Pseudoaneurisma de la arteria femoral profunda secundario a trauma penetrante: reporte de caso / Deep femoral artery pseudoaneurysm secondary to penetrating trauma: case report

Resumen Objetivo: El objetivo del trabajo es presentar una opción terapéutica adecuada para los pseudoaneurismas de la femoral profunda secundarios a trauma penetrante, así como realizar una revisión de la literatura sobre el manejo en estas patologías. Caso clínico: Paciente masculino de 21 años quien 5 meses previos a su valoración sufre una herida por arma punzocortante en el muslo izquierdo, desarrollando aumento de volumen el sitio de la lesión, dolor y limitación al movimiento. Se diagnostica un pseudoaneurisma de la arteria femoral profunda de 2,3 cm x 2,1 cm x 2,7 cm y un hematoma adyacente de 13,5 cm x 12,6 cm x 23 cm. Se realiza exclusión del pseudoaneurisma mediante cirugía endovascular con coils, posteriormente se evacúa el hematoma adyacente. Resultados: El paciente egresa al tercer día posoperatorio con mejoría de la sintomatología, antibioticoterapia y analgesia. Discusión y Conclusión: En el caso presentado la exclusión del pseudoaneurisma mediante coils facilitó el control de éste y la evacuación del hematoma adyacente, disminuyendo el riesgo de sangrado. Por lo que consideramos adecuada esta conducta terapéutica en pseudoaneurismas de la femoral profunda.

Aim: The aim of this paper is to present a case of a deep femoral artery pseudoaneurysm secondary to a penetrating trauma in the left thigh, its management and a literature review. Clinical Case: 21-year-old male referred to the emergency department of our institution 5 months after he was injured with a knife on his left thigh, with severe local swelling, local pain, and difficulty to the mobilization of the left leg. A 2.3 cm x 2.1 cm x 2.7 cm deep femoral artery pseudoaneurysm was diagnosed with a 13.5 cm x 12.6 cm x 23 cm adjacent hematoma. Endovascular exclusion was made with coils and evacuation of the hematoma with open surgery. Results: The patient was discharged on the third day postop without pain and walking with antibiotics and follow-up to a month did not reveal any complications. Discusion and Conclusion: Exclusion with coils is an adequate management in deep femoral pseudoaneurysms that facilitates the evacuation of the hematoma lowering the risk of bleeding.

Endovascular versus open surgical reconstruction in long segment superficial femoral artery occlusive disease

Background: The concept of endovascular intervention has been well supported by the continuous advance in technology in long segment [superficial femoral artery] SFA occlusions. The rapid evolution of stent design, deployment approaches and adjunctive therapy made the practice of [percutaneous transluminal angioplasty] PTA safer and more predictable and has reduced superficial femoral artey surgery

Objectives: To compare the safety and effectiveness of endovascular treatment versus open surgical bypass in treatment of superficial femoral artery occlusive disease

Patients and Methods: This prospective study included 30 patients presenting to the Vascular Department in Cairo University Hospitals with femoropopliteal occlusive disease for whom percutaneous transluminal angioplasty with or without stenting was done for 15 cases. Femoropopliteal bypass surgery with saphenous or synthetic graft was done for 15 cases between March 2017 and January 2018. The procedure, possible complications, benefits, risks and other alternative interventions were all explained to the patients and an informed consent was obtained

