Evolution of surgical techniques for a progressive risk reduction

• Main Authors: Bruno Amato, Mario Santoro, Raffaele Izzo, Giuseppe Servillo, Rita Compagna, Lorenza Di Domenico, Veronica Di Nardo, Giuseppe Giugliano
• Format: Article
• Language: English
• Published: PAGEPress Publications 2017-07-01
• Series: Monaldi Archives for Chest Disease
• Subjects: Evolution of surgical therapy; carotid artery stenting; drugs-eluting balloon; endovascular repair aortic dissection; geriatric population.
• Online Access: https://www.monaldi-archives.org/index.php/macd/article/view/844

Advanced age is a strong predictor of high perioperative mortality in surgical patients and patients aged 75 years and older have an elevated surgical risk, much higher than that of younger patients. Progressive advances in surgical techniques now make it possible to treat high-risk surgical patients with minimally invasive procedures. Endovascular techniques have revolutionized the treatment of several vascular diseases, in particular carotid stenosis, aortic pathologies, and severely incapacitating intermittent claudication or critical limb ischemia. The main advantages of the endovascular approach are the low complication rate, high rate of technical success and a good clinical outcome. Biliary stenting has improved the clinical status of severely ill patients with bile duct stricture before major surgery, and represents a good palliative therapy in the case of malignant biliary obstruction.