International angiology : a journal of the International Union of Angiology
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Comparative Study
Hemodynamic patterns of chronic cerebrospinal venous insufficiency in multiple sclerosis. Correlation with symptoms at onset and clinical course.
Chronic cerebrospinal venous insufficiency (CCSVI) is associated with multiple sclerosis (MS). CCSVI is detected by transcranial and extracranial color-Doppler high-resolution examination (TCCS-ECD) and venography that permit to identify five types of venous malformations and four major (A-D) hemodynamic patterns of anomalous extracranial-extravertebral venous outflow. We investigated possible correlation between such hemodynamic patterns and both the symptoms at onset and clinical course in patients with MS and CCSVI. ⋯ The distribution of venous malformations and the resulting hemodynamic pattern show correlation with symptoms at onset and clinical course in patients with MS and CCSVI.
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Pulmonary embolism (PE) is a common cause of death and morbidity. Anticoagulant therapy reduces the risk of PE but is associated with bleeding. Inferior vena caval (IVC) filters protect against PE but have an increased long term risk of deep vein thrombosis (DVT). Temporary IVC filters allow protection against PE during high risk situations and may be later removed avoiding the need for long term anticoagulation. ⋯ Retrievable IVC Filters are safe and effective in preventing PE in high risk patients. We have demonstrated success in retrieving filters up to 182 days following insertion, avoiding the need for long term anticoagulation.
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The aim of the presented work was to assess the causes of injury to great nerves during varicose vein surgery and comment on the consequences. ⋯ Even a frequent and relatively simple intervention such as varicose vein surgery may be accompanied by serious complications affecting patients for the rest of their lives. Serious motor nerve injuries are encountered only in operations in the popliteal fossa and the fibula head. Complications are more frequent when operations are performed by young general surgeons than when they are performed by an experienced surgeon or an expert in vascular surgery. The affected patients should be referred for neurosurgery; however, results are unpredictable. In spite of an intensive rehabilitation and possible plastic surgery the patients are permanently affected.
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Comparative Study
Carotid endarterectomy: general anaesthesia with remifentanyl conscious sedation vs loco-regional anaesthesia.
To retrospectively evaluate and compare the safety and efficacy of general anesthesia with remifentanyl conscious sedation (RCS) vs local-regional anesthesia (LA) for carotid endarterectomy (CEA). ⋯ General anesthesia with remifentanyl conscious sedation seems to be a safe technique, allowing monitoring of the neurological status, cerebral protection during arterial clamping, better control of the airway and a good compliance to both the surgeon and the patient. A randomized control trial is needed to prove RCS to be effective as LA.