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Biomedical subjects

P Cappabianca

Publications and source records attributed to P Cappabianca.

At least 73 records · Page 4Linked to original sources
PubMed1988

Subarachnoid hemorrhage and "normal pressure hydrocephalus": fatal complication of percutaneous microcompression of the gasserian ganglion. Case report.

A 62-year-old man underwent percutaneous balloon catheter compression of the gasserian ganglion for typical trigeminal neuralgia. After this, a subarachnoid hemorrhage was discovered and normal pressure hydrocephalus developed, which required shunting. Although the neurological function recovered, the patient died 8 months later because of supervening hepatic insufficiency, probably caused by protracted antibiotic therapy. Such a fatal complication, the first one associated with the technique of percutaneous trigeminal compression, was perhaps predisposed by preexistent cerebral atrophy with enlargement of the subarachnoid spaces; the unforeseen piercing of the dilated trigeminal cistern probably permitted the intracranial subarachnoid diffusion of an otherwise trivial hemorrhage. The safety of the procedure may be greatly reduced in such instances.

Catheterization↗
PubMed1986

Cryopreserved homologous saphenous vein: early and late patency in coronary artery bypass surgical procedures.

Autologous saphenous vein has proved to be a satisfactory conduit for use in coronary artery bypass grafting. Unfortunately, it is not always available, and substitute material must sometimes be used. When satisfactory autologous veins were not available and the internal mammary arteries were unsuitable, cryopreserved homologous saphenous veins were used in 28 patients. A total of 76 grafts were constructed. Cryopreserved homologous veins were used for 61 grafts, autologous saphenous veins for 11 grafts, and the internal mammary artery for 2 grafts. Coronary angiography was performed 8 to 12 days postoperatively in 16 patients. Of the 31 homografts studied, 8 were occluded (26%), 3 were stenotic (9%), and 20 were normal (65%). The one internal mammary artery and six autologous veins studied were all patent. Six patients underwent late catheterization 6 to 12 months postoperatively. Thirteen homografts were studied at late catheterization: 11 were occluded, 1 was severely stenotic, and 1 was mildly stenotic. At late catheterization, the one internal mammary artery studied was patent, and the one autologous saphenous vein was 95% occluded. Results of both early and late catheterization performed on 18 patients demonstrated that of the 35 homografts studied, 17 (49%) were occluded, 3 (9%) had greater than 70% stenosis, 1 (3%) had mild disease, and 14 (40%) were free of disease. One year follow-up data obtained on 26 patients revealed that 4 patients (15%) died of cardiac causes, 2 patients (8%) died of noncardiac causes, 11 patients (42%) have recurrent angina, and 9 (35%) are asymptomatic. It is concluded that use of cryopreserved homologous saphenous veins for coronary artery bypass grafting should be avoided if at all possible.

Adult↗
PubMed1986

[Experiences in experimental microneurosurgery].

The authors present their experiences in experimental micro-neuro-surgery referring to the last 2 years. In the field of vascular microsurgery, they explored: the possibility of performing end-to-side anastomoses reducing to few minutes the blood flow interruption in the receiving vessel; experimental reconstructive techniques of the arterial wall in case of giant aneurysm; micro-anastomoses between vessels with calibre smaller than 1 mm. The possibility of carrying out nervous anastomoses between intercostal and lumbar nerves to re-innervate these latter has been also examined on the basis of experimental trials.

Animals↗
PubMed1985

Analysis of morbidity and mortality in patients 70 years of age and over undergoing isolated coronary artery bypass surgery.

With increasing frequency more elderly patients are referred for coronary artery bypass surgery. The operative results of 201 patients 70 years of age and over were compared with the results of 1242 patients under 70 years operated on since 1981. A larger percentage of the elderly patients had triple-vessel disease (66.2% vs 51.0%, p less than 0.001), left main coronary artery obstruction (34.8% vs 16.3%, p less than 0.01), and an ejection fraction of less than or equal to 45% (30.8% vs 21.1%, p less than 0.001). An increase percentage of the patients 70 years of age and over had perioperative myocardial infarction (7.9% vs 4.1%, p less than 0.05), required prolonged ventilatory support (7.9% vs 3.1%, NS), and had major neurologic complications (4.0% vs 1.1%, p less than 0.001). The mortality rate was significantly higher in the elderly patients (5.9% vs 1.9%, p less than 0.01) but did not correlate with degree of coronary artery disease, anginal pattern, or preoperative ventricular function. Only 2 of 12 deaths in the elderly patients were from cardiac causes. This data would suggest that elderly patients have an increased risk for significant cardiac and noncardiac morbidity and mortality following coronary artery bypass surgery and that the higher mortality rate in this age group may be a result of noncardiac organ failure.

Age Factors↗
PubMed1985

Reconstruction of the pituitary fossa in transsphenoidal surgery: an experience of 140 cases.

