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1.
Nursing (Säo Paulo) ; 24(281): 6299-6308, out.-2021.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1344292

ABSTRACT

Objetivo: Avaliar a qualidade de vida dos pacientes submetidos a revascularização por Angioplastia. Métodos: Tratase de um estudo descritivo, transversal, quantitativo, realizado nos meses de março a abril de 2019 com 25 pacientes de um hospital público de referência em cardiologia de Recife (PE). Foi utilizado o questionário WHOQOL-Bref para avaliação da qualidade de vida. Resultados: Verificou-se que 56% (n: 14) da amostra são do gênero masculino e tinham uma mediana de idade de 63 anos. A avaliação da qualidade de vida dos pacientes apresentou resultado moderado, com necessidade de melhora em todos os domínios. O domínio "físico" obteve o escore mais baixo (3,20 ± 1,08), enquanto o domínio relações pessoais obteve o melhor índice (3,71 ± 1,08). A média do escore total foi de 3,38 (DP: 1,11). Conclusão: Os resultados refletiram um grau moderado de qualidade de vida e sua melhora depende do processo de mudança comportamental do indivíduo.(AU)


Objective: To evaluate the quality of life of patients undergoing revascularization by angioplasty. Methods: This is a descriptive, cross-sectional, quantitative study conducted in the months of March to April 2019 with 25 patients from a public cardiology referral hospital in Recife (PE). The WHOQOL-Bref questionnaire was used to assess quality of life. Results: It was found that 56% (n: 14) of the sample were male, with a median age of 63 years. The patients' quality of life assessment showed moderate results, with need for improvement in all domains. The physical domain had the lowest score (3.20 ± 1.08), while the personal relationships domain had the best score (3.71 ± 1.08). The mean total score was 3.38 (SD: 1.11). Conclusion: The results reflected a moderate degree of quality of life and its improvement depends on the individual's behavioral change process.(AU)


Objetivo: Evaluar la calidad de vida de los pacientes sometidos a revascularización mediante angioplastia. Métodos: Se trata de un estudio descriptivo, transversal y cuantitativo realizado en los meses de marzo a abril de 2019 con 25 pacientes de un hospital público de referencia en cardiología de Recife (PE). Se utilizó el cuestionario WHOQOL-Bref para evaluar la calidad de vida. Resultados: Se encontró que el 56% (n: 14) de la muestra eran hombres y tenían una edad media de 63 años. La evaluación de la calidad de vida de los pacientes mostró un resultado moderado, con necesidad de mejora en todos los dominios. El dominio "físico" obtuvo la puntuación más baja (3,20 ± 1,08), mientras que el dominio relaciones personales obtuvo el mejor índice (3,71 ± 1,08). La puntuación total media fue de 3,38 (DE: 1,11). Conclusión: Los resultados reflejaron un grado moderado de calidad de vida y su mejora depende del proceso de cambio de conducta del individuo.(AU)


Subject(s)
Humans , Male , Female , Middle Aged , Quality of Life , Cardiology , Angioplasty , Myocardial Revascularization , Referral and Consultation , Surveys and Questionnaires , Hospitals, Public
2.
Einstein (Säo Paulo) ; 19: eRC5521, 2021. graf
Article in English | LILACS | ID: biblio-1154093

ABSTRACT

ABSTRACT Sophisticated imaging systems have helped to redefine the clinical presentation of acute macular neuroretinopathy and have markedly enhanced diagnostic sensitivity. The proposed mechanism of paracentral acute middle maculopathy is related to ischemia at the level of the superficial and deep retinal capillary plexi. This is a case report of a patient who developed an acute macular neuroretinopathy after an uneventful angioplasty with stents in the coronary artery.


RESUMO Sistemas de imagem sofisticados ajudaram a redefinir a apresentação clínica da neurorretinopatia macular aguda e têm sensibilidade diagnóstica marcadamente aumentada. A maculopatia média aguda paracentral tem sido relacionada à isquemia ao nível dos plexos capilares superficial e profundo da retina. Este é um relato de caso de paciente que desenvolveu uma neurorretinopatia macular aguda após uma cirurgia de angioplastia com stents da artéria coronária sem complicações.


Subject(s)
Humans , Female , Stents/adverse effects , Angioplasty/adverse effects , Coronary Vessels/surgery , Atherosclerosis/surgery , Fluorescein Angiography , Acute Disease , Tomography, Optical Coherence , White Dot Syndromes/etiology , White Dot Syndromes/diagnostic imaging , Macular Degeneration , Middle Aged
3.
Rev. colomb. cardiol ; 27(6): 602-606, nov.-dic. 2020. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1289278

ABSTRACT

Resumen Los mixomas son los tumores cardíacos primarios más comunes. La mayoría tiene curso benigno y pueden tratarse de hallazgos incidentales o ser casi asintomáticos. Los síntomas dependen de su ubicación, en cuyo caso la más frecuente es la aurícula izquierda, de ahí que el riesgo embólico sea elevado. El principal lugar de embolia es el sistema nervioso central; sin embargo, en ocasiones puede afectar los sistemas respiratorio, periférico o coronario(1). Se expone el caso de una paciente con mixoma auricular izquierdo, el cual se manifiesta con accidente cerebral isquémico transitorio, seguido de infarto agudo de miocardio con elevación del segmento ST en la pared ínfero-posterior.


Abstract The myxomas are the most common primary cardiac tumours. The majority of them are benign and can be an incidental finding or be almost asymptomatic. The symptoms depend on their location, with the most common being the left atrium, which carries an increased risk of clots. The main effects of the clots are on the central nervous system, but occasionally they can involve the respiratory, peripheral, or coronary system. The case is presented of a patient with left atrial myxoma, as well as a transient ischaemic stroke and acute myocardial infarction with ST elevation in the inferior-posterior wall.


