13 results on '"Cugnasca M"'
Search Results
2. General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial
- Author
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GALA Trial Collaborative Group, C Lewis, S, P Warlow, C, R Bodenham, A, Colam, B, M Rothwell, P, Torgerson, D, Dellagrammaticas, D, Horrocks, M, Liapis, C, P Banning, A, Gough, M, J Gough, M, Fraser, A, Grant, S, Hunter, J, Leigh-Brown, A, Paterson, M, Soosay, V, Young, A, Williamson, A, Dean, Z, Mazzoli, T, Ricci, S, Valenti, D, Bamford, J, Beard, J, Dearden, M, Murray, G, Ruckley, V, E Norman, P, Sedivy, P, Idla, A, Schmitz-Rixen, T, Maritati, G, Bodenham, A, Cokic, N, Doppler, W, Hlatky, P, Koelblinger, C, Raith, C, Zölss, C, Dimmitt, S, Gharbi, R, Hankey, G, Maden, A, P Mwipatayi, B, Sieunarine, K, Tan, A, Turner, G, Wesseldine, A, T M, E Davis, Audzei, P, Davidovski, I, Dedul, D, Hetsiuk, A, Kornievich, S, Gao, J, Y-G, Huang, Jing, G, H, Li, Y-J, Li, Liu, B, C-W, Liu, J-D, Wu, W, Ye, C-H, Yu, Ban, T, Buljan, K, Candrlic, K, Dapic, D, Ilijasevic, M, Istvanic, T, Kovac, B, Kvolik, S, Lehner, V, Pinotic, K, Hudorović, N, Ivanec, Z, Lovricević, I, Mazul-Sunko, B, Novotny, Z, D De Syo, Vuković, V, Biebl, O, Dolecek, L, C El Samman, Kalasova, H, Kubricht, V, Matous, P, Michalek, P, Stajnrt, M, Stern, M, Svec, M, Vitasek, P, Vrzal, J, Weiss, K, Janousek, L, Kieslichova, E, Mazarova, V, Piza, P, Vychodil, P, Dulovcova, V, Fiksa, J, Hruby, J, Maresch, M, Mathias, M, Rubes, D, Tosenovsky, P, Vidim, T, Henzl, M, Riman, J, Ziegler, Z, Drabek, P, Hrbac, T, Reguli, S, Stigler, J, Bachleda, P, Drac, P, Hudecek, M, Koutna, J, Sanak, D, Utikal, P, Goldemund, D, Gregor, Z, Pavlikova, J, Podlaha, J, Privara, M, Staffa, R, Vlachovsky, R, Barankova, L, Chlouba, V, Fiedler, J, Prazak, P, Priban, V, Wierer, A, Ellervee, T, Järve, H, Sell, A, Taba, P, Kolbassov, V, Kullamaa, S, Paavel, T, Abramishvili, N, Bokuchava, M, Kachapuridze, N, Kipiani, K, Papashvili, K, Pargalava, N, Adili, F, Dietz, A, Neidhart, G, Nentwig, G, M Sitzer, O, Beno, M, Essink-Hassels, M, Lander, K, Ruemenapf, G, Breuer, P, Heldt, R, Melichar, G, Rieper, J, H Eckstein, H, Poppert, H, Schneider, G, Andrikopoulos, V, Angel, A, Bakogiannis, K, Dermitzaki, M, Georgakis, P, Lioupis, C, Maras, D, G Moulakakis, K, Sfyroeras, G, Arato, E, Gyevnar, Z, Hardi, P, Kasza, G, Kollar, L, Menyhei, G, Pal, E, Sinay, L, Verzar, Z, Volgyi, E, S Elmakias, S, Harah, E, Kristal, K, Lebi, D, Leonty, Y, Levy, D, Milo, R, Yoffe, B, Bissi, M, Cappellini, B, Cassamali, T, Corino, L, Denkewitz, T, Ghilardi, G, Massetto, N, P Di Mauro, Tommasino, C, Bartolucci, R, Buffa, V, M Corsi, F, D'Avino, E, F Di Cesare, L Di Pirro, Lappa, A, Luzzi, S, Menichetti, A, Nesi, F, Pannone, A, Picozzi, P, Pogany, G, Rabitti, G, Severi, L, Avella, R, Biandolino, P, P Giomarelli, P, R Monfregola, M, Palasciano, G, Peccianti, V, Pieragalli, D, Setacci, C, Setacci, F, Sirignano, P, Bordoni, M, Casadei, V, Cugnasca, M, A De Troia, Geremia, L, Guffanti, P, G Lo Guercio, V Maniaci, M, Mauri, Morbidelli, A, Aletta, A, Costanzo, E, D'Arrigo, G, F Di Stefano, Lomeo, A, Maugeri, S, C