RESUMO
The Authors show their casistic of about 105 cases of thoracic descending and thoraco-abdominal aorta pathologies between 1.1.1993 and 30.12.1995. After a short introduction about the improvements in anesthesia and reanimation of these pathologies as well as the good reliability of diagnostic and currently available instruments, mortality and mobility parameters are taken into account, the last one referring to paraplegia and ARF. The casistic is evaluated splitting the cases into 2 groups, urgent surgery and election surgery, and differentiating the aneurysm type from the dissection type. Besides, the mortality and mobility are reported for any pathology, with a discussion of the parameters which drove the choice of the most suitable methodology to be adopted (ECC femoro-subclavian shunt, simple clamping). The results achieved show a mortality of 40% in urgency, between 5 and 15% in election, with a rate of paraplegia around 8-10% and a ARF between 5 and 15%. These data match the literature statistics and support the quality of the adopted methodologies.
Assuntos
Aorta Abdominal/cirurgia , Aorta Torácica/cirurgia , Aneurisma da Aorta Abdominal/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Doenças da Aorta/cirurgia , Dissecção Aórtica/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Dissecção Aórtica/diagnóstico , Aneurisma da Aorta Abdominal/diagnóstico , Aneurisma da Aorta Torácica/diagnóstico , Doenças da Aorta/complicações , Diagnóstico Diferencial , Procedimentos Cirúrgicos Eletivos , Emergências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paraplegia/complicaçõesRESUMO
The authors take in exam 34 anatomical variation in the extracranial internal carotid artery (compared with more than 450 operated carotid artery), 15 of which involved kinking in patients with overt neurological symptoms, underwent corrective surgical treatment, and test the most useful and appropriate techniques in any case.
Assuntos
Artéria Carótida Interna/anormalidades , Artéria Carótida Interna/cirurgia , Adolescente , Idoso , Criança , Anormalidades Congênitas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The authors compare the strategus needed for the elimination of paraplegia and for protection of abdominal organs after replacement of descending thoracic or thoraco-abdominal aorta. They analyse single technique considering the advantages and the controindications; furthermore they compare these properties and those of possible variants in the light of the presentation; type of disease and general conditions of the patient. These considerations are in agreement with later literature as well as the attitude of the surgeon.
Assuntos
Aneurisma Aórtico/cirurgia , Complicações Intraoperatórias/prevenção & controle , Traumatismos da Medula Espinal/prevenção & controle , Circulação Extracorpórea , HumanosRESUMO
The Authors report their experience of major and minor complications in carotid surgery. They analyse the causes and emphasize that a thorough preoperative study and a quick surgical technique are very important in reducing the rate of complications in this essentially preventive form of surgery.
Assuntos
Artérias Carótidas/cirurgia , Idoso , Idoso de 80 Anos ou mais , Doenças das Artérias Carótidas/cirurgia , Artéria Carótida Interna/cirurgia , Constrição Patológica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-OperatóriasRESUMO
After a general introduction on Doppler sonography and the anatomy and physiology of the venous circulation in the lower extremities, personal and other experience of the main sonographic techniques used in the diagnosis of lower limb conditions like deep venous thrombosis, venous insufficiency and post-phlebitic syndrome is described.