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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

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HISTORY OF VASCULAR SURGERY: PERSONALITIES, TECHNIQUES, TURNING POINTS  


Giornale Italiano di Chirurgia Vascolare 1999 March;6(1):67-82

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English, Italian

Two aneurysms, presumibly of the innominate artery surgically treated by Luigi Porta in 1871

Argenteri A., Odero A.

From the Faculty of Vascular Surgery Pavia University, Pavia, Italy


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Luigi Porta (1800-1875), Professor of Clinical and Surgical Medicine at Pavia University, is a dom­i­nant fig­ure in the sur­gi­cal land­scape of the sec­ond ­half of the 19th cen­tu­ry due to his intui­tive under­stand­ing of and the qual­ity of his ­research ­into the ­human vas­cu­lar ­system. That rep­u­ta­tion ­resides pri­mar­i­ly on his ­book “On the path­o­log­i­cal alter­a­tions to arter­ies ­caused by lig­a­ture and tor­sion” ­which ­describes ani­mal experi­ments on the var­i­ous arte­ri­al dis­tricts and the col­lat­er­al cir­cu­la­tions affect­ed by occlu­sions. His ­many oth­er stud­ies of the vas­cu­lar ­system ­reflect the influ­ence of his mas­ter, Antonio Scarpa, ­author of a fun­da­men­tal ­text of the peri­od, a mono­graph on Aneurysms, ­whose teach­ing ­helped to ­make Porta a found­ing ­father of vas­cu­lar sur­gery in Italy. Porta’s aca­dem­ic ­career (1832-1875) ­took ­place in a peri­od of pro­found polit­i­cal and ­social ­change dur­ing ­which the king­dom of Lombardy and Venice was sub­sumed ­into the king­dom of the new­ly United Italy, a peri­od too, of inten­sive sci­en­tif­ic activ­ity.
At a ­time ­when the under­stand­ing of aneu­rysms was lim­it­ed and treat­ment was restrict­ed to dis­tal lig­a­ture of the aneur­sy­mat­ic sac the ­book Porta pub­lished in 1871 “On an aneu­rysm pre­sumed to be of the innom­i­nate ­artery sur­gi­cal­ly treat­ed by the Brasdor tech­nique of carot­id and sub­cla­vian lig­a­ture ­which had a ­fatal out­come ­caused by a ­neck ­abscess” was of par­tic­u­lar sig­nif­i­cance. In ­that ­book Porta ­describes a ­case of sus­pect­ed bra­choc­e­phal­ic aneu­rysm ­that was on the ­point of split­ting and was treat­ed by lig­a­ture of the com­mon carot­id and the ­right sub­cla­vian ­artery, but with­out suc­cess ­since with­out ­there ­being any aneu­rys­mat­ic throm­bo­sis, the sac rup­tured caus­ing the ­patient’s ­death. In the ­light of the autop­sy find­ing of a rup­tured aor­toth­o­rac­ic aneu­rysm ­that was prob­ably syph­i­lit­ic in ori­gin, Porta con­ducts an extreme­ly objec­tive exam­ina­tion of the clin­i­cal fac­tors ­that led to his inac­cu­rate diag­no­sis and ­hence his inap­pro­pri­ate sur­gi­cal ­approach.

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