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Biomedical subjects

A Gugulakis

Publications and source records attributed to A Gugulakis.

5 recordsLinked to original sources
PubMed1994

Surgical treatment of extracranial carotid aneurysms.

During the past 23 years, 12 patients with aneurysm of the carotid bifurcation were treated in our department. There were 11 men and one woman between 20 and 68 years (mean age 54.2 years). In as much as 217 patients were operated on for extracranial occlusive carotid disease during the same period, the incidence of these aneurysms in our series has been estimated to be 5%. Eleven patients presented with TIAs ipsilateral to the aneurysm. One patient presented with a painful pulsatile enlarging mass in the neck (ruptured aneurysm) without any neurological complications. Eleven patients underwent surgical repair. Ligation of the common carotid artery was done in one patient, resection of the aneurysm with end-to-end anastomosis was performed in 2 patients, aneurysmorraphy in 4, excision and reconstruction with reversed saphenous vein in one, excision and reconstruction with PTFE graft in one and 2 patients underwent endarterectomy and angioplasty of the carotid bifurcation. One patient with a high internal carotid artery aneurysm (base of the skull) was classified as nonoperable. There were no deaths or strokes postoperatively. Persistent cranial nerve injury was noted in 1 case (8%). Follow-up at 6 months - 10 years (mean 5.5 years) yielded and incidence of post-op TIAs of 8% attributed to intracranial occlusive disease. Surgical correction is the treatment of choice for extracranial carotid aneurysm and can be performed with a very low morbidity and mortality and carries excellent long-term results.

Blindness↗
PubMed1990

Primary leiomyosarcoma of the gallbladder. Case report and review of the literature.

The case of a 64 year old female who was known to have gallstones is presented. She was admitted to the Hospital following an attack of acute cholecystitis. Ten days after vigorous conservative treatment cholecystectomy was performed. The histological examination showed the presence of the gallbladder leiomyosarcoma. Primary sarcomas of the gallbladder are rare, leiomyosarcoma being the most infrequent type, their preoperative diagnosis almost impossible and their prognosis poor.

Acute Disease↗
PubMedDate not supplied

Combined carotid endarterectomy and coronary artery bypass grafting. A literature review.

This is a review article on the management of patients with both carotid and coronary artery lesions. Most authors agree that patients with symptomatic coronary and symptomatic carotid disease should be offered a combined operation (same anaesthetic) in the presence of unstable angina or left main stem coronary disease and staged operations in the presence of stable angina. Patients with symptomatic coronary disease and asymptomatic severe (greater than 80% stenosis) carotid disease should be offered the staged procedure not for preventing perioperative but late stroke. This statement is tentative and not supported by hard data. It should be revised when the results of the multicentre randomised studies of asymptomatic carotid stenosis become available. A prospective randomised study is required in patients with symptomatic coronary and asymptomatic severe unilateral and bilateral carotid stenosis (greater than 80%) in order to determine whether surgery in the carotid decreases the incidence of late stroke. It cannot be overemphasised that the team that does the carotid endarterectomy should have a good track record of combined mortality and morbidity of less than 5% for patients with TIA's and less than 3% for patients with asymptomatic carotid disease.

Carotid Stenosis↗