Histological and scanning electron microscopic alterations in ileal conduit depending on the time factor

Five ileal conduit biopsies, taken after 1-7 years, were examined by light microscopy and scanning electron microscopy. The total height of the lamina mucosa decreased from 700 to 275 microns. The height of the villi diminished from 550 to 50 microns; the depth of the crypts increased from 130 to 244 microns and the villus-crypt index changed from 4.2 to 0.2. Signs of chronic inflammation could be observed. Scanning electron microscopy shows that the number of microvilli per cell was markedly reduced. There was a varied picture of different stages of atrophy. After 3 years microvilli could no longer be observed. In view of the prolonged urinary contamination time, it appears to be imperative to check neobladders with regard to possible carcinoma induction.     

Percutaneous transluminal angioplasty (PTA) of the deep femoral artery.

Between 1979 and 1988 43 percutaneous transluminal angioplasties (PTA) of the deep femoral artery were performed for treatment of severe claudication (n = 15) or for limb salvage (n = 28). Ateriographically, all patients had a long occlusion of the superficial femoral artery. Additional PTA of significant obstructions in the iliac and common femoral artery were performed in 6 patients of each group. Technical success was achieved in 41 of the 43 procedures (95%). Early clinical success was 60% for claudicants and 68% for patients with limb threatening ischemia. Success rates tended to be higher if additional PTA of the inflow tract was performed (75% versus 61%, n.s.). Patient with a good distal outflow benefited more frequently from PTA if they were treated for limb salvage (p less than 0.05). Within a follow-up period up to 24 months (mean 18.0 months) 5 patients died and one late failure occurred. Life table analysis lasting success in patients dilated for limb salvage, whereas success rate decreased to 48% in claudicants. PTA of the deep femoral artery is a less invasive and efficient treatment particularly for patients with limb threatening ischemia, an appropriate obstruction morphology provided.