| Description |
Vascular surgery includes wide scale of operations. We present a survey of vascular surgical procedures performed at our department during the years 2003 and 2004. For carotic stenosis 99 men and 21 women (average age 66,5 years) were operated. We did 107 endarterectomies with venous (57) or prosthetic (50) patch angioplasty, 7 everse angioplasties and 6 other procedures. 21 internal shunts were used. We had no infection or peroperative death. In 10 patients operation was cancelled for peroperative complications. In upper extremities, thrombembolectomy was done in 9 men and 14 women (average age 60,2 and 78,2 years respectively). Other operations were rare. In aorto-femoral region 73 men and 11 women were operated for aortic aneurysm, 21 of them operated urgently for aneurysmal rupture. Average age was 69 and 73 years respectively. There was no peroperative death, 4 patients died before operation. Other 60 men and 3 women were operated for occlusive disease - average age 63,5 and 55 years respectively. To majority of the patients aorto-bifemoral prosthesis was implanted. 16 other reconstructions (ilio-femoral bypass....), 29 anastomotic corrections, 28 thrombectomies and 4 peroperative PTAs were done. Eight inficated prostheses were removed (all implanted before 2003) followed by extraanatomic revascularization in 4 patients (4 axillo-femoral, 1 axillo-popliteal and 2 cross-over bypasses), leg amputation in 2, the rest left on conservative therapy. In 108 men and 26 women (average age 63 years), femoro-popliteal bypasses (84 venous and 50 prosthetic) were implanted. 31 of the 42 subarticular bypasses were venous. There were also 28 profundoplasties, 71 thrombectomies, 9 anastomotic corrections, 12 short supra-infra genu bypasses for popliteal aneurysm, 10 other reconstructions and 13 peroperative PTAs. Postpunctional femoral pseudoaneurysm was solved in 35 cases. We explanted 4 infected prostheses (2 implanted before 2003), infection rate is 1,5%. During the studied years crural venous bypass was implanted in 9 men and 4 women with the average age 65,4 years (distal anastomosis to posterior tibial artery in 12 cases). Pedal venous bypass was implanted in 15 men and 6 women (in 16 patients to dorsal pedal artery). Average age was 69,1 years. In 10 other patients vessels were insufficient for pedal bypass surgery. 9 reconstructional and 13 crural arterial thrombectomies were done In patients with renal failure 269 arteriovenous shunts were prepared. Radiocephalic fistula was the most frequent type (122 on the left forearm, 34 on the right). 101 cubital shunts were established. In 6 men prosthetic fistula was created. We did 36 shunt thrombectomies. In 3 patients shunt infection was solved by abortion of native radiocephalic fistula (1 woman, shunt prepared in 2002) or by prosthetic explantation (2 men). Infection rate was 0,74%. During 2 years 33 lumbal sympathectomies were done. 10 arterial injuries were treated. In 78 men and 29 women (average age 62 and 74,5 years respectively), 59 pedal, 10 crural, 70 femoral and 6 hip amputations were done. Primary amputation rate is 24,1%. We summarize that either spectrum and frequencies of our operations are fully comparable to other centres of vascular surgery.
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