The collateral circulation in aneurism : report of the successful ligation of the innominate, the common carotid, the vertebral, and the internal mammary arteries in a case of right subclavian aneurism / by A.W. Smyth.

  • Smyth, A. W.
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: The collateral circulation in aneurism : report of the successful ligation of the innominate, the common carotid, the vertebral, and the internal mammary arteries in a case of right subclavian aneurism / by A.W. Smyth. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    18/29 (page 15)
    cuiToni, or] from botli causes combiuud, reduces tlie force of the circulation in the artery aud its branches, ou tlie distal side of tlie aueurism, to a certain extent or degree below the force of the general circulation, a retrograde collateral circn- lalion becomes established, through one of the branches on the distal side of the aneurism. The establishment of the collateral circulation on the distal side has the eltect of arrest- ing the obstructed ilirect circulation through the aneurism, and the cure of the aneurism commences from this point. Pulsation may goon in the tumor for .some time after the cir- culation through it ceases. It may even be quite strong, owing to the combined direct three of the circulation on the cardiac side, with the indirect force on the distal side. We know that pulsation in an aneurism, for a time, is not evidence of circulation through it: any more than pulsation up to the jioiiit of ligation on a continuous artery is evidence of circu- lation through this artery; and we are acquainted with the pulsation produced by the collateral circulation. It is fre- (jueutly noticed^eomiug on shortly after ligation ou the cardiac side of ail aneurism and continuing lor two or three days or longer. The arrest of the circulation in an aueurism by the estab- lishment of a collateral circulation on its distal side, when the arrest of icirculation is not otherwise produced, either by total ob.struction to the circulation in the aneurism, or by the application of the ligature either on the cardiac or on the distal side, close to the aueurism, will readily explain to us the way in which compression brings about a cure. Compression lessens the force of the circulation in the artery to the aueurism —reducing the circulation in the artery ou thetlistal side ot the aneurism to the condition required, as already stated, for the establishment of a collateral circulation. / Compression made on the aneurism or on the artery on its distal side, if effective, must act in the same way as when made on the artery on the cariliac side of the aneurism. it is manifest that compression is a very efticieut means of establishing a collateral circulation j and that the lessening of