1,721,059 research outputs found
Severe vascular complication after implantation of a three-piece inflatable penile prosthesis
No full textWe report a case of acute arterial ischemia and deep venous thrombosis due to compression of the external iliac vein and artery by the reservoir of a three-piece inflatable penile prosthesis. Deho' F, Henry GD, Marone EM, Sacca' A, Chiesa R, Rigatti P, and Montorsi F. Severe vascular complication after implantation of a three-piece inflatable penile prosthesis. © 2008 International Society for Sexual Medicine
Therapy of venous disorders in Italy: results of a three-year survey
No full textAim. The aim of this paper was to investigate the behavior of a non-random sample of Italian chronic venous disorders (CVD) sufferers in the management of their complaints and to analyse the treatments recommended by phlebologists towards this problem. Methods. This was a cohort study as a part of a large CVD prevention programme. The sample was a non-random, cross-sectional sample of male and female patients selected through advertisements. Subjects described subjectively the presence of CVD complaints and the presence of CVD was then assessed conclusively by a specialist. Information about the different types of therapeutic intervention implemented before the examination or recommended by the specialist was collected. Each treatment option was related to socio-demographic variables, with particular reference to the region where patients lived, their family history and the severity of objective clinical signs. Results. The study analysed 31 659 subjects. In this sample, the most common manifestations of venous disease, especially in young women, were telangiectases; saphenous or non-saphenous varicose veins are slightly more frequent in males and subjects over 50 years of age. Medical or compression therapies were performed by a large portion of the population (>30%). Young people tend to prefer medical to compression therapy. In Southern Italy, medical therapy is widespread whereas in Central Italy compression stockings are only infrequently used. Specialists tend generally to prescribe conservative therapies for less severe forms of chronic venous insufficiency (CVI). Compression stockings seem to be gradually replaced by drug therapy, in particular products of natural origin. Among natural remedies, bioflavonoids are the most used ones, whereas among terpenes, topical aescine is the most widespread. Conclusion. The present study has demonstrated that in a large percentage of cases, Italian consumers suffering from problems related to venous insufficiency carry out conscious and informed self-medication
Technical features of the INCRAFT (R) AAA Stent Graft System
No full textThe INCRAFT (R) AAA Stent Graft System is the advanced endovascular aneurysm repair (EVAR) technology for the treatment of infrarenal abdominal aneurysms. This new system is designed to address the unmet needs of current endografts by combining unique features and adding new refinements compared to existing endografts delivered through a flexible 14-Fr ultralow system. The INCRAFT (R) AAA Stent Graft System introduces innovative features without deviating from proven stent-graft design principles. It is a three-piece modular system, made of low porosity polyester and segmented nitinol stents. However, the introduction of cap-free delivery and partial proximal repositioning enhances the ability of the device to better match individual aortoiliac anatomy with a high deliverability and placement accuracy in a easy to use system. Moreover, the INCRAFT (R) System allows a "customization" of the implant during the procedure with bilateral in-situ length adjustment features. The present data from the ongoing clinical trials confirm excellent results with this system, but postmarket studies will be necessary to verify the effectiveness of this system in the real-world setting
Endovascular treatment of an early arch aneurysm rupture after open thoracoabdominal aortic repair
No full textOptimal treatment for synchronous aortic aneurysms is still debated. Staged repair is advocated as the standard of care. Its disadvantage however is the consistent risk of rupture of the untreated aortic segment during recovery; moreover a considerable percentage of patients either refuse the second stage or is lost to follow-up. We present the case of a patient with a ruptured aortic arch aneurysm after open-surgery for a type III thoracoabdominal aortic aneurysm. Our therapeutic decision is described and discussed, with all the related advantages and disadvantages.Optimal treatment for synchronous aortic aneurysms is still debated. Staged repair is advocated as the standard of care. Its disadvantage however is the consistent risk of rupture of the untreated aortic segment during recovery; moreover a considerable percentage of patients either refuse the second stage or is lost to follow-up. We present the case of a patient with a ruptured aortic arch aneurysm after open-surgery for a type III thoracoabdominal aortic aneurysm. Our therapeutic decision is described and discussed, with all the related advantages and disadvantages
Chronic venous disorders: Correlation between visible signs, symptoms, and presence of functional disease
