ABSTRACT
Resumen En la práctica clínica habitual existe un crecimiento en la demanda asistencial de servicios de urgencias. El dolor cervical es una patología muy frecuente que compete a diversos profesionales sanitarios. El síndrome de apófisis odontoides coronada, es una patología muy poco frecuente, que hace parte del espectro de las enfermedades por microcristales de pirofosfato cálcico, ocasionando una calcificación de ligamentos del proceso de odontoides cervical, llevando a una clínica de cervicalgia, fiebre y rigidez de nuca. Esta patología entra en el diagnóstico diferencial con patologías potencialmente graves. En muchas ocasiones lleva a procedimientos y gastos farmacológicos innecesarios, principalmente por el desconocimiento que la transforma en una patología infradiag-nosticada. (Acta Med Colomb 2018; 43: 230-232).
Abstract In the usual clinical practice there is a growth in the demand for emergency services. Cervical pain is a very common pathology that concerns various health professionals. The crowned den syndrome is a very rare pathology, which is part of the spectrum of microcrystalline diseases of calcium pyrophosphate, causing a calcification of ligaments of the cervical odontoid process, leading to clinical signs of neck pain, fever and neck stiffness. This pathology enters into the differential diagnosis with potentially serious pathologies. In many cases it leads to unnecessary pharmacological procedures and expenses, mainly due to the ignorance that turns it into an infra diagnosed pathology. (Acta Med Colomb 2018; 43: 230-232).
Subject(s)
Humans , Male , Aged , Bone and Bones , Odontoid Process , Syndrome , Chondrocalcinosis , Neck PainABSTRACT
BACKGROUND: Flow-diverter technology has become an important stent-based embolization tool in the treatment of complex cerebrovascular pathology. We report here the experience of 4 Spanish centers with using the SILK flow-diverter (SFD) device. OBJECTIVE: To evaluate the safety and efficacy of using the SFD in the endovascular treatment of intracranial aneurysms with complex morphology. METHODS: We retrospectively examined a prospectively maintained database of patients treated with SFD devices between July 2008 and December 2013 at 1 of 4 institutions in Spain. Data regarding patient demographics, aneurysm characteristics, and technical procedure were analyzed. Angiographic and clinical findings were recorded during the procedure and at 12 months postoperatively. RESULTS: A total of 175 SFD devices were implanted in 157 patients (women/men: 119/38; mean, median, and range of age: 56.2, 56.7, and 19-80 years, respectively), who were treated in a delayed manner (3-6 months from the event) for 180 aneurysms (165 unruptured and 15 ruptured). Adverse events (acute and delayed) were observed in 28.7% of cases (45/157), and most were resolved (19.1%; 30/157). Six months after the procedure, total morbidity and mortality were 9.6% (15/157) and 3.2% (5/157), respectively. Long-term imaging follow-up showed complete occlusion, neck remnants, and residual aneurysm in 78.1% (100/128), 14.0% (18/128), and 7.8% (10/128) of cases, respectively. CONCLUSIONS: The SFD device is an effective tool for the treatment of challenging aneurysms, and allows complete occlusion within a year of the procedure in most patients, with morbidity and mortality comparable to those previously reported for similar devices.
Subject(s)
Embolization, Therapeutic/methods , Intracranial Aneurysm/epidemiology , Intracranial Aneurysm/therapy , Statistics as Topic/methods , Adult , Aged , Cerebral Angiography/methods , Databases, Factual/statistics & numerical data , Female , Humans , Intracranial Aneurysm/diagnostic imaging , Male , Middle Aged , Prospective Studies , Retrospective Studies , Treatment OutcomeSubject(s)
Brain Ischemia/diagnostic imaging , Extravasation of Diagnostic and Therapeutic Materials/diagnostic imaging , Thrombectomy , Tomography, X-Ray Computed , Acute Disease , Blood-Brain Barrier/drug effects , Brain Ischemia/drug therapy , Brain Ischemia/surgery , Contrast Media/adverse effects , Contrast Media/pharmacokinetics , Endovascular Procedures/adverse effects , Extravasation of Diagnostic and Therapeutic Materials/etiology , Humans , Recombinant Proteins/adverse effects , Recombinant Proteins/pharmacology , Thrombolytic Therapy/adverse effects , Tissue Plasminogen Activator/adverse effects , Tissue Plasminogen Activator/pharmacologyABSTRACT
No disponible
Subject(s)
Humans , Thrombectomy/rehabilitation , Stroke/surgery , Brain Ischemia/surgery , Tomography, X-Ray Computed/methodsABSTRACT
Introducción. La trombosis aguda intrastent es una complicación potencialmente grave en el stenting intracraneal. Es primordial determinar cuál es la terapia más adecuada en las trombosis intrastent. Caso clínico. Mujer de 58 años, el primer caso de trombosis aguda de un stent intracraneal, que fue tratada con éxito mediante fibrinólisis tras la implantación de un dispositivo diversificador de flujo (Silk) en un aneurisma basilar fusiforme. Conclusión. La administración de abciximab como tratamiento de rescate parece segura en los casos de formaciones de trombos agudos intrastent (AU)
Introduction. Acute intrastent thrombosis is a potentially serious complication in intracranial stenting. It is essential to determine which therapy is the most suitable in intrastent thromboses. Case report. Female aged 58, the first case of acute thrombosis of an intracranial stent to be treated successfully by fibrinolysis after the implantation of a flow diverter device (Silk) in a fusiform basilar aneurysm. Conclusion. The administration of abciximab as a rescue treatment seems safe in cases involving the formation of acute intrastent thrombosis (AU)
Subject(s)
Humans , Female , Middle Aged , Stents , Graft Occlusion, Vascular/complications , Thrombosis/therapy , Thrombolytic Therapy/methods , Emergency Treatment/methodsABSTRACT
INTRODUCTION: Acute intrastent thrombosis is a potentially serious complication in intracranial stenting. It is essential to determine which therapy is the most suitable in intrastent thromboses. CASE REPORT: Female aged 58, the first case of acute thrombosis of an intracranial stent to be treated successfully by fibrinolysis after the implantation of a flow diverter device (Silk) in a fusiform basilar aneurysm. CONCLUSION: The administration of abciximab as a rescue treatment seems safe in cases involving the formation of acute intrastent thromboses.
TITLE: Tratamiento de rescate en la trombosis aguda del stent intracraneal.Introduccion. La trombosis aguda intrastent es una complicacion potencialmente grave en el stenting intracraneal. Es primordial determinar cual es la terapia mas adecuada en las trombosis intrastent. Caso clinico. Mujer de 58 años, el primer caso de trombosis aguda de un stent intracraneal, que fue tratada con exito mediante fibrinolisis tras la implantacion de un dispositivo diversificador de flujo (Silk) en un aneurisma basilar fusiforme. Conclusion. La administracion de abciximab como tratamiento de rescate parece segura en los casos de formaciones de trombos agudos intrastent.
