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Biomedical subjects

W S Moore

Publications and source records attributed to W S Moore.

At least 235 records · Page 13Linked to original sources
PubMed1977

The use of ophthalmosonometry in the diagnosis of carotid artery stenosis.

One hundred and fifty-two patients underwent supraorbital Doppler studies of 304 carotid arteries to determine the presence or absence of hemodynamically significant lesions. Subsequent carotid arteriography was used to validate the accuracy of the test. Of 124 patients having abnormal Doppler examinations, 107 (86%) were angiographically proved to have lesions of the internal carotid artery that produced a stenosis of 50% or more. In the last 80 patients, the accuracy was increased to 94%. Of 115 proved stenoses or occlusions, the supraorbital Doppler examination correctly identified 99, for a diagnostic accuracy of 86%. In the last 50 patients, this accuracy was increased to 93%. Since only 58% of the patients with lesions had a bruit, the Doppler study was of particular value in identifying the patients with significant lesions in the absence of a bruit. Likewise, since only 61% of carotid arteries with bruits had lesions of hemodynamic significance, a normal Doppler examination could have been used to avoid angiographic screening of those arteries with bruits in the absence of major lesions, providing those hemodynamically insignificant lesions were not producing symptoms related to emboli. The technique of ophthalmosonometry and the significance of the test in clinical evaluation is discussed.

Blood Flow Velocity↗
PubMed1977

Life expectancy following aortofemoral arterial grafting.

The existence of symptomatic aortoiliofemoral occlusive vascular disease would appear to result in approximately a 10 year decrease in life expectancy compared to that of the "normal" population. However, a significant proportion of the cumulative mortality rate appears to be due to both coronary artery disease and diabetes mellitus, as patients with peripheral vascular disease had a near "normal" life expectancy in the absence of either coronary artery disease or diabetes mellitus. Neither the presence nor the anatomical location of occlusive disease distal to the comon femoral bifurication by itself decreased life expectancy compared to those patients with aortoliofemoral disease but without similar distal occusive disease. Low operative mortality rate, excellent long-term patency, and potentially "normal" life expectancy all encourage an aggressive operative approach in patients with symptoms of peripheral vascular disease but without either diabetes mellitus or coronary artery disease. Revascularization in those patients with diabetes mellitus should be directed at limb salvage rather than at relief of minor symptoms of ischemia.

Adult↗
PubMed1976

Emergency carotid artery surgery in neurologically unstable patients.

Although angiography and carotid artery surgery are illadvised in patients with acute, profound stroke, there is no consensus on the management of patients with stroke in evolution, waxing and waning neurologic deficits, or crescendo transient ischemic attacks. This type of clinical picture was associated with a critical, unstable lesion of the internal carotid artery in each of 12 patients. Emergency angiography permitted identification of the lesions responsible for the varying neurologic manifestations, and emergency carotid thromboendarterectomy produced prompt, complete recovery in all but one patient, who had a total carotid occlusion, received no operation, and died of a cerebral infarction. Based on our experience with these 12 patients, an aggressive diagnostic and therapeutic approach is recommended for patients with acute unstable cerebrovascular disease.

Aged↗
PubMed1976

Extrathoracic repair of branch occlusions of the aortic arch.

Thirty extrathoracic operations in twenty-six patients with occlusive disease involving the primary branches of the aortic arch were reviewed. Spanning a fourteen year experience, these operations included carotid-subclavian artery bypass, retrograde common carotid artery thrombectomy, carotid-carotid artery bypass, and femoral-axillary artery bypass. Dacron bypass grafts were used primarily for reconstruction, but saphenous vein bypass and endarterectomy were also employed. Indications for operation, the presence of concomitant cardiovascular disease, surgical technics, patient survival, and late patency of the reconstructions were reviewed. One patient died postoperatively (3.85 per cent). All Dacron grafts were patent on late follow-up examinations. Low mortality and excellent late functional results make extrathoracic repair the approach of choice in the management of occlusive disease of the branches of the aortic arch.

Adult↗
PubMed1975

The natural history of bilateral aortofemoral bypass grafts for ischemia of the lower extremities.

Analysis of the immediate and long-term results in 180 patients undergoing aortofemoral bypass grafts for occlusive disease of the lower extremities showed the immediate graft limb patency in 360 graft limbs to be 99.2%. The cumulative ten-year graft limb patency was 66%. Factors associated with thrombosis of the graft limb revealed correlations for localized atherosclerotic disease of either the profunda femoris artery or the tibial trifurcation vessels. The highest correlation for graft limb thrombosis was with simultaneous lesions involving both the profunda femoris artery and tibial trifurcation vessels. The acute lower extremity salvage rate was 94%, and the ten-year cumulative extremity salvage for legs at risk of amputation was 85%. Postoperative symtpoms correlated well with patency. Overall operative mortality was five patients out of 180 (2.5%).

Adult↗
PubMed1975

Bacteremic infectability of vascular grafts: the influence of pseudointimal integrity and duration of graft function.

This report describes an experimental study in which dogs with prosthetic graft replacement of the infrarenal abdominal aorta were challenged at progressive time intervals following graft placement with a single intravenous infusion of Staphylococcus aureus in order to determine the duration of susceptibility to graft infection of bacteremic origin. The results demonstrate that the susceptibility of a prosthetic graft to infection by bacteremic seeding virtually was 100 percent up to 1 month following graft placement. The incidence of infection then began to progressively drop but never was eliminated as demonstrated by a 30 percent incidence of graft infection in dogs so challenged 1 year graft placement. Careful scrutiny of the intimal surface of the harvested grafts, 3 weeks following bacteremic challenge, revealed that all grafts in which the pseudointimal coverage was complete were insulated effectively from infection by bacteremic seeding in that their cultures were negative. All grafts that had positive cultures for Staphylococcus aureus were noted to have either an incomplete or absent pseudointimal lining.

Animals↗