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Biomedical subjects

E Ballotta

Publications and source records attributed to E Ballotta.

49 records · Page 3Linked to original sources

[Vascular tumors of the lung: case reports].

The Authors report their experience about 7 cases of vascular pulmonary tumours, some of which extremely uncommon. After indicating the possible anatomopathological classification, argument still under discussion, they describe clinical manifestation and radiological pattern, typical of this neoplasms.

Adult↗

[Left atrial myxoma revealed by saddle occlusion of the aortic carrefour (author's transl)].

A case of a left atrial myxoma revealed a saddle occlusion of aortic carrefour is reported. The embolus has been surgically removed and histology allowed to recognise its myxomatous nature, suggesting source for left atrial cavity. Cardiac catheterisation and angiocardiography confirmed the presence of atrial tumor, which has been successfully excised. Embolisation is referred to villous, friable surface of the neoplasm. Employment of echocardiography in patients with arterial emboli from unknown etiology is highly recommended.

Adult↗

The rationale for patch-graft angioplasty after carotid endarterectomy: early and long-term follow-up.

A prospective study was undertaken in March 1980, at the Vascular Surgery Department of the Padua University, Medical School, to establish whether patch graft angioplasty is useful in preventing restenosis after carotid endarterectomy (CE). Seventy-four patients underwent 86 CE (bilateral in 12 cases) for atherosclerotic disease involving the carotid bifurcation. Thirty-eight (51.4%) patients presented TIA's or non hemispheric symptoms of cerebrovascular insufficiency; 30 (40.5%) were asymptomatic and 6 (8.1%) had partial nonprogressing or fixed strokes. All operations were performed under general anesthesia, with pharmacologic hypertension and systemic heparinization; in all cases, continuous EEG monitoring and 'stump pressure' measurement were employed. The operation was performed without a temporary intraluminal shunt in the patients showing tolerance to carotid clamping. The protection of the shunt was required only in patients with EEG monitoring changes (17). All carotid arteriotomies were extended into the internal carotid artery to overpass the end of the endarterectomy. Overpass was also used in the proximal edge of the arteriotomy, in the common carotid artery. The distal intima was never fixed with stitches and the arteriotomy was routinely closed with a PTFE patch graft angioplasty. Early results of cerebral protection were excellent. No patient presented permanent or transient postoperative neurological problems and no patient died in the postoperative period for causes related to the operation. This is substantiated by results we achieved during the period 1970-1979 in 192 patients, when all carotid endarterectomies were routinely performed without a shunt, with figures of 2.5% of postoperative stroke and 1.5% of mortality. Longterm follow-up (from 6 to 36 months) was completed in 51 patients (60 operations).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Surgical management of extracranial vertebral artery occlusive disease.

Thirty-seven consecutive patients underwent vertebral artery (VA) reconstruction over a 6 years period (1983-1989). Detailed neurologic, medical, and angiographic information was obtained for all patients. Indications for surgery were as follows: (1) stenosis of VA with symptoms of vertebrobasilar insufficiency; (2) very tight stenosis (greater than 75%) of the dominant VA with stenosis or occlusion of the contralateral VA; (3) very tight stenosis of VA with bilateral occlusion of the internal carotid artery (ICA); (4) very tight stenosis of VA with homolateral ICA lesion eligible for simultaneous repair; (5) very tight stenosis of VA and very tight stenosis of the homo or contralateral carotid siphon. There were 15 isolated vertebral lesions (group I), and 22 were VA lesions associated with lesions of the supraaortic trunks which were simultaneously treated (group II). The reconstructions of the first portion of the VA were 30 (12 of group I and 18 of group II) and reimplantation of the VA into the common carotid artery was the procedure of choice. There were 7 revascularizations of the third portion of the VA at C1-C2 level (3 of group I and 4 of group II): carotid-vertebral bypass, using an autogenous vein graft, was the procedure of choice. Three patients in group II died in the immediate postoperative period from myocardial infarction but no patient presented immediate postoperative neurologic deficits. All symptomatic patients but one were relieved of their symptoms in a median follow-up of 31 months. No postoperative complications were observed. Long-term results were satisfactory in all the 28 patients at their last follow-up visit.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Carotid stenosis and obliteration of the contralateral carotid. A prospective study of the risks of a carotid endarterectomy intervention and its long-term results].

