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List of Illustrations

Contents

Illustrations

Charts

1. Graphic recording of skin temperature determinations in relation to changes in room temperature.
2. Incidence of arterial wounds among battle casualties in various wars.
3. Incidence of arterial wounds among American battle casualties in World War II.
4. Incidence of arterial wounds among wounds of extremities in American battle casualties in World War II
5. Causes of amputations among American battle casualties in World War II.
6. Distribution of arterial wounds according to anatomic location in wounds of extremities in various wars.
7. Effect of time lag between wounding and operation on incidence of amputation in arterial wounds of the extremities among American battle casualties in World War II.
8. Effects of presence or absence of associated fractures on incidence of amputation in arterial wounds of extremities among American battle casualties in World War II.
9. Effects of site of arterial wounds of the extremities on incidence of amputation in American battle casualties in World War II and in British battle casualties in World War I.
10. Effect of site of arterial wounds of the extremities on incidence of amputation in American battle casualties in World War II.
11. Effect of site of wounds of the brachial and femoral arteries on incidences of amputation in American battle casualties in World War II.
12. Effect of type of arterial wounds of the extremities on incidence of amputation in American battle casualties in World War II.
13. Results of ligation of comparable arteries with and without ligation of concomitant veins in British casualties in World War I.
14. Results of ligation of comparable arteries with and without ligation of concomitant veins among British casualties in World War I.
15. Results of various therapeutic measures on incidence of amputation in arterial wounds of extremities in American battle casualties in World War II, with special reference to the type of arterial repair.
16. Incidence of amputation in arterial wounds in American battle casualties in World War II according to method of management.
17. Results of sympathectomy and sympathetic block in comparable arterial wounds in American battle casualties in World War II.
18. Temperature chart of patient with Streptococcus viridans septicemia preceding and following operation.
19. Oscillometric and skin temperature determinations in left plantar arteriovenous fistula.
20. Effects of temporary occlusion of arteriovenous fistula on arterial pressure, stroke, volume, heart rate, cardiac output, and atrial pressure.
21. Effects ( in percentages of normal values) of arteriovenous fistula on cardiac output.
22. Ballistocardiographic observations before and after excision of femoral arteriovenous fistula.
23. Effects on blood volume (expressed as changes per square meter of body surface)  of excision of arteriovenous fistula.
24. Ballistocardiographic studies in popliteal artreriovenous fistula before and after intravenous administration of 2 mg. of atropine sulfate.
25. Distribution of measurements of cardiac frontal area ( in terms of predicted area) after operative cure of arteriovenous fitulas in 119 patients in whom the preoperative measurements had not exceeded 115 percent of the predicted.
26. Distribution of measurements of cardiac frontal area ( in terms of predicted area) in 153 patients before and in 161 patients after operative cure of arteriovenous fistula.
27. Proportion of distribution of measurements of cardiac frontal area in percentage of predicted area in 153 patients before and in 161 patients after operative cure of arteriovenous fistula.
28 Proportionate distribution of alteration in cardiac frontal ara in 132 patients after operative cure of arteriovnous fistula.
29. Comparative distribution of preoperative measurements of cardiac frontal area ( in percentages of predicted value) and of postoperative decreases ( percentages of preoperative values) in fistulas caudad and cephalad to the heart.
30. Comparative measurements of cardiac frontal area ( in percentages of predicted valus) in relation to magnitude of response of pulse and blood pressure to temporary occlusion of fistula.

