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Biomedical subjects

P Balas

Publications and source records attributed to P Balas.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Superficial venous thrombosis of the lower extremities co-existing with deep venous thrombosis. A phlebographic study on 57 cases.

The incidence of deep venous thrombosis (DVT) coexistent in patients suffering from superficial venous thrombosis (SVT) has not been well documented. In a series of 57 consecutive patients with SVT of the lower extremities treated in our Department in the last five years without any obvious clinical signs of co-existing DVT, an ascending phlebographic study was performed. Co-existent DVT was disclosed in 19.6% of the patients. There was no correlation between the location or the length of thrombus and the co-existence of DVT. Patients in whom SVT developed in existing varicose veins were younger in age and the incidence of co-existence of DVT was lower. Our findings show that SVT does not always have a benign course. The disclosure of a high incidence of co-existing DVT in our series suggests the necessity of the examination of the deep venous system in all the cases of SVT by using ultrasonic technics, triplex and preferably of the ascending phlebography. The disclosure of DVT in those cases makes the application of anticoagulant treatment mandatory.

Adult↗
PubMedDate not supplied

Ruptured abdominal aortic aneurysms. Clinical and surgical considerations.

Rupture of abdominal aortic aneurysms (AAA) is a life-threatening condition and a leading cause of death in various countries. In spite of increased awareness of most physicians for an early diagnosis of the rupture, the performance of surgery in an early stage and special care in the Intensive Care Unit, postoperative mortality is still high in most medical centers as well as in our Clinic. Two series of patients operated in our Clinic during the last 17 years are analysed. The applied surgical technics are presented and morbidity and mortality are analysed. A distinction between the general mortality was made based on all the inhospital deaths and the postoperative mortality rate including only the deaths after the operation during the postoperative period. Among the other conclusions it is also stressed that a real improvement in the mortality rate depends on elective surgery of all the disclosed AAA larger than 4 cm in diameter.

Aorta, Abdominal↗
PubMedDate not supplied

Panarterial ultrasonography. A non invasive evaluation of the peripheral arterial system.

Based on the concept of the generalized character of atherosclerosis which tends to assume characteristic patterns that may be classified by a predominant site of distribution of the disease within five major categories according to DeBakey, we have developed the examination of the whole arterial system, except the coronary arteries, by using ultrasonic technics which have coined panarterial ultrasonography (PU). This includes a series of ultrasonic examinations by using the Doppler ultrasonic and B-mode duplex or triplex scan apparatus with various probes for the detection of arterial flow and imaging of the various arterial segments. During the last years 716 patients were submitted to PU. The indications for and the findings resulting from the application of PU are presented.

Adult↗
PubMedDate not supplied

Polyarteritis nodosa. An unusual cause of acute abdomen.

Two cases of acute abdomen operated on twice and biopsy specimens confirmed are presented. The diagnosis of a systemic necrotizing vasculitis group of polyarteritis nodosa was established. The syndrome affects predominantly males between the second and forth decade of life. The gastrointestinal tract is involved in approximately 50% of the cases. While a negative laparotomy may be considered as a surgical pit-fall, nevertheless, it is the only way of establishing the diagnosis and treating the complications of the disease in some of the cases.

Abdomen, Acute↗
PubMedDate not supplied

Prophylactic fasciotomy of the legs following acute arterial occlusion procedures.

During the 3-year period, 1983-86, 194 procedures for acute arterial occlusion were performed in our Clinic. In 43 cases following revascularization procedures, decompression fasciotomy of the leg for a developed or impending compartment syndrome was performed. Of these, three fasciotomies were done as a prophylactic procedure, before the development of the syndrome. Adequate and early fasciotomy should be considered by the vascular surgeon in every case of embolectomy when the ischemic time is greater than 6 hours, when the patient is young without sufficient collateral circulation, the history of acute arterial occlusion is precipitous, the patient is hypotensive and the back-flow is inadequate intra-operatively, despite the passage of the Fogarty's catheter down to the malleolus. Skin closure after fasciotomy has to be done early, mainly with approximation of the skin edges, or to cover early the exposed viable muscles with a free split-thickness autogenous skin graft. This was done in our series between the 8th and 14th postoperative days. In the case of muscle necrosis of the anterior compartment, skin coverage of the cavity has to be done later, after 2-3 weeks, as in some of our patients.