Results: In endovascular cases: 1/15[6.66%] cases, developed small haematoma at the site of puncture which resolved by conservative management. After 6 months follow up,6/15 cases [40%] had intact pedal pulsation, 6/15 cases [40%] had popliteal pulsation with marked improvement of their complaints [disappearance of rest pain in 3 cases, the other 3 cases which had gangrene, line of demarcation appeared]. 1/15 case [6.66%] showed popliteal pulse at 3 months follow up which disappeared at 6 months but the patient had good circulation with improvement of rest pain. So, successful cases were 13/15[86.66%] at 6 months follow up. 2 /15 cases[13.33%] showed occlusion, by Duplex 1 case of them showed occlusion of stent and 1 case showed return to original occlusion. In open surgical cases: Postoperative wound infection at groin incision developed in 3/15[20%] cases, 2 cases of them were managed conservatively by IV antibiotic and repeated dressing, and one developed secondary haemorrhage in which ligation of femoral artery was done and the limb became gangrenous and Above knee amputation was done. After 6 months follow up, 5/15 cases [33.33%] had intact pedal pulsation, 7/15 cases [46.66%] had popliteal pulsation with marked improvement of their complaints. Disappearance of rest pain occurred in 3 cases, while 3 cases which had gangrene, line of demarcation appeared and 1 case which had non healing ulcer, healing of ulcer started to occur. So successful cases 12/15[80%] at 6 months follow up. Thus, 3/15 cases [20%] failed, 1 case developed wound infection at groin incision followed by secondary haemorrhage in which ligation of the graft was done, the limb was worsen ended in above knee amputation. The other 2 cases showed occlusion of graft, 1 case ended in above knee amputation, the other below knee amputation was done in which the stump became gangrenous followed by above knee amputation

Conclusion: Percutaneous transluminal angioplasty [PTA] has obtained a definite place in the management of peripheral arterial occlusive disease of the lower limb. It was widely accepted as a first line of treatment for many patients with SFA occlusive disease. The low complication rate and relatively non-invasive nature of PTA made it an increasing popular intervention

Ruptured true superficial femoral artery aneurysm / Aneurisma verdadeiro roto de arteria femoral superficial

Femoral artery aneurysms are rare and generally affect elderly patients. They are often diagnosed in combination with aneurysms in other locations, such as peripheral and aortic aneurysms. This case report describes a young patient whose superficial femoral artery (SFA) had a clinical presentation suggestive of a ruptured aneurysm. The patient underwent standard treatment, with aneurysmectomy and interposition of the ipsilateral saphenous vein. A review of the literature confirms the rarity of this case.

Os aneurismas de artéria femoral são raros e ocorrem geralmente em pacientes idosos. Estão frequentemente associados a outros aneurismas, tanto periféricos como de aorta abdominal. O presente relato refere-se a um jovem portador de aneurisma de artéria femoral superficial (AFS), cuja apresentação clínica foi a ruptura. O paciente foi submetido ao tratamento convencional, com ressecção do aneurisma e interposição de veia safena magna ipsilateral. A revisão da literatura corrobora a raridade do caso.

Patomorfometría de la aterosclerosis de las coronarias e ilíaco-femorales en fallecidos con antecedentes de diabetes e hipertensión / Pathomorphometry of the coronary and iliac-femoral arteries in deceased with a history of diabetes and high blood pressure

Se realizó un estudio en 404 fallecidos en el Hospital Militar Central Dr. Carlos J. Finlay divididos en 4 grupos: diabéticos (n=116), diabéticos-hipertensos (n=68), bajo nivel aterosclerótico (n=100) e hipertensos (n=120) con el objetivo de evaluar el impacto independiente y que en su conjunto, ejercen ambos factores de riesgo sobre la aterosclerosis de las coronarias e ilíaco-femorales al compararlos entre sí y con el grado de afectación de estas mismas arterias encontrado en fallecidos considerados de bajo nivel de aterosclerosis. Se evaluaron las características patomorfológicas y morfométricas empleando el sistema aterométrico. Se obtuvo mayor desarrollo de la aterosclerosis cuando la diabetes estuvo asociada con la hipertensión. La mayor cantidad de variables que presentaron significación estadística se encontraron al comparar los clasificados como bajo nivel aterosclerótico con los otros grupos, seguido de las comparaciones de los diabéticos con los diabéticos-hipertensos, demostrándose así el mayor impacto de ambos factores de riesgo cuando se encuentran asociados

