[Thromboendarterectomy of the superficial femoral artery with a femoro-popliteal endoprosthesis. Technical note on a preliminary experience]. / La Tromboendoarteriectomia (TEA) dell'arteria femorale superficiale (SFA) con posizionamento di endoprotesi femoro-poplitea. Note di tecnica su una esperienza preliminare.

BACKGROUND: The authors report an early experience with a new endovascular approach in the treatment of occlusive superficial femoral artery disease to evaluate the efficacy and the feasibility of the new technique. METHODS AND RESULTS: Four patients with disabling claudication or leg rest pain were treated for long segment occlusion of superficial femoral artery (SFA). A remote endarterectomy (EA) of SFAs has been performed using a single groin incision and a conventional Vollmar ring stripper to remove the entire atheroma core for a length of 20, 10, 9 and 8 cm. In 3 cases following complete extraction of intimal core and a guidewire placement across from the distal endpoint, the endarterectomized segment was lined endoluminally by implanting one or more Self-Expanding Coated Stent (Meadox Passager 6-10 mm); the stent was positioned under fluoroscopic guidance to prevent dissection without any further balloon-dilation. In 1 case a 5 mm diameter thin-walled PTFE endoluminal graft was positioned using a Strecker stent for distal fixation. One patient had an immediate post-operative occlusion of distal stent which required a femoro-popliteal autologous vein bypass. In the remaining 3 cases no postoperative complications were observed and the patients are asymptomatic with normal flow through the stent and the endoluminal PTFE graft at 6 months. CONCLUSIONS: In this report a combined surgical and endovascular procedure has been proposed. A prospective randomized study is carrying on at our Institute to verify if EA+ endovascular grafting of SFA represents an alternative to traditional femoro-popliteal vein bypass.

[Thromboendarterectomy and angioplasty of the carotid bifurcation. Technical notes]. / Tromboendoarteriectomia ed angioplastica della biforcazione carotidea. Note di tecnica.

Exceptional surgical reports of widespread atherosclerotic involvement of both internal and external carotid arteries required us to carry out an unusual surgical procedure. During a four years period an original carotid endarterectomy's technique was performed in four patients. We point on the importance of a correct external carotid endarterectomy on maintaining an effective intracranial arterial flow, especially when atherosclerotic lesions are contemporary present in the extra and intracranial internal carotid arteries.

[Bypass of the outlet of the left ventricle with a Hancock valve tube: report of two cases surgically treated (author's transl)]. / Il bypass della via di efflusso del ventricolo sinistro con tubo valvolato di Hancock. A proposito di due casi operati.

The Authors describe two cases in which the outlet of the left ventricle was recreated by means of a bypass with a valve tube. The first is a case of correct levo-transposition of the great vessels with atresia of the pulmonary, in which a valve tube was applied between the inverted left ventricle and the right branch and trunk of the pulmonary. The second is a case of "long" fibrous subvalvular aortic stenosis, a relapse from former correction of membranous subaortic stenosis, in which bypass was applied between the left ventricle and the ascending aorta. This latter method, adopted by McGoon, is held by the Authors to be easier to apply and more physiological in its hemodynamic effects. The clinical and instrumental results were good in both cases. The hemodynamic and cardioangiographic controls carried out in the second case, 4 months after the surgical operation, showed the normal functioning of the prosthesis, an outflow equal to 60.3% of the total capacity through the bypass, and the ample neostomy of the left ventricle in systolic phase.