Local, clinically detectable symptoms of SVT regress incomparably quicker than thrombus in affected veins. Risk of further thrombus propagation extends well beyond the period of intensive local symptoms of SVT. Regression of thrombus in femoral area requires significantly more time than in popliteal or calf segment. Thrombus propagation is directed with blood flow towards femoral segment.
Central haemodynamics, blood gases, visceral and peripheral tissue perfusion and oxygenation were studied in six patients undergoing coronary artery bypass grafting (CABG) -including one patient with aortic valve reconstruction and another with CABG and aortic valve reconstruction. The patients were operated upon under moderate haemodilution and systemic hypothermia. Visceral perfusion was indirectly assessed by determining the gastric intramucosal pH (pHi). Peripheral tissue perfusion was assessed by continuous recording of subcutaneous tissue PO 2 (PscO 2 ), laser-Doppler skin red cell flux (RCF), transcutaneous PO 2 (PtcO 2 ) and fingertip temperature (Tft) in the upper extremity. During cardiopulmonary bypass (CPB) at the deepest hypothermia, pHi, PaO 2 and PtcO 2 reached maximum values simultaneously with the lowest calculated oxygen utilization: pHi reached its minimum at the end of the operation. During CPB, PscO 2 , RCF and Tft decreased markedly, rose during rewarming and fell again at the end of surgery. These data suggest that the patients' visceral perfusion is well maintained during CPB, and the patients develop hypoperfusion and hypoxia of peripheral tissues at the same time. After closing the wounds, pHi, PtcO 2 index (=PtcO 2 /PaO 2 ) and other peripheral tissue perfusion parameters gained the lowest values indicating impending residual hypothermia and tissue hypoperfusion after rewarming.
Native arteriovenous fistula is considered the best type of access for dialysis. Its function is affected by multiple factors. the aim of the study was to identify risk factors of the loss of fistula patency. material and methods. Between 1990Between -2004 patients underwent 276 surgical procedures involving vascular access creation. In 245 (89%) of cases, a fistula was created using only patient's own blood vessels; in 31 (11%) of cases a vascular graft was implanted. 158 (64%) radio-cephalic fistulae were created, 15 (6%) radiobasilic fistulae, 33 (14%) brachiocephalic and 39 (16%) brachiobasilic fistulae. Duration of primary patency was identified for 217 native fistulae. Age, gender, diabetes mellitus, type, mode of creation and fistula location, vein translocation, type of anastomosis and time of initial cannulation were analyzed as potential factors affecting the fistula patency. Cox proportional hazards model was used in the analysis. Results. Probability of fistula patency loss in patients above 46 years of age was 2.12-fold higher than in younger patients and 1.62-fold higher for end-to-side anastomosis versus end-to-end anastomosis. Risk of loss of patency in fistulae cannulated for the first time within the first 14 days, 15-21 days and 22-35 days from their creation was 31-, 19-and 7-fold higher than when they were cannulated after the first 35 days. conclusions. Type of vascular anastomosis, age above 46 years and time of the first cannulation are independent risk factors of the loss of patency of vascular access. First cannulation should not take place earlier than 7 weeks after its creation.
Introduction: March Training (MT) is one of the ways to improve the results of treatment in patients with peripheral artery disease (PAD). The aim of this study was to investigate the effect of 12 weeks of march training on the claudication distance in patients with PAD who underwent endovascular surgery. Material and methods: The study included 30 patients with peripheral arterial disease (PAD) and evaluated the claudication distance on a treadmill: before endovascular surgery, 3 days and 3 months after the surgery. The maximum claudication distance (MCD) was measured during each test on a treadmill. Patients were randomly divided into 2 groups of 15: group A consisted of patients who were not recommended to march after endovascular surgery and group B consisted of patients to whom training was recommended. Patients in group B were recommended march training at home for 3 months according to the following schedule: walking at a regular walking pace of 60-120 feet's per minute for at least 30 minutes, 3 times a day, 3 days a week, supervised by a physiotherapist.
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