RESUMEN
Kit Carson died of a ruptured aneurysm in rural Colorado in 1868. Since that time, techniques for management of aortic aneurysms have been developed and disseminated to rural areas with small hospitals. A survey of six Colorado rural hospitals' experience with ruptured abdominal aortic aneurysms is presented. Fifty-seven ruptured aneurysms had been managed during periods ranging from three to ten years. The average time to the operating room was 3.5 to 4.0 hours after hospital arrival and less than 45 minutes after diagnosis. Of those cases arriving with a systolic blood pressure less than 100 mm Hg, the mortality was 56%. The overall mortality was 53%. Groups are analyzed according to preoperative delay, occurrence of shock, and other risk factors. The results are compared with several series from metropolitan hospitals. Techniques of management that are of potential benefit in low-volume vascular case settings are discussed.
Asunto(s)
Rotura de la Aorta/cirugía , Hospitales Rurales , Hospitales , Aorta Abdominal , Rotura de la Aorta/diagnóstico , Rotura de la Aorta/historia , Rotura de la Aorta/mortalidad , Colorado , Personajes , Historia del Siglo XIX , Humanos , Ciencia Militar/historia , Factores de Tiempo , Transporte de PacientesRESUMEN
Between May 1975 and March 1977, 193 bovine heterografts and 184 polytetrafluoroethylene (PTFE) grafts (Impragrafts) have been placed for hemodialysis access. A comparison of these materials demonstrates that Impragrafts have significantly fewer late thromboses, increased resistance to infection, and comparable longevity, and they are easier to repair.