Monea, M, Scardavilli, G, Scolaro, A, Aloisi, P, Ciccozzi, A, Manno, M, Marrelli, A, Martinazzo, C, Mastromarino, A, Petrassi, C, Piroli, A, Spartera, C, Ventura, M, Alessandrini, F, Carissimi, C, M Centritto, E, Cinelli, G, C De Filippo, Liberatoscioli, G, Modugno, P, Rossi, M, T Attanzio, M, Bajardi, G, Bellisi, M, Machi, P, Salemi, S, Savettieri, G, A Crea, M, V di Lazzaro, Ferrante, A, Guarneri, S, Manni, R, Snider, F, Stefanuto, C, Berardi, G, Bianchi, A, Comis, M, Cumbo, P, Fadde, M, Ferrero, E, Ferri, M, Filardo, A, Gaggiano, A, Ganzaroli, M, Labate, C, Maggio, D, Mennuti, G, Minicucci, S, Musso, A, Nessi, F, Pasquino, M, Perretta, L, Piazza, S, Verdecchia, C, Viazzo, A, Antico, A, Battan, E, Ciarlo, M, Giardini, G, G Luca Iob, Marinello, C, Piccolo, D, Bove, R, Castrucci, T, Lorido, A, Sammarco, S, Bruzzone, B, Cannata, D, Colotto, P, Finocchi, C, Giudici, N, Mambrini, S, Mazzei, R, Palombo, D, Pellegrino, A, Rousas, N, Viacava, A, Ermirio, D, Faga, D, Simoni, G, Benedetti-Valentini, F, Gabrielli, R, Garofano, R, Gossetti, B, Guerricchio, R, Irace, L, Lenzi, G, Gedins, M, Kisis, K, Krievins, D, Krustina, I, Lietuvietis, E, Malina, M, Morlata, N, Rits, J, Thor, S, Ivanova, P, Kikule, I, Liepa, V, Ligers, A, Stengrevica, N, Vnukova, N, Zvirgzdins, V, P J A, M Brouwers, H Geelkerken, R, Stam, A, M A, M Simon, T den Hoed, P, Oltmans, M, Rettig, H, F Veen, H, Zuidgeest, D, Feldo, M, Kesik, J, Kobusiewicz, W, Łatkiewicz, D, Myślinski, W, Przywara, S, Terlecki, P, Wroński, J, Zubilewicz, T, Alfonso, G, Azevedo, E, R de Albuquerque, Mansilha, A, Al-Salman, M, K Aldaif, A, A Alnasr, T, A El Dawlatly, A, Elkayali, A, M Rabee, H, Chudikova, E, Chudá, I, Dulka, T, Goldenberg, Z, Lofaj, P, Pavlikova, M, Pisar, M, Sefranek, V, Slysko, R, Tomka, J, Tóthová, Z, Zita, Z, A Cairols, M, Iborra, E, Mercadal, M, Rubio, F, Canovas, D, Cobo, L, Gimenez-Gaibar, A, Gonzalez, E, Gonzalo, B, Guilera, N, Hospedales, J, J Laso, M, Perez, J, Solanich, T, Hensater, M, Karlström, L, Kjällman, L, Rosengren, L, C-A, Ewaldsson, Gillgren, P, T-B, Käll, Konrad, P, Lindkvist, M, Nilsson, L, Takolander, R, E von Zweigbergk, Cinar, B, Coruh, T, Kurc, E, Ozsoy, D, Sargin, M, Tutkavul, K, Yekeler, I, Aksoy, M, Aksoy, S, Kurtoglu, M, Arar, C, Canbaz, S, Celik, Y, Ege, T, Ketenc, S, Sunar, H, Unal, S, Asik, I, Bengisun, U, Koksoy, C, Yucemen, N, C Berridge, D, Caldicott, L, Cooper, J, Cross, M, Ford, H, Fuller, R, Gamlin, F, Homer-Vanniasinkum, S, Howell, S, Kent, P, Lumb, A, A I, D Mavor, D J, A Scott, Shah, M, Wanklyn, P, S Budd, J, Mcateer, P, Shaw, L, Dewar, R, H Lewis, M, Potter, C, Richards, H, Roberts, R, Townsend, E, Wagle, A, Woodford, P, Hall, G, Holdsworth, R, Macleod, M, Michels, L, P A, G Sandercock, Sudlow, C, Woods, A, S Abraham, J, Bukhari, M, Bush, A, Calvey, J, Chadwick, I, Krishnaprasad, K, Oldham, T, Tomlinson, M, Vickers, A, Wilson, D, Wilson, P, Greystone, S, C Grocott, E, Hayes, W, Haynes, S, Jenkins, C, Jenkins, D, Moore, W, Nyamekye, I, Overstall, P, Riseboro, S, Williams, H, Boyle, J, Duane, D, Gaunt, M, J Kirkpatrick, P, Martin, P, E Risdall, J, Scurrah, N, L Turner, C, Varty, K, T Ferguson, I, Horsfall, S, C