Nonreversed valve-stripped vein graft.

A technic using nonreversed saphenous vein for arterial graft after eversion valvectomy is described. The nonreversed vein graft can be used advantageously in femoropopliteal, composite, aortopopliteal, tibial, small artery aneurysmal, and aortorenal arterial grafts.

Noninvasive measurement of pulsatile blood volume changes. Its usefulness in peripheral vascular disease.

A clinical trial was made of a new noninvasive technic for the measurement of arterial blood volume changes in a limb segment. The instrument employed is small, portable, provides a digital display in cc/min, is readily calibrated, gives reproducible values of the segmental phen be used to screen patients with peripheral vascular disease and to assess postoperative results.

A new technique for resection of thoracoabdominal aneurysms.

This report describes a temporary bypass shunt as a simple and effective method of reducing stasis time to the visceral arteries when resecting thoracoabdominal aortic aneurysms.

Efficacy of prolonged intermittent therapy with combined 5-fluorouracil and methyl-CCNU following resection for carcinoma of the large bowel. A Veterans Administration Surgical Oncology Group report.

This prospective evaluation of 5-FU and methyl-CCNU administered in combination to patients with curative surgery for histologically proved colorectal adenocarcinoma is based upon 645 patients randomized between August 1973 and July 1979. Beyond the requirement that the resection be clinically and microscopically complete, patients were not stratified prior to random treatment assignment to surgery alone or surgery followed by adjuvant chemotherapy. Drug therapy consisted of discrete 5-day courses administered at 7-week intervals, start to start. Toxic reactions were reported in association with 40% of courses. In 10% of patients with hematologic toxicity, the reactions were sufficiently severe to require the suspension or discontinuation of treatment. Treated patients experienced a slightly more favorable survival than did controls. However, the advantage was seen only in the 216 patients (34% of total) with one to four positive lymph nodes in the resected specimen. Similar proportions of treated and control deaths were attributed to residual or recurrent disease.

In vitro observations of greater saphenous vein valves during pulsatile and nonpulsatile flow and following lysis.

A significant number of saphenous vein femoral-popliteal bypass graft failures have been attributed to flow abnormalities caused by venous valves. Seventy-seven greater saphenous vein valves were observed and photographed through a 0-degree choledochoscope during pulsatile and nonpulsatile flow. No valve was seen to lie flat against the vein wall. With pulsatile flow the valves were noted to close during diastole. Stasis was noted within the valve cusps. Twenty-three valves produced photographs of sufficient quality to allow measurement of the luminal obstruction caused by the valves. This valvular obstruction represented 61% +/- 12% of the total vein lumen. Fifty venous valves were lysed by five different techniques: the microscissors, the Connolly vein stripper, the Mills valvulotome, the venotomy valvulectomy of Hall, and eversion valvulectomy. The first three methods created valvular incompetence, but flaps of valve cusps were observed to disturb flow and place potentially thrombogenic surfaces within the vein lumen. Valvulectomy, whether by venotomy or eversion, removed the valve cusps satisfactorily.