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Biomedical subjects

W H Edwards

Publications and source records attributed to W H Edwards.

At least 109 records · Page 6Linked to original sources
PubMed1977

Management of early postoperative complications of arterial repairs.

Of 1,703 patients undergoing arterial procedures during a three-year period, 81 (4.7%) required reoperation within 72 hours because of early complications. Thrombosis (58 patients) and hemorrhage (19 patients) were the most frequent complications encountered. Reoperation was successful in salvaging a successful outcome in the majority of patients after both hemorrhagic and thrombotic complications. The results seem to justify a continued aggressive approach to the management of early complications following vascular reconstructive procedures.

Aorta, Abdominal↗
PubMed1977

Importance of the external carotid artery in extracranial cerebrovascular occlusive disease.

We have encountered 12 patients whose symptoms of transient ischemic attacks were due to total occlusion of the internal carotid artery with patency of the intracranial circulation being maintained by collateral circulation from the external carotid artery. In each case there was either tight stenosis or total occlusion at the origin of the external carotid artery. Eleven of the 12 patients were operated upon, receiving either thromboendarterectomy of the external carotid artery or a saphenous vein bypass to the patent distal portion of this artery. Ten of these 11 had complete or significant relief of symptoms. Although this condition represents only a small percentage of the total number of clinically significant extracranial occlusive lesions, studies suggest that the external carotid artery may be involved more commonly than previously suspected. Adequate radiographic visualization of the cerebral circulation is essential to evaluate the collateral pathways.

Aged↗
PubMed1976

Arm veins for peripheral arterial reconstruction.

The ipsilateral saphenous vein has become accepted as the best available material for femoropopliteal bypass and for arterial patch grafts as well as for visceral and cardiac bypasses. However, in a few patients, nonavailability or nonsuitability of the saphenous vein forces use of some other material. We report an experience with 32 operations using arm veins. Among the 11 long vein grafts, seven composite vein-Dacron or vein-vein grafts, and 14 vein patch grafts during the past six years, there were no infections or aneurysms and only nine thrombotic failures have been detected to date, to our knowledge. Our present indications are (1) ipsilateral saphenous vein is not available or is not suitable, (2) only a short graft or patch is needed and the saphenous vein may therefore be saved for the future, (3) to join to a saphenous graft or to a Dacron composite graft for additional length, and (4) to reconstruct an arm artery. Our experiences using cephalic and basilic veins confirms them as a useful source of autogenous material for arterial reconstruction.

Adult↗
PubMed1976

Tibial and peroneal bypass in severe occlusive disease of the lower extremities.

Symptomatic arteriosclerotic occlusive disease involving the femoral and proximal popliteal arteries is currently best treated by reversed autogenous saphenous vein bypass graft. Severe occlusive disease frequently includes the popliteal and/or origin of the trifurcation vessels with reconstitution of one or more of the vessels in the lower leg. We have used distal bypass 97 times in 90 patients during the past decade. There was only one postoperative death in the series in spite of the advanced age and concurrent disease in the majority of the patients. Our indications for operation continue to be relief of pain or salvage of an extremity. We rely on high quality preoperative angiograms for selection of vessels to receive the bypass. The posterior tibial artery was used in 63 of the cases, while the anterior tibial and peroneal were used in 24 and 10 cases, respectively. There were 11 immediate inhospital failures in this series of 97 cases requiring amputation in five. Three additional patients had amputations during the ensuing several months. Of the 85 grafts functioning at the time of discharge from the hospital, 16 or (18.8%) failed during the first years. Grafts that remained patent for one year have a high incidence of long term patency which is in keeping with other reported series.

Adult↗
PubMed1975

Conservative surgical treatment of reflux esophagitis and esophageal stricture.

During a recent 3-year period, 17 consecutive patients were seen with advanced fibrotic esophageal strictures secondary to alkaline-acid-pepsin reflux. From detailed preoperative evaluations alone it was impossible to determine whether therapy should consist of excisional surgery, esophagogastroplasty or intra-operative dilatation with correction of reflux. Only at operation could the length, extent, degree and severity of the stricture be fully determined. Each of the 17 patients was treated by controlled dilatation, coupled with an antireflux procedure. This simplified approach proved successful on strictures thought preoperatively to be undilatable. It appears that this conservative approach is applicable to many advanced strictures and excisional and plastic procedures should be reserved for those cases that prove unyielding to intraoperative dilatation. The true appraisal of a reflux stricture and the choice of surgical procedure is best determined at the operating table.

Aged↗