Mitchell, D, Robinson, S, Frankel, J, E Morris, G, Phillips, M, Sansome, A, J Sparkes, D, Williams, J, Ashton, W, Baker, S, Clark, M, G Darke, S, Dunnill, R, Hargreaves, M, Jenkinson, D, Thomson, C, White, N, D Wijesinghe, L, Bapat, P, A Barrett, J, D Blair, S, Chandrasekar, R, Lawrence, G, Lowe, D, Sangster, G, Smith, M, M Van Miert, K Das, S, Malik, O, Nel, M, Rakowicz, W, Aukett, M, Carmichael, M, Colchester, A, R Taylor, P, Wood, C, Ageed, A, J Boom, S, Ghosh, S, Godfrey, J, Hewitt-Gray, J, Mcdiarmid, I, Yousif, S, Ziarkowski, A, Al-Din, A, Carpenter, M, Ch'Ng, K, J Curley, P, Davey, R, Henderson, B, F Hossain, J, D Irvine, C, Loizou, L, Main, A, Stanners, A, Muldoon, T, V Soong, C, Wiggam, I, P Armon, M, Burrows, M, Holmes, L, K Metcalf, A, Nunn, D, Abdul-Hamid, A, Akomalafe, B, Bryce, J, Chetter, I, Samaan, A, Briley, D, Collin, J, Darby, C, Dobson, M, Foex, P, Grange, C, Handa, A, Hands, L, E Higham, H, J M, T Perkins, Sear, J, Stoneham, M, Hamilton, G, Judge, C, Morris-Vincent, P, Pegg, M, A Wilson, L, I Aldoori, M, B E, A Dafalla, Kumar, N, I F, C Hay, Jefferson, P, Muir, I, Peel, W, Rutherford, J, Sathianathan, J, Wight, S, Williams, D, Wrathall, W, Bachoo, P, Brittenden, J, Counsell, C, Patey, R, Read, J, L de Cossart, K Dimitri, S, Edwards, P, Fergusson, N, Jameson, P, Somauroo, J, Taylor, V, D Aravindan, P, Brocklehurst, I, Mirza, S, N Namushi, R, O Oshodi, T, Ruff, D, A Solomon, S, Vassallo, J, Egbe, M, Halstead, G, Onwudike, M, Putland, A, Roberts, N, A Salaman, R, Watson, D, Caine, S, Day, J, Lamont, P, J Murphy, P, Smith, F, Beacham, K, J Dorman, P, Lambert, D, Rodgers, H, Collas, D, Sarin, S, Shah, J, S Baht, H, Banks, J, Cowie, L, Gunathilagan, G, Hargroves, D, Insall, R, G Smithard, D, K Chadha, D, R Pillay, W, Rashid, J, Sayles, J, Hill, S, Lawton, G, M Lloyd, C, Marsh, A, Clarke, G, J Lonsdale, R, Venables, G, Cross, R, Lord, B, Mcilmoyle, J, Y Osman, H, Robinson, J, Chant, H, Mate, A, Sim, D, Upton, P, Thomas, D, H Wolfe, J, Mccollum, C, O'Neill, P, Bernatsky, V, Bondar, L, Karpenko, A, Mamonova, M, Muz, N, and Yavorsky, V
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Carotid endarterectomy ,general anesthesia ,local anesthesia ,carotid surgery ,Anesthesia, General ,law.invention ,Postoperative Complications ,Randomized controlled trial ,law ,medicine ,Humans ,Carotid Stenosis ,General anaesthesia ,general anaesthesia ,Stroke ,Aged ,Endarterectomy ,Endarterectomy, Carotid ,local anaesthesia ,Intention-to-treat analysis ,business.industry ,General Medicine ,Perioperative ,Vascular surgery ,medicine.disease ,Surgery ,Anesthesia ,Female ,business ,Anesthesia, Local - Abstract
BACKGROUND: The effect of carotid endarterectomy in lowering the risk of stroke ipsilateral to severe atherosclerotic carotid-artery stenosis is offset by complications during or soon after surgery. We compared surgery under general anaesthesia with that under local anaesthesia because prediction and avoidance of perioperative strokes might be easier under local anaesthesia than under general anaesthesia. METHODS: We undertook a parallel group, multicentre, randomised controlled