Subject(s)
Humans , Female , Middle Aged , Myxoma , Angiography , Thrombolytic Therapy , Cerebral Infarction , Angioplasty , Myocardial Infarction
5.
Rev. bras. cir. cardiovasc ; 35(5): 706-712, Sept.-Oct. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1137338

ABSTRACT

Abstract Introduction: Diffuse coronary artery disease (CAD) has a poor prognosis and many patients are ineligible for conventional coronary artery bypass grafting (CABG). This study evaluated the 12-month outcomes of coronary artery reconstruction and surgical patch angioplasty of the coronary artery for diffuse CAD. Methods: A retrospective cohort study of patients who underwent CABG with surgical patch angioplasty of the coronary artery (reconstruction group) or standard CABG alone (standard group) at the Cardiovascular Surgery Department of the local Hospital between January 2014 and January 2016. Follow-up was censored at 12 months after surgery. Results: Cardiopulmonary bypass and aortic cross-clamping durations were longer in the reconstruction group (n=32) than in the standard group (n=125) (P<0.05). There were no differences in graft blood flow and postoperative levels of cardiac markers between the two groups (P>0.05). In the reconstruction group, one patient died; a vein graft showed occlusion. In the standard group, two patients died; one left internal mammary artery graft and three vein grafts showed occlusion. There were no significant differences in mortality, major adverse cardiovascular and cerebrovascular events, and patency between the two groups (P>0.05). Conclusion: Coronary artery reconstruction and surgical patch angioplasty of the coronary artery can be performed for diffuse CAD. Patient outcomes were not significantly different from those of patients who underwent standard CABG.


Subject(s)
Humans , Male , Coronary Artery Disease/surgery , Coronary Artery Disease/diagnostic imaging , Angioplasty , Stroke Volume , Retrospective Studies , Follow-Up Studies , Ventricular Function, Left
6.
Rev. colomb. cardiol ; 27(5): 380-387, sep.-oct. 2020. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1289246

ABSTRACT

Abstract Objective: To determine the association between body mass index and indication of angioplasty with stent implantation in women over 50 years of age. Material and methods: Retrospective analytical study, cross-sectional. It were evaluated 83 clinical records of women older than 50 years of age who underwent angiography due to coronary artery disease and were hospitalized in Peruvian Naval Medical Center between 2010 and 2017. A Poisson regression analysis was performed to determine the association. Results: The mean ± standard deviation of age was 66.51 ± 8.94 years. 81.93% had two or more comorbidities. The frequency of angioplasties with stent implantation was 58%. Body mass index in range of obesity (45.83%) was more frequent in patients who received the implant. In the adjusted regression model, overweight patients had lower probability (PR 0.83, 95% CI 0.68 - 0.98) to have the indication of implantation as compared to patients with body mass index less than 25 kg/m2. Conclusions: Although obesity paradox relationship between body mass index and angioplasty with stent indication has been demonstrated by the multivariate analysis of this study, it is necessary to evaluate obesity with better markers than body mass index before assuming that obesity is a good prognostic factor for coronary artery disease in our patient.


Resumen Objetivo: Determinar la asociación entre índice de masa corporal e indicación de angioplastia con implantación de stent en mujeres mayores de 50 años. Material y métodos: Estudio analítico retrospectivo y transversal. Se evaluaron 83 historias clínicas de mujeres mayores de 50 años, a quienes se les practicó angiografía debido a cardiopatía coronaria y fueron hospitalizadas en el Centro Médico Naval de Perú entre 2010 y 2017. Se realizó un análisis de regresión de Poisson para determinar la asociación. Resultados: La media ± desviación estándar de la edad fue de 66,51 ± 8,94 años. El 81,93% de los casos tenía dos o más comorbilidades. La frecuencia de angioplastias con implantación de stent fue del 58%. El índice de masa corporal en rango de obesidad (45,83%) fue más frecuente en las pacientes que recibieron el implante. En el modelo de regresión ajustado, las pacientes con sobrepeso tuvieron menor probabilidad (PR 0,83, 95% IC 0,68 - 0,98) de indicación de implantación, en comparación con las pacientes con índice de masa corporal inferior a 25 kg/m2. Conclusiones: Aunque la paradoja de la relación de la obesidad entre índice de masa corporal y angioplastia con indicación de stent ha sido demostrada por el análisis multivariante de este estudio, es necesario evaluar la obesidad con mejores marcadores que el índice de masa corporal, antes de asumir que la obesidad es un buen factor pronóstico de cardiopatía coronaria en las pacientes.


Subject(s)
Humans , Male , Middle Aged , Angioplasty , Coronary Disease , Peru , Coronary Artery Disease , Angiography , Stents , Cross-Sectional Studies
7.
Invest. educ. enferm ; 38(3): [e05], Octubre 20 2020. Table 1, Table 2, Table 3
Article in English | LILACS, BDENF, COLNAL | ID: biblio-1128918

ABSTRACT

Objective. To explore the relation between adherence to secondary prevention and factors that influence on said adherence in people with acute coronary syndrome, who underwent percutaneous coronary angioplasty in a clinic in Medellín. Methods. Cross-sectional study on a random sample of 128 volunteer patients. A questionnaire was used for sociodemographic variables, the "Scale to measure therapeutic adherence for patients with chronic diseases, based on explicit behaviors" by Trujano, Vega, and Nava and the "Instrument to evaluate adherence by patients according to influential cardiovascular risk factors" validated by Consuelo Ortiz. Results. Socioeconomic factors influenced in very low manner on the adherence to secondary prevention; factors related with the therapy did so moderately and patient factors influenced in low manner. No relation was found between the health provider factor and said adherence. Conclusion. Factors exist that influence in a lesser or higher measure on adherence to secondary prevention and which must be recognized in people with coronary angioplasty to design strategies to improve this aspect of self-care.


