[Radiation-induced lesions of carotid arteries: report of five cases]. / Arterite rádica das carótidas: a propósito de 5 casos clínicos.

This paper is aimed at the analysis and discussion of a personal experience with an unusual entity, the radiation-induced lesions of carotid arteries, based on 5 patients that were observed for the last twelve years. The series is composed of 4 men and woman, with an average age of 65 (between 51 to 77). Malignancies that required radiotherapy were diverse and the carotid lesions were recognized between 8 and 20 years after the irradiation (average 15) . They consisted in 3 occlusions and 5 stenosis of the internal carotid, 4 occlusions of the external carotid, and 2 stenosis of the common carotid artery. Four patients presented with symptoms of cerebrovascular insufficiency and 1 was asymptomatic. Three patients underwent 4 surgical procedures (1 bilateral) which consisted uniformly in the segmental resection of the stenosed arteries followed by its replacement with a graft, autologous or prosthetic. There was no operative mortality, nor significant morbidity. The main features of etiopathogeny, diagnosis and treatment of this entity are discussed, based on data published in literature, where a controversy between conventional surgery and endovascular management is evident. Conventional surgery is recognized as an effective method, bearing excellent and durable results. Endovascular management requires more consistent and long-lasting results, to be confirmed and assumed as a reliable alternative to the surgical treatment of this peculiar form of carotid arteries pathology.

[Aneurysm of the superior mesenteric artery in the context of a multianeurismatic disease. Case report]. / Aneurisma da artéria mesentérica superior no contexto de doenca multineurismática: a propósito de um caso clínico.

Aneurysms of the superior mesenteric artery are one of the most uncommon visceral artery aneurysms. Despite its rarity they course with high risks of rupture and many constitute a permanent threat to patients's life. The authors report the clinical condition of a male patient, with a large aneurysm of the superior mesenteric artery, diagnosed through the image techniques made during the follow-up of a previously operated aorto-iliac and bilateral popliteal aneurysms. Its clinical presentation and the surgical management are subjected to presentation and discussion.

Cirurgia Vascular: substitutos arteriais: passado, presente e futuro / Vascular surgery: arterial substitutes: past, present and future

O desenvolvimento histórico da substituiçäo arterial constitui um capítulo interessante e particularmente instrutivo da história da cirurgia das artérias. Desde o início do século até à actualidade, numerosos materiais foram empregues e avaliados na substituiçäo das artérias no homem, contando-se entre homosexuais cadáveres, autoenxertos (arteriais e venosos), heteroenxertos e próteses arteriais. Os substitutos protésicos têm sido, de longe, os materiais mais utilizados, sobretudo os enxertos de Dracon e PTFE. Recentes aquisiçöes tornaram-se mais eficazes e credores de melhor tolerância e adaptaçäo às suas funçöes bem como à interaçäo com o hospedeiro. Todavia, estäo ainda longe de se poderem assumir o substituto ideal das artérias. O seu comportamento biológico é insatisfatório e o índice de complicaçöes que registram é elevado e por vezes de consequências fatais. Neste trabalho é descrito o estado actual da substituiçäo arterial protésica e säo analisadas e discutidas as perspectivas de desenvolvimento, dando particular enfase à utilizaçäo dos homoenxertos arteriais criopreservados, aos heteroenxertos e à biosíntese laboratorial de artérias