Endovascular treatment combined with stratified surgery is effective in the management of venous thoracic outlet syndrome complications: a long term ultrasound follow-up study in patients with thrombotic events due to venous thoracic outlet syndrome.

Thoracic outlet syndrome (TOS) is caused by compression of peripheral nerves and vascular structures along their course through the upper thoracic aperture to the axilla. The aim of our study was to analyze long-term outcomes of different treatments stratified by symptom severity. We performed a retrospective analysis of a cohort of 73 consecutive patients treated at our institution presenting with TOS-associated venous thrombotic events.

[Late complication of surgical repair of aortic coarctation: ruptured pseudoaneurysm of the aorta treated by thoracic endovascular aortic repair].

Aortic coarctation is a frequent congenital defect requiring early surgical treatment. Late complications of these surgical procedures can be fatal as in the case of a ruptured anastomotic pseudoaneurysm. We present a case of a 49-year-old man presenting with hemorrhagic shock due to this complication who was successfully treated by endovascular techniques with implantation of two stent grafts.

Critical ostial celiac trunk stenosis presenting as abdominal angina during massive pulmonary embolism with cardiogenic shock.

Massive pulmonary embolism complicated by cardiogenic shock and severe abdominal pain represents both a diagnostic and therapeutic challenge. We present the case of a critically ill patient in whom acute abdominal ischemia, which was caused by splanchnic hypoperfusion secondary to critical ostial celiac trunk stenosis, manifested during the course of massive pulmonary embolism complicated by a cardiogenic shock.

Autologous intra-arterial infusion of bone marrow mononuclear cells in patients with critical leg ischemia.

Aim: The injection of bone marrow mononuclear cells (BMMC) into the gastrocnemius muscle has given promising results in patients with critical limb ischemia (CLI). In this article, we have assessed whether a less invasive procedure, i.e.

[Endovascular treatment of acute vascular occlusions].

Acute vascular occlusion is a medical emergency and often a life threatening situation. It is caused by embolization into local arteries, by thrombosis or by occlusion of peripheral arterial bypass grafts. Percutaneous thrombectomy and local thrombolysis represent well established techniques for the treatment of acute limb ischemia and massive deep venous thrombosis especially for ileofemoral and ileocaval occlusion.

[Superior vena cava syndrome--potential of the intervention therapy].

Superior vena cava syndrome is a relatively frequent complication in patient with lung or mediastinal cancer. Standard treatment is usually based on radiotherapy or chemotherapy. In the previous 20 years the use of endovascular methods became increasingly important including stent implantation and local thrombolysis.

Enhancing upper lid aesthetics with the lateral subcutaneous brow lift.

Background: Surgical techniques for improving the upper eyelid aesthetic unit have recently focused on the management of eyebrow position. In our practice, we noticed that in some patients the lateral brow was low preoperatively, whereas in others it was well positioned but overly mobile.

Objective: We describe our experience using the lateral subcutaneous brow lift (LSBL) to elevate and stabilize the lateral brow.

Nasal reconstruction--beyond aesthetic subunits: a 15-year review of 1334 cases.

A retrospective analysis was performed on 1334 patients who underwent nasal reconstruction between 1986 and 2001. The senior author performed all reconstructions in this series after Mohs' histographic excisions. Only secondary reconstructions were performed without a preceding Mohs' excision.

Ultrasound-assisted lipoplasty.

The author considers the circumstances in which it is more beneficial to use ultrasound-assisted lipoplasty (UAL) rather than traditional suction-assisted lipoplasty (SAL). He contends that the absolute benefit of UAL compared with SAL is the ability of the ultrasound to lyse fibrous tissue and fat.

Autologous fat graft in nipple reconstruction.

Reconstruction of the nipple is the penultimate step in breast reconstruction after mastectomy. A number of reconstructive techniques have been described for nipple reconstruction including skin grafts, composite grafts, and various local flaps. The authors' preferred reconstructive technique is the local C-V or modified star flap.

Management of the latex-reactive patient.

The author provides a protocol for managing latex-sensitive surgical patients in the preoperative, intraoperative, and postoperative stages. Not only patients with a history of latex reaction but also patients with recurrent daily latex exposure and specific food allergies require careful monitoring.

