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G F Giuffrida

Publications and source records attributed to G F Giuffrida.

29 records · Page 2Linked to original sources
PubMed1992

[Femoral non-infected anastomotic pseudoaneurysm. Clinical contribution].

The femoral region is the most common site of development of anastomotic pseudoaneurysms that represent a relatively frequent complication of reconstructive vascular surgery. Clinical examination alone generally is sufficient to diagnose these lesions because they usually appear as a pulsatile inguinal mass not accompanied by pain. Echography and angiodynography permit a better evaluation of size and blood flow. CT is useful to evaluate proximal aortic anastomosis specially in pseudoaneurysms with septic pathogenesis. Rupture or thrombosis are rare clinical presentations. Vascular reconstructive surgery is always suggested in this sort of pathology. In this paper the Authors report the clinical experience acquired from 1980 to 1990 in the General and Cardiovascular Surgery Department of the University of Milan (Head: Prof. Ugo Ruberti) is 34 cases of femoral anastomotic aseptic pseudoaneurysms, analyzing the pathogenesis of this sort of lesion, describing the surgical solutions adopted and reporting the immediate and late results.

Aged↗
PubMed1992

[Profundaplasty as the only revascularization procedure in ischemia of the leg. Clinical contribution].

The profunda femoris artery is the primary source of collateral flow to the lower extremity in the presence of superficial femoral and/or popliteal occlusion. The arteriosclerotic disease involvement of this segment is relatively less frequent and in the majority of the cases localized on the ostium and reaches to the first branch. Profundaplasty to relieve limb-threatening ischemia is infrequently employed as an isolated procedure. However many Authors reported their experience on this treatment, in case of critical limb ischemia in patients without significative lesions of the aortofemoral district. Our late four year experience concerns of 22 patients (18 male, 3 female). All the patients had severe ischemia of the lower limbs, with serious symptoms, such as invalidating claudicatio (13), rest pain (7) and gangrene (2). Twenty-two profundaplasty were performed as the only reconstructive procedure. There was no postoperative mortality. Two patients had above knee amputations (15 days and 14 months after the revascularization). All of the other patients improved and follow-up extended to 48 months shows a limb salvage rate of 90%. In conclusion, on the basis of our experience, we think that the operation is recommended, whenever possible, in patients with critical ischemia when the possibilities of more extensive revascularization procedures are considered to be poor.

Aged↗
PubMed1992

[Isolated aneurysms of the internal iliac artery. A clinical contribution].

Five patients with isolated aneurysms of the internal iliac artery were identified and submitted to surgical procedure. Two patients were operated on in election, three in emergency with aneurysmatic rupture. The natural course of this pathology is one of progressive expansion and rupture. This lesion is often asymptomatic, but sometimes we found associated, compression symptoms of genito-urinary, intestinal tract and venous and neurological structures. Echography, CT scan and angiography are the most common and useful diagnostic procedure. Endoaneurysmectomy with proximal and distal suture of the stumps is the appropriate treatment in the majority of the cases.

Aged↗
PubMed1989

[Traumatic lesions of the popliteal artery].

Even today, traumatic lesions of the popliteal artery mean in a large percentage of cases (from 25% to 45% according to recent reports) loss of the extremity, notwithstanding the considerable advances made by reconstructive vascular surgery. The most important series are reported in relation to events of war in the past (Korea, Vietnam) and more recently. As for lesions in everyday life, the highest percentage is the result of road and particularly motorbike accidents. A review of the most recent literature shows that the prognosis for lesions of the proximal and middle segment of the popliteal artery is greatly improved while in lesions of the distal portion and particularly the trifurcation, the percentage of failure with consequent amputation is still very high (from 30% to 40% of cases). Here personal experience of 6 cases of lesions of the popliteal artery due to osteovascular trauma observed in the past two years is reported, the diagnostic procedures and therapeutic treatment adopted being discussed.

Accidents, Traffic↗
PubMed1989

[Treatment of ischemia in late thrombosis after aorto-iliaco-femoral reconstructions].

