ABSTRACT
Background: Type B aortic dissection is usually managed by intensive care medical therapy and surgery is reserved for treating the complications that can occur during the evolution of a case. Aim: To assess the endovascular management of acute complications of type B aortic dissection and the closure of the intimal defect and aortic false lumen. Material and Methods: Retrospective analysis of 8 consecutive patients aged 40 to 57 years (seven males) treated for acute complications in the initial episode of a type B aortic dissection between August 2006 and July 2008. Results: Six/eight were known hypertensive patients. The indications for surgery were intractable pain in one, hypertension refractory to treatment in two and distal hypoperfusion in fve. Five patients required covering of the left subclavian artery ostium, without need for surgical repair. One patient was subjected to renal angioplasty and stenting. Technical success was achieved in all cases, with complete closure of the proximal aortic tear and thoracic aortic false lumen, although 7 of patients had a persistent distal aortic false lumen. One case had a transient lower limb paraparesis. No patient died. Conclusions: Endovascular treatment is effective in closing the aortic tear as well as the thoracic aortic false lumen in aortic type B dissections with a low complication rate. Due to the high frequency of distal aortic false lumen persistence, it is not a defnitive treatment for this condition but it is useful for the acute complications of the initial phase of type B aortic dissection.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Aortic Dissection/surgery , Aortic Aneurysm, Thoracic/surgery , Blood Vessel Prosthesis Implantation/methods , Endovascular Procedures/methods , Aortic Dissection/complications , Aortic Aneurysm, Thoracic/complications , Endovascular Procedures/adverse effects , Retrospective Studies , Treatment Outcome , Tunica Intima/pathology , Tunica Intima/surgeryABSTRACT
Desde su aparición en la práctica clínica la angioplastía trasluminal con balón (APT) ha demostrado ser útil en el tratamiento de la enfermedad arterial oclusiva siendo efectuada como un procedimiento radiológico percutáneo. En un periódo de 3 meses, 7 arterias en 5 pacientes fueron tratados con APT en pabellón de cirugía sin presentar morbimortalidad. Los resultados son buenos aunque el tiempo de seguimiento es breve. Se concluye que la APT, puede ser utilizada en pabellón de cirugía, asociado o no a otro procedimiento de revascularización, con buenos resultados.
Subject(s)
Humans , Male , Female , Middle Aged , Angioplasty, Balloon , Arterial Occlusive Diseases/therapy , Follow-Up StudiesABSTRACT
La infección de una prótesis aortofemoral es una grave complicación de la cirugía vascular, que cuando compromete la región iliofemoral dificulta las posibilidades de efectuar una revascularización bilateral. Se presenta un caso clínico en que se utilizó un puente femorofemoral perineal para solucionar esta complicación, demostrándose como alternativa muy útil, fácil de realizar, para infecciones protésicas aortobifemorales que tengan compromiso séptico de la pared abdominal y/o de la región ileofemoral