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Biomedical subjects

W T Davies

Publications and source records attributed to W T Davies.

8 recordsLinked to original sources

Common femoral artery volume flow in peripheral vascular disease.

Common femoral artery volume flow was measured at rest and during postocclusive reactive hyperaemia in 80 normal subjects and 67 patients with radiological evidence of occlusive peripheral vascular disease. At rest, means(s.d.) common femoral artery volume flow in normal subjects (344(135) ml/min) and all patients with peripheral vascular disease (401(168) ml/min) was not significantly different. During postocclusive reactive hyperaemia, mean(s.d.) peak flow was significantly higher in normal subjects (1951(438) ml/min) than in patients with peripheral vascular disease (996(457) ml/min) (P less than 0.01). Common femoral artery volume flow in patients with critical ischaemia and intermittent claudication did not differ at rest but mean(s.d.) peak flow in patients with critical ischaemia (697(276) ml/min) was significantly lower than in claudicants (1131(447) ml/min) (P less than 0.01). Mean(s.d.) resting common femoral artery volume flow in limbs with femoropopliteal disease (457(185) ml/min) was significantly greater than that in limbs with occlusion of the aortoiliac segment (308(130) ml/min) (P less than 0.01). However, this difference did not persist during postocclusive reactive hyperaemia. A hyperaemic index, calculated from the hyperaemic responses to below knee and whole limb ischaemia, was used to quantify segmental perfusion during postocclusive reactive hyperaemia. The mean(s.d.) value in normal subjects, 46(9) per cent, and in those with aortoiliac disease, 52(12) per cent, indicated approximately equal perfusion of the above and below knee limb segments. In those with femoropopliteal disease the mean(s.d.) hyperaemic index was 17(13) per cent, revealing relative hypoperfusion of the below knee segment.

Adult

Nifedipine in patients with peripheral vascular disease.

The calcium antagonist nifedipine has been studied in a group of patients with intermittent claudication. In a long-term double blind, placebo controlled trial in 27 patients there was no effect on exercise tolerance as measured by pedal ergometry and only a limited improvement in symptom score on double dose nifedipine. Common femoral artery volumetric blood flow (measured by duplex ultrasound) was unaffected. The acute effects on blood flow were also studied, with a mean increase of 23% in common femoral artery blood flow 30 min after sublingual nifedipine. The administration of nifedipine to patients with peripheral vascular disease will not adversely affect claudication symptoms, and may result in an acute improvement in lower limb blood flow. Nifedipine is a suitable antihypertensive in patients who suffer from intermittent claudication.

Administration, Sublingual

Dextran or heparin?

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Clinical Trials as Topic

Dextran 70.

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Adult

Bypass vein grafts in patients with distal popliteal artery occlusion.

The results obtained by placing reversed autogenous saphenous vein bypass grafts in either isolated popliteal artery segments or tibial vessels distal to the popliteal artery segments or tibial vessels distal to the popliteal artery are compared. Fifty-five patients with arteriosclerotic peripheral vascular disease who were threatened with limb loss were followed up from six months to nine years prior to this report. The success rate at one year was 94 per cent for the isolated popliteal segment grafts and 73 per cent for the tibial vessel grafts. The success rate after four years was 70 per cent for the isolated popliteal segment grafts and 63 per cent for the tibial vessel grafts. The clinical factors associated with the success of isolated popliteal segment bypass grafts and the factors apparently associated with failure of vein grafts in both of these groups with very poor distal arterial outflow are discussed. Our results suggest that either an isolated popliteal artery segment graft or a tibial vessel graft is a satisfactory means of treating these patients; however, a graft to an isolated popliteal segment is probably preferable to a graft to a tibial artery.

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