Objetivo. Explorar la relación entre la adherencia a la prevención secundaria y los factores que influyen en dicha adherencia en personas con Síndrome Coronario Agudo, a quienes se les realizó angioplastia coronaria percutánea en una clínica de Medellín. Métodos. Estudio de corte transversal en una muestra aleatoria de 128 pacientes voluntarios. Se utilizó un cuestionario para variables sociodemográficas, la "Escala para medir la adherencia terapéutica para pacientes con enfermedades crónicas, basada en comportamientos explícitos" de Trujano, Vega y Nava y el "Instrumento para evaluar la adherencia de los pacientes según factores influyentes de riesgo cardiovascular" validado por Consuelo Ortiz. Resultados. Los factores socioeconómicos influyeron de manera muy baja en la adherencia a la prevención secundaria, los factores relacionados con la terapia lo hicieron en forma moderada y los factores del paciente influyeron de manera baja. No se encontró relación entre el factor del proveedor de salud y dicha adherencia. Conclusión. Existen factores que influyen en menor o mayor medida en la adherencia a la prevención secundaria y que deben ser reconocidos en las personas con angioplastia coronaria para que se diseñen estrategias para el mejoramiento de este aspecto del autocuidado


Objetivo. Explorar a relação entre a adesão à prevenção secundária e os fatores que influenciam essa adesão em pessoas com Síndrome Coronariana Aguda, submetidas a angioplastia coronária percutânea em uma clínica de Medellín (Colômbia). Métodos. Estudo transversal em amostra aleatória de 128 pacientes voluntários. Foi utilizado um questionário para variáveis sócio-demográficas, a "Escala para medir a adesão terapêutica para pacientes com doenças crônicas, baseada em comportamentos explícitos" de Trujano, Vega e Nava, e o "Instrumento para avaliar a adesão do paciente de acordo com fatores de risco cardiovascular influenciadores" validado por Consuelo Ortiz. Resultados. Os fatores socioeconômicos tiveram uma influência muito baixa na adesão à prevenção secundária, os fatores relacionados à terapia tiveram uma influência moderada e os fatores do paciente tiveram uma influência baixa. Não foi encontrada relação entre o fator provedor de saúde e a referida adesão. Conclusão. Existem fatores que influenciam em menor ou maior grau a adesão à prevenção secundária e que devem ser reconhecidos em pessoas com angioplastia coronariana para que estratégias possam ser traçadas para melhorar esse aspecto do autocuidado.


Subject(s)
Humans , Self Care , Cross-Sectional Studies , Angioplasty , Acute Coronary Syndrome , Secondary Prevention , Treatment Adherence and Compliance
8.
Enferm. foco (Brasília) ; 11(2): 11-17, jul. 2020. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1103998

ABSTRACT

Objetivo: validar instrumento do tipo checklist, intitulado "Cuidados de enfermagem para o período pré-operatório de angioplastia transluminal percutânea". Método: estudo metodológico, que incluiu a técnica Delphi para validação de conteúdo. Realizaram-se duas rodadas de avaliação e incluíram-se 15 juízes avaliadores. As respostas dos juízes foram submetidas ao Índice de Validade de Conteúdo, considerando válidos conteúdos com 80% ou mais de validação. Resultados: na primeira rodada obtiveram-se valores de concordância entre os juízes de 0,66 a 1 por conteúdo avaliado. Após as adequações sugeridas obteve-se índices de concordância de 0,90 a 1 por conteúdo avaliado. Conclusão: houve validação dos conteúdos pelos juízes, sendo pertinente a adequação do instrumento para a aplicabilidade na prática clínica. (AU)


Objective: To validate a checklist instrument entitled "Nursing care for the preoperative period of percutaneous transluminal angioplasty". Method: a methodological study that included the Delphi technique for content validation, being evaluated objectivity, relevance, writing accuracy and feasibility. Two rounds of evaluation were held and 15 evaluating judges were included. The judges' answers were submitted to the Content Validity Index, valid content with 80% or more validation was considered valid. Results: in the first round, agreement values between the judges were obtained from 0.66 to 1 per evaluated content. After the suggested adjustments, agreement indexes were obtained from 0.90 to 1 per evaluated content. Conclusion: there was content validation by the judges, pertinent to the adequacy of the instrument called Checklist of preoperative nursing interventions for angioplasty regarding its content, considering the content validity index for applicability in clinical practice. (AU)


Objetivo: validar un instrumento de lista de verificación titulado "Atención de enfermería para el período preoperatorio de angioplastia transluminal percutánea". Método: estudio metodológico que incluyó la técnica Delphi para la validación de contenido, evaluando objetividad, relevancia, precisión de escritura y factibilidad. Se realizaron dos rondas de evaluación y se incluyeron 15 jueces evaluadores. Las respuestas de los jueces se enviaron al índice de validez de contenido, el contenido válido con 80% o más de validación se consideró válido. Resultados: en la primera ronda, se obtuvieron valores de acuerdo entre los jueces de 0,66 a 1 por contenido evaluado. Después de los ajustes sugeridos, se obtuvieron índices de acuerdo de 0,90 a 1 por contenido evaluado. Conclusión: hubo validación de contenido por parte de los jueces, pertinente a la idoneidad del instrumento denominado Lista de verificación de intervenciones de enfermería preoperatorias para la angioplastia con respecto a su contenido, considerando el índice de validez de contenido para la aplicabilidad en la práctica clínica. (AU)


Subject(s)
Nursing Care , Perioperative Nursing , Angioplasty , Validation Study , Patient Safety
9.
Geriatr., Gerontol. Aging (Impr.) ; 14(2): 108-113, 30/06/2020.
Article in English | LILACS | ID: biblio-1103695