Even though the main problems of transsphenoidal surgery are encountered during the intra- and suprasellar portions of the operation, proper reconstruction of the sella turcica plays an important role in the overall results, greatly influencing the final outcome. Improper measures may bring about a complicated postoperative course, whereas a wise and precise method allows one to control any surgical condition, preventing the more dangerous consequences of the transsphenoidal approach (i.e., empty sella, cerebrospinal fluid leakage, hemorrhage, infection, etc.). The authors review the different methods of sellar plugging and, on the basis of their own experience, indicate the most suitable one for each of the more usual situations. A good result is achievable if only natural materials are used and one avoids synthetic prostheses. Extradural packing is the technique of choice whenever a hermetic closure and a particularly effective intrasellar plug are required.

Adenoma↗
PubMed1985

Efficacy of percutaneous transluminal coronary angioplasty compared with single-vessel bypass.

The use of percutaneous transluminal coronary angioplasty has been increasing rapidly. When the procedure is successful, the clinical relief of symptoms is similar to that achieved with direct coronary artery bypass. It has been suggested that the angioplasty procedure, however, can accomplish these results with potentially less morbidity and mortality, along with a shorter hospital stay. In order to evaluate the results of percutaneous transluminal coronary angioplasty with single-vessel coronary artery bypass, we performed a retrospective review. From January, 1982, to December, 1983, a total of 198 angioplasty procedures were performed. They were successful in 142 patients (71.7%). Emergency bypass was performed in 21 (10.6%) of the 56 patients who had undergone unsuccessful angioplasty procedures. Perioperative myocardial infarction occurred in eight of these patients (38.1%). There were no operative deaths, but there was one death after angioplasty. Elective bypass was performed in 28 of the patients who had angioplasty procedures, with no perioperative myocardial infarctions or operative deaths. Recurrent symptoms developed in 31 (21.8%) of the 142 patients who had undergone initially successful angioplasty. From 1982 to 1983, single-vessel bypass was performed in 143 patients. The internal mammary artery was utilized in 102 patients and the autogenous saphenous vein in 41 patients. There were no perioperative myocardial infarctions or deaths. No patients developed recurrent symptoms during the study interval. Percutaneous transluminal coronary angioplasty is an acceptable alternative to coronary artery bypass in patients with localized lesions that are sufficiently serious to cause symptoms and warrant surgical bypass. However, the angioplasty procedure, when compared to single-vessel coronary artery bypass, may result in an increased incidence of acute myocardial infarction and in a significantly (p less than 0.001) increased incidence of early recurrence of symptoms.

Adult↗
PubMed1984

Lumbar disk. Surgical tricks for safeguarding the "root's ecology".

Restoration of a physiologic periradicular environment is a fundamental step toward improving the results of surgical procedures on the herniated lumbar disk. Combined with the preservation of periradicular fat (or free transplant of subcutaneous fat), reconstruction of the yellow ligament, recreating the interlaminar plane, may act as a barrier against postoperative adhesions. An operative technique is described that is aimed toward preserving the yellow ligament with the purpose of reconstructing it at the end of the surgical procedure on the root.

Humans↗
PubMed1984

Surgery of the lumbar intervertebral disc. Results of a personal minimal technique.

Surgery of the intervertebral disc, despite its relative simplicity, has a high failure rate at the functional level. There is often severe residual pain which is a real problem because it is so difficult to treat either the symptom or its cause. We report the results of 122 procedures in 100 patients, some of whom had multiple lesions, using a technique (already described in a preliminary paper) consisting of an interlaminar approach modified to provide greater preservations of neural, bony and joint structures. The results were very good, both soon after operation and at later follow-up (between six months and five years). There were no cases of recurrence or pseudo-recurrence, one case of contralateral recurrence (cured by further operation) and a very low incidence of residual backache. These results confirm that, provided the patients have been well selected so that not every patient with lumbar backache is operated on but only those with proven disc lesions, operation does fundamentally influence the quality of the results.

Humans↗
PubMed1983

Reliability of stereotactic biopsy. A model to test the value of diagnoses obtained from small fragments of nervous system tumors.

Because of the variability of the structural features of cerebral tumors, the characteristics observed in biopsy samples may not be representative of the whole neoplasm. The reliability of cerebral stereotactic biopsy is therefore greatly debated. In order to test the value of diagnoses based on biopsy samples, the authors compared histological and cytological data obtained from a small fragment of a tumor with the definitive diagnosis obtained from surgical or necropsy specimens. An analysis of 64 cases is reported, where a correct diagnosis from the biopsy sample was achieved in 92.2% of the cases. Neuroglial tumors were more difficult to characterize than other types of intracranial tumors, with an accuracy of 81.5%.

Biopsy↗
PubMed1981

The empty sella.

The data from 55 patients with empty sellae seen during the past five years are examined. The clinical and radiological features most helpful in defining and classifying each case are identified. The most frequent and most serious complications and the warning signs useful in diagnosis are discussed. The indications for and the results of surgical treatment are reviewed.

Adolescent↗
PubMed1981

Benign intrasellar cysts.

Four cases of benign intrasellar cysts are reported. Three of these were treated surgically. Their origin and typical clinical features are discussed, in particular the altered pituitary function and visual disturbances. Computerized tomography has many advantages over traditional neuroradiological tools in reaching a diagnosis. The indication for active treatment and the surgical techniques and the methods used in the prevention of complications are outlined.

Adult↗