No full textBackgroun& The aim of this study was to investigate the frequency of chronic venous disorders (CVD) in different demographic groups in Italy and to provide correlations between patterns of valve incompetence and clinical feature of disease severity. Methods. Advertisements in television and newspapers in 53 Italian cities were used to solicit 16,251 subjects (13,826 women, mean age 50.4 years; 2,425 men, mean age 59.1 years). They underwent a clinical examination of the lower limbs, including presence and severity of visible signs (CEAP classification), and assessment of functional disease by color-coded duplex ultrasound imaging. Results. Varicose veins and telangiectases were the most common objective signs in both men and women. Older people were more severely affected. Telangiectascs were more frequent in women, and men had a higher incidence of trunk varices, trophic changes, and venous reflux. Frequency of both visible and functional venous disease increased with family history and body mass index. Presence of reflux correlated positively with increasing CEAP grade of visible disease (P for trend < .0001 for all superficial venous segments). A large number of subjects, especially women, complained of subjective symptoms in the legs, and the presence of symptoms correlated almost always positively with both worsening of visible findings (P for trend < .001) and presence of hemodynamic change in both genders. Conclusions: The frequency of reflux increased with the severity of visible signs of disease as described by the CEAP classification. In men, the occurrence of subjective symptoms was mostly correlated with functional disorders. OI Petrini, Orlando/0000-0002-1234-783
Visceral aortic patch aneurysm after thoracoabdominal aortic repair: Conventional vs hybrid treatment
No full textObjective: Visceral aortic patch (VAP) aneurysm repair following thoracoabdominal aortic aneurysm (TAAA) open treatment carries high morbidity and mortality rates. The aim of this study is to compare the outcomes of our series of patients who underwent redo VAP aneurysm open surgery (conventional group) with a selected group of high-risk patients who underwent, in the same time period from 2001-2007, an alternative hybrid surgical and endovascular approach (hybrid group). Methods: Conventional group: Twelve patients (11 males, median age 71.5 years, range, 65 to 77 years) underwent VAP aneurysm (median maximum diameter 62 mm, range, 52 to 75 mm) repair with re-inclusion technique via redo thoracophrenolaparotomy or bilateral subcostal laparotomy. Reimplantation of a single undersized VAP or separate revascularization of one or more visceral arteries was performed. Hybrid group: Seven patients (5 males, median age 70 years, range, 63 to 78 years) defined as at high risk for conventional surgery having American Society of Anesthesiology (ASA) class 3 or 4 associated with a preoperative forced expiratory volume in 1 second (FEV1) <50% or an ejection fraction <40%, underwent VAP aneurysm (median maximum diameter 73 mm, range, 62 to 84 mm) repair via median laparotomy, visceral arteries rerouting, and VAP aneurysm exclusion using commercially available thoracic aortic endografts. Results: Conventional group: Perioperative mortality was 16.7% and major morbidity 33.3%. One perioperative anuria was successfully treated with bilateral renal artery stenting. No paraplegia or paraparesis were observed. At a median follow-up of 2.3 years (range, 1.6-7 years), we observed one case of peri-graft fluid collection with sepsis at postoperative day 46 requiring surgical drainage and prolonged antibiotic therapy and one case of renal failure at day 68 requiring permanent hemodialysis. Hybrid group: perioperative mortality was 14.3% and major morbidity 28.6% with one case of transient delayed paraplegia. At a median follow-up of 1.9 years (range, 0.3-6.8 years), we observed one case of late pancreatitis (46 days postoperatively) resolved with pharmacologic treatment and one death due to an acute visceral grafts thrombosis (78 days postoperatively). We did not observe other procedure-related deaths or complications, VAP aneurysm growth, endoleak, and endograft migration. Conclusion: Hybrid repair is clearly a feasible alternative to simple observation for patients unfit for redo VAP aneurysm open surgery. However, despite our promising early results, new mid-term specific procedure-related complications have been observed and a widespread use of this technique should be currently limited until longer-term follow-up is availabl
Therapeutic Options and Patterns of Prescription in Chronic Venous Disorders: Results of a 3-Year Survey in Italy
No full textObjectives: To assess self-management of chronic venous disorders (CVDs) in a selected Italian population and the pattern of prescription by selected Italian phlebologists. Design: Cross-sectional study carried out between 2003 and 2005. Materials: Non-random, transverse sample of men and women recruited by advertising. Methods: Assessment of therapeutic habits of respondents, treatment advice given by phlebologists related to socio-demographic variables and severity of the disease. Multivariate odds ratios for sex, age, class, region, family history and severity of the disease. Results: Women undergo CVD therapy more than men (odds ratio (OR): 2.37 for medical treatment; 1.29 for surgical treatment and 5.72 for sclerotherapy). Young people prefer drug treatment to compression stockings. Drug therapy for CVD is 1.5 times more likely in southern Italian respondents, as is compression stockings (OR: 1.91). Surgical therapy is more frequent in Northern Italy (OR for Central Italy: 0.79; Southern Italy and Islands: 0.76). Family history of CVD leads people to early treatment of symptoms. Conclusions: This study provides insight into self-medication of CVD in Italy and the prescribing patterns of Italian phlebologists in the treatment of CVD. It shows that the population interviewed is able to practise responsible self-medication of their CVD problems. (c) 2009 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved
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