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The authors assess the value of cardiac scintigraphy using thallium dipyridamidole in the preoperative examination of vascular patients. Data from the literature indicate the real possibility of cardiac complications in major vascular surgery. These complications, which range from simple arrhythmias to lethal myocardial infarctions, have an incidence of 0.5-2% in aortic surgery, 0.6-3% in peripheral revascularisation increasing to 2.6-8.3% in distal revascularisation, although they are less important in carotid surgery. From January 1993 to March 1994 cardiac risk was evaluated in 44 patients due to undergo major vascular surgery using cardiac scintigraphy with thallium dipyridamidole. The test was negative in 14 cases. The presence of one or more redistribution areas was observed in 23 cases, and a fixed zone in 7 cases. In line with the proposals made by Eagle, the authors conclude that it is necessary to restrict the indications for this test to those cases presenting at least two risk factors.

Atherosclerosis is a polydistrectual disease. The patients with peripheral, carotid or aortoiliac pathology suffer frequently from coronary disease; so, a careful evaluation of operative risk is indispensable related to the anatomic district that we intend submit to surgery. In this work we separately explore the risk related to peripheral revasculations, aortic surgery and carotid surgery following the current literature and our experience.

The authors are interested in verifying the correlation between clinical findings and CT scan imaging in acute pancreatitis. Forty-one patients with acute episodes of pancreatitis are studied according to classic clinical Ranson prognostic factors and radiological Hill classification. All patients are investigated with G.E. 9800 Quick TC scanner. Our data show a significant correlation especially for patients of extreme classes: 78.3% of patients in first Ranson class are included in 0-I-II Hill grades, 74% of the patients in the cumulative third and fourth Ranson classes are correlated with IV and V Hill grades. Finally the authors underline the usefulness of clinical and tomographic evaluation for prognostic and therapeutical trends in patients with acute pancreatitis.