Functional outcomes of transmetatarsal amputation in the diabetic foot: timing of revascularization, wound healing and ambulatory status.

Transmetatarsal amputation (TMA) is an effective surgical approach to treat forefoot infection and gangrene in diabetic patients. However, a high rate of complications and failure to heal require reamputation in a large number of cases. We analysed the outcomes of TMA to define the role of revascularization, wound healing and ambulatory status.

Extreme endovascular revascularization for limb salvage in critical limb ischemia.

Aim: Distal bypass has been considered as a primary choice for the treatment of critical limb ischemia (CLI). When bypass failed with limb threatening ischemia, the amputation rate is high in patients with increased surgical risks and lack of conduit. Percutaneous transluminal angioplasty (PTA) has been shown to be effective and safe in the setting of CLI even in patients with failed bypass graft.

The efficacy of Iloprost for the treatment of chronic venous ulcers of the lower limbs.

Background: The purpose of this study was to assess the effect of Iloprost in the treatment of venous ulcers.

Patients And Methods: We recruited 52 patients with uncomplicated venous ulcers of the lower limbs. They were divided into two groups: the first (29 patients) was given Iloprost in saline solution for three weeks, while the second (23 patients) received saline solution only.

[Aneurysms of the splenic artery: our experience].

Splenic artery aneurysms, although rare, are the most common visceral artery aneurysms with a high risk of rupture. The purpose of this retrospective study was to analyse our experience with such aneurysms. Eight patients (6 women, 2 men; mean age: 60.

Outcome of iatrogenic injuries to the abdominal and pelvic veins.

Purpose: To analyze the management and outcome of iatrogenic injuries to the abdominal and pelvic veins.

Methods: We reviewed a series of patients who sustained iatrogenic vein injuries between 1989 and 2004.

Results: Thirty patients (21 men and 9 women ranging in age from 38 to 82 years; mean age, 53.

Infrainguinal endovascular procedures based upon the results of duplex scanning.

Aim: The aim of this study was to report the role of duplex scanning in selection of patients with lower limb ischemia for infrainguinal endovascular revascularization.

Methods: From January 2002 to December 2005, 95 patients (66 male, 29 female) underwent infrainguinal endovascular revascularization based on duplex scanning. The indications for surgery were severe claudication (11%), rest pain (15%), gangrene (40%), and non-healing ulcer (34%).

[Popliteal aneurysms: comparison of the results of elective and emergent treatment].

The purpose of this study was to compare the outcomes of elective versus emergent operative repair of popliteal artery aneurysms. From 1988 to 2004, 108 popliteal aneurysms were repaired in 76 patients (mean age: 66 years; range: 42-86). Repair was elective in 70 cases - 19 asymptomatic (17%), 51 symptomatic (46%); and emergent in 38 cases; 12 of these with no identified outflow target vessel at initial arteriogram underwent intra-arterial thrombolysis.

[Post-operative analgesia in thoracic surgery: physiopathological features, therapeutic framework and methodologies].

Pain after surgery is a major handicap for patients as it bounds and decreases ability for spontaneous movement, cough and deep breathing, aiding the onset of complications and invalidating the recovery capabilities of operated patients. In thoracic surgery, the need to compile and employ guidelines for post-surgical pain management has become a pressing requirement in recent years. Currently available protocols include several options of treatment that are frequently a subject in the most recent scientific papers and play a key role, as they constitute the framework upon which building with changes and fixes that take account of incidental circumstances, in relation to both patients and surgery, again for both the organizational and structural features of the surgical environment.

Infrainguinal revascularization based on duplex ultrasound arterial mapping.

Aim: Recent reports have advocated duplex ultrasound arterial mapping (DUAM) as the sole preoperative imaging modality for planning infrainguinal revascularization. This study reports the outcome of arterial revascularization procedures for chronic limb ischemia based on DUAM.

Methods: From January 2002 to December 2004, 253 patients (175 men, 78 women) underwent infrainguinal revascularization based on DUAM.

[Thromboembolic risk and prevention of deep venous thrombosis in open and laparoscopic surgery].

Deep Vein Thrombosis (DVT) and pulmonary embolism are the dangerous and serious complications in patients undergoing surgery. It is known that prognosis is strictly linked to timely recognition of the pathogenetic-clinical phase of the thromboembolic disease and that prevention, therefore, plays the leading role in patients at risk. The most recent series show that, in absence of prophylaxis, the frequency of DVT, diagnosed by objective tests, is still significant in abdominal surgery.

[Comparison between magnetic resonance angiography and duplex ultrasound for preoperative planning of lower limb revascularisation].

The purpose of this study was to compare magnetic resonance angiography with duplex ultrasound for defining anatomical features relevant to performing lower limb revascularisation. From June 2003 to June 2004, 30 consecutive patients with chronic lower limb ischaemia underwent magnetic resonance angiography and duplex ultrasound investigations before undergoing lower limb revascularisation procedures. The mean age was 72 years (range: 45-93).

[Aneurysm of the abdominal aorta associated with an ectopic pelvic kidney and abnormal vascularisation: a case report].

Renal malformations during surgery for repair of an abdominal aortic aneurysm are a rare occurrence that can create technical problems during the operation in terms of preservation of renal parenchyma and vascularisation. A case of abdominal aortic aneurysmectomy associated with an ectopic pelvic kidney is presented. Preoperative diagnosis is necessary in order to plan the surgical technique to be employed in each anatomical variant encountered.

[Retroperitoneal approach in the treatment of supra- and infrarenal aortic aneurysms].

The retroperitoneal approach for the treatment of thoracoabdominal type IV and infrarenal aortic aneurysms is an accepted alternative to thoraco-phrenolaparotomy. The purpose of this retrospective study was to report our experience and results in terms of respiratory and renal complications. From January 1997 to December 2003, 48 patients (36 with thoracoabdominal type IV and 12 with infrarenal aortic aneurysms) were treated by a retroperitoneal extrapleural approach in intercostal space X or XI.