ABSTRACT
BACKGROUND: To evaluate the efficacy of treatment with prostaglandins (Iloprost and Alprostadil) in patients with peripheral arterial disease in whom a surgical act or a redo operation is not proposable and to set the role of these drugs in the therapy of arterial diseases. METHODS: We analyzed the results of 96 treatments in patients with peripheral arterial diseases of different etiology, treated in the Day Hospital in the Division of Vascular Surgery from the 1/1/1993 to the 30/6/1998. The efficacy of the treatment has been evaluated on the basis of the clinical picture (healing or reduction of ulcers, reduction of rest-pain, improvement of the ability to walk). RESULTS: We had positive results in 60% of the patients who completed the treatment, a good outcome for patients with particularly severe arterial disease. Interruptions induced by the occurrence of uncontrolled side-effects are a few (6.25%). Better results have been found in a special category of disease (arterial diseases not associated with diabetes, not very advanced clinical picture, female gender). Iloprost proved to be superior to Alprostadil. CONCLUSIONS: Prostaglandins today represent an effective therapeutic solution to be considered. Further studies need to be done to find a category of patients who can have the best benefit from this kind of drug.
Subject(s)
Alprostadil/therapeutic use , Iloprost/therapeutic use , Vasodilator Agents/therapeutic use , Adult , Aged , Aged, 80 and over , Alprostadil/adverse effects , Arterial Occlusive Diseases/drug therapy , Feasibility Studies , Female , Humans , Iloprost/adverse effects , Male , Middle Aged , Peripheral Vascular Diseases/drug therapy , Vasodilator Agents/adverse effectsABSTRACT
Twelve cases of mesenteric artery embolism surgically treated with a surviving rate of 66% are reported. The Authors point out the diagnostic features and the various factors affecting the surgical result.
Subject(s)
Embolism/surgery , Mesenteric Vascular Occlusion/surgery , Adult , Aged , Humans , Mesenteric Arteries , Middle Aged , Postoperative CareABSTRACT
The results of 112 femoral embolectomies performed on 100 patients were reviewed. Operative mortality rate was 15% and early amputation (within 30 day-after the procedure) 18%. The role of early amputation was closely related to the time of leg ischemia. Current follow-up as established for 86 patients. 5 years and 10 years survival rates for the group were 49% and 40%. Although early survival is decreased after femoral embolectomy long term survivors can be expected to live independently with excellent limb salvage and function.
Subject(s)
Embolism/surgery , Femoral Artery/surgery , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Middle AgedABSTRACT
Aneurysms of the lower duodenal pancreatic artery are an extremely rare dilatative arterial pathology. Diagnosis is often difficult and rupture is a frequent clinical evolution; surgical therapy, especially when rupture has already occurred, entails a high risk of operative mortality. A case is described of aneurysm of the lower duodenal pancreatic artery which was treated by elective surgery with good results.
Subject(s)
Aneurysm/surgery , Mesenteric Arteries/surgery , Aneurysm/diagnostic imaging , Aneurysm/pathology , Duodenum/blood supply , Female , Humans , Mesenteric Arteries/diagnostic imaging , Mesenteric Arteries/pathology , Middle Aged , Pancreas/blood supply , Tomography, X-Ray ComputedABSTRACT
The haemodynamic premises for extra-anatomical by-pass in the treatment of stenosis and obstructions of the subclavian and vertebral arteries are discussed with a report on a surgically treated series.
Subject(s)
Arterial Occlusive Diseases/surgery , Axillary Artery/surgery , Carotid Artery, Internal/surgery , Subclavian Artery , Vertebral Artery , Anastomosis, Surgical/methods , Constriction, Pathologic/surgery , HumansSubject(s)
Cadaver , Kidney Transplantation , Tissue and Organ Procurement/methods , Brain Death , Humans , Organ PreservationSubject(s)
Aortic Diseases/surgery , Adult , Aged , Aorta, Abdominal , Constriction, Pathologic/surgery , Female , Humans , Male , Middle Aged , Renal Artery , Thrombosis/surgerySubject(s)
Hemangiopericytoma/surgery , Thigh , Hemangiopericytoma/pathology , Humans , Male , Middle AgedSubject(s)
Femoral Vein/surgery , Iliac Vein/surgery , Thrombophlebitis/surgery , Adult , Aged , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Postoperative Complications , Time FactorsABSTRACT
In connection with 7 cases of the popliteal artery entrapment syndrome observed, the Authors discuss certain anatomical, clinical, diagnostic and therapeutic aspects of the cases.
Subject(s)
Popliteal Artery/abnormalities , Popliteal Artery/surgery , Adult , Aneurysm/surgery , Arterial Occlusive Diseases/surgery , Collateral Circulation , Female , Humans , Intermittent Claudication/surgery , Male , Middle AgedSubject(s)
Aneurysm/surgery , Adult , Aged , Brachial Artery , Female , Femoral Artery , Humans , Male , Middle Aged , Popliteal Artery , Subclavian ArteryABSTRACT
A case of gastrocnemia artery aneurysm observed before the appearance of clinical complications is reported. This localization is up to date unreported. The clinical behaviour and the angiographic investigation did not allow to identify the site of the arteriopatic lesion. This was possible only with surgical treatment.
