[Lymphomanometry in the study of lymphatic circulation in post-phlebitis syndrome of the lower limb].
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Biomedical subjects
Publications and source records attributed to F Mascoli.
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Deep venous thrombosis is a quite frequent pathology with a high degree of morbidity and death-rate. Two are the main problems of this disease: the risk of pulmonary embolism and outcome of a post-thrombotic syndrome, leading patients to infirmity. The patients max exposed to the risk of deep venous thrombosis are the surgical ones: the authors, with a retrospective study on 480 surgical patients, examine the risk factors mostly related with the onset of deep venous thrombosis. At the end they refer about connection between the risk factors studied and the clinical display of in surgical patients.
The Authors report their experience in the thoracoscopic surgical treatment of neurovascular abnormalities of the upper extremities. The experience acquired in the last two years with mini-invasive video-assisted thoracic surgery of the pleura and lung forced the Authors to perform thoracic sympathectomy following the same approach. In this way 4 thoracic sympathectomies were performed in 3 patients. Two of them presented Raynaud's phenomenon, and one was affected by bilateral idiophatic upper limb hyperhidrosis. The operation is performed thanks to 3 12mm Thoracoports that allow the introduction of the telescope and operative instruments. It is easy to recognize and remove the sympathetic gangliar chain from T2 to T3. The short operative time required, the absence of mortality and morbidity, the regression of the symptomatology, the rapid return to work authorize to consider endoscopic transthoracic sympathectomy the gold standard in the treatment of neurovascular abnormalities of the upper extremities.
The authors report a case of acute inveterate right subclavian artery obstruction. The leading role of US vascular investigation and the surgical technique adopted are pointed out. The personal findings are compared with those from the international references.
The authors enhance the current importance of the hemodynamic evaluation of the vascular carotid territory by means of Doppler-CV although the great development of the "real time" ultra sonographic imaging. Combined US/Doppler-CV technique is really useful in differential diagnosis of the severe obstructive disease of extracranial carotid arteries. The authors report the possibilities of pitfalls in diagnosis due to the limitation of devices employed or to the frequent anatomical variability featured by examination of severe obstruction of vascular carotid territory.
Cerebro-vascular insufficiency may be caused by morphologic anomalies of the extracranial internal carotid artery (10-15% of symptomatic patients). These alterations are characterized by anomalous elongation which conditions particular attitudes of the carotid: tortuosity, coiling, kinking. In the first case the artery assumes an "S" or "C" shape; in the second the elongation is more emphasized and the artery develops one or more loops; kinking, the most frequent morphologic anomaly, is a sharp angulation of the first part of the internal carotid artery. The etiology of these anomalies seems to be related to congenital causes, that may be unmasked by arterial growing old process. Surgical correction, indicated for symptomatic patients or patients with important hemodynamic alteration, requires rectilinearisation of the internal carotid artery associated with TEA eversion of the same.
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