trial of 3526 patients with symptomatic or asymptomatic carotid stenosis from 95 centres in 24 countries. Participants were randomly assigned to surgery under general (n=1753) or local (n=1773) anaesthesia between June, 1999 and October, 2007. The primary outcome was the proportion of patients with stroke (including retinal infarction), myocardial infarction, or death between randomisation and 30 days after surgery. Analysis was by intention to treat. The trial is registered with Current Control Trials number ISRCTN00525237. FINDINGS: A primary outcome occurred in 84 (4.8%) patients assigned to surgery under general anaesthesia and 80 (4.5%) of those assigned to surgery under local anaesthesia; three events per 1000 treated were prevented with local anaesthesia (95% CI -11 to 17; risk ratio [RR] 0.94 [95% CI 0.70 to 1.27]). The two groups did not significantly differ for quality of life, length of hospital stay, or the primary outcome in the prespecified subgroups of age, contralateral carotid occlusion, and baseline surgical risk. INTERPRETATION: We have not shown a definite difference in outcomes between general and local anaesthesia for carotid surgery. The anaesthetist and surgeon, in consultation with the patient, should decide which anaesthetic technique to use on an individual basis. FUNDING: The Health Foundation (UK) and European Society of Vascular Surgery.
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- 2008
3. Spinal Cord Stimulation for Treatment of Peripheral Vascular Disease.
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Broggi, G., Servello, D., Franzini, A., Giorgi, C., Luccarelli, M., Ruberti, U., Cugnasca, M., Odero, A., Tealdi, D., and Denale, A.
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- 1987
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4. The crimped bovine pericardium bioprosthesis in graft infection: Preliminary experience
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Odero, A., Argenteri, A., Cugnasca, M., and Pirrelli, S.
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- 1997
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5. Fresh and cryopreserved arterial homografts in the treatment of prostetic graft infections: experience of the Italian Collaborative Vascular Homograft Group
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Sara Mantero, G. Piccolo, F. Prestipino, F. Bonalumi, D. Frigerio, G. Agrifoglio, M. Scalamogna, Biasi G, Attilio Odero, Paolo Biglioli, G. Spina, G. Sirchia, Roberto Chiesa, S. Pirrelli, Gianluca Polvani, Anna Guarino, C. Novali, M. Cugnasca, Angelo Sala, S. Costantini Brancadoro, A. Jannello, Domenico Astore, P. Locati, Germano Melissano, P. Mingazzini, G. Corsi, Chiesa, R, Astore, D, Piccolo, G, Melissano, G, Jannello, A, Frigerio, D, Agrifoglio, G, Bonalumi, F, Corsi, G, Costantini Brancadoro, S, Novali, C, Locati, P, Odero, A, Pirrelli, S, Cugnasca, M, Biglioli, P, Sala, A, Polvani, G, Guarino, A, Biasi, G, Mingazzini, P, Scalamogna, M, Mantero, S, Spina, G, Prestipino, F, Sirchia, G, Chiesa, Roberto, Melissano, Germano, Brancadora, Sc, Biasi, Gm, and Sirchia, G.
