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Biomedical subjects

J H Jacobson

Publications and source records attributed to J H Jacobson.

At least 91 records · Page 5Linked to original sources
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A new clamp for end-to-side microvascular anastomosis.

A new clamp for use in microvascular end-to-side anastomosis is described. The advantages of the clamp are that the end of the donor vessel is placed precisely over the opening of the recipient vessel without tension, good exposure of the posterior wall is provided, and the tension on the stay sutures is easily adjusted.

Arteries↗
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Factors contributing to stroke in patients with atherosclerotic disease of the great vessels: the role of diabetes.

The incidence of carotid artery disease and cerebrovascular symptoms were determined in 102 consecutive patients with peripheral arterial disease. Symptoms were correlated with risk factors of age, hypertension, smoking and diabetes and with the extent of disease at the carotid bifurcation. The incidence of stroke with permanent neurological deficit was twice as high in diabetics as in non-diabetics with equivalent atherosclerotic vascular disease (p less than .05). In women, the incidence of stroke was three times higher in diabetics (p less than .02). The number of transient ischemic attacks was significantly higher in non-diabetics (p less than .02). The total number of ischemic episodes in diabetics and non-diabetics was equivalent. This indicates that diabetics are more prone to irreversible destruction of ischemic brain tissue regardless of the nature of the circulatory disturbance.

Age Factors↗
PubMedDate not supplied

The modified bovine carotid artery as a vascular substitute in man. Personal experience and review of the literature.

The modified bovine heterograft is one of the vascular prostheses currently available for clinical use. This report reviews the mode of preparation of the heterograft and its physical and biological qualities. The experience of the authors with this heterograft for vascular reconstruction in 32 patients and for the construction of s.c. arteriovenous (A-V) fistulas in 80 patients is reported. The modified bovine heterograft was found to be a satisfactory prosthesis when used in vascular reconstruction above the inguinal ligament or for the construction of A-V fistulas for hemodialysis. In reconstructions in the femoropopliteal segment of the circulation, the use of the heterograft by the authors was associated with an unacceptable rate of morbidity and graft failures. Experience reported in the literature has so far been incomplete and inconclusive, with one-year patency rates ranging between 20 and 74%.

Animals↗
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Aorto-caval fistula: a clinical spectrum.

Ten cases of aortocaval fistula (ACF) associated with abdominal aortic aneurysm (AAA) were reviewed. In 5 cases the ACF became apparent after evacuation of the thrombus; only 5 patients presented with features of patent ACF. Four patients in addition presented with extra-caval rupture of the aneurysm. Based on these variables, a classification relating ACF and AAA was developed. In this series all patients were male with a mean aneurysm size of 8.5 cm. All patients required bifurcation grafts for reconstruction. A multifactorial etiology related to enlargement and rupture of all aneurysms seems to apply to ACF. Eight of 10 patients survived. Awareness of this entity and proper preparation allow for successful outcome in the treatment of this condition.

Aged↗
PubMedDate not supplied

Evaluation of axillo-axillary artery bypass for the treatment of subclavian or innominate artery occlusive disease.

Because of the higher morbidity and mortality of transthoracic procedures, extrathoracic techniques to revascularize the subclavian or innominate artery, such as carotid subclavian and axillo-axillary artery bypasses have gained wide acceptance. The present work evaluates the results of axillo-axillary bypass in 33 patients who underwent this procedure in the past 13 years. There were 13 males and 20 females with a mean age of 61 years. The occlusive disease was present in the subclavian artery in 19 patients and in the right subclavian artery in 14 patients. Eleven patients presented with central nervous system symptoms and 10 patients complained of ischemic arm symptoms. The remaining 12 patients had both central neurological and upper extremity complaints. Twenty-one of these patients were followed for up to 5 years (mean follow-up 21 months). One patient died during the procedure from myocardial infarction (mortality of 3.03%). Patency of the bypass was determined by palpation of the graft pulse, doppler examination, and brachial arterial pressure determination. The patency rate, after 5 years, calculated by life table analysis, was 72%. In conclusion, axillo-axillary artery bypass can provide durable relief of symptoms with an acceptably high patency rate and low morbidity and mortality. It is the technique of choice in high-risk patients.

Aged↗