[Retrospective analysis of short-term and mid-term results of percutaneous endovascular repair in patients with abdominal aortic aneurysm]. / Retrospektívna analýza krátkodobých a strednodobých výsledkov perkutánnej endovaskulárnej liecby pacientov s aneuryzmou abdominálnej aorty.

INTRODUCTION: Endovascular abdominal aortic aneurysm repair (EVAR) is a modern and, compared to conventional open surgery, less invasive therapeutic strategy with short-term lower morbidity and mortality. The aim of our retrospective analysis was the assessment of safety, technical success, short-term and mid-term results of elective patients scheduled for total percutaneous EVAR implantation (PEVAR). MATERIAL AND METHODS: One hundred and sixteen consecutive patients (M:F 104:12, age 71±9 years, maximum AAA diameter 60±14mm) underwent elective PEVAR between January 2009 and August 2012. All the patients were treated under local anaesthesia by total percutaneous approach via femoral access. The immediate technical success of stentgraft implantation as well as the presence of 30-day and 1-year complications and the need of reintervention rate were assessed. RESULTS: In 115/116 patients (99.1%),immediate technical success of the procedure was recorded, with no need of conversion to open surgery; in 1 patient (0.9%) the performance technically failed due to unfavourable arterial anatomy. The mortality in 30-day follow-up was 2.6% (3 patients), during 1-year follow-up it amounted to 8.6% (10 patients), without causal relationship with stentgraft implantation. Overall event-free survival was 85% (98/116) without serious complications (mortality, MI, stroke, reintervention, severe ischemic complication) in the one-year follow-up period. CONCLUSION: Endovascular AAA repair is a safe and feasible method with low mortality and acceptable complication rate in patients scheduled for EVAR implantation. Percutaneous approach allows for the extension of indications also for the highest-risk group of polymorbid patients. Technical feasibility and adequate periprocedural management are essential for further reduction in adverse events after PEVAR.

Antigenic spectrum of soluble serum glycoproteins in rheumatoid arthritis.

Compared with healthy controls, rheumatoid arthritis patients were found to have higher serum (1 M) perchlorate filtrate (CHLF) levels of alpha-antitrypsin. In addition to orosomucoid, alpha2-HS-glycoprotein, haptoglobin, haemopexin and beta2-glycoprotein, the filtrate also contains detectable amounts of albumin, prealbumin and - in patients with high serum glycoprotein levels - also IgA. Serum sulphosalicylate filtrate (SF) contains chiefly orosomucoid, together with alpha1-antitrypsin, haptoglobin, haemopexin and beta2-glycoprotein. CHLF contains larger amounts of glycoprotein than SF. The glycoproteins of CHLF correlate with the patient's synovitis, while a high SF glycoprotein content, as estimated by the polarographic activity of the sulphydryl groups, tends to be indicative of visceral complications of RA.

[Globulinopathy and hyperuricemia]. / Globulinopathie und Hyperurikämie.

Investigation of the locomotor system of 20 patients is reported. One patient with arthrosis of the hip joint and concomitant osteonecroses had a myeloma. In 5 RA patients the manifestations of secondary amyloidosis are described. Among the patients with monoclonal gamma globulinemia two had polyarthritis and RA could not be excluded in one of them, one had arthritis of the ankle and foot joints, and one had a vasculitis characteristic of polyarteritis nodosa. Among those with polyclonal immunoglobulinemia one had RA, two had arthrosis of knees and hips, and two had ankylosing spondylitis. Furthermore four patients with alpha2-hyperglobulinemia which is important in evaluation of the alpha2-globulin peak in amyloidosis, are described. Three patients had cryoglobulinemia. In 10 patients hyperuricemia was found repeatedly (by the uricase method). Consequently in these diseases it is necessary to search clinically for crystal induced synovitides and arthropathies. The classification of globulinopathies and the method of their determination is indicated and particular investigations are recommended for such diseases, where the activity of the joint process does not correlate with laboratory findings.