Biomedical subjects

K Okadome

Publications and source records attributed to K Okadome.

77 records · Page 5Linked to original sources

PubMedDate not supplied

Initial histopathology of the autovein graft in late occlusion after arterial reconstruction.

Five patients developed local stenosis of autologous vein grafts implanted for femoro-popliteal arterial occlusive lesions. This stenosis occurred in the vein grafts 2 months to 5 years after the initial operation. Histopathologic study revealed that the stenotic segments had a thickened intima with a prominent proliferation of smooth muscle cells associated with fibrous extracellular matrix. There were no findings showing deposition of mural thrombi, as has heretofore been reported. The intimal thickening due to excessive fibromuscular proliferative response of the vein graft may possibly play an important role in the development of late graft occlusion.

Adult↗

PubMedDate not supplied

Occluded persistent sciatic artery.

The case of a patient with ischemic symptoms due to occlusion of a persistent left sciatic artery is presented. Femoral arteriography revealed a tapering hypoplastic superficial femoral artery terminating as small branches in the distal thigh and a hyperplastic profunda femoris artery. Also, translumbar aortography demonstrated an abrupt occlusion of a hyperplastic left hypogastric artery just distal to the inferior gluteal artery. The popliteal artery was found to be patent and perfused by collaterals. A bypass graft using a composite E-PTFE prosthesis and an autogenous vein graft was successfully performed.

Angiography↗

PubMedDate not supplied

Wrapping technique for prevention of anastomotic false aneurysm in synthetic prostheses: clinical and experimental.

A clinical review of late anastomotic false aneurysm in 293 prosthetic reconstructions including 694 anastomoses for larger arteries at the Department of Surgery II, Kyushu University, from 1965 to 1979, revealed the incidence of anastomotic false aneurysm to be 3.9% of 204 abdominal aortic anastomoses and 12.9% of 209 common femoral anastomoses, respectively. A major contributing factor to development of the anastomotic false aneurysm was deterioration of the parent artery. In order to prevent this complication, we successfully applied a dacron felt wrapping to 45 abdominal aortic, 44 iliac arterial and 27 common femoral arterial anastomoses and there have been no postoperative complications at 5 years. The reliability of the dacron felt wrapping technique was also evaluated by an experimental study using dogs. Furthermore, we devised a double wall anastomosis technique for application in cases with severely sclerotic abdominal aortic aneurysms. Five patients in whom this technique was used are well after 3 years.

Animals↗

PubMedDate not supplied

Failure of dacron arterial prostheses caused by structural defects.

We have observed unusual aneurysmal complications associated with structural defects of Dacron fabrics in three patients. The first patient had beadshape aneurysms along the course of the bilateral axillo-femoral prosthetic bypasses 4 or 5 years after surgery. Round defects or longitudinal rents in the lower third of the prostheses (Vascular-D knitted Dacron graft of high porosity, USCI) were the source of the aneurysmal complications. In the second patient, the transverse diameter of the aorto-femoral Dacron graft (Vascular-D, USCI) was increased to twice that of the original graft with formation of an anastomotic false aneurysm in the groin 3 1/2 years after surgery. The defective prostheses in these two cases were successfully replaced by Cooley double velour knitted Dacron grafts. The third patient developed an arterio-ureteral fistula originating from a round defect of the aorto-femoral prosthesis (Tetoron that is woven Dacron graft with a low porosity, Nakao-Filter, Japan) 8 years postoperatively and died from massive hematuria and subsequent disseminated intravascular coagulopathy. Microscopic examination of the removed prostheses revealed a complete loss of the conformation of the weave with fragmentation and disruption of the graft fibers. Therefore, patients with Dacron arterial prostheses should be followed up regularly and with great care.

Adult↗

PubMedDate not supplied

A new revascularization procedure for extensive arterial occlusions of lower extremity. A.V shunt procedure.

A revascularization procedure for extensive arterial occlusive lesions of the lower extremity, namely "A-V shunt procedure" was devised. The occluded popliteal artery is recanalized by open endarterectomy in association with E-PTFE bypass for occlusion of the superficial femoral artery, and the patency of reconstructed arterial segments is ensured by an arterio-venous shunt created at the distal end of the recanalized tibio-peroneal trunk. The branches of the genicular arterial network are also reopened by a technique of thrombectomy. Numerous collaterals develop through the reopened genicular network increasing blood flow to the ischemic distal areas. From 1967 to 1980, 63 extremities in 57 patients, which had extensive arterial occlusions of lower extremities with impending ulcer and/or severe rest pain in their feet or toes, underwent this procedure. Remarkable improvement of ischemic symptoms resulted in 76.2% of extremities at the time of the hospital discharge and 57.1% in follow-up.

Adult↗