Late thrombosis of inserted prosthetic grafts for arterial reconstructive surgery is one of the most frequent late complication. Its incidence is influenced by many factors: hemodynamic conditions, quality of run-in and run-off, technical aspects of the primary repair. Progressive arteriosclerosis in femoral vessels was the cause of graft limb thrombosis in most instances. When graft occlusion does occur, there is, in a majority of patients, an immediate return of ischemia which often is severe and redo-operation is indicated to restore circulation. A new angiogram is mandatory, especially for the recognition of the inflow to the central anastomosis and for the evaluation of the distal run-off. Several surgical techniques are in use for redo-operation (graft thrombectomy with or without graft prolongation, partial or total replacement of the prosthesis, reconstruction by an extra-anatomical by-pass). Very important is the role of the deep femoral artery: in patients with a multi-level occlusive disease a patent deep femoral artery most often provides an effective inflow repair with a combined use of profundaplasty and lumbar sympathectomy. In this report of 188 late thrombosis, in a twenty year experience, at the Department of General and Cardiovascular Surgery, University of Milan, we made a redo-operation in 83% of the cases, according our preference in surgical procedures, to the partial substitution of the prosthesis with large profundaplasty. An associated lumbar sympathectomy was performed in 25% of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Natural history and course of aneurysmal disease in patients operated on for abdominal aortic aneurysms].

This study is aimed at analyzing our experience in the evolution of aneurysmatic disease after surgical treatment of the typical subrenal abdominal aortic aneurysm. In fact in some cases we reobserved these patients for the onset of a new important dilatation involving the proximal tract of the abdominal aorta or the common iliac arteries. From 1980 to December 1992, 24 patients out of a group of 1508 patients previously submitted to an aorto-aortic or aorto-iliac reconstructive procedure using dacron prosthetic grafts were reoperated for relapsing aneurysmatic disease. In six cases the dangerous ectasia was located above the proximal aortic anastomosis; in four patients the re-reconstructive procedure was performed clamping the subdiaphragmatic abdominal aorta and performing the proximal anastomosis just below the ostia of the renal arteries. In two cases the aneurysmatic process involved the origins of the visceral vessels and a left thoracophrenolaparotomic access was necessary in order to perform a thoracoabdominal reconstruction reimplanting the visceral arteries on the prosthetic graft. In 18 cases the progressive aneurysmatic process involved the common iliac axis provoking, in some cases, a kinking or a shortening of the aortic prosthetic graft. The results of these reintervention are good with no mortality at operation and a satisfactory middle term (average 3 years) follow-up. Our investigation demonstrates that in a small, but significant (1.6%) percentage of patients the aneurysmatic disease spreads upward and downward involving arterial segments formerly non affected.

Aged↗
PubMedDate not supplied

[Aneurysm of the popliteal artery. Prognostic and therapeutic criteria].

Experience of the management of 45 patients affected by popliteal artery aneurysms is reported. All patients, but one, underwent operative treatment. The importance of immediate surgical reconstruction whenever a popliteal artery aneurysm has been detected is stressed. In fact the most frequent complication represented by sudden thrombosis of the aneurysmatic sac and/or by peripheral embolization is generally followed by an irreversible closure of the vascular run off, determining the high rate of failures (28% in our experience) in spite of a prompt surgical reconstructive procedure.

Aged↗
PubMedDate not supplied

[Reconstructive surgery of the abdominal aorta in a case of left-positioned inferior vena cava. Clinical case and review of the literature].

An unsuspected left-sided inferior vena cava (IVC) can present a formidable challenge for the surgeon attempting abdominal aortic surgery. The incidence of congenital anomalies of the post-renal (infrarenal) vena cava is approximately 3%, with double inferior vena cava most frequently occurring. The authors refer to a case of isolated left-sided vena cava in a 53 year old man who underwent an aorto-femoral bypass graft for aorto-iliac occlusive disease. On the basis of a literature review the authors recall the incidence and the embryology of this anomaly, and analyze its surgical implications, with particular reference to abdominal aortic surgery.

Anastomosis, Surgical↗