From March 1980 to July 1988 a consecutive series of 256 patients (p.) underwent 301 carotid endarterectomy + patch with routine use of continuous intraoperative EEG monitoring and selective use of an intraluminal shunt (IS) for the presence of an atherosclerotic plaque concerning the internal carotid artery (ICA). Patients were divided in two groups: the first (42 p.) marked by contralateral ICA occlusion, the second (214 p.) without contralateral ICA occlusion (259 CEA). Immediate peroperative, long term and global (immediate and long term) outcomes were prospectively and comparatively studied. A temporary IS was inserted in 27 p. (64%) of the group I and in 38 p. (14%) of the group II. Immediate permanent postoperative neurological deficit occurred in 1 p. of group I (2.38%) and in 2 p. (0.9%) in group II. Immediate postoperative mortality was 0% and 0.9% in group I and II respectively. All p. had neurological valuation and Echo-Doppler of operated ICA and of the contralateral ICA every 6 months (middle follow-up 44 months). New neurological symptoms compared in 5.8% of p. of group I and in 5.23% of p. of group II with a stroke rate of 0% and 2.32% respectively. There were 2 restenosis of operated ICA, both of them in p. of group I, that underwent reoperation. In the two groups the principal causes of deaths were myocardial infarct and cancer; in the group I no death was due to stroke versus 1.86% in the group II.

Aged↗

EEG monitoring, selective shunting and patch graft angioplasty in carotid endarterectomy. Early and longterm results.

From March 1980 to July 1986 at the Department of Vascular Surgery of the University of Padua, 182 patients underwent 210 carotid revascularizations for atherosclerotic stenosis involving the carotid bifurcation (28 operations were bilateral). Carotid endarterectomies (CE) and patch graft angioplasty totalled 192 (166 patients); an enlarging patch graft angioplasty of the internal carotid artery (ICA) without CE was performed in 14 cases (13 patients); in the remaining four surgical procedures (3 patients), for technical reasons prohibiting CE, the operation consisted of a great saphenous vein bypass between a donor vessel and the ICA distal to the lesion. The preoperative symptoms in 182 patients were as follows: TIAs (98 cases, 54%), non-hemispheric symptoms (21 cases (12%) and fixed stroke or TIAIR (10 cases, 5%). Fifty-three patients (29%) were asymptomatic. In all cases, continuous EEG monitoring was employed. The operation was performed without a temporary intraluminal shunt in the patients showing tolerance to carotid clamping. The protection of the shunt was required only in patients with EEG changes (47 cases). The arteriotomy was routinely closed with a PTFE patch graft angioplasty. Early results of the operation were excellent: none of the patients presented permanent or transient neurological deficits in the immediate postoperative period and none of them died. All patients were reassessed with C.W. Doppler sonography and Duplex scanning in the postoperative period. In all cases, the success of the operation was demonstrated. Longterm follow-up (6-72 months, mean follow-up: 35 months) was done in 121 patients (142 operations): 107 patients were completely asymptomatic, 5 remained stable or slightly improved the preoperative status. Five patients had a new or recurrent TIAs, 3 suffered a stroke, one showed a recurrence of non-hemispheric symptoms. With the exception of two patients suffering a stroke, all had a second arteriography but none of these patients showed extracranial lesions. Two patients presented an asymptomatic restenosis of the ICA. Eight patients (8.8%) revealed a significant evolution of the disease of the contralateral unoperated ICA.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

[Surgical treatment of subclavian steal syndrome and innominate steal syndrome. Long-term results].

Thirty-four patients who underwent carotid-subclavian bypass (64.7%), aorto-carotid bypass (17.6%), endarterectomy of subclavian artery (5.8%) or endarterectomy of innominate artery for "subclavian" or "innominate steal" syndromes, had a follow-up studies 3-8 years since surgery. All patients demonstrated originally a differential in systolic blood pressure in the upper extremities. The surgical indications were posed on the basis of neurologic symptoms of vertebrobasilar insufficiency and the angiographic evidence of "subclavian (79.4%)" or "innominate (20.6%) steal". The carotid-subclavian bypass has been the preferred surgical treatment technique in patients with "subclavian steal". This operation is indicated also in nearby asymptomatic patients in order to prevent the evolution of the natural history of vertebrobasilar insufficiency. Longterm results are considered satisfactory in surgically treated patients.

Adult↗

The surgical treatment of atherosclerotic occlusion of the innominate and subclavian arteries. Personal experience with longterm follow-up.

Among 78 patients operated on for occlusive disease of the supraaortic trunks in the period 1970-78, 34 patients who underwent carotid-subclavian bypass (64.7%), aortocarotid bypass (17.6%), endarterectomy of subclavian artery (5.8%) or endarterectomy of innominate artery, had follow-up studies of 3-10 years after surgery. All patients demonstrated originally a differential in systolic blood pressure in the upper extremities. The surgical indications were posed on the basis of neurologic symptoms of vertebrobasilar insufficiency and the angiographic evidence of "subclavian" (79.4%) or "innominate" (20.6%) steal. Carotid-subclavian bypass has been the preferred surgical treatment technique in patients with "subclavian steal". This operation is indicated also in nearly asymptomatic patients in order to prevent the natural history of vertebrobasilar insufficiency. In our experience, operative risk in carotid-subclavian bypass is not present, unless an associated lesion of carotid bifurcation exists, which needs an endarterectomy with patch-graft angioplasty. Longterm results are considered satisfactory in surgically treated patients.

Angiography↗