Publications by authors named "Vandone P"

Objective: Ultrasonic tissue characterization of epi-aortic vessels may be useful to define the composition of atherosclerotic plaques. Videodensitometry provides a histogram representing the frequency distribution of gray levels corresponding to different compositions of the carotid wall. However, lack of standardization limits the clinical application of this technique.

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Alterations of chromosomes 7 and 11 have been involved in the progression of atherosclerosis. Twenty-three carotid endarterectomy specimens were studied for the presence of alterations in chromosomes 7 and 11, and fibroblastic growth factor-3 (FGF-3) gene amplification. Besides classic histological stainings, immunophenotyping of cellular and vascular components and fluorescence in situ hybridization (FISH) were performed.

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Background: The authors analyse the indications for the various surgical strategies through a retrospective study of the morbility and mortality rates in their own series of cases and during follow-up.

Methods: 107 patients were operated for type A aortic dissection between 1978 and 1998: 69 using a technique performed under moderate hypothermia (Group A) and 38 in deep hypothermia (Group B). All patients who survived from 1978 to 1994 underwent an accurate follow-up.

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Background: In vascular pathology the endothelial lesions easily reflect on blood cells, inducing a reactive state. In the present study the eventual presence of activation signals in leukocytes and platelets was tested.

Methods: Fifty-eight subjects with major vascular pathology and 14 with lower limbs venous insufficiency were studied, together with a control group of 25 normal subjects.

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Materials And Methods: In the period 1986-1994, 2950 patients with cardiovascular diseases were surgically treated. In 2104 cases we placed biological or synthetic grafts to maintain vascular continuity. The most common has turned out to be abdominal aortic aneurysm.

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Acute mesenteric ischemia is a severe complication after aortic reconstructive surgery for AAA repair. This ischemic event, due to a poor intestinal perfusion especially in ruptured AAA in consequence of the hypotension and the hypovolemic shock, shows different clinical manifestations such as delayed canalization, ischemic colitis or more serious like intestinal infarction. Between 1989 and 1994, 965 cases of abdominal aortic aneurysms have been surgically treated in General and Cardiovascular Surgery Institute of University of Milan.

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The aneurysms of the internal iliac artery are rare and very often asymptomatic. Because of the anatomic location of this artery, it can be difficult to diagnose this kind of aneurysm, when isolated. Frequently it is diagnosed in consequence of aneurysmatic complication, such as rupture and/or impending rupture.

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In this assay we take into consideration 3410 retroperitoneal prosthetic reconstructions in aorto-iliac pathology performed in the last 25 years at the General and Cardiovascular Institute of Milan. Thirty-nine retroperitoneal prosthetic dehiscences were observed; 35 of them had been subjected to their first operation in our Institute (1.03%).

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Acute aortic occlusion is a rare event, usually related to atherosclerotic lesions, cardiac embolism or traumatic events. During the last twelve years, we observed 25 acute aortic occlusions: 12 patients (48%) were affected by aortic bifurcation embolism, and 13 patients (52%) by acute aortic thrombosis. There were 18 men (72%) and 7 women (28%) with a median age of 63 years.

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Varicocele must be regarded of the utmost importance in determinating male infertility. Surgical indications should be considered of primary interest in order to achieve a qualitative and quantitative improvement in spermiogram parameters in the majority of the cases. Recent reports showed that it is not the severity of the lesions to determine the alterations in seminal parameters but the length of time of the varicocele.

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Renovascular hypertension in subjects with a solitary kidney, though an infrequent condition, requires surgical direct revascularization procedures either to reduce the hypertensive state and, more important, to preserve renal function. This paper reports a series of six surgically treated cases between 1982 and 1990, with at least two years follow-up. Preoperative renal function, as evaluated by BUN and blood creatinine, was reduced in 5 cases, the remaining one being normal.

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Twenty out of 32 patients undergoing major vascular surgery received autologous blood transfusion and hemostatic and hematological parameters were evaluated in both transfused and non-transfused groups. Blood and urine samples were also analysed. No acceleration of the hemostatic process was observed during either surgery or the postoperative period; free hemoglobin present in reinfusion sacks (?), even in high doses, was immediately restored to normal values in the patient's circulation.

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The profunda femoris artery is the primary source of collateral flow to the lower extremity in the presence of superficial femoral and/or popliteal occlusion. The arteriosclerotic disease involvement of this segment is relatively less frequent and in the majority of the cases localized on the ostium and reaches to the first branch. Profundaplasty to relieve limb-threatening ischemia is infrequently employed as an isolated procedure.

