Aim: Conventional management of popliteal artery aneurysms (PAA) through a medial approach may be lon term ineffective. We report our long term rate of continued sac perfusion after ligation and bypass, combined to duplex ultrasound (DUS) surveillance protocol.
Patients And Methods: Follow-up data of 24 PAA (mean diameter 37.
Aim: The surgical approach to the pararenal aorta can be performed through a midline laparotomy or retroperitoneal approach. The current paper reports the techniques for the suprarenal aortic approach, through the review of technical literature on this topic.
Methods: Forty-six out of 82 technical papers regarding the surgical approach to the suprarenal aorta were reviewed, focusing on relevant technical details, such as the position of patient, type of incision, aortic approach and anatomical limitations.
Background: Acute mesenteric ischemia (AMI) after cardiac surgery is a rare but serious complication associated to high mortality. The time of onset is the key point to correctly evaluate the clinical scenarios.
Methods: Data from adult patients who underwent laparotomy for AMI after elective or urgent cardiac surgery were reviewed (January 2005 - December 2019) to report their anatomoclinical features in relationship to time of onset.
Background: The present study reported perioperative changes in PCT levels occurring in cardiac patients with acute mesenteric ischemia (AMI) undergoing laparotomy. The aim of this study was to demonstrate that PCT kinetics may confirm the presence of AMI after cardiac surgery, distinguishing between bowel infarction and diffuse ischemia.
Methods: PCT values from adult patients undergoing laparotomy for AMI after elective or urgent cardiac surgery (January 2010-December 2019) were determined at the ICU admission after cardiac surgery, 24 hours later and at the onset of clinical symptoms.
Aim: The purpose of this study was to examine the influence of aneurysm size on early outcome in women undergoing abdominal aortic aneurysm (AAA) repair, with suggestion of lowered threshold for intervention.
Patients And Methods: Retrospective cohort study on the early outcome of 25 females undergoing elective endovascular (EVAR) and open AAA repair, compared to 340 males from 2005 to 2017. The study was focused on 30-days mortality (primary endpoint) and incidence of non fatal major adverse events - MAE (secondary endpoint) of two subgroups of women: AAA diameter <50 mm (n.
Unlabelled: The knowledge of both normal and abnormal anatomy of the veins of the neck may be important for surgeons performing neck surgery, to avoid inadvertent injury to vascular structures. In a 75-year-old man candidated to carotid endarterectomy preoperative CT-scan showed a rare anomaly of the venous drainage in the area of the anterior jugular vein (AJV), that usually begins in the suprahyoid region via the confluence of several superficial veins, to open into the ipsilateral external jugular vein. A large left sided venous trunk, originating from an anomalous proximal confluence with the internal jugular vein, descended in the AJV anatomical position, to cross over the sternum draining into the right subclavian vein.
View Article and Find Full Text PDFBackground: The management of abdominal compartment syndrome (ACS) has been included as a standard of care in our therapeutic algorithm after diagnosis of acute mesentheric ischemia (AMI), following cardiac surgery. This report is an updated review of our results compared to previous experience.
Materials And Methods: A retrospective, observational, cohort study on a series of 26 patients (20 males, 6 females, mean age 75.
J Cardiovasc Med (Hagerstown)
November 2014
Background: Current guidelines do not recommend routine coronary evaluation preceding abdominal aortic aneurysms (AAA) repair in low-risk patients. The purpose of the present study is to report the incidence of coronary lesions in candidates for AAA repair with a Revised Cardiac Risk (Lee) Index (RCRI) < 2, which are usually excluded from preoperative cardiological work-up. Early-term and long-term results of prophylactic myocardial revascularization are also reported.
View Article and Find Full Text PDFAims: This prospective registry was designed to evaluate the early and long-term incidence of clinical events in patients with carotid obstructive disease (COD), after carotid artery revascularisation selected by consensus of a cardiovascular team.
Methods And Results: 403 consecutive patients with COD scheduled for carotid revascularisation were included: 130 were treated with carotid endarterectomy (CEA) and 273 with carotid artery stenting (CAS). Propensity score matching was performed to assemble a cohort of patients in whom all baseline covariates would be well balanced.