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Adult ,Male ,medicine.medical_specialty ,Prosthesis-Related Infections ,medicine.medical_treatment ,Aortoenteric fistula ,Revascularization ,Sepsis ,Duplex scanning ,ABO blood group system ,medicine ,MED/22 - CHIRURGIA VASCOLARE ,Humans ,Transplantation, Homologous ,Endocarditis ,Vascular Patency ,Aged ,Cryopreservation ,business.industry ,Mortality rate ,Arteries ,General Medicine ,Middle Aged ,medicine.disease ,Blood Vessel Prosthesis ,Surgery ,Arterial Graft Infection, Arterial Homografts, Arterial OmoTransplant ,Treatment Outcome ,surgical procedures, operative ,Italy ,Female ,Cardiology and Cardiovascular Medicine ,business ,Abdominal surgery - Abstract
Following the experience of cardiac surgeons with homografts in the treatment of infective aortic valve endocarditis, cardiovascular surgeons have investigated in situ revascularization by means of homografts in the management of vascular prosthetic graft infections. Preliminary results are encouraging, but their late fate in long-term follow-up and the influence of preservation techniques are still under investigation. This article reports the experience of the Italian Collaborative Vascular Homograft Group, with the use of fresh and cryopreserved arterial homografts for the treatment of prosthetic graft infections. Between March 1994 and December 1996, 44 patients with prosthetic graft infection were treated with homografts (13 preserved at 4 degrees C, 31 cryopreserved). The mean age of the patients was 65 years. Emergency surgical procedures were performed in eight patients (18%). Sepsis was diagnosed in 11 patients, aortoenteric fistula in 13, and false aneurysms in 10. Staphylococcus was the main cause of infection. The types of vascular reconstruction with homograft were: 32 aortobifemoral, 3 aortoaortic, 2 iliofemoral, 4 peripheral, and 3 axillobifemoral. Human lymphocyte antigen (HLA) and antibody (ABO) blood group system compatibility between donors and recipients was not respected. The mean duration of follow-up was 15 months (range 1-33). Clinical and duplex scanning evaluations were routinely performed. Computed tomography (CT) or magnetic resonance (MR) scanning or arteriography were performed on the basis of duplex scanning results. There were six deaths during the early postoperative period (30 days) with a mortality rate of 13.6%. During the follow-up there were five late deaths with a mortality rate of 11.4%. Eight patients had graft occlusion. Three cases were successfully treated with thrombectomy. Two cases were successfully treated with femoropopliteal bypass with autologous vein. In three cases leg amputation was necessary. The results of fresh and cryopreserved homograft were compared. No significative differences of early postoperative mortality, late mortality, homograft related mortality, and graft occlusion were observed. We have evaluated the actuarial survival of the patients and the actuarial patency of the homografts on the aortoiliac reconstructions. Twelve months after the surgery the actuarial survival of the patients was 73% and the actuarial patency of the homografts was 56%. In our preliminary experience, we have not observed any significant difference in terms of clinical outcome by using fresh rather than cryopreserved homografts. In the near future it will be our policy to employ only cryopreserved homografts. Moreover, we will extend vessel harvesting to nonheart-beating donors, thus maximizing retrieval. The aforementioned solutions will supply the best graft availability to obtain dimensional and ABO compatibility between donors and recipients.
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- 1998
6. Ultrasonic endarterectomy: experimental and initial clinical results in carotid stenosis.
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La Rosa A, Argenteri A, Cugnasca M, Rossi G, and Odero A
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- Aged, Arteriosclerosis pathology, Cadaver, Carotid Arteries pathology, Female, Humans, Male, Middle Aged, Carotid Arteries diagnostic imaging, Endarterectomy, Carotid methods, Ultrasonography, Interventional
- Abstract
Purpose: The effects of ultrasonic endarterectomy, evaluated experimentally and clinically, were compared with the results obtained with controversial endarterectomy., Experimental: An ultrasonic vascular dissector with a frequency of 29 kHz was used for ultrasonic endarterectomy. Gross and histologic observation was made on 22 fresh human cadaver atherosclerotic vessels, of which 16 were treated with ultrasound endarterectomy and 6 conventionally. Clinical: Twenty-eight patients requiring carotid endarterectomy were chosen at random. Seven patients underwent ultrasonic endarterectomy after traditional access surgery, while 21 patients were treated with conventional endarterectomy. In the clinical study, an intraoperative gross observation of the endarterectomized surfaces was made, followed by duplex scanning after 18 and 24 months., Results: Histologic observation of the cadaveric revealed particularly smooth surfaces in 87.5%; there was no debris, flaps, or vessel damage in any of the ultrasonically treated samples. In contrast, the traditional technique produced regular surfaces without residual debris in only 50% of the experimental cases. Favorable results were also seen in the clinical carotid experience, in which there was no need to surgically correct the ultrasonically endarterectomized surface in any case. In fact, achieving a satisfactory outcome was greatly facilitated by the use of ultrasound. In the conventionally treated patients, however, only 19% (4) demonstrated a smooth luminal surface on gross observation even after surgical correction. No postoperative complications were encountered in either group, and no restenosis has occurred in ultrasonic endarterectomy-treated patients after 2 years., Conclusions: Favorable experimental results using ultrasonic endarterectomy prompted the successful clinical application of this new technique in carotid stenosis treatment. Whether or not ultrasonic endarterectomy can reduce postoperative morbidity and restenosis is still under study.
