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V Treska

Publications and source records attributed to V Treska.

At least 91 records · Page 5Linked to original sources
PubMed1998

Role of crossover bypasses in the treatment of ischemia of the lower extremity.

AIM: To evaluate the role of crossover bypasses in the treatment of the lower extremity ischemia. METHODS: A retrospective study (1978-1997) included 51 patients with 52 femoro- or iliofemoral crossover bypasses. The most frequent indication for crossover bypass was unilateral thrombotic occlusion of the bifurcated graft or unilateral pelvic occlusion (49.0%) and the rest pain (40.4%). The main type of crossover reconstruction was "U" shaped, subcutaneous femorofemoral bypass. The first, third, and fifth year primary patency rates were evaluated using the life table analysis method. RESULTS: The cumulative patency rates were 91.3%, 73.9%, and 54.5% at 1, 3, and 5 years, respectively. Limb amputation had to be performed in five (9.6%) failed reconstructions. In four (7.7%) cases, thrombosis of reconstruction, and in one (1.9%) case, graft infection, caused the bypass occlusion. One patient (1.9%) died within 30 days after surgery from an acute myocardial attack. CONCLUSION: Crossover bypass is an attractive method because of its technical simplicity, low morbidity, and good long-term results.

Aged↗
PubMed1997

[Aneurysms of the abdominal aorta].

The authors present the experience of the Plzen department with treatment of aneurysms of the abdominal aorta (AAA) during the last five-year period (1992-1996) when they operated a total of 111 AAA in patients with an average age of 67.9 years (44-91 years). The number of symptomatic AAA was 15 (13.5%), 36 ruptures (32.4%). The most frequent risk factor was ischemic heart disease (IHD) in 74 (66.7%) and hypertension in 47 (42.3%) of the patients. Within 30 days after surgery two asymptomatic patients died (3.9%) and three (20%) with symptomatic AAA. The most frequent cause of death was acute myocardial infarction (AIM) in four (80%). Of 36 patients with rupture of AAA 17 (47.2%) died. A statistically significant factor for death of patients with rupture of the AAA was sever shock (blood pressure < 40 mm Hg) before surgery (p < 0.01), blood in the abdominal cavity (p < 0.01) and hypertension in the patient's case history (p < 0.05). Aimed screening of AAA in patients of risk groups and early elective surgery are important for reducing the incidence of ruptures of AAA. A patient with rupture of the AAA needs surgery urgently and unnecessary examination (CT, USG) frequently causes delay and reduces the patient's chance of survival.

Adult↗
PubMed1997

[Role of pulse spray thrombolysis in acute ischemia of the extremities--comparison of results with the low dose technique of local thrombolysis, embolectomy and thrombectomy].

BACKGROUND: The reported mortality of patients suffering from acute limb ischemia is in the range of 10% to 30%, as is the incidence of amputation in the survivors. MAIN PURPOSE: The evaluation of the pulse spray thrombolysis (PST) role in the treatment of acute extremity ischemia originating from thrombosis or embolism of native artery or bypass graft. The comparison of PST with low dose technique thrombolysis (LD), thrombectomy (TE) and embolectomy (EE). METHODS: Ninety nine consecutive patients were evaluated during a two year interval (1994-1996). PST, resp. LD, TE and EE were the method of choice in 22, resp. 11, 35 and 31 patients of average age 58.3 +/- 13.7; resp. 60.0 +/- 8.9; 74.2 +/- 11.7; 76.9 +/- 9.3 years. The native artery was occluded in 15 (68.2%), resp. 8 (72.7%), 31 (88.6%) and 30 (96.8%) patients with PST, resp. LD, TE and EE treatment. The vascular reconstruction was occluded in the rest of the cases. The lower limb extremity arteries were occluded in 20 (90.9%) of patients indicated for PST, 10 (90.9%) for LD, 33 (94.3%) for TE and 26 (83.9%) for EE. The contraindication for local fibrinolysis was severely ischemic limb in which viability was imminently threatened. RESULTS: PST was successful in 19 (86.4%), LD in seven (63.4%), TE in 13 (37.1) and EE in 27 (87.1%) patients. The failure of procedure required amputation in one patient (4.5%) with PST, one (9.1%) with LD, nine (25.7%) with TE-p < 0.001 and two (6.5%) with EE. The mortality was 4.5% (one patient), resp. 0%, 28.6% (10 patients)-p < 0.001 and 3.2% (one patient) in PST, resp. LD, TE and EE. The long term results were better if the successful local fibrinolysis was combined with percutaneous transluminal angioplasty (PTA), stent implantation or small vascular reconstruction. CONCLUSION: PST is the method of choice in the treatment of thrombotic or embolic occlusion of native artery or bypass graft in condition of good limb viability where there is no danger of time delay. EE is indicated in limb embolism where the viability of extremity is threatened. Thrombectomy alone has no place in the treatment of artery or bypass graft thrombosis.