Aim: To report surgical treatment of a ruptured abdominal aortic aneurysm (AAA) associated with spondylodiscitis due to Salmonella in emergency setting.
Case Report: A 69-year-old male with an history of hypertension, presented with a ruptured AAA infected by nontyphoidal Salmonella (type H), associated with spondylodiscitis. Patient underwent an emergency operation consisting in surgical debridment of infected tissue and aortic replacement with a prosthetic Dacron graft impregnated with Gentamycine.
Background: Hospitals without percutaneous coronary intervention (PCI) capabilities are used to transfer patients who need coronary angiography and/or PCI to other centers. In order to optimize economic resources and hospital bed management, PCIs might be performed with an in-service organization, with re-transfer to the community hospital immediately after the procedure. The aim of our study was to evaluate the safety of a consecutive, unselected series of in-service PCIs compared to PCIs performed in patients admitted to hospitals with cath-lab capabilities.
View Article and Find Full Text PDFObjectives: The purpose of this study is to assess the outcome of neovalve construction in two consecutive series of patients affected by postthrombotic syndrome and valve agenesis. The technique was modified in the second series so as to correct a cause of failure.
Methods: Between December 2000 and June 2007, 40 neovalve constructions were carried out in 36 patients (19 males, 17 females, median age 57, range, 29-82) affected by deep venous insufficiency.
The laparoscopic approach has represented a major step forward in general and emergency surgery. Its application in the emergency setting still raises a number of concerns that limit its more widespread use. To assess the true scope of laparoscopic surgery in the acute abdominal setting, we retrospectively evaluated our experience.
View Article and Find Full Text PDFBackground: The presence of significant carotid artery disease in patients undergoing coronary artery bypass grafting has been reported to be as high as 17%. The optimal management of patients with significant coronary and carotid artery disease remains controversial. In this study, we analyze our recent experience with patients who underwent synchronous carotid endarterectomy (CEA) and coronary artery bypass grafting.
View Article and Find Full Text PDFThe aim of the study was to report our clinical experience with the surgical treatment of iatrogenic pseudoaneurysms of the peripheral arteries. The study is a retrospective review of 101 consecutive patients (52 males, 49 females, mean age 66.2 years, range 33-86), with iatrogenic pseudoaneurysms of the peripheral arteries, surgically treated in a vascular unit from October 1990 to June 2006.
View Article and Find Full Text PDFSurgical repair of popliteal artery aneurysms is usually performed by vascular exclusion and femoro-popliteal bypass grafting via a medial route. The vascular exclusion of a popliteal artery aneurysm may, however, prove ineffective long-term. We report on a patient with a large popliteal artery aneurysm observed twelve years after conventional surgical treatment and discuss alternative surgical options to be considered for long-lasting effective popliteal artery aneurysm treatment.
View Article and Find Full Text PDFBackground: Complications due to undetectable coronary artery disease are the major causes of morbidity and mortality in the surgical treatment of abdominal aortic aneurysm (AAA). The aim of our study was to evaluate the importance of significant coronary artery disease identification and the impact of coronary revascularization on early and late outcomes after surgical repair of AAA.
Methods: Between January 1994 and July 2004, 210 patients (204 males and 6 females, mean age 68 +/- 12 years) were candidates to elective surgical repair of AAA.
Isolated abdominal aortic dissections are rare events. Their anatomic and clinical features are different from those of atherosclerotic aneurysms. We report 4 cases of isolated abdominal aortic dissection that were successfully treated with surgical or endovascular intervention.
View Article and Find Full Text PDFBackground: The aim of this study was to evaluate the incidence of late cardiac events in patients submitted to carotid endarterectomy (CEA), asymptomatic for coronary artery disease during the carotid surgical procedure.
Methods: During a period of 11 years, 162 patients (122 males, 40 females, mean age 68 +/- 12 years), asymptomatic for coronary artery disease and/or without sings of coronary artery disease at the cardiological screening, were submitted to CEA for symptomatic or severe (> or = 70%) carotid stenoses. Clinical follow-up was performed on 151 patients (93%), to identify the incidence of cardiac and neurological events and freedom from late death.