ABSTRACT

OBJECTIVES: To assess clinical and coronary angiographic characteristics, previous medical history, and clinical course, by age group, in older adults after myocardial infarction who underwent primary percutaneous coronary intervention (pPCI). METHODS: Single-center, cohort study that enrolled all patients with ST-segment elevation myocardial infarction who underwent pPCI at a specialized cardiology reference center in the South of Brazil. Older adults were defined as age ≥60 years, as set out in Brazilian legislation. Patients in the following age groups were compared: 60 to 64 years, 65 to 69 years, 70 to 74 years, 75 to 79 years, and ≥80 years. Patients' clinical course was assessed at initial hospital admissions and after 2 years of clinical follow-up. Data were analyzed using SPSS 19, and significance was established at p <0.05. RESULTS: From December 2015 to December 2018, a total of 636 patients were enrolled consecutively. Angiographic success rates were around 90% in all age groups. There were no differences in medications used, except for glycoprotein IIb/IIIa inhibitors, which were more frequently used in patients of lower age groups. Older patients had more in-hospital acute renal failure and higher in-hospital mortality. Predictors of mortality were age over 75, chronic renal failure, need for ventilatory support, severe arrhythmia, and sepsis. CONCLUSIONS: pPCI in older adult patients is a safe procedure with a high success rate.


OBJETIVOS: Avaliar características clínicas e angiográficas, história clínica pregressa e evolução clínica, por faixa etária, em idosos submetidos a intervenção coronária percutânea primária (ICPp) após infarto do miocárdio. METODOLOGIA: Estudo de coorte, de centro único, que incluiu todos os pacientes com infarto do miocárdio com supradesnivelamento do segmento ST submetidos ICPp em um centro de referência especializado em cardiologia no sul do Brasil. Os idosos foram definidos como aqueles com idade ≥60 anos, conforme estabelecido na legislação brasileira. Os pacientes nas seguintes faixas etárias foram comparados: 60 a 64 anos, 65 a 69 anos, 70 a 74 anos, 75 a 79 anos e ≥80 anos. O curso clínico dos pacientes foi avaliado nas admissões hospitalares iniciais e após 2 anos de acompanhamento clínico. Os dados foram analisados usando o SPSS 19, e p <0,05 foi considerado significativo. RESULTADOS: De dezembro de 2015 a dezembro de 2018, 636 pacientes foram incluídos consecutivamente. As taxas de sucesso angiográfico foram de cerca de 90% em todas as faixas etárias. Não houve diferenças nos medicamentos utilizados, com exceção dos inibidores da glicoproteína IIb/IIIa, que foram mais frequentemente utilizados em pacientes em faixas etárias mais baixas. Pacientes mais velhos apresentaram mais insuficiência renal aguda intra-hospitalar e maior mortalidade hospitalar. Os preditores de mortalidade foram: idade superior a 75 anos, insuficiência renal crônica, necessidade de suporte ventilatório, arritmia grave e sepse. CONCLUSÕES: O ICPp em pacientes idosos é um procedimento seguro e com alta taxa de sucesso.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Angioplasty , Myocardial Infarction/complications , Myocardial Infarction/therapy , Brazil , Health Services for the Aged
10.
Rev. cuba. angiol. cir. vasc ; 21(1): e87, ene.-abr. 2020. fig
Article in Spanish | LILACS, CUMED | ID: biblio-1126373

ABSTRACT

Introducción: La indicación más clara de revascularización en las extremidades inferiores lo constituye la presencia de lesiones isquémicas y el tratamiento de elección, siempre que sea posible, es el endovascular debido a su buena permeabilidad, baja morbilidad y mortalidad. Objetivo: Presentar un caso en el que se utilizó la angioplastia transluminal percutánea del sector fémoro-poplíteo. Presentación del caso: Se presenta un caso con diagnóstico de enfermedad arterial periférica en la extremidad inferior derecha. La angioplastia transluminal percutánea se utilizó para cicatrizar lesiones isquémicas aún en presencia de oclusiones no revascularizables de las arterias infra-poplíteas. El paciente presentaba al examen físico lesión isquémica en el primer dedo y patrón esteno-oclusivo fémoro-poplíteo. Se detectó disminución de los índices de presiones en poplítea y distales. En la arteriografía se apreciaron lesiones esteno-oclusivas en la femoral superficial y oclusión de las arterias infra-poplíteas. Se realizó angioplastia transluminal percutánea de la femoral superficial y el paciente recuperó pulso poplíteo con mejoría hemodinámica. Evolucionó satisfactoriamente y egresó con tratamiento médico. A los cinco meses de operado mantiene su pulso poplíteo presente y la lesión cicatrizada. Conclusión: La angioplastia del sector fémoro-poplíteo es beneficiosa para la cicatrización de la lesión isquémica aún en presencia de oclusiones infra-poplíteas no revascularizables(AU)


Introduction: The clearest indication for revascularization in lower limbs is the presence of ischemic lesions. The treatment of choice, whenever possible, is the endovascular one, due to its good permeability, as well as low morbidity and mortality. Objective: To present a case in which percutaneous transluminal angioplasty of the femoro-popliteal sector. Case presentation: A case is presented with a diagnosis of peripheral arterial disease in the right lower limb. The percutaneous transluminal angioplastywas used to heal ischemic lesions even in the presence of nonrevascularizable occlusions of the infra-popliteal arteries. On physical examination, the patient presented an ischemic lesion on the first finger and a femoro-popliteal steno-occlusive pattern. Decrease in pressure indices was detected in the popliteal and the distal ones. Arteriography showed steno-occlusive lesions in the superficial femoral and occlusion of the infra-popliteal arteries. Percutaneous transluminal angioplasty of the superficial femoral artery was performed and the patient recovered the popliteal pulse with hemodynamic improvement. The patient evolved satisfactorily and was discharged with medical treatment. Five months after surgery, the patient maintains popliteal pulse and the lesion has cicatrized. Conclusion: Angioplasty of the femoro-popliteal sector prove beneficial for the healing of the ischemic lesion even in the presence of nonrevascularizable infra-popliteal occlusions(AU)


