A ruptured infrarenal abdominal aortic aneurysm (rAAA) is associated with an in-hospital mortalit... more A ruptured infrarenal abdominal aortic aneurysm (rAAA) is associated with an in-hospital mortality rate of 40% and an overall mortality rate of 60–80%. Open surgical repair for rAAA remains the principal method of treatment when endovascular repair is not available. Graft infection occurs in 1–4% of patients at 5 years, with a high incidence following emergency treatment. Other graft-related complications include pseudoaneurysm, graft occlusion and aorto-enteric fistula. This case report describes a 66-year-old male patient that was admitted to hospital complaining of intense abdominal pain, low blood pressure and tachycardia. He was diagnosed with a rAAA and treated using segmental resection of the abdominal aorta followed by reconstruction with a synthetic Dacron prosthesis. A pedicle omental flap was wrapped around the prosthetic graft and it was also used to fill the retroperitoneal cavity in order to reduce the risk of graft-related complications. Computed tomography angiograph...
Background: Breast reconstruction (BR) after radical mastectomy is intended to recreate symmetric... more Background: Breast reconstruction (BR) after radical mastectomy is intended to recreate symmetrical natural-appearing breasts while preserving patient safety and quality of life. Purpose: To evaluate the esthetic results and the complications of various BR methods after radical mastectomy.
The progresses in surgical field are amazing regarding the possibilities of soft tissue reconstru... more The progresses in surgical field are amazing regarding the possibilities of soft tissue reconstruction. Techniques of breast reconstruction have been evolved since the last 40 years. There was a trend from pedicled flaps toward microsurgical free flaps. In the English literature have been reported several types of free flaps for BR. Although DIEP is the workhorse for the reconstruction, there are patients that do not have enough abdominal tissue to use. In those cases, other donor area such as buttock, thigh, lumbar area has been reported. The present article describes the choices for BR with non-abdominal autologous tissue.
Abstract Nanoparticles are defined as objects, which have one, two or three external dimensions i... more Abstract Nanoparticles are defined as objects, which have one, two or three external dimensions in the nanoscale, ranging from 1 to 100 nm (ISO/TR 18401:2017). In order to reduce vascular complications like thrombosis, infection and graft rejection, nanoparticle technologies show growing applications in the field of angiology and vascular surgery. The aim of this review is to evaluate the literature concerning the role of nanoparticles as a carrier for vascular agents and for improving biomaterial particularities used as substitutes in vascular surgery. While important advances have been achieved in vascular medicine with the emerging of nanotechnologies, much more fundamental and clinical work needs to be done before vascular implants and therapies reach the ideal state.
Introduction & objectives: Starting from the well-known functional hemispheric asymmetry and conc... more Introduction & objectives: Starting from the well-known functional hemispheric asymmetry and concomitantly, from the clinical findings of practitioners involved in the post-stroke rehabilitation process, the aim of this study was to evaluate whether ischemic stroke in the dominant hemisphere results in more severe initial motor deficit and if its motor recovery is decreased compared to that of the non-dominant hemisphere. Material and method: This was a retrospective study, comprising 39 patients with ischemic stroke in the middle cerebral artery territory, divided into two groups depending on the hemispheric location of the lesion (left/right). They were evaluated for their segmental muscle strength using the Medical Research Council Muscle Strength Grading Scale, both in terms of initial value and evolution between two successive admissions. Results and conclusions: No significant difference was found for motor deficit evaluated on the occasion of the first admission between patie...
Polyarteritis nodosa (PAN) is a rare disease that occurs predominantly in middle-aged males; its ... more Polyarteritis nodosa (PAN) is a rare disease that occurs predominantly in middle-aged males; its onset during pregnancy is exceptional. We present a case of PAN with peripartum onset in a patient with a twin pregnancy after ovarian stimulation for primary infertility. The pregnancy outcome was good in terms of the children's health. In the case of the mother, however, the presence of nonspecific signs and symptoms, a noncontributory ovarian biopsy, and mimics of a puerperal infection delayed the diagnosis of PAN. The emergence of a tender subcutaneous nodule on the forearm and its histopathologic findings were diagnostic. Treatment with pulse methylprednisolone and intravenous cyclophosphamide resulted in the patient's prompt recovery. We present the case to stress the value of careful physical examination in unveiling the presence of a rare disease.
A pseudoaneurysm of the gastroduodenal artery (GDA) is the rarest splanchnic artery aneurysm, com... more A pseudoaneurysm of the gastroduodenal artery (GDA) is the rarest splanchnic artery aneurysm, comprising fewer than 10% of these lesions. Bleeding into the gastrointestinal tract is the most rapidly fatal complication of an arterial visceral pseudoaneurysm, affecting 4-10% of patients. We present an unusual case of a GDA pseudoaneurysm that ruptured in the common bile duct, and that was successfully treated by partial resection and hepatic artery reconstruction. The postoperative evolution was favourable and the CT performed six months later disclosed the absence of a vascular tumour.