A study was made in 404 autopsied people in the HMC Dr. Carlos J. Finlay divided in four groups, Diabetics (n=116), Diabetics and Hypertensions (n=68), Low-level Atherosclerotic (n=100) and Hypertensions (n=120), with the objective of evaluating the independent impact and that in their group they exercise both factors of risk on the atherosclerosis from the coronary and ileac-femoral when comparing it among if and with the grade of affectation of these same arteries found in considered of atherosclerotic low-level. The characteristic pathomorphological and morphometric were evaluated using the atherometric system. Bigger development of the atherosclerosis was obtained when the diabetes was associated with the hypertension. The biggest quantity in variables that are presented statistical significance when comparing the classified ones as low-level atherosclerotic with the other groups, followed by the comparisons of the diabetics with the diabetics and hypertensions, being demonstrated this way the biggest impact in both factors of risk when they are associate

Estudo piloto do impacto da terapia antiproliferativa com everolimus administrado por via oral na diminuição de reestenose após implante de stent auto-expansível de nitinol para tratamento de lesões oclusivas da artéria femoral superficial / Pilot study of the impact of antiproliferative therapy with everolimus administered orally in the reduction of restenosis after implantation of selfexpandable nitinol stent for treatment of occlusive lesions of the superficial femoral artery

INTRODUÇÃO: A implantação de stent auto-expansível de nitinol para o tratamento das lesões oclusivas femoro-poplíteas tem sido associado com maus resultados a longo prazo. O everolimus administrado via oral para inibir reestenoses do stent foi investigado recentemente em animais com bons resultados, porém sua segurança e eficácia não têm sido estudada em seres humanos. O propósito deste estudo piloto foi avaliar o impacto da terapia antiproliferativa com everolimus administrado via oral por 28 dias na diminuição de reestenose após implante de stent auto-expansível de nitinol para tratamento de lesões oclusivas da artéria femoral superficial. MÉTODOS E RESULTADOS: Trinta e quatro pacientes foram recrutados para este estudo randomizado, prospectivo. O grupo que recebeu everolimus via oral foi constituído por 15 pacientes e o grupo que não recebeu medicação composto por 19 pacientes. As características basais e do procedimento foram similares entre os dois grupos. Todos os pacientes tinham isquemia crônica do membro inferior e oclusão da artéria femoral superficial (média da lesão de 83,14 mm no grupo sem medicação e 105 mm no grupo everolimus). O objetivo primário do estudo foi a redução da porcentagem média do diâmetro da reestenose intra-stent após seis meses da angioplastia avaliada por angiografia quantitativa. A porcentagem média do diâmetro das reestenoses foi 46,9% no grupo tratado com everolimus e 44,5% no grupo que não recebeu a medicação (p=0,81). Não foram observados efeitos colaterais graves nos grupos. No acompanhamento clínico aos 24 meses não houve diferenças significativas entre os grupos em relação a eventos clínicos. A patência primária, primária assistida e secundária em 24 meses, foi 42%, 74% e 79% no grupo sem medicação e 27%, 73% e 73% no grupo tratado com everolimus. CONCLUSÃO: O everolimus via oral por 28 dias em doses altas é seguro e bem tolerado, com baixo índice de efeitos colaterais, porém não é eficaz na redução da...

INTRODUCTION: The implantation of a self-expanding of nitinol stent in the treatment of femoropopliteal occlusive lesions has been associated with a poor outcome in a long term setting. Everolimus administered orally to inhibit restenosis of the stent was investigated recently in animals with good results, but its safety and efficacy has not been studied in humans. The purpose of this pilot study was to evaluate the impact of antiproliferative therapy with everolimus administered orally for 28 days in the reduction of restenosis after implantation of self-expandable nitinol stent for treatment of occlusive lesions of the superficial femoral artery. METHODS AND RESULTS: Thirty-four patients were recruited for this randomized, prospective study. The group that received oral Everolimus was consisted of 15 patients and the group that received no medication was 19 patients. The baseline characteristics and procedure were similar in both groups. All the patients had chronic lower limb ischemia and occlusion of the superficial femoral artery (mean of the lesion of 83.14 mm in the group without medication and 105 mm in the everolimus group). The primary objective of the study was to evaluate the reduction of the average percentage of the diameter of in-stent restenosis six months after angioplasty assessed by quantitative angiography. The in-stent mean percent diameter stenosis was 46.9% in the group treated with everolimus and 44.5% in the group that received no medication (p = 0.81). There were no serious side effects seen in either group in the clinical follow up at 24 months. There was no significant difference between groups in relation to clinical events. The primary patency, assisted primary and secondary in 24 months was 42%, 74% and 79% in the group without medication and 27%, 73% and 73% in the group treated with Everolimus. CONCLUSION: Everolimus administered orally for 28 consecutive days to stent implantation in high doses proves to be safe and...