Subject(s)
Humans , Male , Middle Aged , Popliteal Artery , General Surgery , Angiography , Angioplasty , Femoral Artery
11.
Ciênc. cuid. saúde ; 19: e47408, 20200000.
Article in Portuguese | LILACS, BDENF | ID: biblio-1121682

ABSTRACT

Introduction: Having the profile of patients undergoing angioplasty helps to improve their quality of life and assist the health team. Objective: to analyze the epidemiological, clinical, and angiographic aspects and their relationship with the gender of patients undergoing primary percutaneous coronary intervention. Method: this is a descriptive and cross-sectional study carried out at a University Hospital in Rio Grande do Norte. Data collection took place between April and October 2017 from data found in the computerized and printed medical records of 93 patients undergoing Primary Percutaneous Coronary Intervention. Tests such as Kolmogorov-Sminorv, Mann-Whitney (U), and Pearson's chi-square (X2) evaluated the information evidenced by the research. Results: 64.5% of the 93 patients included in the study were men, with a mean age of 62.3 years old. Regarding the door-to-balloon time, 18.2% of women and 8.3% of men had time less than 90 minutes. The comorbidities of systemic arterial hypertension, diabetes mellitus, and alcoholism stand out. Conclusion: the results on the epidemiological, clinical, and angiographic aspects evidenced in this study favor greater knowledge, contributing to the generation of strategies for the prevention of diseases of patients submitted to primary Percutaneous Coronary Intervention.


Introdução: Dispor do perfil de pacientes submetidos à angioplastia colabora para a melhoria da qualidade de vida dos mesmos e trabalho assistencial da equipe de saúde. Objetivo: analisar os aspectos epidemiológicos, clínicos e angiográficos e suas relações com o sexo dos pacientes submetidos à intervenção coronária percutânea primária. Método: estudo descritivo e transversal realizado em Hospital Universitário do Rio Grande do Norte. A coleta de dados ocorreu entre abril e outubro de 2017 a partir de dados encontrados no prontuário informatizado e impresso de 93 pacientes submetidos à Intervenção Coronária Percutânea Primária. Utilizaram-se testes como o Kolmogorov-Sminorv, Mann-Whitney (U) e Qui-quadrado de Pearson (X2) para a avaliação das informações evidenciadas pela pesquisa. Resultados: dos 93 pacientes inclusos no estudo, 64,5% eram homens, com média de idade de 62,3 anos. Sobre o tempo porta-balão,18,2% das mulheres e 8,3% dos homens conseguiram o tempo menor que 90 minutos. Quanto às comorbidades, destacam-se Hipertensão Arterial Sistêmica, diabetes mellitus, além do hábito de vida etilismo. Conclusão: os resultados sobre os aspectos epidemiológicos, clínicos e angiográficos evidenciados neste estudo favorecem um maior conhecimento, contribuindo para a geração de estratégias para a prevenção de agravos de pacientes submetidos à Intervenção Coronária Percutânea Primária.


Subject(s)
Humans , Male , Female , Patients , Angioplasty , Percutaneous Coronary Intervention , Patient Care Team , Tobacco Use Disorder , Cardiovascular Diseases , Risk Factors , Diabetes Mellitus , Emergencies , Sedentary Behavior , Health Promotion , Hypertension , Infarction
12.
Article in English | WPRIM | ID: wpr-786216

ABSTRACT

Therapeutic angiogenesis is an important strategy to rescue ischemic tissues in patients with critical limb ischemia having no other treatment option such as endovascular angioplasty or bypass surgery. Studies indicated so far possibilities of therapeutic angiogenesis using autologous bone marrow mononuclear cells, CD34⁺ cells, peripheral blood mononuclear cells, adipose-derived stem/progenitor cells, and etc. Recent studies indicated that subcutaneous adipose tissue contains stem/progenitor cells that can give rise to several mesenchymal lineage cells. Moreover, these mesenchymal progenitor cells release a variety of angiogenic growth factors including vascular endothelial growth factor, fibroblast growth factor, hepatocyte growth factor and chemokine stromal cell-derived factor-1. Subcutaneous adipose tissues can be harvested by less invasive technique. These biological properties of adipose-derived regenerative cells (ADRCs) implicate that autologous subcutaneous adipose tissue would be a useful cell source for therapeutic angiogenesis in humans. In this review, I would like to discuss biological properties and future perspective of ADRCs-mediated therapeutic angiogenesis.


Subject(s)
Angioplasty , Bone Marrow , Extremities , Fibroblast Growth Factors , Hepatocyte Growth Factor , Humans , Intercellular Signaling Peptides and Proteins , Ischemia , Mesenchymal Stem Cells , Stem Cell Transplantation , Stem Cells , Subcutaneous Fat , Vascular Endothelial Growth Factor A
13.
Rev. Hosp. Ital. B. Aires (2004) ; 39(4): 108-114, dic. 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1099618

ABSTRACT

En la Argentina no existen datos epidemiológicos sobre displasia fibromuscular. La realización de un registro nacional puede aportar información que conduzca a una actualización de los consensos y recomendaciones para un correcto diagnóstico, evaluación y tratamiento. El Registro Argentino de Displasia Fibromuscular (SAHARA-DF) inició su actividad de recopilación de datos en octubre de 2015. Al año 2019 se confirmaron 49 pacientes (44 mujeres, 38 hipertensos, edad 45,3 ± 17,2 años, 12 con presentación neurológica). Veintidós pacientes tuvieron lesiones vasculares en más de un sitio, a pesar del sesgo diagnóstico por falta de estudios complementarios en casi la mitad de los casos. El sitio afectado más frecuente fue el renovascular, seguido por el carotídeo y el ilíaco, y las lesiones multifocales fueron más frecuentes que las unifocales (35 versus 14, respectivamente). Se constató la presencia de aneurismas asociados en 13 casos y disección arterial en 4 casos. De las 22 angioplastias renales realizadas, 14 fueron con colocación de stent (endoprótesis). En este estudio preliminar de una población argentina se evidencia el carácter sistémico de la enfermedad y se plantea un llamado a actuar en cuanto a la necesidad de debatir el algoritmo diagnóstico y el método de tratamiento. (AU)