In the last decades, there has been a trend in breast reconstructions toward more and more free p... more In the last decades, there has been a trend in breast reconstructions toward more and more free perforator flaps. The Deep Inferior Epigastric Perforator Flap is commonly used with the great advantage of not disturbing the rectus abdominis muscle. For thin patients, this donor area is unavailable and other options, such as implants or free flaps from the buttock region, can be used. SGAP and IGAP are useful tools for reconstruction, but their pedicle is relatively short and the donor area volume is significantly changed. The Fasciocutaneous Infragluteal Flap (FCI) is based on the end artery of infragluteal vessels and has the advantage of a long pedicle. Its anatomy is relatively constant and the donor area is well hidden. Good upper pole fullness is obtained with this flap, and the dissection and preparation of the flap is not difficult.
Nipple-areola complex (NAC) reconstruction represents the final stage of breast reconstruction an... more Nipple-areola complex (NAC) reconstruction represents the final stage of breast reconstruction and it is usually performed several months after the breast volume was restored. Ideally, the reconstructed areola should have the same size, color and texture as the opposite areola. Most common techniques are skin graft and tattooing. When the contralateral areola has significant size (>7 cm diameter), we prefer using part of it for reconstruction. If mastopexy or breast reduction is necessary for obtaining symmetry, the areola reconstruction is simultaneously performed at this stage. The outer part of the donor areola is deepithelialized and used as a thick split thickness graft. A “tie over” dressing is placed for 5 days. The advantage of this technique is that the “excess” of the normal areola is not wasted.
Plantar area reconstruction represents the most challenging part of the lower limb. The anterolat... more Plantar area reconstruction represents the most challenging part of the lower limb. The anterolateral thigh (ALT) flap proved to be a versatile flap for this special area. Herein, we present the application of bilateral ALT free flaps for foot salvage after frostbite injury and long-term follow-up. Single perforator bilateral ALT flaps (304 and 320 cm) were harvested and anastomosed to posterior tibial vessels. The lateral femoral cutaneous nerve was anastomosed to the calcaneal branches of the posterior tibial nerve. The two-point discrimination test showed values from 16 to 28 mm in different flap areas 5 years later. The patient is able to walk with crutches. This is the first case report of bilateral ALT for foot salvage.
A ruptured infrarenal abdominal aortic aneurysm (rAAA) is associated with an in-hospital mortalit... more A ruptured infrarenal abdominal aortic aneurysm (rAAA) is associated with an in-hospital mortality rate of 40% and an overall mortality rate of 60–80%. Open surgical repair for rAAA remains the principal method of treatment when endovascular repair is not available. Graft infection occurs in 1–4% of patients at 5 years, with a high incidence following emergency treatment. Other graft-related complications include pseudoaneurysm, graft occlusion and aorto-enteric fistula. This case report describes a 66-year-old male patient that was admitted to hospital complaining of intense abdominal pain, low blood pressure and tachycardia. He was diagnosed with a rAAA and treated using segmental resection of the abdominal aorta followed by reconstruction with a synthetic Dacron prosthesis. A pedicle omental flap was wrapped around the prosthetic graft and it was also used to fill the retroperitoneal cavity in order to reduce the risk of graft-related complications. Computed tomography angiograph...
Background: Breast reconstruction (BR) after radical mastectomy is intended to recreate symmetric... more Background: Breast reconstruction (BR) after radical mastectomy is intended to recreate symmetrical natural-appearing breasts while preserving patient safety and quality of life. Purpose: To evaluate the esthetic results and the complications of various BR methods after radical mastectomy.
The progresses in surgical field are amazing regarding the possibilities of soft tissue reconstru... more The progresses in surgical field are amazing regarding the possibilities of soft tissue reconstruction. Techniques of breast reconstruction have been evolved since the last 40 years. There was a trend from pedicled flaps toward microsurgical free flaps. In the English literature have been reported several types of free flaps for BR. Although DIEP is the workhorse for the reconstruction, there are patients that do not have enough abdominal tissue to use. In those cases, other donor area such as buttock, thigh, lumbar area has been reported. The present article describes the choices for BR with non-abdominal autologous tissue.
Abstract Nanoparticles are defined as objects, which have one, two or three external dimensions i... more Abstract Nanoparticles are defined as objects, which have one, two or three external dimensions in the nanoscale, ranging from 1 to 100 nm (ISO/TR 18401:2017). In order to reduce vascular complications like thrombosis, infection and graft rejection, nanoparticle technologies show growing applications in the field of angiology and vascular surgery. The aim of this review is to evaluate the literature concerning the role of nanoparticles as a carrier for vascular agents and for improving biomaterial particularities used as substitutes in vascular surgery. While important advances have been achieved in vascular medicine with the emerging of nanotechnologies, much more fundamental and clinical work needs to be done before vascular implants and therapies reach the ideal state.