[Comparison of the cost effectiveness of treatment of acute myocardial infarct with primary angioplasty and thrombolysis ].

Introduction: Primary angioplasty (PTCA) or intravenous thrombolysis are the recommended treatment of acute myocardial infarction. According to results of clinical investigations however primary PTCA provides a more favourable short-term as well as long-term prognosis. As this method is much more expensive we were interested in its cost-effectiveness as compared with cheaper intravenous thrombolysis.

Incidence of cleft palate fistula: an institutional experience with two-stage palatal repair.

The purpose of this study was to determine the incidence of cleft palatal fistula in a series of nonsyndromic children treated at the authors' institution. This retrospective analysis of 103 patients with cleft palate treated by five surgeons between 1982 and 1995 includes 60 boys and 33 girls, whose median age was 18.4 months at the time of surgery.

Microdermabrasion in clinical practice.

Microdermabrasion is the general term applied to the technique of abrading the skin with a high-pressure flow of crystals. Patient selection, equipment, and technique for face, hands, and chest are described. Results of a survey on the efficacy of the treatment are provided.

Lack of association of angiotensin-converting enzyme and angiotensinogen genes polymorphisms with left ventricular structure in young normotensive men.

Left ventricular (LV) hypertrophy is a strong predictive factor for cardiovascular morbidity and mortality. LV structure and function are influenced by many variables, including genetic background. The potential role of gene polymorphisms of different components of the renin angiotensin system remains controversial.

A prospective analysis of patients undergoing silicone breast implant explantation.

Despite the lack of a scientifically proven link between silicone implants and disease, many women have chosen to have their implants removed out of concern for their health. Unfortunately, there are few studies in the literature that have investigated the outcome of explanations, and there are no prospective analyses of the effect explantation has on a patient's general health. The goal of this study was to use a prospective database to determine whether there were any preoperative parameters that could be used to predict which patients would be improved following removal of silicone breast implants and to provide a quantifiable measure of that improvement.

Total soft-tissue reconstruction of the middle and lower face with multiple simultaneous free flaps in a pediatric patient.

A 2-year-old boy sustained a massive facial soft-tissue wound secondary to a dog attack. Essentially all the soft tissues of the face were absent, including innervation and intraoral lining. We describe the reconstruction of this defect with five simultaneous free tissue transfers.

Comparative lipoplasty analysis of in vivo-treated adipose tissue.

A comparative histologic and chemical analysis was undertaken of adipose tissue treated in vivo with traditional, ultrasound-assisted, and external ultrasound-assisted lipoplasty. A series of six healthy women undergoing elective liposuction according to the superwet technique using a 1:1 infiltration ratio with the estimated quantity of fat to be removed was included in the study. Four separate regions on each patient were treated independently in vivo with traditional liposuction, internal ultrasound-assisted liposuction, or external ultrasound-assisted liposuction for 7 minutes.

Early results of vermilion lip augmentation using acellular allogeneic dermis: an adjunct in facial rejuvenation.

The definitive approach to lip augmentation has yet to be defined. Herein is described a technique using acellular allogeneic dermal grafts that is easy, effective, and reproducible. Our results over the past 2 years include 47 patients (94 grafts).

Mersilene suture as a vehicle for delivery of growth factors in tendon repair.

Extensive clinical and laboratory studies have demonstrated that growth factors accelerate and modulate the wound-healing process. The purpose of this experiment was to apply the principles of growth factor-enhanced wound healing to an in vitro rat tendon model. A method was developed for covalently binding a biologically active peptide to nonabsorbable braided polyester suture (Mersilene).

Sensory changes after traditional and ultrasound-assisted liposuction using computer-assisted analysis.

Postoperative sensory changes (i.e., hypesthesias) that occur after suction-assisted lipoplasty (SAL) are expected clinical sequelae.

Operative principles for optimizing results in circumferential body contouring with ultrasound-assisted lipoplasty.

The optimization of results in body contouring requires simultaneous visualization of all body regions. This goal is achieved through a circumferential and balanced surgical approach. Adjacent areas must blend together to evoke a smooth contour silhouette.