Resultados de las angioplastias del sector femoropoplíteo en isquemia crítica / Femoropopliteal angioplasty for the treatment of critical limb ischemia

Introducción: La isquemia critica de las extremidades inferiores (EEII) es una condición que afecta a pacientes que presentan grave patología ateromatosa en múltiples territorios y por ende tienen mal pronostico vital. La terapia endovascular validada en algunos sectores, en éste no ha logrado posicionarse. Objetivo: Evaluar la evolución de los pacientes sometidos a Angioplastia Endoluminal Percutánea (AGP) del territorio femoropoplíteo por isquemia critica. Material y Método: Estudio retrospectivo que incluye 58 extremidades en 54 pacientes con isquemia critica de las EE.II por patología femoropoplítea, sometidos a angioplastia entre Julio del 2001 a Diciembre del 2004 y seguidos en su evolución hasta Abril del 2006. Resultados: Fueron realizadas 58 AGP (54 pacientes): masculinos 54 por ciento, femeninos 46 por ciento, y 74 por ciento diabéticos. Edad promedio 70,6 años. El grupo incluye lesiones TASC A, B, C y D. El 24 por ciento de las extremidades no tenía run off. Éxito técnico inicial se obtuvo en el 84 por ciento. La permeabilidad primaria 43,3 por ciento a 1 año (ES 6,52), 32,7 por ciento a 2 años (ES 7,44) y 16,9 por ciento a 3 años (ES 6,31). Durante el periodo, 4 pacientes fueron sometidos a nuevas angioplastias del mismo territorio y 7 pacientes a by pass. Mortalidad a 30 días 1,7 por ciento. Existieron 4 complicaciones mayores (8 por ciento). Al término del seguimiento hay 20 amputaciones mayores (34 por ciento), cuatro de ellas por compromiso local, las restantes por isquemia irreversible. La mortalidad al final del seguimiento fue de 29,6 por ciento. Conclusión: La angioplastia infrainguinal en la isquemia crítica es posible, segura y de baja morbimortalidad, no excluyendo revascularizar mediante by pass si fracasa.

Introduction: The critical ischemia of the lower extremities is a condition that affects patients who present serious atheromatous pathology in multiple territories and, consequently, have bad live prognosis. Endovascular therapy, valid in some sectors, has not been able to find a position in this one yet. Objectives: to evaluate the gradual development of patients who were subjected to angioplasty of the femoropopliteal territory because of critical ischemia. Material and method: retrospective study, which includes 58 extremities in 54 patients with critical ischemia of the interior extremities due to femoropopliteal pathology who were subjected to angioplasty between July 2001 and December 2004, and whose development was studied until April 2006. Results: 58 AGP were performed in 54 patients: 54 percent male, 46 percent female, and 74 percent diabetics. The average age was 70.6 years old. The group includes TASC A, B, C, and D lesions. 24 percent of the extremities did not have run off. The initial technical success was obtained in 84 percent of the cases. The primary permeability 43,3 percent after a year (ES 6,52), 32,7 percent after 2 years (ES 7,44) and 16,9 percent after 3 years (ES 6,31). 4 patients were subjected to further angioplasty of the same territory and 7 patients were subjected to bypass during this period. The 30-day mortality was 1,7 percent. There were 4 major complications (8 percent). By the end of the monitoring, there are 20 major amputations (34 percent), 4 of these due to local compromise, and the rest of them due to irreversible ischemia. The mortality at the end of the monitoring was 29,6 percent. Conclusion: infrainguinal angioplasty on critical ischemia is possible, safe and presents a low morbimortality, not excluding revascu-larization through bypass in case of failure.

