[Role and possible control of the risk factors in atherosclerotic vasculopathies for the evaluation of results of surgical treatment. Preliminary study on the use of pentoxifylline].
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Biomedical subjects
Publications and source records attributed to U Ruberti.
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Reference is made to a series of 620 cases of Raynaud's phenomenon observed at the University of Milan between 1951 and 1977. The following parameters are analysed: sex, age, aetiology (where known), incidence of involvement of the four limbs, presence or otherwise of a complete sign, percentage of trophic lesions, arteriographic picture, lab examinations performed. 534 thoracic sympathectomies were performed in 464 patients with Raynaud or Raynaud-like forms. The results are described.
5 cases of pulmonary embolism are reported. 3 of these were subjected to pulmonary embolectomy with complete success; repeated controls bear witness to the good long-term cardiorespiratory condition. Two patients died, one following angiography, the other at anaesthetic induction; this fact shows the desirability of submitting patients to partial support extracorporeal circulation prior to angiography and, in any cases, before submitting them to anaesthesia. This surgical success obtained in treatment of the three cases shows that embolectomy continues to play a decisive role.
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The frequency of pulmonary embolization seems to be increasing. Venostasis, intimal damage and hypercoagulability of blood are the more recognized causes of pulmonary thromboembolism. It is especially threatening to the elderly, obese, immobilized (for an accident or an operation) patients. Pulmonary isotopic scans or angiograms are most often relied upon to establish the diagnosis. A properly performed pulmonary angiography is necessary to establish or refute the diagnosis in almost every case. With the exception of the patients suddenly dying for a massive pulmonary embolism, the period of time between onset of symptoms and death is usually adequate for substantiating a diagnosis and promptly beginning a fit anticoagulation therapy using continuous intravenous heparin or fibrinolytic agents infusion. Although it is not proper to separate surgical and medical treatment of thromboembolism, the Authors, on the ground of their experience on 5 patients affected by massive pulmonary embolism, in 3 of whom was performed a successful embolectomy, think that heparin anticoagulation treatment is at any rate to apply for treating pulmonary embolism, but in patients in whom the shock is unresponsive to vasopressors or in whom anticoagulation therapy is controindicated, the surgical removal of pulmonary emboly, with the support of a pump oxygenator, is the treatment of choice for the acute massive pulmonary thromboembolism.
Authors analyze a personal series of patients surgically treated for renal artery diseases (177 cases). Criteria of screening and diagnosis of stenosis are discussed and also are referred the clinical data. Authors describe their own personal reconstructive technique on renal arteries. Early and late results are widely analyzed.
Twenty-one cases of gastro-enteric complications during aorto-iliac-femoral reconstructive surgery carried out from 1965 to 1973 in the Department of Surgery of University in Milan are studied. Causes, frequence, clinical data and medical and surgical procedures are discussed.
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