Adult↗
PubMedDate not supplied

Peripheral occlusive arterial disease in longstanding diabetes mellitus. A population study.

One hundred and seventy-five diabetic patients belonging to the same cohort were investigated. They were all inhabitants of a suburb of Athens and were initially identified during a diabetes detection drive conducted 11 years earlier. The study comprised a full physical examination, answering of a detailed questionnaire--with emphasis on signs of intermittent claudication (IC)--and a 12 lead ECG (analyzed according to the Minnesota code). It was shown that clinical signs of peripheral occlusive arterial disease were significantly associated to male sex, increased duration of diabetes, type of treatment and major ECG signs of coronary heart disease, while increased age, current smoking and existence ease, while increased age, current smoking and existence of hypertension were not significantly associated to POAD.

Arterial Occlusive Diseases↗
PubMedDate not supplied

Complement activation in atherosclerosis: effect of angiography and surgery.

Complement activation in the plasma of patients with severe atherosclerosis (arterial occlusive or aneurysmatic disease) was investigated in this study. The effects of angiography and reconstructive arterial surgery (RAS) were also assessed. Atherosclerosis was not found to be associated with systemic complement activation. Angiography resulted in high levels of C3 breakdown products. Surgery caused a significant degree of systemic complement activation in both patients with atherosclerosis and controls. Post-operative levels of C3 breakdown products were significantly higher in atheromatic patients than in controls, most likely due to the insertion of dacron arterial prostheses in the first group.

Angiography↗
PubMedDate not supplied

Long-term results and current indications in femoropopliteal vascular reconstructions.

The current indications to and long-term results of the femoropopliteal by-passes are analysed. The absolute indication is critical ischaemia with rest pain or trophic change i.e. ulcers and gangrene. The most important factor influencing the long-term results is the nature of the graft per se. The indications, arteriographic run-off, site of anastomosis, earlier femoropopliteal operations all exert a major influence on the late results, particularly prosthetic grafts are used. The results indicate the need for more prospective studies with careful monitoring of different variants in order to better understand the role of the femoropopliteal by-pass in the palliation of infra-inguinal atherosclerotic occlusive disease.

Blood Vessel Prosthesis↗
PubMedDate not supplied

Early surgical results on acute arterial occlusion of the extremities.

Although the earliest possible embolectomy is still correlated with best rates of limb salvage, we consider, as do most other authors, that the only critical criterion for operability must be the viability of the ischemic limb. Even in the presence of gangrene of the foot relief of arterial occlusion is recommended in order to secure a more distal amputation. Arterial embolectomy seems to be a simple surgical procedure; however, in the presence of atherosclerotic arteries or in the cases of acute arterial thrombosis the operative procedure needs considerable experience in vascular surgical techniques to secure a successful outcome. Finally, the prevention and early treatment of the revascularization syndrome together with appropriate cardiopulmonary management in a strict intensive-care unit can improve the mortality significantly in cases of acute arterial occlusion of the extremities.

Acute Disease↗
PubMedDate not supplied

Recurrent aortic occlusion due to malignancy.

A 62-year-old male had repeated episodes of aortic bifurcation occlusion by malignant masses of the same histologic type as the previously excised adenocarcinoma of the ascending colon. In spite of an extensive investigation of the lungs, heart and aorta no trace of the origin and the route of dissemination of the carcinomatous masses was found. Severe suspicion arises of massive malignant direct invasion of the aorta from the local recurrence of the tumor of the descending colon excised 3 years previously.

Adenocarcinoma↗