Kramer, David W.; Perilstein, Paul K.; de Medeiros, Algy
April 1957
Angiology;Apr1957, Vol. 8 Issue 2, p129
Academic Journal
1. A survey of 2300 case records was made, showing the incidence of the various disorders which one may expect to find in the average course of practice, in clinics or in hospitals. Among the arterial disorders, the most commonly met conditions are arteriosclerosis obliterans, diabetic atheromatosis, and thrombosis of the arteries due to various causes. It may be noted that thromboangiitis obliterans, although frequently mentioned among the vascular disorders, is not as common as might be expected. We have not fully computed the number of our cases where the abdominal aorta shows some pathologic changes. This is not uncommon, and will be discussed in another presentation. Arteriospasm was commonly found among our patients with circulatory disturbances. Among the venous disorders, thrombophlebitis is a condition which is commonly found and the incidence seems to be increasing. 2. The method of evaluating the effects of treatment and the rules that were formulated to score the results of therapy into three groups (good results, moderate improvement and failures) were discussed. 3. The methods of treatment were briefly outlined, as were the various procedures used in the arterial cases and in the thrombophlebitis group. 4. The results of treatment showed that of the 1000 cases that were treated, the arterial group showed 381 good results (54.9 per cent); 259 were cases of moderate improvement (37.4 per cent); and 53 failures (7.7 per cent). Of the venous series, 254 cases showed good results (76.1 per cent), 73 (21.8 per cent) showed a moderate improvement, and 7 (2.1 per cent) were failures. Of the lymphatic series, 2 of the 9 cases showed good results, 4 were moderately improved, and 3 were unimproved. 5. Attention may be focused chiefly on the occlusive vascular group, because it is, particularly, for this type of patient that surgery is being advocated. In view of our very satisfactory results in improving these cases and preventing the development of gangrene, the question is raised whether surgery for these patients is justifiable at the present time. 6. Under medical treatment, patients have been carried along for 5 to 10 years or even longer, with comfort and were able to continue their activities. The incidence of gangrene in patients with thrombosis, excluding thromboangiitis obliterans and diabetes, is minimal. 7. Furthermore, it is quite possible that in the near future, further advances in biochemistry and the study of hormones may eventually not only contain the progressiveness of thrombosis, but may be helpful in inducing a regression of this pathologic condition.


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