ABSTRACT
OBJECTIVE@#To evaluate the role of Rotarex mechanical thrombectomy system in treating instent restenosis of peripheral artery disease (PAD).@*METHODS@#The clinical data of 7 in-stent restenosis (ISR) cases of lower extremity PAD from June 2017 to Dec 2018 were retrospectively analyzed. There were 5 males and 2 females and the mean age was (70.0±7.6) years from 59.0 to 76.0 years. All the cases were treated by Rotarex mechanical thrombectomy system. In the 7 cases, time interval from the previous stent implantation to ischemia recurrence was 1.0 to 72.0 months, and the median time was 6.0 months. The period from ischemia recurrence to endovascular therapy was 3 days to 2 years, and the median time was 62 days. Rotarex mechanical debulking catheter and percutaneous transluminal angioplasty (PTA) were used in all the cases, and the stent was used only when it was necessary. Anticoagulation was used for 24 hours after procedures and then antiplatelet agents were used as usual. Doppler ultrasonography was taken during the followed-up.@*RESULTS@#All the 7 cases were successful in technology, 3 of which were implanted with new stents for the fracture of the old ones. while for the other four cases, no new stent was implanted. The ankle-brachial index (ABI) increased from 0.31±0.08 to 0.86±0.08 after treatment (t=-12.84, P < 0.001). Thrombectomy was applied urgently in one case because of acute thrombosis in the stent, and the result was good. There was no other complications in hospital. All the patients were followed up for 5.0-22.0 months, and the median time was 14.0 months. No death and amputation occurred during the follow-up. One patient stopped antiplatelet agents because of gastrointestinal bleeding, which resulted in acute thrombosis. in-stent restenosis reappeared in 3 cases.@*CONCLUSION@#Debulking using Rotarex catheter is safe and effective in treating in-stent restenosis of PAD, especially in reducing stents implantation, but is not good at dealing with old thrombus and proliferating intima, and can do nothing about fractured stents and hyperplasia of intima, so it needs to be combined with stents and drug coated balloons.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Arteriosclerosis Obliterans/surgery , Coronary Restenosis , Femoral Artery , Lower Extremity , Recurrence , Retrospective Studies , Stents , Thrombectomy , Treatment OutcomeSubject(s)
Humans , Male , Aged , Coronary Artery Disease/surgery , Arteriosclerosis Obliterans/surgery , Carotid Stenosis/surgery , Vascular Surgical Procedures/methods , Stents , Angioplasty/methods , Carotid Stenosis/complications , Carotid Stenosis/diagnosis , Coronary Stenosis/surgery , Coronary Stenosis/diagnosis , Cardiac Surgical Procedures/methods , Treatment Outcome , Cerebrovascular Disorders/etiologyABSTRACT
Se estudiaron 25 pacientes que presentaban aterosclerosis obliterante de los miembros inferiores en estadío III y IV con un promedio de edad de 68,5 años a los que se les realizó profundoplastia. Se analizaron entre otras variables el estadio de la enfermedad, las enfermedades asociadas, la extensión de la aterosclerosis y el comportamiento hemodinámico. La mortalidad fue del 4
Subject(s)
Middle Aged , Humans , Male , Female , Amputation, Surgical/methods , Arteriosclerosis Obliterans/surgery , Femoral Artery/surgery , Leg/surgeryABSTRACT
Se realizó un análisis dde los resultados de la profundoplastia en un grupo de 25 pacientes durante un período acumulativo de 30 meses y fueron considerados por validación o discriminante según el método de Truett-Cornfield un índice pronóstico preoperatorio y otro posoperatorio, que mostraron un mayor tanto por ciento de sensibilidad, especificidad y bien clasificados
Subject(s)
Middle Aged , Humans , Male , Female , Amputation, Surgical/methods , Femoral Artery/surgery , Prognosis , Arteriosclerosis Obliterans/surgery , Leg/surgeryABSTRACT
Se realizó un estudio de 680 pacientes diagnosticados como aterosclerosis obliterante de los miembros inferiores durante un período de 5 años, de los cuales el 79% correspondió al sexo masculino y el 21% al femenino. El 62,2% de los enfermos se encontraban en el estadío IV de la clasificación de Fontaine, requirieron amputaciones mayores el 64% de los mismos y sólo la tercera parte fueron sometidos a algún tipo de cirugía revascularizadora. Los patrones oclusivos que predominaron fueron: el femoropoplíteo y las arterias de la pierna con el 45,5 y 25,4% respectivamente. El 88% eran fumadores, el 42% hipertensos, el 13,8% obesos y de los 364 estudios de lípidos realizados se observó hipercolesterolemia e hipertrigliceridemia en el 39 y 31% respectivamente, aislada o combinada. Se señaló la necesidad de influir sobre el cuadro de salud de nuestra población mediante el programa de prevención secundaria y analizar con un criteriomás objetivo aquellos pacientes susceptibles de cirugía revascularizadora a fin de evitar el riesgo de amputación y optimizar el nivel de las mismas
Subject(s)
Adult , Middle Aged , Humans , Male , Female , Arteriosclerosis Obliterans/surgery , Leg/surgeryABSTRACT
Cinquenta e um pacientes com amputaçöes de membro inferior decorrentes de doença arterial periférica foram avaliados quanto a condiçöes e tempo de reabilitaçäo e acompanhados no seguimento tardio por um período médio de 24 meses. Trinta e três pacientes (64%) eram diabéticos. Sucesso imediato de reabilitaçäo foi considerado como a recuperaçäo da marcha bi-pedal com prótese. Quarenta e cinco pacientes (88%) atingiram esta condiçäo. O tempo médio de reabilitaçäo para amputados ao nível da perna foi de três meses e para amputados ao nível da coxa de cinco meses. No seguimento tardio a avaliaçäo foi feita quanto `a persistência no uso da prótese e grau de independência de vida. A mortalidade foi estudada pelo método atuarial. Todos os pacientes amputados na perna (100%) usavam a prótese para locomoçäo e tinham vida independente no último seguimento, enquanto 75% dos amputados em coxa estavam em uso da prótese e apenas 25% tinham vida totalmente independente. A mortalidade estudada pelo método atuarial foi analisada para pacientes diabéticos e näo diabéticos. Todas as mortes exceto uma ocorreram nos diabéticos, resultando neste grupo sobrevida cumulativa de 31% em 4 anos