Stratagy and prognosis of managing culprit vessel with two lesions undergoing primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction / 中国介入心脏病学杂志

Objective To asess the primary percutaneous coronary intervention(PPCI) strategies of culprit vessel with two lesions in ST-segment elevation myocardial infarction(STEMI) patients and their prognosis.Methods The study retrospectively reviewed 418 patients with STEMI undergoing PPCI in the General Hospital of Shenyang Military Region from January 1st to June 30th in 2015 and 75 patients were included. According to whether the non-infarct-related lesions(N-IRL) being treated or not,the patients were identified as both IRL and N-IRL being treated(the research group,n=33) or the culprit lesion(or infarct-related lesion,IRL) being treated only(control group,n=42). The endpoint was major adverse cardiocascular event(MACE) which was a composite of death from cardiac causes,nonfatal myocardial infarction,target vessel revascularization(TVR) and hospitalization with angina or heart failure.Results The study endpoint betwwen the two groups showed no statistical differences in MACE(P=0.446). Multivariate Cox regression analysis showed that age, diameter of N-IRL were predictive factors of MACE. When N-IRL located beyond the culprit lesion, the research group showed higher risk of MACE(P=0.022) and TVR(P=0.039).Conclusions The non-infarct-related lesions of patients with STEMI undergoing PPCI may be left for conventional medical treatment. It may be reasonable to choose drug therapy for distal N-IRL and to choose PCI for proximal N-IRL.

Trauma de aorta abdominal: presentación de caso y revisión bibliográfica / Trauma to abdominal aorta: case study and bibliographic references

Presentamos el caso de un paciente con trauma penetrante de abdomen (arma de fuego), con lesión vascular grado V (lesión del 70% de la luz de la aorta a nivel suprarrenal), sometido a laparotomía exploradora, realizando rafias aórticas, hepática (trauma grado III), gástrica y laparotomía contenida (por imposibilidad para cerrar la pared abdominal debido al edema de asas intestinales); es sometido a 9 lavados de cavidad en el transcurso de 1 mes, permitiendo el cierre de la pared abdominal y evolucionando favorablemente a pesar de lo difícil de controlar las lesiones.

A case of a patient with penetrating trauma to abdomen (gunshot), with vascular lesion of Grade V (lesion of 70% of aortic lumen at the level of the suprarenal.) and who undergoes exploratory laparotomy. Patient is left with a laparotomy because it was impossible to close abdominal wall due to intestinal edema. Patient undergoes abdominal drainage for a month which allowed abdominal wall to close and lead to recovery.