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T Theodorides

Publications and source records attributed to T Theodorides.

11 recordsLinked to original sources
PubMed1993

Long-term results of semiclosed endarterectomy of the superficial femoral artery and the outcome of failed reconstructions.

PURPOSE: The optimal method of treatment of superficial femoral artery occlusive disease has yet to be established. Therapeutic options include percutaneous transluminal angioplasty for short lesions and reversed or in situ autologous saphenous vein bypass for long lesions. Currently, staged revascularization with polytetrafluoroethylene as an initial conduit and autologous vein for secondary procedures is suggested. An alternative to these procedures is endarterectomy of the occluded superficial femoral artery, followed by a femoropopliteal bypass in cases of endarterectomy failure. Our results with this procedure are reviewed in this article. METHODS: From 1980 until 1990, 259 endarterectomies of the superficial femoral artery were attempted, 231 of which were successfully performed in 197 patients (145 men and 52 women), with an average age of 64 years (range 40 to 82 years). The indication for successfully performed endarterectomy was claudication in 186 patients (80%), rest pain in 21 (9%), and gangrene in 24 (11%). The postoperative mortality rate was 0.8% with a complication rate of 10%. RESULTS: Eighty-two failures occurred during follow-up, of which 33 were treated with peripheral bypass. Five additional bypasses were performed because of occlusions distal from the endarterectomized segment. The 5-year primary overall patency rate of successfully performed endarterectomy was 71% (SE 3.6). The 5-year overall secondary bypass patency rate was 61% (SE 11.3). The combined endarterectomy and bypass patency rate (tertiary patency) was 79% (SE 3.3) after 5 years and 45% (SE 7.6) after 10 years. The overall amputation rate was 5.6% and the amputation rate was 1.6% in patients treated for claudication. CONCLUSIONS: The combination of endarterectomy and peripheral bypass provides a valuable alternative to the current treatment of superficial femoral artery occlusive disease.

Arterial Occlusive Diseases↗
PubMed1991

Long-term results with vein homograft in femoro-distal arterial reconstructions.

There still is a need for an alternative to autologous vein especially for infra-inguinal vascular reconstructions. Since 1984 we have used a denatured venous homograft in patients in whom the saphenous vein was either absent or unsuitable. One hundred and five homografts were implanted in the femoro-popliteal and 51 in the femoro-infrapopliteal position. The results obtained were satisfactory, with a 5-year cumulative patency (life-table method) of 53% overall, 68.4% in patients with disabling claudication, and 42% in those with critical ischaemia. The cumulative aneurysm rate was rather high, at 18% after 3 years and 58% after 5 years. An excellent limb salvage rate of 85% was achieved in patients with critical ischaemia. The management of graft aneurysms and the indications for reconstructive surgery with a denatured venous homograft are discussed.

Aged↗
PubMed1989

Site and pathogenesis of infarcts associated with carotid endarterectomy.

We analyzed perioperative strokes in 658 carotid endarterectomies with the purpose of explaining the pathogenesis from the morphologic aspect of the infarct on cerebral computed tomograms. All endarterectomies were performed with continuous electroencephalographic monitoring. Of the 42 ischemic strokes (6.4% of all endarterectomies), 34 could be studied. Seven infarcts were hemodynamically induced (five watershed infarcts, two patients with bilateral ischemia); all seven occurred during surgery. Twenty-three of the remaining 27 infarcts were within the territory of the middle cerebral artery (20) or anterior cerebral artery (three) and were probably of thromboembolic origin; 13 of these 23 occurred during surgery (57%). If intraoperative stroke was heralded by permanent electroencephalographic changes, these were not related to the moment of cross-clamping. In four patients the computed tomogram was normal. We believe these facts favor the hypothesis that thromboembolism is the most important factor in the pathogenesis of perioperative stroke associated with carotid endarterectomy under conditions of optimal cerebral monitoring.

Brain↗
PubMed1988

Three years experience with denaturated venous homografts as an arterial substitute: a clinical, pathological and immunological study.

Over a three-year-period 105 peripheral arterial reconstructions were performed using a denaturated venous homograft in a group of patients with no suitable autologous vein. A retrospective analysis has been carried out to investigate the patency rate of this graft. After three years 64% of all grafts are functioning well (according to the Life Table Method, Kaplan & Meyer). No significant differences in patency rates were found between reversed autologous veins and the material tested in this study but analysis of grafts removed after failure showed obstruction due to thrombosis or aneurysmal dilatation. No evidence of an immune response to the grafts was seen.

Aged↗
PubMedDate not supplied

Hypoplasia of the abdominal aorta.

A case of a 10 year old girl with hypoplasia of the inter-reno-mesenteric region of the abdominal aorta, which was accompanied by other pathological entities, is reported. The classification, etiology, clinical manifestations and diagnosis is discussed in detail. Successful treatment was accomplished with aorto-aortic bypass grafting and additional saphenous vein bypass from the aorta to the right renal artery. The conclusion of this study is that the hypoplasia of the abdominal aorta is a rare disease which may affect beyond the confines of the aorta and may involve the origins of vital arteries. Surgery offers the only chance of a favourable outcome.

Abnormalities, Multiple↗