Infection at the site of vascular anastomosis is a serious complication of vascular surgery and is associated with a high limb loss and mortality rate. The classical method of management is ligation of the injured artery, adequate wound debridement and restoration of circulation. The latter is achieved by either in situ or extra-anatomic bypass. If the distal circulation is not maintained, subsequent amputation is most likely.
Objectives: In this study we tried to assess the efficacy of extra-anatomic synthetic bypass grafts in the treatment of vascular infection in the groin to save the limb and avoid the inevitable amputation.
Methods: Between January 2006 and December 2007, ten male patients aged twenty to thirty five years (mean=27.3years), with previous vascular surgery (reversed saphenous vein grafting) for sub-inguinal penetrating injuries complicated with infection and bleeding were admitted and managed surgically in the Department of Thoracic and Vascular Surgery, Surgical Specialties Hospital, Medical City Teaching Complex, Baghdad. These patients were studied retrospectively regarding their demographic and clinical features as well as details of the operative procedures and surgical outcome.
All patients received emergency wound debridement, arterial ligation and extra-anatomic synthetic (PTFE) bypass grafts (External iliac or common femoral to distal superficial femoral or popliteal artery, six routed laterally and four routed medially in the thigh away from the original surgical field).
Results: Excellent results were obtained in nine patients who saved amputation while one patient ended with above knee amputation. No mortality recorded.
Conclusion: Extra-anatomic bypass is a useful approach in dealing with infected and disrupted vascular anastomosis and can be used in emergency as well as elective situations as mentioned in most literatures.
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Background: Vascular tumors and malformations, comprising a broad category of lesions often referred to as vascular anomalies. Hemangioma, represents a variety of vascular lesions (both malformations and tumor), while lobular capillary hemangioma is a common vascular lesion of the skin and mucous membranes that occurs mainly in children and young adults. Lymphangiomas are malformations of the lymphatic system. At the level of light microscopy the small lymphatics vessels may be similar to capillaries and sometimes are only tentatively identified by the nature of their contents or by immunohistochemical staining procedure. This study aimed to assess the vascular and lymphatic vessels density in benign vascular lesions using CD34 and D2-40 im
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Abstract Ternary Silver Indium selenide Sulfur AgInSe1.8S0.2 in pure form and with a 0.2 ratio of Sulfur were fabricated via thermal evaporation under vacuum 3*10-6 torr on glasses substrates with a thickness of (550) nm. These films were investigated to understand their structural, optical, and Hall Characteristics. X-ray diffraction analysis was employed to examine the impact of varying Sulfur ratios on the structural properties. The results revealed that the AgInSe1.8S0.2 thin films in their pure form and with a 0.2 Sulfur ratio, both at room temperature and after annealing at 500 K, exhibited a polycrystalline nature with a tetragonal structure and a predominant orientation along the (112) plane, indicating an enhanced de
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Background Median sternotomy is the gold standard incision for most cardiac operations. However, with the advent of minimal invasive surgery, a new approach emerged in cardiac surgery named mini-sternotomy and has been successfully used to perform a variety of operations.
The aim of this paper is to present our experience of using mini-sternotomy to harvest the left internal mammary artery (LIMA) for off-pump revascularization of the left anterior descending artery (LAD)
Methodology Over a 2-year period (October 2012-October 2014), 100 patients underwent coronary artery bypass grafting (CABG) via conventional median sternotomy (CMS) (n=80) and mini-sternotomy (MS) (n=20). The
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Heart disease is a significant and impactful health condition that ranks as the leading cause of death in many countries. In order to aid physicians in diagnosing cardiovascular diseases, clinical datasets are available for reference. However, with the rise of big data and medical datasets, it has become increasingly challenging for medical practitioners to accurately predict heart disease due to the abundance of unrelated and redundant features that hinder computational complexity and accuracy. As such, this study aims to identify the most discriminative features within high-dimensional datasets while minimizing complexity and improving accuracy through an Extra Tree feature selection based technique. The work study assesses the efficac
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Aromaticity, antiaromaticity and chemical bonding in the ground (S0), first singlet excited (S1) and lowest triplet (T1) electronic states of disulfur dinitride, S2N2, were investigated by analysing the isotropic magnetic shielding, σiso(r), in the space surrounding the molecule for each electronic state. The σiso(r) values were calculated by state-optimized CASSCF/cc-pVTZ wave functions with 22 electrons in 16 orbitals constructed from gauge-including atomic orbitals (GIAOs). The S1 and T1 electronic states were confirmed as 11Au and 13B3u, respectively, through linear response CC3/aug-cc-pVTZ calculations of the vertical excitation energies for eight singlet (S1–S8) and eight triplet (T1–T8) electronic states. The aromaticities of S
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Bringing about urban, economic, and social changes in rural areas similar to those occurring in urban areas aims to reduce urban-rural disparities by providing services in those areas, decentralizing the management of these services, expanding citizen participation in local governance (decentralized administration), and achieving comprehensive development, developing and empowering localities, and keeping pace with new transformations and their impacts on the functions of the center and localities. In fact, the lack of clarity of the role of local government in planning and managing services has hindered development plans, and declined the level of services in rural areas, and has negative
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