Panminerva medica
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A series of 62 femorofemoral bypass grafts (FFBG) is reported. The indication for this operation was unilateral iliofemoral occlusion with severe ischemia of the lower limb in poor-risk patients. Severe ischemia presented as rest pain and/or minor necrotic lesions to the foot fingers, while patients were defined poor-risk for aging and concomitant diseases advising major surgical procedures and general anaesthesia. ⋯ In the group of patients who underwent FFBG as the first vascular procedure, five early occlusions occurred: three Fogarty catheter thrombectomies were successful. Cumulative patency rate was then 77% at 36 months in the series of 58 survivors. Rest pain was relieved in any instances and a satisfactory improvement of claudication was obtained.
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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. ⋯ No deaths occurred. The possibility of curing this type of cancer with minimal operative risk and good results is discussed.
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Comparative Study
The usefulness of dynamic CT in patients with aneurysm of Willis circle. Comparative study with the angiography.
The diagnosis of cerebral aneurysm is currently based on the angiographic data. We have tried to evaluate the usefulness of a less-invasive examination, such as the dynamic-CT, in the diagnosis of intracranial aneurysm and of the possible and concomitant subaracnoid haemorrhage. The CT examination is useful in the diagnosis of both subarachnoid haemorrhage and giant trombosed aneurysm. It is less reliable than the angiography as regard to aneurysm of small dimension.