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- 1994
- Full Text
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7. Traumatic pathology of the thoracic aorta. Personal experience based on 42 cases.
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Ruberti U, Arpesani A, Giorgetti PL, Cugnasca M, Rampoldi V, and Selva S
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- Adult, Aortic Rupture pathology, Aortic Rupture surgery, Child, Female, Humans, Male, Middle Aged, Aorta, Thoracic injuries
- Abstract
Between 1974 and 1989, 42 patients have been operated on at the Istituto di Chirurgia Generale e Cardiovascolare of University of Milan, for traumatic pathology of the thoracic aorta: in 14 cases it occurred an acute rupture at the level of aortic isthmus and in 28 cases a posttraumatic fals aneurysm. We had an operative mortality of 28% (4 cases) in the acute rupture: 3 patients died for neurological complications which were present at hospitalization. In one case appeared a serious ARDS. We had no surgical deaths in patients operated on for the posttraumatic false aneurysm. In 15 cases, the patients suffered for a postoperative paraplegia. Surgical indications are discussed, overall for the posttraumatic false aneurysms. The authors consider the advantage and the risks of the use of ECC and of total heparinization of the patients.
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- 1990
8. Use of extraanatomical procedures in vascular surgery.
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Odero A, Miani S, Cugnasca M, Tealdi D, and Ruberti U
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- Adult, Aged, Arteries surgery, Female, Humans, Male, Middle Aged, Blood Vessel Prosthesis, Graft Occlusion, Vascular surgery, Ischemia surgery, Leg blood supply
- Published
- 1985
9. Internal mammary artery to pulmonary artery fistula.
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Ruberti U, Odero A, Arpesani A, Giorgetti PL, Cugnasca M, Rampoldi V, and Anguissola GB
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- Adult, Aneurysm etiology, Arterio-Arterial Fistula surgery, Female, Humans, Ligation, Arterio-Arterial Fistula diagnosis, Mammary Arteries surgery, Pulmonary Artery surgery, Thoracic Arteries surgery
- Abstract
A rare case of arteriovenous fistula between an internal mammary artery and a pulmonary artery is presented. The clinical history of recurrent bronchitis and dyspnoea during exercise, the presence of right parasternal murmur with normal heart size and normal blood gases justified the execution of an arteriovenous thoracic angiography which revealed the presence of a cirsoid aneurysm supplied by the internal and external mammary arteries. Diagnostic investigation and surgical indication in patients with the rare fistulous communication between the internal mammary artery and the systemic or pulmonary circulation are analysed.
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- 1986
10. Surgical treatment of thoracic aortic aneurysms. Personal experience.
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Ruberti U, Odero A, Arpesani A, Giorgetti PL, Cugnasca M, Rampoldi V, Anguissola GB, Morbidelli A, Scorza R, and Selva S
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- Adult, Aged, Aged, 80 and over, Aortic Dissection diagnosis, Aortic Dissection mortality, Aorta surgery, Aorta, Thoracic injuries, Aorta, Thoracic surgery, Aortic Aneurysm diagnosis, Aortic Aneurysm mortality, Aortic Rupture diagnosis, Aortic Rupture mortality, Blood Vessel Prosthesis, Extracorporeal Circulation, Follow-Up Studies, Humans, Middle Aged, Aortic Dissection surgery, Aortic Aneurysm surgery, Aortic Rupture surgery
- Abstract
A series of 262 observed cases of aneurysm of the thoracic aorta is examined in which 216 cases of surgical correction were performed between 1974 and 1987. Dissecting aneurysms and post-traumatic pseudoaneurysms, although of different aetiology and morbid anatomy, are also included since the surgical technique adopted is similar in all groups. Clinically different aspects of acute and chronic lesions are analyzed. Of all preoperative examinations, angiography is preferred as it gives the most precise definition of the aortic lesion. This is especially necessary in the case of acute dissection or rupture of thoracic aorta although the role of CAT scan is becoming progressively more important. In cases of aortic dissection with massive aortic valve insufficiency, the substitution of the ascending aorta and aortic valve with reimplantation of coronary arteries, in accordance with Bentall's technique is also indicated. The improvement in surgical results is emphasized, since surgical mortality has decreased from 30.6% to 22% in the last eight years. This is due to improvement in surgical technique, to extra corporeal circulation and myocardial protection.
