Clinical results of autologous infrainguinal revascularization using grafts originating distal to the femoral bifurcation in patients with mild inflow disease.

AIM: Chronic critical limb ischemia (CLI) often requires venous bypass grafting to distal arterial segments. However, graft patency is influenced by the length and quality of the graft and occasionally patients may have limited suitable veins. We investigated short distal bypass grafting from the superficial femoral or popliteal artery to the infrapopliteal, ankle or foot arteries, despite angiographic alterations of inflow vessels, providing that invasive pressure measurement at the site of the planned proximal anastomosis revealed an inflow-brachial pressure difference of <or=10 mmHg. METHODS: Four hundred and twenty-three consecutive infrainguinal bypass grafts were performed for CLI between June, 1999 and November, 2002 at our institution. All patients underwent preoperative clinical examination, arteriography and assessment of the veins by duplex ultrasound. The study group are patients in whom the proximal and distal anastomoses of the bypass are below the femoral bifurcation and the popliteal artery, respectively. Invasive arterial pressure measurements were recorded at the level of the planned proximal anastomosis which was performed at that level if the difference of the inflow-brachial pressure was <or=10 mmHg, irrespective of angiographic alterations of the inflow vessels proximal to the planned anastomosis. All patients had a clinical follow-up included a duplex examination of their graft, at 1 week, 3, 9 and 12 months and, thereafter, annually. No patient was lost to follow-up. RESULTS: Sixty-seven patients underwent 71 short distal bypass grafts in 71 limbs with reversed saphenous vein grafts in 52, in situ saphenous veins in 11, reversed cephalic vein in 1 and composite veins in 7, respectively. Surgical or endovascular interventions to improve inflow were required in 4 limbs (5.6%). The mean follow-up time was 22.5 months and the two-year survival was 92.5%. Primary and secondary patency rates at 2 years were 73% and 93%, respectively, and the limb salvage rate was 98.5%. CONCLUSION: In appropriately selected patients, short distal venous bypass grafts can be performed with satisfactory patency and limb salvage rates even in the presence of morphologic alterations of the inflow vessels providing that these are not hemodynamically significant, or can be corrected intraoperatively.

Report on a special investigation of the City of Riverside for the period July 1, 2006 through December 31, 2012

Report on a special investigation of the City of Riverside for the period July 1, 2006 through December 31, 2012

Examination report on the City of Sully, Iowa for the period July 1, 2012 through June 30, 2013

Examination report on the City of Sully, Iowa for the period July 1, 2012 through June 30, 2013

Report on a review of the Sixth Judicial District Department of Correctional Services for the period July 1, 2008 through June 30, 2012

Report on a review of the Sixth Judicial District Department of Correctional Services for the period July 1, 2008 through June 30, 2012

Examination report on the City of Emerson, Iowa for the period July 1, 2012 through June 30, 2013

Examination report on the City of Emerson, Iowa for the period July 1, 2012 through June 30, 2013

Report on a review of selected general and application controls over the Iowa Department of Transportation’s Vehicle Registration and Title System for the period April 16, 2012 through May 15, 2012

Report on a review of selected general and application controls over the Iowa Department of Transportation’s Vehicle Registration and Title System for the period April 16, 2012 through May 15, 2012

Examination report on the City of Dike, Iowa for the period July 1, 2012 through June 30, 2013

Examination report on the City of Dike, Iowa for the period July 1, 2012 through June 30, 2013

Examination report on the City of Urbana, Iowa for the period July 1, 2012 through June 30, 2013

Examination report on the City of Urbana, Iowa for the period July 1, 2012 through June 30, 2013

Examination report on the City of Murray, Iowa for the period July 1, 2012 through June 30, 2013

Examination report on the City of Murray, Iowa for the period July 1, 2012 through June 30, 2013

Examination report on the City of Magnolia, Iowa for the period July 1, 2012 through June 30, 2013

Examination report on the City of Magnolia, Iowa for the period July 1, 2012 through June 30, 2013

Examination report on the City of Rhodes, Iowa for the period July 1, 2012 through June 30, 2013

Examination report on the City of Rhodes, Iowa for the period July 1, 2012 through June 30, 2013

Report on a review of selected general and application controls over the Iowa Public Employees’ Retirement System I-Que Pension Administration System for the period May 20, 2013 through July 12, 2013

Report on a review of selected general and application controls over the Iowa Public Employees’ Retirement System I-Que Pension Administration System for the period May 20, 2013 through July 12, 2013

Determination of the critical period of weed control in corn using a thermal basis

Field studies were conducted over 3 years in southeast Buenos Aires, Argentina, to determine the critical period of weed control in maize (Zea mays L.). The treatments consisted of two different periods of weed interference, a critical weed-free period, and a critical time of weed removal. The Gompertz and logistic equations were fitted to relative yields representing the critical weed-free and the critical time of weed removal, respectively. Accumulated thermal units were used to describe each period of weed-free or weed removal. The critical weed-free period and the critical time of weed removal ranged from 222 to 416 and 128 to 261 accumulated thermal units respectively, to prevent yield losses of 2.5%. Weed biomass proved to be inverse to the crop yield for all the years studied. When weeds competed with the crop from emergence, a large increase in weed biomass was achieved 10 days after crop emergence. However, few weed seedlings emerged and prospered after the 5-6 leaf maize stage (10-20 days after emergence).

Examination report on the City of Granger, Iowa for the period July 1, 2012 through June 30, 2013

Examination report on the City of Granger, Iowa for the period July 1, 2012 through June 30, 2013