El aneurisma de arteria poplítea es una entidad patológica que afecta a hombres mayores de 65 años con múltiples morbilidades, siendo la hipertensión arterial la más frecuente. Se asocia a aneurisma contralateral y aneurisma en otras áreas, principalmente la arteria femoral y la aorta abdominal. El diagnóstico en la mayoría de los casos se realiza en pacientes sintomáticos, principalmente debido a complicaciones trombo-embólicas. En este grupo la amputación se realiza hasta en el 20% de los casos y la mortalidad alcanza el 5%. La cirugía abierta es el procedimiento de elección, la cual se realiza mayoritariamente por un abordaje medial aislando el aneurisma mediante ligaduras y realizando un bypass con vena autóloga. En el tratamiento de urgencia puede asociarse trombolisis intraoperatoria, la cual mejora el resultado de la cirugía. La cirugía endovascular no ha demostrado ser mejor, sin embargo, posee resultados similares en el tratamiento de pacientes asintomáticos. Cuad. Cir. 2009; 23: 39-43
The Carotid Revascularization Endarterectomy vs Stenting Trial (CREST) is a multicenter, randomized clinical trial designed to compare the safety and efficacy of carotid artery stenting (CAS) and carotid endarterectomy (CEA) in patients with severe carotid stenosis. The primary endpoint is the composite of death, stroke, and myocardial infarction (MI) during the first 30 days after the procedure and ipsilateral stroke up to 4 years. The trial enrolled 2,522 patients with symptomatic and asymptomatic carotid stenosis. J Stroke Cerebrovasc Dis. 2010 March; 19(2): 153–162. © 2010 National Stroke Association. Published by Elsevier Inc. All rights reserved
We report a single-center experience with the endovascular management of mycotic aortic aneurysms. Vascular and Endovascular Surgery 44(8) 693-696. Copyright The Author(s) 2010
Traumatic thoracic aortic injury (TTAI) is associated with high mortality rates. Data supporting thoracic endovascular aortic repair (TEVAR) to reduce mortality and morbidity for TTAI is limited to small series and meta-analyses. In this study, we evaluated the trends and outcomes of open surgery and TEVAR for TTAI in New York State. JOURNAL OF VASCULAR SURGERY Volume 51, Number 3. From the New England Society for Vascular Surgery. Copyright © 2010 by the Society for Vascular Surgery.
We present a 67-year-old man who had undergone aortobifemoral synthetic graft surgery one year earlier. The patient experienced thrombosis of the graft nine months after the operation, and thrombectomy of the graft was planned. However, the patient refused to undergo repeat surgery for thrombus removal and was referred to our center for possible endovascular treatment. We treated the patient with percutaneous aspiration thrombectomy. The thrombi were chronic in nature but could be removed with minimal residue in any part of the graft by using repeated aspiration thrombectomy with 7 F guiding catheters. Diagn Interv Radiol 2012; 18:142–145 © Turkish Society of Radiology 2012
The purpose of this study was to evaluate the diagnostic accuracy of 64 MDCT for the detection of hemodynamically significant disease within the lower extremity peripheral vasculature as compared to digital subtraction angiography (DSA). Copyright 2011 Wiley Periodicals, Inc. Catheterization and Cardiovascular Interventions 75:23–31 (2010)
Virtual angioscopy 3D reconstruction (VA) based on Multidetector computed tomography (m-CT) can be an important tool in endovascular aortic repair assessment. Here, we present a case of an acute type B aortic dissection, evaluated with preoperative virtual angioscopy 3D reconstruction (VA). Case Report: A 60 yearsold- man presented with type B acute aortic dissection. Due to renal malperfusion and uncontrolled hypertension TEVAR and renal stenting was performed based on m-CT and VA images. Discussion: Aortic dissection endovascular repair requires an accurate evaluation based on M-CT or magnetic resonance angiography (MRA). VA is a CTbased 3D reconstruction that provides a sort of information comparable to intravascular ultrasound (IVUS) that can be very helpful when it is not available and has many other potential applications in vascular surgery. Copyright 2011 Wiley Periodicals, Inc. Catheterization and Cardiovascular Interventions 75:32–34 (2010)
Objective: To compare the results of percutaneous transluminal angioplasty (PTA) and bypass graft surgery (BGS) for the treatment of infrapopliteal lesions in individuals presenting with critical limb ischemia (CLI). Vascular and Endovascular Surgery 44(8) 625-632. Copyright The Author(s) 2010.
Trabajo presentado en la reunión de la Societat Catalana d´Angiologia i Cirugia Vascular i Endovascular en Enero del 2011. El Dr. Fernández Valenzuela es miembro del Servico de Angiología, Cirugía Vascular y Endovascular del Hospital Vall d´Hebron de Barcelona.
