Von 1959 bis 1971 wurden bei 221 Patienten mit obliterierenden Veränderungen an den supraaortalen Gefäßen 244 Operationen vorgenommen: 147 Operationen im distalen, 97 im proximalen Abschnitt. Die Gesamtietalität betrug 4,1°/o, neurologische Komplikationen traten postoperativ bei 12°/o der Operierten auf. 87°/o der Patienten verließen die Klinik beschwerdefrei oder in gebessertem Zustand. In einer Nachbeobachtungszeit von 2 bis 12 Jahren starben 110/o der Operierten, in 2°/o traten neue zerebrale Symptome auf. Bei 180/o blieben die Beschwerden unverändert. In 690/o der Fälle konnte durch den rekonstruktiven Gefäßeingriff eine Besserung erzielt werden. Bei richtiger Indikationsstellung kann mit dem rekonstruktiven Gefäßeingriff nicht nur in einem hohen Prozentsatz Beschwerdefreiheit, sondern auch eine Verlängerung des Lebens erreicht werden. Alle Manuskripte sind direkt an die Schriftleitung zu richten. Grundsatzlich werden nur solche Arbeiten angenommen, die vorher weder im Inland noch im Ausland veröffentlicht worden sind. Die Manuskripte dürfen auch nicht gleichzeitig anderen Blättern zum Abdruck angeboten werden. -Mit der Annahme des Manuskriptes erwirbt der Verlag die ausschließliche Nutzung an allen Verwertungsrechten im Sinne der 15 if. des Urhebereechtsgesetzes, insbesondere das Recht der Vervielfältigung und Verbreitung sowie der Übersetzung. -Kein Teil der Zeitschrift darf ohne schriftliche Genehmigung des Verlages über den in

No abstract

There are different opinions concerning the benefits of oblique anastomosis and stripping of the adventitia before microvascular anastomosis. For clarification of this question, microvascular anastomoses by different techniques were performed in the aortas and the femoral arteries of 80 female Wistar rats. The average diameter of the aortas in these rats was 1.4 mm, and the average diameter of the femoral arteries was 0.7 mm. The following procedures were carried out: transverse division of the vessel and end-to-end anastomosis; transverse division of the vessel with adventitial stripping of the ends before end-to-end anastomosis; oblique division of the vessel and end-to-end anastomosis; oblique division of the vessel with adventitial stripping before anastomosis. Forty of the animals were sacrificed after 5 hours, and the remaining 40 animals were sacrificed after 3 weeks, and histologic studies were performed. All anastomoses performed on the aorta were patent at the 5-hour follow-up. The 3-week follow-up showed no differences between the transverse anastomoses both with and without adventitial stripping, but there was an accumulation of false aneurysms in the groups with oblique anastomoses and adventitial stripping. In the animals that received femoral artery anastomoses, 80% of the transverse anastomoses without adventitial stripping were patent after 5 hours of 3 weeks. The animals that received oblique anastomoses without stripping had patent vessels after 3 weeks, but there was a significant accumulation of false aneurysms in the two groups that received adventitial stripping. As this study demonstrates, the patency rate of microvascular anastomoses in vessels less than 1 mm in diameter cannot be improved significantly by oblique division with or without adventitial stripping. In addition, adventitial stripping was followed by a high percentage of false aneurysms.

Using various storage and conservation methods, we examined amputated and subsequently replanted limbs for their ischaemia tolerance level by investigating the changes in the adenylphosphocreatine system and glycolysis cycle. After replantation, amputated limbs that had been stored at room temperature (21.0 +/- 1.5 degrees C) for 2 hours were examined 14 days after operation. The adenosine triphosphate level of the skeletal muscle was reduced to 51% and the creatine phosphate to 77% of that of the control group. The glycogen was 13% of the normal value. The biochemical findings correlate with the histomorphological findings. After 2 hours ischaemia, the cross striations of the skeletal muscle and nuclear staining remained intact. There is a breakdown of the biochemical systems after 4 hours of ischaemia. They are no longer intact and the ischaemic limb does not recover. Histologically, muscle necrosis can be observed.

No abstract