Introduction & objectives: Starting from the well-known functional hemispheric asymmetry and conc... more Introduction & objectives: Starting from the well-known functional hemispheric asymmetry and concomitantly, from the clinical findings of practitioners involved in the post-stroke rehabilitation process, the aim of this study was to evaluate whether ischemic stroke in the dominant hemisphere results in more severe initial motor deficit and if its motor recovery is decreased compared to that of the non-dominant hemisphere. Material and method: This was a retrospective study, comprising 39 patients with ischemic stroke in the middle cerebral artery territory, divided into two groups depending on the hemispheric location of the lesion (left/right). They were evaluated for their segmental muscle strength using the Medical Research Council Muscle Strength Grading Scale, both in terms of initial value and evolution between two successive admissions. Results and conclusions: No significant difference was found for motor deficit evaluated on the occasion of the first admission between patie...
Polyarteritis nodosa (PAN) is a rare disease that occurs predominantly in middle-aged males; its ... more Polyarteritis nodosa (PAN) is a rare disease that occurs predominantly in middle-aged males; its onset during pregnancy is exceptional. We present a case of PAN with peripartum onset in a patient with a twin pregnancy after ovarian stimulation for primary infertility. The pregnancy outcome was good in terms of the children's health. In the case of the mother, however, the presence of nonspecific signs and symptoms, a noncontributory ovarian biopsy, and mimics of a puerperal infection delayed the diagnosis of PAN. The emergence of a tender subcutaneous nodule on the forearm and its histopathologic findings were diagnostic. Treatment with pulse methylprednisolone and intravenous cyclophosphamide resulted in the patient's prompt recovery. We present the case to stress the value of careful physical examination in unveiling the presence of a rare disease.
A pseudoaneurysm of the gastroduodenal artery (GDA) is the rarest splanchnic artery aneurysm, com... more A pseudoaneurysm of the gastroduodenal artery (GDA) is the rarest splanchnic artery aneurysm, comprising fewer than 10% of these lesions. Bleeding into the gastrointestinal tract is the most rapidly fatal complication of an arterial visceral pseudoaneurysm, affecting 4-10% of patients. We present an unusual case of a GDA pseudoaneurysm that ruptured in the common bile duct, and that was successfully treated by partial resection and hepatic artery reconstruction. The postoperative evolution was favourable and the CT performed six months later disclosed the absence of a vascular tumour.
In the last decades, there has been a trend in breast reconstructions toward more and more free p... more In the last decades, there has been a trend in breast reconstructions toward more and more free perforator flaps. The Deep Inferior Epigastric Perforator Flap is commonly used with the great advantage of not disturbing the rectus abdominis muscle. For thin patients, this donor area is unavailable and other options, such as implants or free flaps from the buttock region, can be used. SGAP and IGAP are useful tools for reconstruction, but their pedicle is relatively short and the donor area volume is significantly changed. The Fasciocutaneous Infragluteal Flap (FCI) is based on the end artery of infragluteal vessels and has the advantage of a long pedicle. Its anatomy is relatively constant and the donor area is well hidden. Good upper pole fullness is obtained with this flap, and the dissection and preparation of the flap is not difficult.
Nipple-areola complex (NAC) reconstruction represents the final stage of breast reconstruction an... more Nipple-areola complex (NAC) reconstruction represents the final stage of breast reconstruction and it is usually performed several months after the breast volume was restored. Ideally, the reconstructed areola should have the same size, color and texture as the opposite areola. Most common techniques are skin graft and tattooing. When the contralateral areola has significant size (>7 cm diameter), we prefer using part of it for reconstruction. If mastopexy or breast reduction is necessary for obtaining symmetry, the areola reconstruction is simultaneously performed at this stage. The outer part of the donor areola is deepithelialized and used as a thick split thickness graft. A “tie over” dressing is placed for 5 days. The advantage of this technique is that the “excess” of the normal areola is not wasted.
Plantar area reconstruction represents the most challenging part of the lower limb. The anterolat... more Plantar area reconstruction represents the most challenging part of the lower limb. The anterolateral thigh (ALT) flap proved to be a versatile flap for this special area. Herein, we present the application of bilateral ALT free flaps for foot salvage after frostbite injury and long-term follow-up. Single perforator bilateral ALT flaps (304 and 320 cm) were harvested and anastomosed to posterior tibial vessels. The lateral femoral cutaneous nerve was anastomosed to the calcaneal branches of the posterior tibial nerve. The two-point discrimination test showed values from 16 to 28 mm in different flap areas 5 years later. The patient is able to walk with crutches. This is the first case report of bilateral ALT for foot salvage.
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Papers by Marius Fodor