In Argentina there are no epidemiological data regarding fibromuscular dysplasia. Building a National Registry may provide information leading to updated consensus and recommendations for a correct diagnosis, assessment and treatment. Data gathering for the Argentine Registry of Fibromuscular Dysplasia (SAHARA-DF) was initiated in October 2015. By 2019, 49 patients were confirmed (44 women, 38 hypertensives, age 45.3 ± 17.2 years, 12 with a neurological presentation). Twenty-two patients had multi-site vascular lesions, in spite of a diagnosis bias due to lack of supporting studies in almost half of the cases. The renovascular site was the most affected, followed by the carotid and iliac sites, and multifocal lesions were more frequent than unifocal (35 versus 14, respectively). Associated aneurysms were found in 13 cases, and arterial dissection in 4. Twenty-two renal angioplasties were performed, 14 with stent placement. In this preliminary study of an Argentinian population, the systemic nature of the disease is evidenced, and a call for action arises regarding the need for discussing the diagnostic algorithm and treatment method. (AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Records/statistics & numerical data , Fibromuscular Dysplasia/diagnosis , Argentina/epidemiology , Algorithms , Bias , Sex Factors , Cross-Sectional Studies , Risk Factors , Age Factors , Angioplasty/methods , Anthropological Factors , Vascular System Injuries/diagnostic imaging , Fibromuscular Dysplasia/classification , Fibromuscular Dysplasia/etiology , Fibromuscular Dysplasia/therapy , Fibromuscular Dysplasia/epidemiology , Hypertension/epidemiology , Aneurysm, Dissecting/diagnostic imaging
14.
Ciênc. Saúde Colet ; 24(12): 4541-4554, dez. 2019. graf
Article in Portuguese | LILACS | ID: biblio-1055751

ABSTRACT

Resumo No contexto de crise e restrições de recursos é razoável supor o agravamento de fragilidades do Sistema Único de Saúde (SUS), como desigualdades regionais, subfinanciamento e problemas na qualidade do cuidado. Este estudo explorou a aplicação de indicadores de acesso e efetividade, facilmente compreensíveis e calculados, passíveis de refletir a crise na rede hospitalar. Cinco indicadores extraídos do Sistema de Informações Hospitalares, relativos ao Brasil e a estados da Região Sudeste, foram analisados no período de 2009-2018: internações resultantes em morte; internações cirúrgicas resultantes em morte; cirurgias eletivas no total das internações cirúrgicas; próteses de quadril na população de idosos; e angioplastias na população de 20 anos ou mais. Utilizaram-se gráficos de controle estatístico para a comparação dos indicadores entre estados, antes e a partir de 2014. No Brasil, as mortes hospitalares tiveram um leve crescimento enquanto que as mortes cirúrgicas uma queda; as cirurgias eletivas e próteses de quadril também diminuíram. No Sudeste, o Rio de Janeiro apresentou os piores resultados, em especial a queda de cirurgias eletivas. Os resultados ilustram o potencial dos indicadores para monitorar efeitos da crise sobre o cuidado hospitalar.


Abstract In the context of crisis and resource constraints, it is reasonable to assume the deteriorated weaknesses of the Unified Health System (SUS), such as regional inequalities, underfinancing, and care quality issues. This study explored the application of easily comprehensible and calculated access and effectiveness indicators that could reflect the hospital network crisis. Five indicators extracted from the Hospital Information System, related to Brazil and states of the Southeastern region, were analyzed in the 2009-2018 period: hospitalizations resulting in death; surgical hospitalizations resulting in death; elective surgeries in the total of surgical hospitalizations; hip prostheses in the senior population; and angioplasties in the population aged 20 years and over. Statistical control charts were used to compare indicators between states, before and from 2014. In Brazil, overall hospital deaths had a slight increase while surgical deaths declined; elective surgeries and hipprosthesis also decreased. In Southeastern Brazil, Rio de Janeiro was the worst performer, especially the decrease of the elective surgeries. The results illustrate the potential of indicators to monitor crisis effects on hospital care.


Subject(s)
Humans , Adult , Aged , State Health Plans , Economic Recession , Health Services Accessibility , Inpatients , National Health Programs/economics , Quality of Health Care , Surgical Procedures, Operative/mortality , Surgical Procedures, Operative/trends , Brazil/epidemiology , Health Care Rationing , Hospital Information Systems , Hospital Mortality/trends , Angioplasty/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Arthroplasty, Replacement, Hip/statistics & numerical data , Resource Allocation , Healthcare Disparities , Middle Aged
15.
Medicina (B.Aires) ; 79(5): 424-427, oct. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1056745

ABSTRACT

La arteritis de Takayasu es una vasculitis idiopática y granulomatosa crónica que se manifiesta en forma de panaortitis, de etiología desconocida, aunque se postula un origen autoinmune. Es progresiva y genera, tanto en adultos como en niños, estenosis segmentaria, oclusión, dilatación y/o aneurismas. La vasculitis aislada gastrointestinal sin afectación sistémica es rara. Este caso lleva a tener en cuenta la manifestación abdominal atípica de la arteritis de Takayasu en el diagnóstico diferencial de un síntoma frecuente, como la epigastralgia, y a destacar el rol que ocupan en la actualidad los métodos de imágenes no invasivos para su diagnóstico.


