Saturday, July 1, 2023

A Pionner; Reynaldo dos Santos

Reynaldo dos Santos (1880-1970) was a Portuguese physician, writer and art historian.  During WWI Dos Santos served as a surgeon in British Hospitals in France and, later, at the Portuguese Expeditionary Corps.  Once back in Portugal after WWI, he created a research and teaching center in Lisbon.

Building on the work of Antonio Egas Moniz who first developed cerebral angiography in 1927, Dos Santos performed the first translumbar aortogram in Lisbon in 1929.  He later reported 300 patients on whom the abdominal aorta and its branches were visualised with translumbar angiography.  He became a professor in 1930 and in 1941 became the Dean of the Faculty of Medicine of the University of Lisbon.

The procedure did not find immediate acceptance into clinical practice due to toxicity of the contrast media.  When water soluble iodinated contrast media were introduced the side-effects were diminished and interest in the procedure was revived. In 1947, Dos Santos had performed and reported on 3,000 angiograms without any fatality. 

Thus translumbar abdominal aortography performed with a  needle which was advanced under the 12th left rib at the level of L1 vertebra played an important role in the evaluation of abdominal aortic aneurysms, occlusions and/or stenoses of its branches.  It also became the method of choice in the diagnosis of congenital vascular lesions such as aberrant vessels, arteriovenous fistulae and aneurysms of the abdominal aorta's side branches.   

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