Ruptured abdominal infrarenal aortic aneurysms - surgical treatment and outcome

Emergency Institute Of Cardiovascular Diseases ”Prof.Dr.C.C. Iliescu” Vascular Surgery Department, Bucharest, Romania, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011Repair of ruptured abdominal aortic aneurysm carries a considerable rate of morbidity and mortality. Management of ruptured abdominal aortic aneurysms demands immediate diagnosis and a trained team to assess and deliver operative care, as well as logistic support in a dedicated center. Materials and method: Our experience consists of 63 cases of ruptured abdominal aortic aneurysm repair (2004- June 2011) - 57 males (90,5%) and 6 females (9,5%). There were 61 infrarenal abdominal aortic aneurysms (96,8%) and 2 thoracoabdominal aneurysms (3,2%). 35 patients were admitted in hemorrhagic shock (55,5%) and 38 were hemodynamically stable (45,5%). Results: We encountered 7 intraoperative deaths (11,1%), 19 postoperative deaths (30,1%) and 37 patients with long term survival (58,7%).Conclusions: Ruptured abdominal aortic aneurysm is a life-threatening condition that requires emergent surgery, followed by significant perioperative mortality and morbidity

Carotid endarterectomy in treatment of critical symptomatic and asymptomatic carotidian stenosis

Emergency Institute Of Cardiovascular Diseases ”Prof. Dr. C.C. Iliescu” Vascular Surgery Department, Bucharest, Romania, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011This presentation’s objective is to identify efficacy of the surgical treatment of critical carotid stenosis using direct endarterectomy, in our experience. It’s been over 50 years since the first CEA and 15 years since the publication of the Nord-American and European trials’ results- which stated surgery as the elective procedure of treatment for the extracranial cerebrovascular occlusive disease.Material and Method: Our experience consists of 411 cases of carotid endarterectomies (1997- June 2011). There were 139 asymptomatic patients and 272 symptomatic patients, 173 with minor stroke, 99 with TIA. 380 carotid endarterectomies were performed, followed by venous patch angioplasty in 332 cases, Dacron patch angioplasty in 39 cases and PTFE patch in 8 cases. There were 31 cases of primary closure of the arteriotomy, and 5 patients with bilateral simultaneous carotid endarterectomy. Results: 2 patients suffered postoperative major stroke (one ischemic, one hemorrhagic) and 4 deaths (2- AMI and 2- major stroke). Mortality and combined mortality/perioperative stroke rate was of 1,21 % (only in symptomatic patients). Conculsions: In our experience, carotid endarterectomy remains the method of choice in critical carotid stenosis treatment