Takayasu arteritis is an idiopathic and chronic granulomatous vasculitis manifested in the form of panaortitis, of unknown etiology, even though an autoimmune origin is postulated. It is progressive and generates, in adults and children, segmental stenosis, occlusion, dilation and / or aneurysms. Isolated gastrointestinal vasculitis without systemic involvement is rare. This case leads us to take into account the atypical abdominal manifestation of Takayasu arteritis in the differential diagnosis of a frequent symptom, such as epigastralgia, and to highlight the role currently played by non-invasive imaging methods for its diagnosis.


Subject(s)
Humans , Male , Middle Aged , Celiac Artery/pathology , Takayasu Arteritis/pathology , Celiac Artery/diagnostic imaging , Angioplasty/methods , Takayasu Arteritis/therapy , Takayasu Arteritis/diagnostic imaging , Diagnosis, Differential , Positron Emission Tomography Computed Tomography , Computed Tomography Angiography
16.
Rev. cir. (Impr.) ; 71(5): 454-457, oct. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1058301

ABSTRACT

Resumen Introducción: El síndrome compartimental se genera por aumento de presión compartimental que sobrepasa a la de perfusión. Es una entidad rara en contexto posangioplastía coronaria. Requiere alta sospecha y medidas rápidas. Caso clínico: Hombre de 41 años con diagnóstico de infarto agudo de miocardio (IAM) con supradesnivel ST (SDST) que fue trombolizado y derivado para angioplastía, que sufre sangrado en antebrazo derecho posprocedimiento y evoluciona con síndrome compartimental que requiere de fasciotomía en volar y medial. Discusión: La entidad clínica es rara en este contexto, por ende, requiere alta sospecha basándose principalmente en dolor de inicio súbito con aumento de volumen. El tratamiento es fasciotomía de urgencias. De no pesquisarse a tiempo puede evolucionar con severas alteraciones neuromusculares llevando a trastornos de la anatomía de la mano.


Introduction: The compartment syndrome is caused by an increase on the compartment pressure that exceed the perfusion pressure. In coronary postangioplasty context it is a rare entity. Requires a high suspicion and to take fast steps. Clinical case: Forty-one years old man with a STEMI thrombolysed and derived to angioplasty suffered a post-procedure bleeding on his right forearm and evolved with a compartment syndrome that required a volar and medial fasciotomy. Discussion: The clinical entity is rare in this context, so require a high suspicion based basically on sudden pain with an increase of volume. The treatment is the urgent fasciotomy. To not diagnose it at time could evolve with severe neuromuscular disorders and hand anatomy disorders.


Subject(s)
Humans , Male , Adult , Compartment Syndromes/surgery , Compartment Syndromes/complications , Postoperative Complications , Angioplasty/adverse effects , Fasciotomy/methods
17.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(4): 350-355, out.-dez. 2019. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1047208

ABSTRACT

Cardiologistas intervencionistas são expostos a riscos ocupacionais, que incluem a ocorrência de catarata, malignidades e lesões ortopédicas. A intervenção coronária percutânea (ICP) assistida por robô pode reduzir esses riscos ocupacionais, além de oferecer grande precisão e controle fino da manipulação de dispositivos médicos, podendo conferir benefícios ao paciente. O objetivo desta revisão é descrever as vantagens e as limitações da ICP assistida por robótica, os dados clínicos mais recentes e as futuras aplicações da tecnologia robótica


Interventional cardiologists are exposed to occupational hazards, including cataract, malignancies and orthopedic injuries. Robot-assisted percutaneous coronary intervention (PCI) can reduce these occupational hazards and offer great precision and fine-grained control over the handling of medical devices, potentially benefitting the patients. The aim of this review is to describe the advantages and limitations of robot-assisted PCI, the latest clinical data and future applications of robotic technology


Subject(s)
Robotics/methods , Angioplasty/methods , Percutaneous Coronary Intervention/methods , Technology , Occupational Risks , Cardiology , Stents
18.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(3): 336-340, set. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058705

ABSTRACT

RESUMEN Un síndrome caracterizado por dolor cervical y un apófisis estiloides alargado fue descrito por primera vez por Watt Eagle en 1937. Aunque el síndrome de Eagle en su variante vascular es raro y no es reconocido como causa clara de disección carotídea, en los últimos años ha sido reportado un incremento del número de casos de disección carotídea causada por una apófisis estiloides alargada. Paciente de 56 años que acudió al servicio de urgencias por paresia facial izquierda aguda y habla confusa. Presentaba dolor cervical de dos días de evolución, relacionado con un ataque de tos. Se activó el código ictus y la tomografía computarizada (TC) mostró isquemia del lóbulo temporal derecho y disección bilateral de la arteria carótida interna. La angio-TC de los troncos supraaórticos con reconstrucción tridimensional, identificó una apófisis estiloides alargado en ambos lados. El paciente fue sometido a una angioplastía con colocación de dos stents. Debido al alto riesgo de padecer nuevo ictus, se decidió realizar tratamiento quirúrgico. Para el lado derecho se realizó un abordaje transoral y en el izquierdo un abordaje abierto. La apófisis estiloides alargado es una causa importante de disección carotídea y de las complicaciones cerebrovasculares relacionadas.


