Vascular Surgery [antikvár]

INTRODUCTION Vascular surgery may be defined as the surgery of the arteries, the veins and the lymphatics, together with certain related procedures such as fasciotomy for acute vascular occlusion. For convenience operations upon the heart and the portal vascular system have been placed in other volumes. There is also a close association between vascular surgery and organ transplantation, because the success or failure of an organ transplant procedure depends in no small measure upon the vascular anastomoses between the host and the transplanted organ. A brief history of the development of vascular surgery is now given because a note of this type is a useful introduction to any subject. The first permanent union of two blood vessels either in the laboratory or clinical practice appears to have been accomplished in 1897 by Eck, a Russian surgeon. Before this there were occasional reports of lateral suture of blood vessels, but in 1900 Dörfler reviewed this subject and he concluded that the literature contained reports of only nine patients with a successful arterial repair by direct suture. In 1905 Carrel and Guthrie began experimenting with the anastomosis of blood vessels in the Hull Physiological Laboratory of the University of Chicago, and the techniques they developed have, except for minor variations, remained unchanged to the present time. In the field of operative surgery some events stand out as milestones where a genuinely new clinical procedure was performed for the first time. Murphy in 1897 reported the first successful end-to-end arterial anastomosis using an invagination technique of the proximal into the distal artery. In 1907 Lexer used an autogenous vein graft for the first time to replace a peripheral aneurysm, and in 1913 Pringle was the first English-speaking surgeon to report the insertion of a vein graft into the human arterial system. In 1947 Dos Santos was the first to perform the procedure of thrombo-endarterectomy in the way we use this technique today. In 1949 Kunlin introduced the procedure of femoro-popliteal by-pass grafting using an autogenous vein, and in 1951 Dubost, Allery and Oeconomos reported for the first time the successful resection of an aneurysm of the abdominal aorta and its replacement by an arterial homograft. Lastly, in 1952 Voorhees, Jaretzki and Blekemore were the first to report the use of porous plastic cloth tubes to bridge arterial defects, a procedure which DeBakey and others have developed and improved. We must not forget sympathectomy and the surgery of the venous system. In 1891 Trendelenburg reported ligature of the long saphenous vein for lower limb varices and admitted a recurrence rate of 22 per cent after a four-year follow-up. This led to the improved techniques used today. Sympathectomy was performed as a peri-arterial procedure by Jaboulay in 1899 and it appears that Jonnesco in 1923 was the first to resect the sympathetic ganglia. Finally, we should remember the debt that vascular surgeons owe to those who developed arteriography and phlebography. In 1923 Sicard and Forestier performed phlebograms in humans and in 1924 Brooks injected sodium iodide into a patient's femoral artery producing the first arteriogram. These techniques were improved and developed by Moniz and Dos Santos in Portugal together with many of our Swedish colleagues. Charles Rob