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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
HISTORY OF VASCULAR SURGERY: PERSONALITIES, TECHNIQUES, TURNING POINTS
Giornale Italiano di Chirurgia Vascolare 1999 March;6(1):67-82
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
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.