Clinical and pathological assessment of different suture techniques for microvascular anastomosis in rat femoral artery

This study examined the clinical and pathologicalfeatures after a microvascular anastomosis of a ratfemoral artery using four different suture techniques.Sixty Sprage-Dawely rats were divided randomly into 4groups. Fifteen bisected arteries (one from each animal) inGroup I, II, III and IV were sutured with the simpleinterrupted suture, continuous suture, sleeve suture andcuff suture, respectively. The anastomosis times in GroupI, II, III and IV were 28.67, 14.67, 15.47 and 15.93 min,respectively. Immediate bleeding that stopped withoutintervention (grade I) was observed in 67%, 73% and60% of the anastomosed vessels in Groups II, III and IV,respectively, while 60% of the vessels in Group I showedlight bleeding that was inhibited by gentile pressure(grade II). All vessels examined appeared to be patent at 5and 15min after the anastomosis. On the 7th daypostoperatively, the vessels of Group I showed the highestpatency rate (93%) compared with Groups II (67%), III(73%) and IV (87%). Moreover, there were morepronounced pathological changes in Group I than in theother groups. These changes included endothelial loss,endothelial proliferation, degeneration and necrosis of thetunica media. Suture materials surrounded by aninflammatory reaction were also observed. In conclusion,the simple interrupted suture is preferable formicrovascular anastomosis due to its highest patency rate.The other techniques investigated can be good alternativesbecause of their short anastomotic time and moderatepathological changes.

[Lower limp ischemia due to femoral artery thrombosis after rectal excinian in lithotomy position]

Lower limb ischemia is an unusual and severe complication of abdominal surgery. We report a case of left femoral artery thrombosis following elective low anterior resection for rectal cancer in lithotomy position. Despite thrombectomy and femoro-femoral bypass the patient lost the involved limb due to irreversible ischemia. We discuss the factors that my have a role in the occurrence of this complication

Pseudoaneurysm of profunda femoris artery following internal fixation of intertrochanteric fracture: two cases report.

The authors report two cases of an uncommon but preventable complication after fixation of intertrochanteric hip fracture, the pseudoaneurysm of the profunda femoris artery. Both cases in the present study presented as proximal thigh mass, and soft tissue sarcoma was suspicious in one case. The diagnosis was confirmed by angiographic study and the feeding vessels were successfully occluded during angiography. Proper placement of the retractors, using a shorter drill or drill guard, accurate screw length and a shorter side-plate DHS were recommended to prevent this problem.

Estudio morfológico-informático de las estenosis de las arterias femorales humanas para su aplicación como complemento diagnóstico / Morphological and informatical study of human femoral arteries stenoses for its application as diagnostic complement

El presente trabajo estudia el comportamiento del flujo sanguíneo a partir de arterias femorales humanas estenóticas con distintos grados de obstrucción, extraídas de autopsias y de amputaciones quirúrgicas y de simulaciones producidas por un programa computacional simulador original basado en el método de los elementos finitos para líquidos newtonianos, homogéneos e incompresibles. Su empleo produjo numerosas curvas de máxima resumidas en un único gráfico de aplicación sencilla para el profesional. Más allá de la evaluación del origen y del impacto de los remolinos analizando las distintas variables intervinientes (esto es: presión, velocidad y tensiones), los resultados aquí reportados pueden constituir un útil complemento diagnóstico junto a los demás métodos usados actualmente, a los que no contraviene ni invalida.

Aneurisma de arteria femoral superficial: reporte de un caso y revisión de la patología / Superficial femoral artery aneurysm: report of a case and review of the pathology

El aneurisma arteriosclerótico aislado de la arteria femoral superficial es una patología inusual. Presentamos el caso de un paciente de 89 años que acude a nuestro hospital por una masa pulsátil de muslo derecho. Se demostró la presencia de un aneurisma a través del diagnóstico por imágenes y procedimos a su resección quirúrgica. Realizamos una revisión de la literatura de esta patología poco frecuente.

