[The treatment of vasospastic disease by chronic spinal cord stimulation. A case report]. / Tratamiento de la enfermedad vasoespática con la estimulación medular crónica. Presentación de un caso.

In 1976, by first time, Cook used the chronic medullar stimulation (CMS) for the treatment of chronic arteriopathies at the limbs in patients with distal ischemic ulcerations. Up to now, some studies about this procedure have been published. Results, poor at first, have presented an important improvement with the time and the better choosing of patients. In 1981, Neglio used by first time CMS as a treatment of vasospastic disease, with excellent results. With this procedure, pain and vasospastic crisis disappeared and re-epithelialization of ischemic ulcerations is found. In this article, we presented a case interesting because it show the different possibilities of this method as a symptomatic treatment of such kind of disease. Patient, with a Raynaud syndrome secondary to an sclerodermia treated previously by medical and surgical procedures, was treated, in different times, with CMS because of digital ischemic ulcerations in both hands. Results were positives and ulcerations healed.

[Embolism of the humeral artery originating in a thrombosed axillo-femoral bypass]. / Embolia de arteria humeral originada por un by-pass axilo-femoral trombosado.

A case of a patient, with acute arterial ischemia at the upper limb is reported. On this case, ischemia was caused by humeral arterial embolism. The embolic origin was focused on the proximal end of a thrombosed axillofemoral bypass. After a rude manipulation during surgical procedure, part of the thrombus, following the sanguineous current, occluded the humeral artery. Patient underwent an emergent surgery. Posterior course was good. Histology showed a re-epithelialized, ancient thrombus. Cardiologic studies and angiography showed no others embolic focuses.

[Ulcerated plaque in the terminal aorta as a source of recurrent embolism in the young patient]. / Placa ulcerada de aorta terminal como fuente de embolias de repetición en paciente joven.

In the last years, some case reports about peripheral arterial embolism originated from ulcerative disorders in the wall of aorta and main vascular structures, have been published. Patients affected by this disease are usually aged and arteriosclerotic injuries at divers levels are common. The current case report presents a patient, 37 years old, with a history of 3 surgical procedures because of recurrent arterial embolism in the left femoro-popliteal area with unknown embolic origin. Further, a complete angiographic exploration was realized because a new occlusion in the left ileo-femoral area occurred and suspicious images of an ulcerative atheroma plaque in final aorta were found. This conjecture was confirmed during surgical procedure. It should be noted that some histories of peripheral embolism, with unknown origin, in young patients could be caused by this type of disorders.