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A Journal on Forensic Medicine
Minerva Medicolegale 2012 March;132(1):3-20
Endovascular iliac surgery and forensic medicine: caution, inevitability, technical failure and burden of proof
Specialista in Medicina Legale e Chirurgia Vascolare, Libero Professionista, Torino, Italia
Endovascular treatment is now an efficacy therapy for aortoiliac occlusive diseases or stenosis. Consensus documents, as TASC I and II, and other international guidelines give recommendations for the treatment of aortoiliac lesions and recognize what treatment is preferred in such lesions. However, the clinical features are more numerous than the guidelines describe. Even if the endovascular treatment is less invasive than open surgery and the use of devices, ballons, catheter, guidewire, needle and stent into a pathological artery vessels is described as safe, the procedure has same risk and complication. The failure of the treatment must be taken also into account. The burden of proof is on the defendant, the endovascular surgeon or the radiological interventionist. In lawsuit the duty to prove or disprove the complication, the failure or the disputed fact depends on other causes, than his action, is placed upon the defendant. The analysis of the clinical diary and the vision of the angiography is of great importance.