1,721,047 research outputs found
Comparison between unibody and two body rectal endograft in patients with abdominal aortic aneurysms: a prospective, multicentric, controlled study
No full textIschemia intestinale e colite ischemica nella chirurgia dell’aorta sottodiaframmatica
No full textIschemic colitis resulting in colonic infarction after aortic ream smut ion is a highly lethal corn plication. The etiology and pathogenesis of this condition demonstrate that in many instances it may he prevented. Early recognition, particularly of the transmural ischemic injury, is essential. Numerous techniques used during surgery for assessing the adequacy of colonic perfusion have been evaluated and found to he inaccurate in terms of predicting colonic ischemia. The purpose of this study is to assess the mains monitoring technique for prediction of ischemic colitis during aortic surgery as: colonic mescnterit Doppler signals, inferior mesenteric arteries stump pressure sigmouiil intramiuosal pH and measumnent of mucosal capillary haemoglobin oxy gen saturation by reflectance spectrophotometry A 15-year experience with 1912 patio its undergoing abdominal aortic reconstruction was reviewed to determinated both the incidence of intestinal ischemia and the Clinical anatomic, and technical factors associated with this complication of aortic surgery. Copyrigh
Intestinal and colonic ischaemia in the surgery of subdiaphragmatic aorta
No full textIschemic colitis resulting in colonic infarction after aortic ream smut ion is a highly lethal corn plication. The etiology and pathogenesis of this condition demonstrate that in many instances it may he prevented. Early recognition, particularly of the transmural ischemic injury, is essential. Numerous techniques used during surgery for assessing the adequacy of colonic perfusion have been evaluated and found to he inaccurate in terms of predicting colonic ischemia. The purpose of this study is to assess the mains monitoring technique for prediction of ischemic colitis during aortic surgery as: colonic mescnterit Doppler signals, inferior mesenteric arteries stump pressure sigmouiil intramiuosal pH and measumnent of mucosal capillary haemoglobin oxy gen saturation by reflectance spectrophotometry A 15-year experience with 1912 patio its undergoing abdominal aortic reconstruction was reviewed to determinated both the incidence of intestinal ischemia and the Clinical anatomic, and technical factors associated with this complication of aortic surgery. Copyrigh
Middle verus long-term results in EVAR: a ten-year follow-up experience
No full textAim. Endovascular repair of abdominal aortic aneurysms is a relatively new technique, with few studies about long-term results. Our aim was to find if endovascular aneurysm repair (EVAR)'s complication rates at long-term were higher than at middle-term and to define a minimal period of follow-up to consider a patient as completely recovered. Methods. From 1998 to 2003, 186 patients underwent EVAR in our center. Patients were followed-up at 1, 6, 12 months and every year. Mean follow-up period was 89 months for long-term result (range 61-121 months). We collected data about cardiac and renal complications, thrombosis, surgical conversions, endoleaks, death and death from aortic rupture. All data were analysed using Sigma Statâ 3.0. Results. We observed a significant increase of mortality rate (50.40% vs. 33.70%, P<0.05); we recorded an increase in the incidence of cardiovascular adverse events (5.80% vs. 1.80%), thrombosis of EVG (2.90% vs. 1.90%), type II (3.90% vs. 3.20%) and type III endoleaks (0.89% vs. 0.53%), but there were not any statistical significant differences. Incidence of renal failure and type I endoleak were significant lower than at middle-term. There weren't any type IV endoleaks or surgical conversion after 60 months. At 120 months 24.58% of patients were alive and free from any major adverse events and 96,87% were free from aortic rupture. Conclusion. EVAR had important complications at long-term follow-up, but their rates weren't significantly higher than those of middle-term; the incidence of late aortic rupture was acceptably low. We could not define a period of follow-up after which a patient could be considered as completely recovered
Endovascular treatment of hepatic artery aneurysm in a patient with Ehlers-Danlos syndrome : Case report
No full textEhlers-Danlos syndrome (EDS) is a rare, variably inherited disorder affecting connective tissue. Patients with EDS often develop aneurysms of the thoracic and abdominal aorta as well as the visceral arteries. We report our experience with an elective endovascular exclusion of an hepatic artery aneurysm in a 26-year-old female patient with EDS type IV. A balloon-expandable 4×26 mm stent-graft was placed in the common hepatic artery, excluding the aneurysm. The follow-up at the 2, 6 and 18 months showed the patency of the common hepatic artery, the absence of endoleak and the right location of the stent-graft. In EDS patients, the endovascular treatment could be preferable to open surgery because of the minimum trauma
