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Biomedical subjects

J D Gruss

Publications and source records attributed to J D Gruss.

83 records · Page 5Linked to original sources
PubMedDate not supplied

Results of femoropopliteal and femorotibial greater saphenous vein in situ bypass. Life table analysis.

Five-hundred-ninety-four nonselected "in situ" reconstructions were analysed retrospectively using the life table method. Especially after immediate occlusion cumulative patency is very unsatisfactory. After 5 years cumulative patency rate in these cases is 39.5% vs. 64.9% in all cases. Patency rates are influenced by the anastomotic site and the run-off quality. While statistically not significant, popliteal anastomoses perform a little better after 5 years than peripheral anastomoses (67% vs. 51% cumulative patency rate). The number of patent tibial arteries seems to be the most important determinant. In non-occluded run-off cases (three patent tibial vessels) the cumulative patency rate after 5 years is 82.2% vs. 56% in cases with only one patent tibial artery. The difference is statistically significant.

Aged↗
PubMedDate not supplied

Direct reconstructive venous surgery.

Unilateral occlusions of the pelvic veins may be corrected by a Palma operation. In the classic Palma operation the contralateral long saphenous vein is suprapubicly led to the opposite side and is anastomosed end-to-end or end-to-side with the common femoral vein of the occluded side. Just lately, spirally wall reinforced PTFE grafts showed more favourable results than Palma grafts. Circumscribed occlusions of the superficial femoral vein can be interposed by the May-Husni operation. Thereby the ipsilateral long saphenous vein is implanted end-to-side into the popliteal vein. We perform the Palma operation as well as the May-Husni operation under the protection of a temporary av-fistula. The ascending venography only permits to make a statement on the morphological operability, whereas the functional operability is indicated by means of phlebodynamometry. Phlebodynamometry and plethysmography are the best means to judge the functional result of the operation which is of importance for the patient. The results of the Palma operation can be regarded as very satisfactory, provided that the morphological and functional indication for the operation was correct. The use of the endothelium protective operative technique by Robert Mays as well as the application of a temporary av-fistula yield a success that is above 80 p.c. As against that, the May-Husni operation achieves less than 50 p.c. success, even if a temporary av-fistula is established in the area of the ancle. Less favourable are the results obtained by direct restorative interventions on the subclavian vein, so that these operations should only be indicated in exceptional cases.

Arteriovenous Shunt, Surgical↗
PubMedDate not supplied

Shoulder girdle compression syndrome.

Nowadays all compression syndromes at the upper chest like the costoclavicular syndrome, the scalenus syndrome, the hyperabduction syndrome and the Page-von Schroetter syndrome are included under the term of thoracic-outlet-syndrome. Apart from a constitutional disposition (cervical rib, anomalies of the tendons, etc.), it needs special factors like professional activities, sports, trauma, etc. to develop a T.O.S. syndrome. The symptoms range from prickling paresthesia, early fatigue, pains in shoulder and neck, claudication like pains and strong tendency towards swelling and rest pain or peripheral gangrene. Among 3126 vascular-surgical operations 128 transaxillary rib resections were performed during the time from June 1st, 1975 until March 31st, 1980. On 105 occasions rib resection was combined with the thoracic sympathectomy. In only 4 cases the resection of a cervical rib was sufficient to obtain decompression; in 15 cases the first rib had to be resected with a cervical rib. In 3 cases direct reconstructions of the artery and subclavian vein was performed by way of transaxillary approach. Postoperatively, 56% of the patients remained completely asymptomatic, 32% were decidedly improved and 12% unchanged.

Adult↗
PubMedDate not supplied

Arterial reconstruction for distal disease of the lower extremities by the in situ vein graft technique.

From January 1st, 1975 to December 31st, 1979, 285 femoropopliteal and femorocrural bypasses have been performed in 260 patients. In 57% of all cases the operation was carried out for limb salvage. The first 100 in situ transplants were angiographically examined 2 years after the operation. 5 years after the operation all patients were examined clinically, angiologically and by ultra sound Doppler technique. The patency rate amounts to 84% after 2 years and 76% after 5 years. With a patency rate of 57% after 2 years and 38% after 5 years the results achieved in the revascularization of a single crural artery are much more unfavourable. The results may be compared with those demonstrated by other authors who use the in situ technique. Compared to the classical venous bypass, the in situ bypass comes off a little better after a five years period.

Aged↗