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The ability of angiodynography (or Color Flow Imaging) to achieve accuracy in image resolution of thin details of venous as well as arterial vessels has made continuous wave Doppler and frequency analysis Doppler almost obsolete techniques. Some controversies exist about the effectiveness of color flow imaging versus duplex scanner imaging, but recent progress in ultrasound imaging technology seems to overcome the problem. Angiodynography can effectively substitute X-ray angiography in some specific instances and is able to limit the use of invasive techniques to cases in which surgical procedures are really foreseeable.

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Thirty-four cases of combined abdominal aortic aneurysm (AAA) and renal artery stenosis (RAS) are reported. Hypertension was found at admission in 32 subjects, the other two being well responsive to drug therapy. Angiography and selective renal vein renin assay were always performed: renal artery stenosis was unilateral in 21 (61.

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The Authors report a case of arterio-venous fistula of the left renal pedicle, twenty six years after nephrectomy. The diagnosis was made by clinical signs and confirmed by angiography. Treatment was surgical with complete removal of the fistula.

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Between january 1965 and november 1990, 32 operations for neck paraganglioma were performed: 29 chemodectomas (carotid body tumors) and 3 paragangliomas of the vagus nerve. Seven subjects were affected with bilateral chemodectomas and one of them showed concurrent unilateral vagal paraganglioma. Two paragangliomas were malignant, with invasion of the latero-cervical lymphnodes revealed at operation.

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DVT is a fairly frequent event and often fails to be recognised. Its main complication, pulmonary embolism, is the third cause of death in Italy with more than 70,000 deaths per annum. In the presence of infra- and suprarenal floating thrombi, cases in which the application of neither intraluminal nor extraluminal filters is indicated, the treatment of choice is thrombectomy with direct surgical access to the cava.

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The authors' experience of surgical management of abdominal aortic aneurysms (AAA), in 1725 consecutive patients, operated on in a ten years period (1980-1989) is presented. Surgical indications, operative technique, and outcome of elective and emergency procedures are analyzed. A ten years follow-up period is also presented.

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Of the multiple endocrine syndromes, the association between pheocromochytoma, medullary thyroid carcinoma (MTC) and parathyroid-hyperplasia (Sipple's syndrome, MEN IIa), and the association of MTC, with multiple monocutaneous neuromas and with a characteristic facial appearance (MEN IIb syndrome) are well known. Furthermore in about 10% of the patients affected by Von Recklinghausen's disease (neurofibromatosis) a pheocromochytoma is present. A new classification of this important (even though rare) chapter of endocrine pathology was developed by Pears in 1968 when he hypothesized a common neuroectodermic origin for groups of cells diffused throughout the body and nested in different organs.

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From 1980 to 1990 a yearly medical-surgical control was carried out on 950 arteriopathic patients hospitalised in the General and Cardiovascular Surgery Institute, Milan University, during the above mentioned period. The operations for surgical reconstruction were mainly for arteriosclerotic lesions involving the abdominal-peripheral district (750 patients, 79%) and the supra aortic trunks (200 patients, 21%). 84% of the patients were males.

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The concomitance of horseshoe kidney and abdominal aortic aneurysm is rare but represents an interesting challenge for vascular surgeons. The trouble is greater if the diagnosis is formulated intraoperatively and specially if it is an emergency operation for aortic rupture or fissuration. The surgeon's aim is to get to the aneurysm collar without damaging the kidney, the renal arteries or the urinary tract that often have an anomalous development.

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The diagnosis of extra-adrenal paraganglioma requires the recognition of catecholamine hypertension and the site of the lesion. I-131-MIBG scintigraphy, CAT scan and angiography may localize primitive and metastatic lesions. Six cases of extra-adrenal paraganglioma (5 abdominal, 1 thoracic) surgically treated with complete resolution of the hypertensive state are presented here.

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Two cases of posttraumatic aneurysms of splanchnic arteries were referred to Istituto di Chirurgia Generale e Cardiovascolare del-l'Università di Milano (Italy) during 1989, and are the subject of this report. In both the instances a history of blunt abdominal trauma was collected, and histology confirmed the characters of false aneurysms of the lesions. The arteries involved were the middle colic and the splenic, respectively, with a long lasting history of recurrent abdominal pain related with particular physiologic events (e.

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The paper reports the results obtained in 20 patients affected by varicophlebitis of the lower limbs following the oral administration of an anti-inflammatory substance. Results were compared with findings in single-blind study performed in a group of 20 patients treated with placebo. The evaluation of residual signs and symptoms and the control of recanalization of venous collectors using Doppler tests revealed a difference between the two groups in favour of the patients treated with the anti-inflammatory agent, although this was not statistically significant.

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