1,721,018 research outputs found
Il Doppler nella diagnosi e nel monitoraggio post-operatorio dei traumi arteriosi degli arti
No full textThe Authors describe their experience of patients with peripheral vascular traumas. 14 patients were examined by Doppler flowmeter. The most significant cases are documented and described. Granted that angiography confermed more precision in seat diagnosis, they come to the conclusion that Doppler is useful and unreplaceable during the operative stage on sugical reparation level and on distal pulses as in the post-operative monitoring of revascularisation. Doppler urgently performed must precede angiography because often it is sufficient to value the entity of haemodinamic damage and the injury's level avoiding the resort to radiological exam (50% in our experience). Doppler is particularly indicated: a) when the injury is in doubt, b) in the traumatized patient in shock conditions
Our experience in 31 cases of vascular lesions in open fractures
No full textA carefully preoperatory evaluation of limb ischemic damage is mandatory. Angiography is essential in dobiuos cases. The surgical techniques of repair employed were: anastomosis with or without patch, venous autotransplat, for small arterial tissues losses when the venous autotransplant is not advisable for the surrounding tissues conditions, it is eventually possible to resect a small portion of the bone with a resulting little shortening of the limb. Stable skeletal fixation is essential to assure a strong support to the vessels repair and it must preceed the vascular surgical reapir. If the preopeartory ischemic period has been long or if, owing to the fact of the fracture particular nature a long bone repair is foreseen, it is possible to accomplish a perfusion of the ischemic limb with cooled Ringer solution, or to perform the vascular repair before the bone fixation
Traumatismi vascolari arteriosi degli arti.
No full textVengono presentati 75 casi di lesioni vascolari arteriose maggiori, osservate dagli autori dal 1981 al 1986. Il trattamento di rivascolarizzazione è stato attuato nel 35% di casi con anastomosi termino-terminale, l'autoinnesto in vena safena invertita nel 27%, mentre nel 10% dei casi non si è proceduto a trattamento dopo valutazione arteriografica e Doppler, con attesa e conseguente risoluzione spontanea. Nel 6,6% dei casi si è effettuata disobliterazione con catetere di Fogarty, infine nel 5% si è affettuata riparazione con patch. In un solo caso si è effettuata ricostruzione della poplieta con innesto PTFE. Nei casi di associata frattura si è proceduto prima alla osteosintesi. La percentuale delle amputazioni successive è stata del 7,27%. Si sottolienea come un fattore importante nel salvataggio dell'arto sia il lag-time che non può superare le 6-8 ore
Trattamento in urgenza delle lesioni traumatiche del ginocchio. Lesioni acute associate vascolo-nervose.
No full textThis report evaluates resulta in the management of 51 cases of traumatic popliteal vessels injuries associated to traumatic lesions of the knee. In 40 cases the arterial injury was diagnosed both clinically and by Doppler exam; in 11 cases arteriography was performed. Bone synthesis was first performed in 11 cases with Hoffmann's external fixation device, in 7 cases with "a minima" synthesis and in further 7 cases with A.O. tecnique. Forty-eight of the 51 arterial recontructions required interposition by-pass graft, 40 of wich were autogenous saphenous veins. Thirty-four patients had associated venous injuries and 22 venous injuries were repaired. In 18 patients the ischemic time was shortened by the use of temporary silastic shunt for restoration of arterial flow. In 12 cases fasciotomy there was functinal loss: particularly when nerves were injured or articular bone fractures were present
Vascular injuries associated to fractures or dislocations
No full textIn complex injuries of limbs vessels are frequently involved. Immediate identification and proper treatment of such injuries are fundamental, since a late diagnosis and treatment frequently result in loss of limb or in permanent disability. During the last ten years (1969-1979) 35 patients with vascular injuries associated with comples trauma of limbs were treated in our Dept. In 80% of patients the injuries resulted from traffic accidents, in 20% from other causes. In 30% of patients pre-operatory arteriography was performed to recognize the exact site of the lesion, in other cases the site of the vascular injury was obvious. If distal ischemia persist after reduction of associated dislocation or fracture of the knee, we never made a clinical diagnosis of arterial spasm, but we have always performed the surgical exploration of the vessels. In 25% of arterial injuries we made the restoration of blood flow by end-to-end anastomosis; in 2,5% by autologous venous patch and 47,5% by reversed saphenous vein graft. The most involved arteries were: Superficial femoral, popliteal and brachial artery. An overall amputation of 12% was requested, when the period of limb ischemia was prolonged over 8 hours and when sotf tissues were severely damaged
Densitometric evaluation of DNA content in colorectal cancer
No full textThe aim of the present study was to provide information on the DNA content in colorectal tumours using densitometric techniques on histological samples and correlating the findings with age, sex, histological grade, stage, presence or absence of lymph-node metastasis and survival time. The distribution of DNA values was significantly related with the histological grade. Dukes' stage and infiltration of the peritumoral lymph-nodes. The distribution of DNA values was not significantly correlated with age and sex. From the data obtained in this study it can be concluded that evaluation of DNA content in colorectal adenocarcinoma can be used as a prognostic test that is complementary to histological investigation. The ploidy can provide information for classifying the degree of malignancy and can also be used to determine which tumours are biologically most aggressive
Considerations onlag-time in the surgical treatment of peripheric arterial traumas
No full textthe period of time within which to operate the arterial lesions of the arts is a controversial problem. After a comprehensive review of the literature, the authors expose their experience in the specific case, with good results respecting a lag-time of 6 hours after the traumatic event. describes 41 cases treated
Peripheric vascular traumas: treatment of the associated skletal lesions
No full textlimb arterial lesions are often associated with fractures. After examining the mechanisms of injury, the authors illustrate the steps of diagnosis and surgical treatment. is finally exposed the personal series
Traumi vascolari periferici: trattamento delle lesioni scheletriche associate.
No full textIn corso di lesioni complesse traumatiche degli arti la lesione vascolare arteriosa ha per prima l'indicazione alla riparazione chirurgica, ma essa può condizionare il trattamento dlla eventuale frattura associata. Infatti la stabilizzazione del segmento osseo fratturato può essere necessaria come primo momento chirurgico al fine di consentire la rivascolarizzazione arteriosa su un arto stabile; a volte invece la sutura vascolare in accorciamento del vaso può condizinare una osteosintesi dell'osso fratturato in accorciamento al fine di non esercitare trazioni sul vaso ricostruito. Viene analizzata l'esperienza pluriennale degli autori in questo particolare tipo di traumi
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