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Background: The aim of this comparative clinical study was to evaluate the efficacy of the association of alphatocopherol, rutin, melilotus officinalis, and centella asiatica with oral administration in patients with chronic venous insufficiency., Methods: Thirty patients with chronic venous insufficiency have been randomized in two groups of fifteen subjects (control and treatment group). During the period of treatment the patients didn't wear elastocompressive stockings. The therapeutic efficacy and the clinical tolerability of this association have been valued with clinical-instrumental evaluations and by a control after 15 and 30 days. Functional bothers, cramps and the edema have been valued in function presence and of their gravity with a clinical-score between 0 and 4., Results: At the end of the observation period, a significant improvement of the clinical simptomatology was obtained, characterised by a diminution of the sovrafascial edema., Conclusions: The present study confirms previous clinical experiences regarding the described treatment and suggests its application in chronic venous insufficiency.

Cerebro-vascular insufficiency may be caused by morphologic anomalies of the extracranial internal carotid artery (10-15% of symptomatic patients). These alterations are characterized by anomalous elongation which conditions particular attitudes of the carotid: tortuosity, coiling, kinking. In the first case the artery assumes an "S" or "C" shape; in the second the elongation is more emphasized and the artery develops one or more loops; kinking, the most frequent morphologic anomaly, is a sharp angulation of the first part of the internal carotid artery. The etiology of these anomalies seems to be related to congenital causes, that may be unmasked by arterial growing old process. Surgical correction, indicated for symptomatic patients or patients with important hemodynamic alteration, requires rectilinearisation of the internal carotid artery associated with TEA eversion of the same.

The authors describe their experience concerning the surgical treatment of aneurysmatic pathology of the popliteal artery. This is the most frequent site for aneurysm after aortic aneurysm. Since 1979 to 1994, 26 patients, 21 men and 5 women (mean age 65.8 years), have been treated at the Institute of Clinical Surgery of the University of Ferrara for a total of 37 popliteal aneurysms. Thirteen patients had more than one aneurysm. Before the operation, all patients underwent DSA, and echo Doppler, 7 with CAT and 4 with RMN. Twenty-nine substitutions, 7 by passes and 1 ligation were performed. Twelve of the 29 substitutions were made by reversed saphenous vein. Fourteen by PTFEe, and 3 by dacron. In 4 cases it was necessary to reimplant either the anterior tibial artery (3 cases) or the posterior tibial artery (1 case) separately. The results obtained were good especially in the post-trauma patients. Only 3 amputations were necessary due to graft obstruction immediately after surgery, and in post-traumatic conditions.

The goals of non-invasive duplex vascular diagnosis of the venous system of the lower limbs are: 1) To make evaluation of the venous system during deambulation feasible under physiological, pathological and post-surgical or elastocompressive conditions. Moreover, any such evaluation must be achieved using a standardized, easy, highly reproducibly method which is inexpensive and utilizes the diagnostic instruments available. 2) To achieve detailed, selective localization of the valvular and parietal dysfunctions at the basis of any reflux pathology. 3) To identify and quantify venous flux and reflux during deambulation. The present work gives the results achieved over the period of one year after a new method simulating deambulation (Walk System 1 patented) was set up for several utilizations, principally correlated to the use of conventional duplex scanning in studying the venous system. The main purpose of the Walk System 1 is step simulation to uncover the location and extent of venous disease. This application test of: a pneumatic pump which compresses the calf to 100-120 mmHg in 0.3 sec thus simulating muscolar pumping during deambulation; standard 40 mmHg compression of the foot in order to rule out any hemodynamic involvement of the foot pump venous system. We can use this pump in the hemodynamic component, a part, during the step simulation, with synchronism with calf pump in TVP prophylaxis or in vascular therapy; an easy-to-use application software able to quickly pulsed Doppler data of flux and reflux by means of the flux and reflux orthodynamic indices or with measures in ml/sec. The study was performed on 80 lower limbs in normal subjects in order to define the normality range and in 380 lower pathologic limbs. The study has yielded a clinical-instrumental correlation between the hemodynamic data observed during inflation-deflation of the calf cuff, positioning the pulsed Doppler sample volume in the saphenous vein in the saphenous-femoral ostium zone and the underlying venous morphology. The results have made it possible to determine physiological S-F reflux and to establish 4 pathological classes of orthodynamic S-F reflux, each class corresponding to a specific range in the orthodynamic reflux index (class 0 = 0 < RI < 0.25; class 1 = 0.25 < RI < 2; class 2 = 2 < RI < 3.5; class 3 = 3.5 < RI < 6; class 4 = RI > 5) and to a particular morphological conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Smooth muscle cell proliferation is a step of the repair process after vascular injury. A similar process occurs after percutaneous transluminal angioplasty and can lead to intimal hyperplasia and vascular restenosis. We have recently observed this process in an anastomotic restenosis after saphenous vein by-pass in the popliteal artery. We suppose that myointimal hyperplasia can also be an aspecific response to surgical intimal injury.

In this paper the Authors report their experience on diagnostic and surgical procedures with respect to aneurysms of the visceral district. The clinical review during the last ten years of surgical activity in the Istituto di Clinica Chirurgica (Università di Ferrara) regards 13 patients with different visceral aneurysms. The study reports the different percentage of localization, the diagnostic approach, the surgical procedure performed and discussion of results obtained. Patients at risk for this disease are pointed out.

Modern technology has recently provided us with new resorbable suture material for use also in vascular surgery. Clinical use of these sutures has been impeded however by not little mistrust and by old dogmas without a rational experimental basis. We have therefore begun studies of two slowly resorbable materials, polyglactin 910 and polyglycolic acid, in comparison with two classic nonreabsorbable materials, nylon and polypropylene, used in experimental model of end-to-end anastomosis rats'infrarenal aorta, following up the healing process and its evolution after an interval. The results are discussed in relation to data collected from current literature.

An anomalous (because of the advanced age of its onset) case of isthmic coarctation of the aorta in preductal site observed at the persistence of hypertensive symptomatology associated with cephalgic and lipothymic attacks is reported. Instrumental examinations confirmed the clinical suspicion and resective-reconstructive surgical treatment led to complete resolution of both cause and effect.

A case of retroesophageal right subclavian artery, occasionally observed in a patient submitted to diagnostic investigation and surgical treatment for bilateral steno-obstructive involvement of the carotid district, is described.

Personal experience on the intraoperative use of HR echography for the evaluation of the immediate surgical results in carotid bifurcation T.E.A. is reported. It is already assessed that early failure in vascular surgery is due to technically incorrect procedures.