Ultrasound guided compression repair of post-catheterization femoral pseudo-aneurysm

Iatrogenic pseudoaneurysm have traditionally been treated surgically Recently, this problem has been successfully treated without operation by the ultrasound-guided compression [UGC]. The purpose of this study is to describe the indications, technique and results for UGC of femoral pseudoaneurysms and to define the factors that predict its success. One hundred and two [102] patients were referred to the vascular division with suspected pseudoaneurysm [PA] over a 36 months period. Data regarding the location and morphologic characteristics of the pseudoaneurysms, anticoagulation status and morbid diseases were documented. Each pseudoaneurysm was compressed with a 4-7 MHz linear transducer for 10-minute intervals until the PA was completely occluded or the procedure was considered to be a failure. Out of 102 patients referred with suspected PA, 36 had a duplex confirmed PA [22 post cardiac catheterization, 10 postaortogram and four post femoral central line]. UCG was successful in 29 patients [81%], the rest were surgically treated. UGC provides a reliable alternative to surgical treatment for post catheterization femoral pseudoaneurysm. Anticoagulants, large PAsize [> 6 cm] and hypertension were main preditors for UGC failure

Estudo experimental do uso de um antagonista do receptor da glicoproteína IIb/IIIa das placentas na prevençäo de tromboses em microanastomoses vasculares / An experimental study on the use of an antagonist of the platelet glycoprotein IIb/IIIa receptor in the prevention of thrombosis in vascular microanastomoses

O autor comparou, experimentalmente, a eficácia da droga abciximab, um antagonista do receptor da glicoproteína IIb/IIIa das plaquetas, na prevençäo da trombose nas microanastamoses arteriais em ratos Wistar.Utilizou 20 animais, dos quais 10, do grupo controle, receberam soluçäo salina e 10 receberam abciximab, na concentraçäo de 0, 8mg/Kg, injetados na veia femoral.Trinta minutos após a administraçäo da soluçäo salina ou abciximab, todos os animais foram submetidos ao mecanismo provocador de trombose vascular da artéria femoral do lado oposto ao utilizado para administraçäo da droga, por meio de um trauma externo promovido por aparelho IMPACTOR, desenvolvido pela New York University para padronizaçäo de lesäo da medula nervosa, o que padronizou a lesäo arterial. Todos os animais foram submetidos à microanastomose vascular com mononáilon 10-0, em pontos separados, no local do trauma externo.Foram realizados testes para analisar a perviabilidade vascular da artéria femoral no peíodo de 10, 20 e 30 minutos após o término da anastomose. Após este período, todas as artérias femorais submetidas à microanastomoses foram ressecadas e analisadas em microscopia óptica para avaliar a presença de formaçäo de trombos.Após a análise estatística dos dados, o autor conclui que o uso do antagonista do receptor da glicoproteína IIb/IIIa das plaquetas diminui a incidência de tromboses nas microanastomoses vasculares.

Atherosclerotic changes in the carotid and femoral arteries in asymptomatic hemodialysis and predialysis patients

The present study was designed to evaluate the early atherosclerotic changes of large arteries in hemodialysis. Intima-media thickness [IMT] and atherosclerotic plaques of the carotid and femoral arteries were examined in three groups [30 hemodialysis patients, 30 predialysis patients and 20 healthy control subjects matched for age and sex] by high resolution B-mode ultrasound. The results have shown that IMT values of the carotid and femoral arteries in the hemodialysis patients were significantly higher than in the predialysis patients and were significantly higher in both patients groups than in healthy control subjects. Atherosclerotic plaques were found in the majority of hemodialysis patients [60%], 40% in predialysis patients vs. 13.3% in healthy controls. The present study has shown that the IMT of the carotid and femoral arteries is significantly increased in asymptomatic hemodialysis as well as in predialysis patients. Atherosclerotic and arteriosclerotic vessel wall changes are present in most chronic uremic patients before or after hemodialysis