Figures


1. View of room with temperature and humidity controls used for examination and testing of patients with vascular injuries and diseasees at vascular center of DeWitt General Hospital.
2. Mechanical compressor for carotid artery.
3. Special arteriographic study of restorative opeation in femoral arteriovenous fistula.
4. Through-and-through wound of popliteal artery.
5. Laceration of popliteal artery treated by nonsuture anastomosis.
6. (Case 10) Laceration of femoral artery and vein treated by nonsuture anastomosis.
7. A. Details of nonsuture technique.
    B. Transection of popliteal artery treated by nonsuture technique.
8. Tense swelling of muscles of calf, without significant subcutaneous edema, 12 hours after transection of popliteal artery.
9. (Case 24) Complete severance of right femoral artery and vein treated by ligation below profunda femoris.
10. Diagrammatic representation of various types of arteriovenous fistulas and associated aneurysms.
11. Roentgenograms showing change in heart size and evidence of pulmonary infarction.
12. Kodachrome of specimen removed at operation viewed from venous side of arteriovenous fistula.
13. Photomicrograph of portion of excised arteriovenous fistula showing two bacteria-studded vegetations, (H. and E. stain, high power magnification).
14. Diagrammatic showing of location and general appearance of the four arteriovenous fistulas present following injury by land mine.
15. A. Plantar arteriovenous fistula.
16. Serial teleoroentgenograms in femoral arteriovenous fistulas.
17. Exposure of lower femoral and popliteal vessels by medial approach anterior to sartorius muscle.
18. Skin incision for exploration of popliteal vessels.
19. Exposure of popliteal vessels.
20. Resection of head of fibula for exposure of tibial and peroneal vessels.
21. Exposure of arteriovenous fistula of posterior tibial vessels by removal of upper third of fibula.
22. (After Henry). Exposure of plantar vessels through medial approach, which is facilitated by detachment of abductor hallucis muscle from its origin.
23. Incisions for exposure of A innominate, B subclavian, and C axillary vessels.
24. Incision for exploration of distal portion of axillary and first portion of brachial vessels.
25. Incisions for exposure of vessels in antecubital fossa.
26. Exposure of fistula between brachial artery and vein in antecubital space.
27. A and B show cirsoid aneurysm of the scalp condition before operation, 8 May 1945. C. and D. Apperance of head 3 months after operation.
28. Resection of clavicle subperiostally to expose aneurysm of subclavian artery.
29. Operative exposure of vessels of superior anterior mediastinum by division of sternum and resection of inner third of left clavicle.
30. Normal range of shoulder motion in patient submitted to exposure of blood vessels in superior anterior and mediastinum by technique shown in figure 29.
31. (Case 2) Roentgenograms showing successive changes in size of heart in traumatic arteriovenous fistula involving innominate vessels.
32. (Case 2) Exposure of innominate vessels for correction of arteriovenous fistula.
33. (Case 5) Roentgenograms showing innominate aneurysm.
34. Surgical approach to a fistula between lower portions of the right vertebral vessels.
35. Surgical approach to a fistula between upper portions of the left vertebral vessels
36. (Case 4) Transvenous repair of arteriovenous fistula involving left subclavian artery and innominate vein.
37. (Case 7) Carotid-jugular arteriovenous fistula.
38. (Case 10) A. Preoperative arteriogram showing arteriovenous fistula involving upper portions of superficial femoral vessels, with small aneurysm on lateral aspect of artery. B. Postoperative arteriogram following diagonal suture.
39. Ligation and transfixion of arteriovenous fistula.
40. Lateral arteriorrhaphy.
41. End-to-end suture.
42. (Case 28, Table 31.) Postoperative artriogram taken 10 weeks after resection of fitula between femoral and profunda femoris arteries and femoral vein, with end-to-end suture of profunda artery proximally to femoral arrtery distally.
43. Vein transplantation.
44. Infrared photograph of patient with arteriovenous fistula involving abdominal aorta and vena cava.
45. Diagrammatic representation of findings at operation for arteriovenous fistula of abdominal aorta and vena cava.
46. (Case 2) A and B. Aneurysm of left carotic artery 8 weeks after injury.  C. Five months later apparent spontaneous cure of lesion.
47. (Case 9.) Right axillary aneurysm 3 months after injury.
48. (Case 9.)  Drawing of condition found at operation.
49. Traumatic aneurysm excised 11 years after its origin.
50. Poorly organized thrombus from a large brachial aneurysm of 2 months duration.
51. Typical digital symcope in patient with Raynaud's disease on exposure to cold.
52. A. Patient with longstanding Raynaud's disease showing bilateral superficial gangrene in fingertips. B. Complete healing of ulcerative areas shortly after bilateral doral sympathectomy.
53. A. Marked livido reticularis of lower extremities in patient with Raynaud's symdrome. B. Appearance of feet following bilateral lumbar sympathectomy.
54. A. Massive edema of right hand in patient with vasomotor disorder following trauma. B. Disappearance of edema several weeks after institution of intensive active exercise and physical therapy.
55. A. Massive edema and ulceration of left foot and lower leg in patient with post tramatic vasomotor disorder and resistant infection.
56. A. Edema of left foot in patient with post-traumatic vasomotor disorder and hysteria 11 months after injury.