Embolectomy↗
PubMed1996

[Use of endogenous proteins in the early diagnosis of dysfunction in transplanted kidneys].

The early diagnosis of renal allograft dysfunction in the immediate posttransplantation period is very important. The prospective study was undertaken in 60 patients after kidney transplantation. The significance of blood and urine levels of glomerular and tubular proteins was studied for early diagnosis of allograft dysfunction. The authors evaluate some glomerular (CRP, transferrin, immunoglobulins) and tubular (alfa 1 microglobulin and beta 2 microglobulin) proteins for differential diagnosis of acute tubular necrosis and acute rejection of transplanted kidney.

Adult↗
PubMed1996

[Compartment syndrome].

Compartment syndrome most commonly occurs following revascularization of an acutely ischemic extremity. It is not only a danger for patient's extremity but also for his or her life if it is not detected and treated in time. The authors present 37 patients treated during 10-years period at the Department of Surgery, University Hospital in Pilsen for compartment syndrome after acute extremity ischemia due to arterial occlusion or trauma. Twenty-five (67.6%) patients healed without complication. Amputation and mortality rate was 16.2%. The main cause of patient's death was reperfusion injury. The length of ischemia and time of fasciotomy were statistically significant factors for the result of treatment. The authors emphasize the significance of early diagnosis and treatment of compartment syndrome.

Adolescent↗
PubMed1995

[Surgical aspects of Buerger's disease].

BACKGROUND: The Buerger's disease (BD) is known for more than 100 years. It inflicts especially young men, smokers, at the age of about 40 and manifests itself by ischemia in the periphery of limbs which cannot be explained by precedent injury, embolism, diabetes or hyperlipemia. The disease inflicts the medium or small peripheral arteries of extremities. The occurrence of BD is most frequent in the Mediterranean and East-Asian countries. The therapy is so far symptomatic and is unsuccessful in cases when the patient is reluctant to cease smoking. AIM: The study is aimed at ascertainment of the results of surgical therapy in 14 patients with BD hospitalized in the Surgical Clinic FN in Plzen during the period from 1986 to 1995. METHODS: The average age of patients was 39.6 +/- 1.2 y. The ratio males/females was 13:1. All patients were smokers. 4 patients had a trophic defect in the periphery of the upper and 11 of the lower limbs. 9 (64.3%) patients displayed the Raynod's phenomenon and seven (50%) had thrombophlebitis. All patients were treated conservatively (vasodilators, anticoagulants, antiaggregants, corticoids, prostacyclins, nifedipine). Sympatectomy (lumbal, upper thorax) was performed in 10 (71.4%), and profundoplasty in 2 patients (14.3%). RESULTS: Conservative therapy, sympatectomy and revascularization methods failed to have a long-term effect. Repeated hospitalization of the patients was necessary, namely 7 times in average, and limbs were amputated in high percentage of patients (50%). However in cases when patients ceased smoking, the disease withdrew or became stabilized. CONCLUSION: Despite the fact that BD has become less frequent in our population, it still disables young groups of patients. The therapy is so far symptomatic and the successfulness of therapy strongly depends on the patient's willingness to cooperate (cessation of smoking) and as such it is often unsuccessful. The surgical therapy, so far, fails to have a long-term effect and high percentage of limb amputation is necessary. (Ref. 11.).

Adult↗
PubMed1993

[Arterial "crossover" reconstruction in ischemic disease of the lower extremities].

The authors present a group of 20 patients where in the course of a 15-year period (1978-1992) a crossover bypass was made to save a lower extremity with advanced ischaemia. Based on their own experience which they compare with results of physicians abroad they submit an analysis of indications for this type of extra-anatomical reconstruction. In the authors' opinion crossover bypasses have their place in reconstruction surgery of the arteries of the lower extremities if they are perceived as extra-anatomical reconstructions and thus are subjects to strict criteria for indication.

Aged↗
PubMed1993

[Cardiac complications in patients after elective pelvic reconstruction in ischemia of the lower extremities].