ABSTRACT A syndrome characterized by cervical pain and an abnormally elongated styloid process was first described by Watt Eagle in 1937. Even though vascular Eagle syndrome is uncommon and is not well recognized as a cause for carotid artery dissection, in the last few years there have been an increasing number of case reports of carotid artery dissection caused by an elongated styloid process. A 56 years old man presented to the emergency department with acute left facial weakness and slurred speech. He complained of two days neck pain, related to a coughing fit. The code stroke protocol was activated and imaging showed a right temporal bone stroke and a bilateral internal carotid artery dissection. A scan angiography of the supra-aortic vessels with 3D reconstruction was performed showing a bilateral abnormally elongated styloid process. The patient underwent angioplasty with two stent placements. Due to the high risk of recurrent strokes, the patient was evaluated in the otolaryngology department for styloid process resection. Finally a transoral approach for the right side and an open approach for the left side were performed. We have to consider an elongated styloid process as an important cause of carotid artery dissection and subsequent cerebrovascular complications


Subject(s)
Humans , Male , Middle Aged , Ossification, Heterotopic/complications , Carotid Artery, Internal, Dissection/etiology , Carotid Artery, Internal, Dissection/therapy , Stroke/etiology , Temporal Bone/abnormalities , Tomography, X-Ray Computed , Angioplasty , Neck Pain/etiology , Carotid Artery, Internal, Dissection/diagnostic imaging
19.
Int. braz. j. urol ; 45(5): 925-931, Sept.-Dec. 2019. graf
Article in English | LILACS | ID: biblio-1040066

ABSTRACT

ABSTRACT Objective To evaluate the effectiveness and outcomes of endovascular treatment of TRAS with PTA. Materials and Methods We searched our prospectively collected database looking at cases of TRAS between January 2005-December 2011. CCT was the gold-standart for diagnosis of TRAS. Parameters analysed comprised technical aspects, arterial blood pressure variation, and renal function. A minimum follow-up of 24 months was considered. Results Of the 2221 renal transplants performed in the selected period, 22 (0.9%) patients were identified with TRAS. Fourteen (63.6%) were male and mean age was 377±14.8years (12-69). Kidney graft was from deceased donnors in 20 (80%) cases. On doppler evaluation, mean blood flow speed after transplantation, at TRAS diagnosis and after TAP was 210.6±99.5, 417±122.7 and 182.5±81.6mL/sec, respectively (p<0.001). For SBP and DBP, there was a significant difference between between pre-intervention and all post-treatment time points (p<0.001). After 1 month of the procedure, there was stabilization of the Cr level with a significant difference between mean Cr levels along time (p<0.001). After a mean follow-up of 16±4.2 (3-24) months, overall success rate was 100%. Conclusions Endovascular treatment with PTA/stenting is a safe and effective option for managing TRAS, ensuring the functionality of the graft and normalization of blood pressure and renal function.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Aged , Young Adult , Renal Artery Obstruction/surgery , Renal Artery Obstruction/etiology , Kidney Transplantation/adverse effects , Angioplasty/methods , Renal Artery Obstruction/diagnostic imaging , Time Factors , Blood Pressure/physiology , Angiography/methods , Reproducibility of Results , Retrospective Studies , Analysis of Variance , Follow-Up Studies , Treatment Outcome , Creatinine/blood , Middle Aged
20.
Enferm. foco (Brasília) ; 10(3): 126-133, jul. 2019. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1050193

ABSTRACT

Objetivo: analisar aspectos epidemiológicos e angiográficos de pacientes submetidos à Angioplastia Transluminal Coronariana eletiva em um hospital de referência em cardiologia do estado do Rio Grande do Norte. Métodos: trata-se de uma pesquisa exploratória, descritiva, transversal com abordagem quantitativa. A coleta de dados ocorreu de abril/2017 a outubro/2017. Resultados: foram incluídos no estudo 129 pacientes, destes 65,8% eram do sexo masculino. O stent farmacológico foi mais utilizado nos procedimentos com 79 (61,2%). A via femoral predominou entre os dois sexos, com 29 (65,9%) entre mulheres e 54 (63,5%), nos homens.Conclusões:nota-se predomínio de pacientes do sexo masculino, idosos, baixo grau de escolaridade, pardos, casados e aposentados. A análise angiográfica constitui-se de pacientes com predominância de implantação de um (1) stent do tipo farmacológico, Descendente anterior e Coronária direita como coronárias tratadas, sendo a punção de acesso com maior prevalência a por via femoral. (AU)


Objective: to analyze epidemiological and angiographic aspects of patients submitted to elective Coronary Transluminal Angioplasty at a referral hospital in cardiology in the state of Rio Grande do Norte. Methodology: This is an exploratory, descriptive, transversal research with a quantitative approach. Data collection occurred from April / 2017 to October / 2017. Results: 129 patients were included in the study, of which 65.8% were male. The pharmacological stent was more used in the procedures with 79 (61.2%). The femoral route predominated between the two sexes, with 29 (65.9%) between women and 54 (63.5%), in men. Conclusions: a predominance of male patients, elderly, low educational level, pardos, married and retired people. Angiographic analysis consists of patients with a predominance of implantation of one (1) stent of the pharmacological type, Anterior descending and Right coronary as treated coronaries, being the access puncture with greater prevalence to the femoral route. (AU)


Objetivo: analizar aspectos epidemiológicos y angiográficos de pacientes sometidos a la Angioplastia Transluminal Coronariana electiva en un hospital de referencia en cardiología del estado de Rio Grande do Norte. Metodology: setrata de una investigación exploratoria, descriptiva, transversal con abordaje cuantitativo. La recolección de datos ocurrió de abril / 2017 a octubre / 2017. Resultados: fueron incluidos en el estudio 129 pacientes, de estos 65,8% eran del sexo masculino. El stent farmacológico fue más utilizado en los procedimientos con 79 (61,2%). La vía femoral predominó entre los dos sexos, con 29 (65,9%) entre mujeres y 54 (63,5%), en los hombres. Conclusiones: se observa predominio de pacientes del sexo masculino, ancianos, bajo grado de escolaridad, pardos, casados y jubilados. análisis angiográfico consistía en pacientes con despliegue predominante de (1) el tipo stent farmacológico antes de la arteria coronaria descendente y la coronaria derecha tratada como la punción de acceso con la prevalencia más alta a través de la arteria femoral. (AU)


Subject(s)
Percutaneous Coronary Intervention , Cardiovascular Diseases , Myocardial Reperfusion , Angioplasty , Myocardial Infarction
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