Morphologic change of the internal elastic lamina in Buerger's disease

Morphologic features and pathogenesis of arterial changes occurring in Buerger's disease (thromboangiitis obliterans) are still controversial. This study describes histopathologic features of medium sized arteries from patients with Buerger's disease, particularly of the internal elastic lamina in relation to the immunologic mechanism of the injury. Seventeen segments of occluded arteries (femoral or popliteal arteries) from 17 patients with Buerger's disease were analyzed by histopathological and immunohistochemical methods. The most characteristic features were total luminal obliteration, together with a varying degree of recanalization and deposition of hemosiderin pigments. Detailed analysis, however, showed marked undulation and multiplication of the internal elastic lamina (100%) associated with basophilic degeneration and delicate linear calcification (47%). Lymphocytic infiltration along the internal elastic lamina was seen in 71% and was associated with localized edema. Lymphocytes along the lamina were consistently positive for T cell marker. Mild to moderate fibrosis was present at the media in 24%. Adventitial changes included mild, nonspecific and irregular fibrosis seen in 53%. Immunologic injury to the internal elastic lamina associated with T-lymphocytic infiltration might be the initial morphogenetic mechanism of the thrombotic occlusion and organization of medium-sized arteries in Buerger's disease.

Efeito da vitamina E, da vitamina C e da associacao vitamina E-vitamina C, na sindrome de isquemia-reperfusao, em membro posterior de rato / Effects of vitamin E, the vitamin C and the association of vitamin E-vitamin C, in ischemia-reperfusion syndrome, on the posterior paw of rat

O possivel efeito da vitamina E, vitamina C e da associacao de ambas foi avaliado na atenuacao das lesoes de reperfusao da pata posterior de ratos, submetida a isquemia total. Foram estudados cinco grupos experimentais: Grupo 1-grupo controle em que nao foi realizada isquemia-reperfusao; grupos 2, 3, 4 e 5 com isquemia-reperfusao, onde um clampe microcirurgico foi colocado na arteria femoral por um periodo de 4 horas, de modo a causar uma isquemia total do membro. Depois, o clampe foi retirado, permitindo a reperfusao por 2 horas. As alteracoes devidas ao processo isquemia-reperfusao e os eventuais efeitos da vitamina E, da vitamina C e da associacao de ambas foram estudados pela avaliacao do grau de edema, tomando-se a medida da circunferencia da pata em 3 momentos: apos a anestesia; ao final da isquemia; e ao final da reperfusao. Os produtos da peroxidacao lipidica das membranas celulares foram...

Acute lower limb ischemia due to femoropopliteal embolism of hydatid cyst

In addition to the liver, human hydatidosis has been reported in the lung, brain, abdominal viscera, muscles, and heart chambers. Infarction of the brain has also been documented. Arterial embolism of the lower extremities by hydatid cyst, however, is extremely rare. In the presented case, acute ischemia of the patient's left leg led to gangrene and amputation. Complete workup for localization of the primary focus of hydatid cyst was inconclusive; however, the most probable explanation is spontaneous rupture of a left ventricular wall hydatid cyst which subsequently embolized to the aorta and lodged in the left femoral artery

Anticorpo antifosfolipídio e múltiplos fenômenos trombóticos / Antiphospholipid antibody and multiple phenomena thrombotic

Os autores apresentam o caso de uma paciente de 35 anos de idade com fenômenos trombóticos envolvendo artérias e veias de extremidades, além da artéria retiniana. Os eventos trombóticos ocorreram numa seqüência de alguns meses, envolvendo inicialmente as artérias femoral e ilíaca direitas, depois trombose venosa profunda e finalmente o envolvimento vascular retiniano. O anticorpo antifosfolipídio tipo IgG foi positivo. Ressalta-se a importância de pesquisa dos anticorpos antifosfolipídios em adultos jovens com fenômenos trombóticos.