Implantation of endoprostheses with bone cement is followed by alterations of the circulation. Intoxication, caused by the monomer of bone cement or pulmonary embolism by intramedullary contents constitute the two mostly accepted pathophysiological hypotheses. Because of the lack of pulmonary and circulatory physiological data a clinical decision concerning the value of the hypotheses was not possible until now. Hip prosthesis implantation was analyzed in 15 patients by measuring equipment controlled by an on-line-computer. The device allowed a high rate of data retrieval. The bone cement implantation syndrome reveals itself as cardiorespiratory sequelae of a disseminated pulmonary embolism which is originating in intramedullary contents, squeezed intravasal. Usual prophylactic methods are revisited.
Out of a total of 140 gastro-intestinal procedures performed with mechanical suture techniques 25 partial gastrectomies (according to Billroth I or II) are discussed. Provided the operating instructions are followed and possible complications are avoided, these mechanical techniques have proved advantageous.
This is to report as an example of 2 such cases, the indications and operative procedures of total hip-femur-knee joint alloplastics for malignant fractures of the femur. This is an alternative to the exarticulation of the femur in the case of impossibility to fix the osteosynthesis material on the remaining femur. The higher radicality of this method in comparison to the common femur-saving way might lead to a wider usage.
The IVUS system allows for a complete, only slightly invasive assessment of the femoral, pelvic and abdominal vessels in cross-section within the framework of intraoperative diagnostics and quality control. This method provides clear information concerning the vascular walls and internal structure. In our experience so far, it provides an ideal form of intraoperative control in cases of venous thrombectomy, embolectomy in the abdominal and pelvic vessels, following half-closed and open thromboendarterectomy and after intraoperatively performed angioplastic interventions.
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