Vascular surgery at the Second Department of Surgery, St. Anne’s Faculty Hospital, Brno, in the years 2003–2005



Year of publication 2006
Type Article in Periodical
Magazine / Source Scripta medica
MU Faculty or unit

Faculty of Medicine

Description The aim of the study is to present the spectrum of vascular procedures carried out at our department during the years 2003 to 2005. In the carotid region there were 185 operations for carotid stenosis (144 men, 41 women, average age 65.9 years). Carotid endarterectomy with venous (86) or prosthetic (77) patch angioplasty was the most frequent procedure. In 20 % an intraluminal shunt was used. There were 6 strokes (3.24 %) in the perioperative period. Five patients were operated for vascular injury. There were no infectious complications. We did 39 thrombembolectomies in the upper extremities (15 men, 24 women, average age 74 years). Two women were operated for the thoracic outlet syndrome, three men for the subclavian steal syndrome. Six patients were operated for injury of the brachial or antebrachial vessels. There were no infectious complications. During the studied years 383 arteriovenous fistulas for hemodialysis were established (232 according to Brescia-Cimino, 144 cubital shunts). In 49 cases thrombectomy was done. We solved 4 infections (2 native shunts, 2 prosthetic), with the incidence of 0.78 %. For aortic aneuryms, 118 men and 17 women were operated (107 electively, 28 urgently). There was no perioperative death. Furthermore, 144 patients were operated for atherosclerotic occlusive disease. In 24 cases we solved anastomotic pseudoaneurysm in the groin. Thirty-five thrombectomies were done. In 13 patients vascular prosthetic infection was treated, 9 of them being implanted before 2003. The incidence rate is 1.46 %. In 227 patients (180 men, 47 women, average age 61.3 years) femoropopliteal bypass was implanted, 141 of them using autologous vein. In 72 cases the lower anastomosis was situated below the knee. In 17 patients short supra-infra genu venous bypass was implanted for popliteal artery aneurysm. Fortyone profundoplasties and 30 anastomotic repairs were carried out. We also solved 41 postpunctional groin injuries. Furthermore, 117 thrombectomies were done. In 4 cases bypass infection was treated; the incidence rate is 0.88 %. In the femur-distal region 18 crural bypasses (17 venous, 1 prosthetic) were implanted, with a distal anastomosis to the posterior tibial artery in 16 cases. Thirty-six pedal reconstructions (33 venous, 3 composite grafts) were implanted, distal anastomosis to dorsal pedal artery in 27 cases. In 22 patients the arteries were insufficient for reconstruction. We also did 29 crural thrombembolectomies. One pedal infection was solved (bypass implanted in 2002). During the 3 years we did 39 lumbar sympathectomies, 25 perioperative angioplasties (10 in the iliac, 15 in the femoral region) and 17 extra-anatomic econstructions. From the 220 amputations 92 were localised to the foot, 13 were crural and 101 femoral amputations and 9 hip exarticulations; primary amputation rate is 25.6 %. We summarise that both the spectrum and the results of our operations are fully comparable with other vascular surgical centres.

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