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- 1988
11. Neoplastic thrombosis of the inferior vena cava and right atrium due to kidney cancer. Three surgically treated cases.
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Odero A, Giorgetti PL, Cugnasca M, Rampoldi V, Bortolani EM, and Ruberti U
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- Aged, Carcinoma, Renal Cell diagnostic imaging, Carcinoma, Renal Cell surgery, Female, Heart Diseases diagnostic imaging, Heart Diseases surgery, Humans, Kidney Neoplasms diagnostic imaging, Kidney Neoplasms surgery, Male, Middle Aged, Thrombosis diagnostic imaging, Thrombosis surgery, Tomography, X-Ray Computed, Vena Cava, Inferior surgery, Carcinoma, Renal Cell complications, Heart Diseases etiology, Kidney Neoplasms complications, Thrombosis etiology, Vena Cava, Inferior diagnostic imaging
- Abstract
Extension into vena cava and right atrium of tumor thrombus from a renal cell carcinoma presents a surgical challenge. The use of cardiopulmonary by-pass, hypothermia and cardiac arrest with temporary exsanguination has allowed the successful surgical excision of this tumor. During 1986 and 1987 3 patients with cancer of kidney invading the vena cava were operated on with this surgical technique. No deaths occurred. The possibility of curing this type of cancer with minimal operative risk and good results is discussed.
- Published
- 1989
12. Acute ruptures of the thoracic aorta. Personal experience.
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Ruberti U, Odero A, Arpesani A, Giorgetti PL, Cugnasca M, Rampoldi V, Soleri V, Morbidelli A, and Selva S
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- Accidents, Traffic, Acute Disease, Adolescent, Adult, Aorta, Thoracic injuries, Aortic Rupture diagnosis, Aortic Rupture surgery, Female, Humans, Male, Aortic Rupture etiology
- Abstract
The statistical incidence, etiopathogenesis, diagnostics and surgical treatment of acute ruptures of the thoracic aorta are described. A personal series of 7 cases is reported; surgical techniques, benefits and risks of extracorporeal circulation during surgical treatments are analysed and discussed.
- Published
- 1987
13. Acute aortic dissection. Personal experience.
- Author
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Ruberti U, Odero A, Arpesani A, Giorgetti PL, Cugnasca M, Rampoldi V, and Selva S
- Subjects
- Acute Disease, Adult, Aged, Aortic Dissection diagnostic imaging, Aortic Dissection mortality, Aortic Aneurysm diagnostic imaging, Aortic Aneurysm mortality, Aortic Rupture diagnostic imaging, Aortic Rupture mortality, Aortic Rupture surgery, Blood Vessel Prosthesis, Emergencies, Female, Humans, Male, Middle Aged, Radiography, Retrospective Studies, Aortic Dissection surgery, Aortic Aneurysm surgery
- Abstract
Aortic dissection is a catastrophic event with a high mortality rate for untreated patients. One hundred and thirteen patients with acute aortic dissection were observed in the IInd Surgical Department of Milan University from 1974 to 1985; 55 had type I and II aortic dissection and 58 had type III aortic dissection. All patients with type I and II and about 50% of patients with type III aortic dissection underwent surgical correction. In the second type III group the aortic lesion was surgically corrected only when visceral ischaemia or ischaemia of the lower limb was recognized. In the other type III cases, medical treatment was preferred. The mortality rate was lower after medical treatment (15%) than after surgical treatment (37%). Follow-up was performed for the majority of patients and was recently completed with non-invasive techniques like Magnetic Resonance. It accurately shows the residual dissection and follows, the development of occlusion of the false lumen without any risk to the patients.
- Published
- 1988
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