The authors investigated the incidence of cardiac complications in patients after elective pelvic reconstructions on account of ischaemic disease of the lower extremities in 1985-1990 and in 1990-1993. The first group of patients was examined by an experienced internist and the second by a cardiologist. The second group had a substantially higher percentage of risk factors than the first one. In the first group the postoperative cardiac morbidity was 3.4 and the mortality 2.1%. In the second group of patients both morbidity and mortality were 2.7%. The mortality quoted in the world literature is lower than 3%. The authors emphasize the necessity of comprehensive preoperative examination of patients indicated for pelvic reconstruction, perfect surgical technique and anaesthesia provided by an anaesthesiologist with experience with patients suffering from vascular diseases. It is very important to monitor rheological parameters in patients during the postoperative period immediately after surgery.

Elective Surgical Procedures↗
PubMed1992

[Arterial injuries of the upper extremities].

At the Department of Surgery in Pilsen in 1982-1991 a total of 26 patients with upper extremity vascular injuries was treated. Brachial artery was injured most commonly (50%). The direct trauma was responsible for 88.5% injuries, indirect injury was recorded in 11.5% cases only. The incidence of concomitant injuries of the vein, nerve or bone was 73.1%. Approximately one third of arterial injuries was caused by criminal offences. The vascular reconstruction was performed in all 26 patients. The overall patency rate was 84.6%, the amputation rate was 3.8%. One patient with polytrauma died of sepsis (3.8%). The authors give a comprehensive review of the causes, diagnosis and treatment of vascular injuries of the upper extremities.

Adolescent↗
PubMed1992

[Nosocomial infections in surgical intensive care of multiple injuries].

The authors present an abridged version of the final report of a State research programme. By introduction of a series of provisions and expedient use of funds available for research it proved possible to reduce the incidence of nosocomial infections in surgical patients from 14% to 12% and in a group with multiple injuries in the surgical intensive care unit from 18% to 10%.

Anti-Bacterial Agents↗
PubMed1992

[Diverticulosis of the small intestine].

The authors describe a case of a patient who has reoperated for generalized peritonitis shortly after elective inguinal hernia repair. The cause of peritonitis was small bowel diverticulosis with a ruptured diverticulum.

Aged↗
PubMed1992

[Extra-anatomic bypasses in reconstructive vascular surgery in the lower extremities].

Extra-anatomic Bypass was used in 36 patients for limb salvage at the Department of Surgery, University Hospital in Pilsen in a period of almost eleven years (1th January 1981-1th November 1991) constituting 8.2% of all vascular reconstructions. Amputation rate was 22.2% and mortality rate 8.3% (without direct connection with reconstruction). Extra-anatomic reconstruction was used in such cases only where the anatomic bypass was excluded for general or local causes.

Adult↗
PubMed1992

[Drug therapy in vascular occlusions of the lower extremities].

The authors report their three-year experience with application of thrombolytic treatment in 31 patients with vascular occlusions of the lower extremities. They were successful in two thirds of the patients. The authors analyze the advantages and shortcomings of systemic or selective administration of antithrombotic therapy. Concurrent administration of hyperbaric oxygen is a rational therapy.

Adult↗
PubMed1991

[Incidence of aneurysms of the abdominal aorta in the Czechoslovak population and possibilities of its detection].

A significant increase not only in the number of operations for AAA but also in the incidence of autopsy findings of AAA from 1.5 per cent to 4.5 per cent has been observed during the last 20 years. Ultrasound screening of the abdominal aorta in patients examined for other reasons revealed asymptomatic dilatation of the infrarenal aorta to more than 4 cm in 3.8 per cent of men older than 60 years. AAA should be actively searched for at every physical and ultrasound examination of the abdomen in men over 60 years of age.

Aged↗
PubMed1990

[Aneurysms of the peripheral arteries].

The authors discuss the problem of the right peripheral arterial aneurysm. In 1985-1989, five patients with peripheral arterial aneurysm were operated on at the surgical department, teaching hospital. Plzen. The paper gives an account of each case pointing to the specific features of this particular part of vascular surgery. Further, the authors describe the etiology, diagnostics and treatment of the disease.

Aged↗
PubMed1990

[Fibrinolytic therapy of acute arterial occlusions in the lower extremities].

The authors submit their initial experience with fibrinolytic treatment of acute arterial occlusions. In a group of 14 patients streptokinase and urokinase was administered 12 times as general treatment and twice locally. Treatment was successful in seven patients, no change in the local finding was recorded in two patients, in another two patients despite treatment progression of the ischaemia occurred. Two patients died in causal relation with treatment, one patient died for other reasons. Based on their own experience and that of authors abroad the authors emphasize the necessity of strict indication for fibrinolytic treatment, they prefer local to general administration, with regard to the number of complications. In the authors' opinion fibrinolysis holds a justified position in the treatment of acute arterial occlusions as a supplementary method of surgical treatment.

Acute Disease↗