Surgery of the innominate artery.

The authors describe their experience with the surgical treatment of 28 patients with obliteration or stenosis of the innominate artery. In 18 (64.3%) patients an intrathoracic operation was done and in three of these a multiple bypass from the aorta to the affected trunks was carried out. In the remaining 10 patients (35.7%) extrathoracic operations were carried out. Immediate results were good in 24 (85.7%) of cases. Thrombosis occurred in 3 during the first 30 days after operation. One patient suffered thrombosis of the bypass and following removal of this became comatose and subsequently died. Long term results were good inasmuch as at 5 years 94.8% of patients survived with a patent reconstruction. The clinical procedures reviewed as is the topography of associated lesions of the other supra-aortic trunks together with the different techniques employed and their indications. The authors express their preference for the technique of an end to side graft in the aorta and end to end in the innominate artery, when the distal portion of this artery is patent and the age and general state of the patient permits a thoracic approach. This technique assures revascularization of the right carotid and vertebral areas, apart from complying with optimal hemodynamic conditions.

[Distal bypass to the critical ischemia]. / Bypass distal a la poplítea en la isquemia crítica.

Possibilities from the distal popliteal by-pass practiced with the purpose to conserve the extremity in cases of critical ischaemia at lower limbs are analyzed. A variant from the III-Fountaine-stage based on an haemodynamic criterium was established. Authors's experience with such distal by-pass is exposed and indications and results are analyzed.

[New criteria for the classification of the popliteal artery entrapment syndrome. Our experience with 14 extremities]. / Nuevos criterios de clasificación del síndrome de atrapamiento de la arteria poplítea. Nuestra experiencia sobre 14 extremidades.

Authors explain their experiences with eight patients (14 affected limbs) with a popliteal artery entrapment syndrome. Classification, diagnosis and treatment were reviewed. Six limbs, with any malformation and presenting as a unique sign an important hypertrophy of their intern gastrocnemius muscle, couldn't be classified. As a result, a new classification of this pathology is presented being based on the anatomical and arteriographic aspects as well as oh the surgical indication. The important correlation between anomaly, physical complexion typus athletic and sports is noted.