exists, that angulation reduces the carotid lumen significantly and reproduces symptoms, and that the risk of operation is less than the expected risk of stroke in untreated patients.

Adolescent↗