Lesiones vasculares asociadas a la práctica del pádel. El síndrome de Paget-Schroetter / Vascular lesions associated with the padel practice. Paget-Schroetter síndrome

INTRODUCCIÓN: El pádel es un joven deporte que atrae a millones de personas, de ambos sexos, de todas las edades y condición social. Practicarlo aporta numerosos beneficios para la salud, pero también puede inducir lesiones. OBJETIVOS: Analizar la relación patología vascular y pádel, y presentar los aspectos más significativos del síndrome de Paget-Schroetter, y relacionarlos con dicho deporte. METODOLOGÍA: Se realiza una revisión de la literatura, hasta el 1 de agosto del 2019, en PubMed, Google y revistas españolas especializadas; conjuntamente presentamos un caso clínico. RESULTADOS: La búsqueda realizada no encontró ninguna referencia entre pádel y patología vascular, pero identificó 20 artículos que relacionan deportes de raqueta y patología vascular, que nos permite inferir algunos de sus aspectos al pádel. CASO CLÍNICO: Varón de 34 años, practicante habitual de pádel, diagnosticado mediante eco-Doppler de una trombosis venosa axilo-subclavia derecha (síndrome de Paget-Schroetter); fue tratado satisfactoriamente mediante fibrinolisis local, a través de catéter, y posterior resección de la primera costilla (toracoscopia). Actualmente está asintomático y bajo anticoagulación oral. CONCLUSIONES: 1) Escasa bibliografía al respecto; 2) Baja frecuencia de complicaciones vasculares durante la práctica de los deportes con raqueta; y 3) Primer caso de la literatura, de un síndrome de Paget-Schroetter asociado al pádel. Consecuencias prácticas: 1) El mecanismo de producción se explica por la combinación de factores desencadenantes (repetición de movimientos del hombro, asociados a posiciones forzadas - abducción del brazo), y predisponentes (compresión venosa por estructuras anatómicas anómalas); y 2) Pensar en esta entidad, fundamentalmente ante jóvenes, deportistas, y sin antecedentes patológicos; únicamente un manejo precoz evita complicaciones (embolia pulmonar), recidivas y secuelas (síndrome postrombótico)

INTRODUCTION: Padel is a young sport that attracts millions of people, of both sex, all ages and social status. Practicing padel brings numerous health benefits, but it can also induce injuries. OBJECTIVES: To analyze the relationship between vascular and padel pathology, and present the most significant aspects of Paget-Schroetter syndrome, and relate them to padel. METHODOLOGY: Literature review, until August 1, 2019, in PubMed, Google and specialized Spanish journals; and presentation of a clinical case. RESULTS: The search did not find any reference between padel and vascular pathology, but I identify 20 articles that relate racket sports and vascular pathology, to infer some of its aspects to padel. Clinical case: A 34-year-old male, a regular padel practitioner, diagnosed (echo-Doppler) with a right axillary subclavian venous thrombosis (Paget-Schroetter syndrome); satisfactorily treated by local fibrinolysis (through catheter) and resection of the first rib (thoracoscopy). Currently asymptomatic and under oral anticoagulation. CONCLUSIONS: 1) Little bibliography in this regard; 2) Low frequency of vascular complications during racquet sports; and 3) First case of the literature, of a Paget-Schoetter syndrome associated with padel player. Practical consequences: 1) The mechanism of production is explained by the combination of triggers (repetition of shoulder movements, associated with forced positions - abduction of the arm), and predisposing factors (venous compression by anomalous anatomical structures); and 2) Think of this entity, mainly before young people, athletes, and without a pathological history; only early management prevents complications (pulmonary embolism), relapses and sequelae (post-thrombotic syndrome)

Disruption in "Nonanastomotic Section" of an Axillofemoral Bypass: A Thorough Critical Review of the Literature.

This work is a thorough nonsystematic critical review (PubMed/MEDLINE 1950-September 2016) of "disruption in nonanastomotic section of an axillofemoral bypass." Fourteen cases were selected (including that provided by the authors of this publication) dating from 1963 to 2016 (53 years). This type of disruption is a very unusual complication in the axillofemoral bypass. The cases described reveal that this disorder is more frequent in unifemoral bypass (9 cases), in ringed polytetrafluorethylene, in blunt trauma, and at costal level especially on the left side. The mean age of the patients was 65.2 (38-83) years, and the men:women ratio was 2:2. The usual symptom was a false aneurysm (10 cases). Although the imaging diagnosis of the first cases was done by arteriography, computed tomography is currently more used. The usual treatment (7 cases) consisted in the resection of the affected segment and the interposition of the new prosthesis. Furthermore, 2 cases treated with coated stent have been described, as well as 1 case of femorofemoral bypass, 1 of suture, and 1 of exeresis without revascularization. One patient refused surgery, and there was as a case where the treatment was unknown. The evolution in the short term is satisfactory, with no perioperative mortality registered.

Isquemia aguda en extremidad superior secundaria a un mixoma / Acute ischemia in upper limb secondary to myxoma

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