[Perioperative complications in carotid endarterectomy with respect to the stage of the cerebrovascular disease]. / Perioperacijske komplikacije karotidnih endarterektomija s obzirom na stadij cerebrovaskularne bolesti.

Records of perioperative complications following 407 consecutive carotid endarterectomies performed in 366 patients in the 18-year period have been presented. The complications are categorized according to the clinical stage of vascular disease, that is, according to the indications for the surgery. Out of the total number, 46 (11.3%) operations were done in the 1st, asymptomatic stage of disease, for the haemodinamically significant stenoses and ulcerated plaques; 173 (42.5%) in the 2nd clinical stage for hemispheral and nonhemispheral transient ishemic attacks (TIA) and reversible neurologic deficits (RIND); 3 (0.7%) in the 3rd stage which is a progressive cerebrovascular stroke and 185 (45.5%) in the 4th clinical stage of the disease, in patients with previous cerebral infarction and a permanent neurologic deficit. The rate of a temporary and permanent neurologic deficit, as well as mortality in the first stage of the disease equals zero. In the second stage of the disease, the rate of a temporary neurologic postoperative morbidity increases to 1.7%, of a permanent neurologic morbidity to 1.2%, while the rate of mortality is 1.2%. In the 3rd and 4th stage, those rates amount to 66.7%, 0% and 33.3%, and 1.1%, 3.8% and 1.6%, respectively. The rates of perioperative morbidity and mortality are in proportion to the scope of preoperative brain dysfunction. Results of this work suggest the necessity of categorization of patients, candidates for carotid endarterectomy, according to the clinical stage of the disease, which will enable a better comparison with other authors' results, give a more reliable view on the efficacy of the surgical treatment and justify the surgeons' attitude towards indications.(ABSTRACT TRUNCATED AT 250 WORDS)

[The importance of the claudication test performed on a treadmill and its use in clinical practice]. / Vrijednost klaudikacijskog testa na pokretnom sagu i njegova primjena u klinickoj praksi.

A group of 55 patients with lower limb occlusive arterial disease was submitted to a treadmill walking exercise test in order to estimate the walking exercise length. The treadmill speed was fixed at 3 km/h and the carpet incline was 0% and 12% respectively. Doppler method for blood pressure estimation was applied in 10 patients to art. brachialis and art. dorsalis pedis bilaterally prior to and 2.5 and 10 minutes after the test. The ankle pressure index was calculated prior and post exercise. Results showed 51 +/- 9% difference between patients walking (3 km/h/0%) and patients climbing (3 km/h/12%). Ischaemic pain and blood pressure fall over art. dorsalis pedis during exercise correlated significantly 2 and 5 minutes after the test. Arteria dorsalis pedis pressure at rest and 2 and 5 minutes post exercise was statistically significant. Blood pressure indices prior and post exercise were related in the same manner. There was no difference in art. dorsalis pedis pressure and ankle pressure indices in our control group. The walking treadmill exercise test showed to be a simple reliable method for estimation of the functional degree of lower limb arterial insufficiency and for assessment of their surgical or drug therapy.

Evaluation of serial application of capillaroscopy, photoplethysmography, and dermothermometry in diagnosis and prevention of radiolesions of peripheral microvessels.

This study was performed with the aim of evaluating the justifiability of serial application of nailfold capillaroscopy, digital dermothermometry and digital photoplethysmography in the diagnosis of vascular radiolesions in subjects occupationally exposed to ionizing radiation. Thirty-eight exposed examinees, as well as 30 control persons, were included in the study. In order to establish the condition of the peripheral blood flow, each subject was examined by all the three methods. The results of this work and their statistical evaluation showed the nailfold capillaroscopy and digital dermothermometry to be the most suitable combination of methods for detection of initial changes on the smallest skin blood vessels, subsequent to skin irradiation, while the use of photoplethysmography should be limited to such cases where alterations of digital arterioles are expected.