Designed to treat degenerative aneurysms of the thoracic and abdominal aorta, endovascular stent-grafts have been increasingly employed as an off-label emergency treatment for blunt traumatic aortic injury (BTAI). In this review we explore the controversies associated with thoracic endovascular aortic repair (TEVAR) for BTAI. Early versus delayed treatment of aortic injuries is controversial, and stent-graft repair has further confused the issue of timing the repair. The diagnosis and management of minimal aortic injuries remains elusive. We analyze the available literature pertaining to BTAI, including the recent multicenter prospective trial from the American Association for the Surgery of Trauma. J Endovasc Ther. 2009;16(Suppl I):I53–I62. Copyright 2009 by the International Society of Vascular Specialists.
TRANS-APICAL AORTIC VALVE IMPLANTATION. Francesco Maisano. Discussant: Ruggero De Paulis. ENDOVASCULAR CONTRIBUTIONS TO TREATMENT OF TYPE A AORTIC DISSECTION. Roy K. Greenberg. Discussant: Francesco Siclari. CARDIAC PROTECTION IN MAJOR VASCULAR SURGERY. Luigi Tritapepe. Discussant: Maria Grazia Calabrò. NEAR-INFRARED SPECTROSCOPY (NIRS) MONITORING IN AORTIC ARCH SURGERY. John M. Murkin. Discussant: Luigi Beretta. HYBRID OPEN AND ENDOVASCULAR TREATMENT FOR AORTIC ARCH DISEASE. Yamume Tshomba. Discussant: Maurizio Puttini. APPROACH TO RETROGRADE DISSECTION INTO THE AORTIC ARCH AND RESIDUAL DISSECTION AFTER OPEN TREATMENT OF TYPE A DISSECTION. Vicente Riambau. Discussant: Guido Bajardi ANOMALIES AND VARIANT ANATOMY OF THE AORTA AND SUPRA-AORTIC VESSELS: ADDITIONAL CHALLENGES MET BY HYBRID PROCEDURES. Carlo Setacci. Discussant: Patrizio Castelli.
Purpose: To report our preliminary experience using cutting balloon angioplasty (CBA) in symptomatic iliac artery in-stent restenosis (ISR). J ENDOVASC THER 2008;15:193–202. Copyright 2008 by the INTERNATIONAL SOCIETY OF ENDOVASCULAR SPECIALISTS
Chronic critical limb ischemia (CLI) occurs as a result of reduced arterial blood flow resulting in: ischemic limb pain at rest, non-healing ischemic ulceration, or gangrene. CLI is a chronic condition that must be differentiated from acute limb ischemia, which is an acute medical emergency related to abrupt arterial occlusion requiring emergency treatment. The pathophysiology of CLI is related to inadequate arterial limb perfusion that is below the threshold needed to meet the metabolic demands of the limb, resulting in resting ischemia with skin breakdown and eventual tissue necrosis. If untreated, gangrene ensues with the eventual loss of the limb (from amputation or mummification) and perhaps life (from sepsis). Vascular Medicine 2008; 13: 267–279. Copyright © 2008 SAGE Publications, Los Angeles, London, New Delhi and Singapore
This prospective, non-randomized study evaluated the short- and mid-term feasibility, safety, primary patency, and limb salvage of cutting balloon percutaneous transluminal angioplasty (CB-PTA) for the treatment of peripheral arterial occlusive disease (PAOD). JOURNAL OF VASCULAR SURGERY Volume 48, Number 5. Copyright © 2008 by The Society for Vascular Surgery.
Lower extremity peripheral arterial occlusive disease poses a unique challenge to traditional angioplasty-based endovascular therapies. The diffuse nature of lower extremity atherosclerotic disease, the presence of chronic total occlusions, poor distal runoff, and the presence of critical limb ischemia all have contributed to the disappointing results of balloon angioplasty for complex infrainguinal arterial disease. These challenges have spawned the development of a host of new technologies in an attempt to improve the safety and effectiveness of percutaneous revascularization for lower extremity peripheral arterial occlusive disease. This review summarizes the recent advances in available technologies, including novel angioplasty balloons; nitinol stents, stent grafts, and drug-eluting stents; excisional, laser, and rotational atherectomy devices; devices for crossing total occlusions; true-lumen reentry devices; thrombectomy catheters; and embolic protection devices. Circulation. 2007;116:2072-2085. Copyright © 2007 American Heart Association. All rights reserved. Print ISSN: 0009-7322. Online: ISSN: 1524-4539.
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