Tables

1. Combined diagnostic analysis report Ashford General Hospital Vascular Center.
    Combined diagnostic analysis report Ashford General Hospital Vascular Center (Continued)
   Combined diagnostic analysis report Ashford General Hospital Vasuclar Center (Continued)
2. Combined operative analysis report Ashford General Hospital Vascular Center
    Combined operative analysis report Ashford General Hospital Vascular Center (Continued)
    Combined operative analysis report Ashford General Hospital Vascular Center (Continued)
3. Comparative distribution of  arterial injuries among World War I (British) and World War II (American) casualties.
4. Indications for amputation in 189 cases of vascular injury.
5. Special laboratory studies (Case 8)
6. Distribution of 814 arterial aneurysms and arteriovenous fistulas.
    Distribution of 814 arterial aneuryms and arteriovenous fistulas (Continued)
7. Oscillometric variations in the two arms at different positions during normal breathing and deep inspiration.
8. Techniques of operative treatment in 209 arterial aneurysms.
9. Techniques of operative treatment in 585 arteriovenous fistulas.
10. Associated injuries in 159 arterial aneurysms.
11. Associated injuries in 288 arteriovenous fistulas.
12. Distribution of multiple aneurysms and arteriovenous fistulas among 20 patients with 46 lesions.
13. Preoperative and postoperative ballistocardiographic observation in 47 patients with arteriovenous fistulas.
14. Preoperative and postoperative blood volume studies in 41 patients with arteriovenous fistulas.
15. Preoperative and postoperative studies of effects of temporary occlusions in 25 patients with arteriovenous fistulas.
16. Preoperative studies of effects of temporary occulsion with and without atropinization in 5 ptients with arteriovenous fistulas.
17. Location of lesion and age distribution.
18 Interval in months between injury and preoperative roentgenogram between injury and operation, and between operation and post operative roentgenogram.
19. Proportionate distribution of preoperative measurements of the cardiac frontal area.
20. Proportionate distribution of postoperative measurements of the carida frontal area.
21. Proportionate distribution of postoperative alterations in cardiac frontal area.
22. Proportionate distibution of cardiac enlargement in relation to size of fistula in patients with popliteal and femoral arteriovous fistulas.
23. Proportionate Distribution of Preoperative Cardiac Frontal Area in Variously Located Fistulas 7 Millimeters or More in Diameter and from 3.1 to 6.5 Months Duration
24. Relationship of duration and size of fistula to preoperative cardiac frontal area.
25. Relationship of duration of fistula to preoperative cardiac frontal area in patients with popliteal and femoral fistulas of large size (diameter of 7 mm.+)
26.Comparison of cardiac frontal area in patients in whom more than one measurement was made before operation.
27. Comparison of cardiac frontal area in patients in whom more than one measurement was made after operation.
28. Analysis of results of various operative procedures in patients with innominate aneurysms and arteriovenous fistulas.
29. Ligation and transfixion of fistula - data on 13 patients with arteriovenous fistulas.
30. Lateral arteriorrhaphy-data on 5 patients with aneurysms and arteriovenous fistulas.
31. End-to-end suture data on 10 patients with arterial aneurysms and arteriovenous fistulas.
32. Vein transplant - data on 6 patients with arterial aneurysms and arteriovenous fistulas.
33. Oscillometric studies following arterial repair in 28 patients.
34. Chemical constituents of blood.
35. Sympathectomy performed before or at the time of operation for aneurysm or arteriovenous fistula.
36. Sympathectomy performed before operation for aneurysm or fistula.
      Sympathectomy performed before operation for aneurysm or fistula (Continued)
37. Sympathectomy performed before operation for aneurysm or fistula.
      Sympathectomy performed before operation for aneurysm or fistula (Continued)
38. Sympathectomy performed before operation for aneurysm or fistula.
      Sympathectomy performed before operation for aneurysm or fistula (Continued)
39. Symptathectomy performed before operation for aneurysm or fistula.
40. Sympathectomy performed before operation for aneurysm or fistula.
41. Sympathectomy performed before operation for aneurysm or fistula.
42. Sympathectomy performed at the time of operation for aneurysm or fistula.
      Sympathectomy performed at the time of operation for aneurysm or fistula (Continued)
43. Incidence of sympathectomy in patients with arterial aneurysm and arteriovenous fistula.
44. Sympathectomy performed after operation for aneurysm and arteriovenous fistula.
      Sympathectomy performed after operation for aneurysm and arteriovenous fistula (Continued)
45. Sympathectomy performed after operation for aneurysm and arteriovenous fistula.
46. Sympathectomy performed after operation for aneurysm and arteriovenous fistula.
47. Sympathectomy performed after operation for aneurysm and arteriovenous fistula.
      Sympathectomy performed after operation for aneurysm and arteriovenous fistula.
48. Symptoms and signs in post-traumatic vasomotor disorders.
49. Sympathectomy in post-traumatic vasomotor disorders.
50. Sympathectomy in post-traumatic vasomotor disorders.
      Sympathectomy in post-traumatic vasomotor disorders (Continued).
51. Sympathectomy in post-traumatic vasomotor disorders.
      Sympathectomy in post-traumatic vasomotor disorders (Continued).
52. Sympathectomy in post-traumatic vasomotor disorders.