J Mal Vascul
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The measurement of the pulse wave velocity (PWV) is widely used in clinical practice to assess the elasticity of the arterial system. It can be influenced by a number of factors. The present study was undertaken to assess the possible role of anthropometric factors, hemorheological parameters and blood pressure on this element. ⋯ The PWV-diastolic pressure relationship is well-known. In contrast, the effect of the hematocrit and body surface area has never been reported.(ABSTRACT TRUNCATED AT 250 WORDS)
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Out of 1,048 Raynaud patients followed for 10 years, only 7.48% underwent surgery. This fact also results from the recent utilization of high-level epidural spinal stimulation, which we perform first, before surgery, in all "critical" Raynaud patients. We treated 40 Raynaud patients with SCS and the results were always positive: excellent in 18, good in 6 and moderate in 6. ⋯ Regular monitoring was carried out both clinically and with noninvasive and hemorheological tests. SCS appears to act like cervicothoracic surgical sympathectomy, but in contrast to the latter, it does not inhibit perspiration. Its mechanism in therefore different but the data is as yet insufficient to allow for more than personal hypotheses.
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Comparative Study
Arterial reconstructions of the lower limbs in diabetics and nondiabetics. Comparative late results.
1,261 arterial reconstructions concerning the pelvis level and the lower limbs were performed in our department between 1970 and 1981. 510 of all patients (35.4%) were diabetics, a vascular reconstruction could be performed in 337 diabetic patients, in 173 an amputation was unavoidable. 62% of all diabetics underwent a bypass operation, 38% an aorto-iliac reconstruction. There were one and a half more females than in nondiabetics. The diabetics were operated five years later than nondiabetics. ⋯ Comparative results between diabetics and nondiabetics concerning the five-, eight- and ten year patency and limb salvage rate for different graft materials were demonstrated. In diabetics the possibility of a deterioration after surgery is three times more frequent and the amputation rate is three times higher than in nondiabetics. The five year patency rate is 12% and the five year limb salvage rate 7% lesser in diabetics after femorotibial bypass.
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Together with others, the author notes that the common carotid resistance index defined by Planiol and Pourcelot has no significant value in assessing the degree of a possible distal stenosis affecting the internal carotid. Using two cases similar in terms of anatomical lesions (the intracranial internal carotid being considered to be healthy), the author suggests the classification of two types of tight stenosis of the origin of the internal carotid according to whether the Planiol and Pourcelot index is raised or abnormally normal or even low:--tight stenosis of the origin of the internal carotid situated on a functional carotid system, with normal index of resistance for the common carotid;--tight stenosis of the origin of the internal carotid situated on a carotid system in the process of exclusion, with high index of resistance for the common carotid. The author feels that the possibilities of adaptation of the microcirculation and possible collateral circulations may underly these findings.