Sistemi di protezione cerebrale in corso di angioplastica
No full textMalignant peripheral nerve sheath tumors (MPNST) are spindle-cell sarcomas that appear in a setting of neurofibroma or schwannoma or are associated with peripheral nerves or demonstrate nerve sheath differentiation. Malignant triton tumor (MTT) is a subtype of MPNST that also contain tissue with skeletal muscle differentiation (embryonal, plemorphic and botryoid rhabdomyosarcoma). The estimated incidence of MPNSTs in patients with NF1 is 2-5% compared with 0.0001% in the general population and approximately 69% of the reported cases of MTT are associated with von Recklinghausen disease. In July 2002 a 37-year old man was readmitted to the Department of Oncologic Surgery of the S. Camillo-Forlanini Hospital in Rome for both a right-sided retroperitoneal paravertebral not palpable mass, incidentally detected at a follow-up MRI, and a left-sided popliteal mass, discovered at clinical evaluation. Seventeen months before, when the patient underwent surgery at the same Department for both a left-sided paravertebral inferior mediastinal neurofibroma and a right-sided axillary neurofibroma, diagnosis of von Recklinghausen disease (NF1) was made, according to the criteria established by the NIH Consensus Development. Conference on Neurofibromatosis of 1987. A xifopubic laparotomy was performed: the tumor appeared to be localized, well-capsulated and strictly associated to the lumbar and sacral nervous radicles (L4, L5, S1) without evidence of invasion. The tumor was completely resected with sparing of the psoas muscle and the lumbar plexus through a subperineural dissection technique. No intra-operative pathologic examination was performed. Postoperative pathologic findings showed evidence for a trition tumor. The popliteal mass was resected too and resulted to be a neurofibroma just like the tumors resected 17 months before when diagnosis of von Recklinghausen disease was made. The patient was disease free 6 months after initial surgery. Sarcoma arising in anatomic site other than extremity and superficial trunk are often more difficult to control because of anatomic constraints, delayed disease presentation, proximity to neurovascular and osseous structures and toxicity for normal adjacent tissues that limits the use of adequate radiation doses. Indeed, the anatomic site is an important prognostic factor in STS and the prognosis for retroperitoneal tumors is considerably worse than for extremity tumors. Reported local recurrence rates for retroperitoneal sarcomas range from 40% to 80% and, in marked contrast to extremity STS, most of patients can and do die from local recurrence in the absence of metastasis. In contrast to the benefit most patients with high grade soft tissue sarcomas of the extremities receive from adjuvant radiation and chemotherapy, these modalities have been of little value for retroperitoneal tumors. To overcome the problem of dose limitation, intraoperative electron beam radiotherapy (IORT) in combination with ERBT has been proposed. IORT plus ERBT was found to improve local control of disease in recent clinical trials. Current chemotherapy for retroperitoneal sarcomas is ineffective. Local adjuvant therapy such as intraperitoneal chemotherapy or experimental immunotherapy seems to be attractive in theory, but needs further investigations through prospective randomized multicentric trials. In conclusion, to date aggressive surgical management remains the most effective modality for selected primary and recurrent retroperitoneal soft tissue sarcomas including MPNSTs and the subtype MTT. Patients with incomplete resection and other risk factors such as younger age and high grade tumors may be suitable candidates for investigational adjuvant therapy
Ulcera penetrante della aorta toracica : indicazioni e tecnica per un trattamento endovascolare
No full text
Medical treatment in carotid artery disease. Review
No full textStroke is an enormous public health problem in the western world and the third most common cause of death in the United States. Carotid artery disease is an important cause of stroke and its cause is most often atherosclerosis. There are two main strategies for the treatment of carotid stenosis. The first is to stabilize the progression of the carotid plaque through lifestyle changes, risk factor modification and drugs administration, and the second one, is to eliminate the carotid plaque by angioplasty. Major trials have established carotid endarterectomy as the "gold standard" treatment option in patients with severe (>70%) carotid stenosis. More recently, carotid artery stenting has been proposed as an alternative to carotid endarterectomy. The role of endovascular treatment in carotid disease will be established with the completion of ongoing large randomized trials. Surgical or endovascular angioplasty which is the mainstay of therapy of severe carotid stenosis, is beyond the scope of this review. Actually, the aim of this study is to review evidence for the very best medical treatment of patients with carotid artery disease
- …
