Browsing by Author "Naidoo, Nadraj G"

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    The fate of proximally excluded iliac arteries following open repair of abdominal aortic aneurysms
    (2016) Dube, Bhekifa; Naidoo, Nadraj G
    Aneurysms occur throughout the length of the aorta, with a large proportion occurring in the infra-renal segment of the abdominal aorta (least 9 to 10 times more common than thoracic aortic aneurysms). Aneurysmal disease of the aorto-iliac segment which commonly occurs as a result of a degenerative process is invariably a progressive entity. Concomitant iliac artery aneurysms have been noted to occur in 15-40% of patients with abdominal aortic aneurysms (AAAs). As a result, following open AAA repair, there is a concern regarding the progressive enlargement of the iliac arteries. The aim of this study was to investigate the long term outcome of proximally excluded common iliac arteries (CIAs) following open bifurcated abdominal aortic aneurysm (AAA) repair. Baseline clinical and demographic data of 165 consecutive patients undergoing open AAA repair between April 2004 and April 2014 was collected. The aorta and iliac segments were measured in the 120 available preoperative Computed Tomographic (CT) angiograms. A single postoperative CT scan was performed and measurements recorded in 46 patients available for follow-up. The patients were grouped according to the type of surgical repair, open tube graft repair or bifurcated graft repair to the common iliac (CIA), external iliac artery (EIA) or common femoral artery (CFA). Entered into the study were 165 patients (133 men, 32 women) with a mean age of 66 years and a mean AAA diameter of 6.7cm (range 5.1 - 10.3cm). After a median follow-up of 49 months, 46 patients (88 CIAs) were available for a single postoperative CT scan.
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    Pattern and distribution of peripheral arterial disease in diabetic patients with critical limb ischemia (Rutherford Clinical Category 4-6)
    (2016) Motsumi, Mpapho; Naidoo, Nadraj G
    Background: The literature tends to support the notion that diabetic patients typically suffer from tibio-peroneal artery occlusive disease (1) (2) (11) (5) (10) (8) with relative sparing of the foot arteries (1). This study seeks to investigate the pattern and distribution of peripheral artery occlusive disease and the arterial foot arch status in diabetic patients with critical limb ischaemia Methods: This is a one year prospective study -(January 2014 to December 2014) carried out on consecutive patients seen at Groote Schuur Hospital, Vascular Department. The inclusion criteria is: diabetic patients ≥18 years of age with critical limb ischemia who had pre- and post-intervention vascular imaging. The calculated minimum sample size of 63 limbs [756 patency levels (63x12)] was needed to achieve a power of 86% to detect a difference of 0.1900 (19%) with a target significance level of 0.05 (using PASS 11 software). The equality of distribution of categories was analyzed using the One sample Chi-square test (SPSS 22) with our Null hypothesis (N0) assuming that categories occur with equal proportions. In this case categories refers to the 5 patency levels used in this study. All 12 main arteries from infra-renal aorta to crural arteries had their patency levels graded from category 1 to category 5 (widely patent to occluded). The findings were then stratified according to gender, age group ( <40 years, 40-54 years and ≥ 55 years) and risk factor combinations [ Group1 = (DM, HPT, Dyslipidemia); Group 2= (DM, HPT, dyslipidemia, exsmoker); Group 3 = (DM, HPT, dyslipidemia, smoker)]. The three risk combination groups formed the majority of our study group (79%).