ABSTRACT
AIM: Chronic traumatic thoracic aneurysms are results of blunt trauma of the chest during motorcar accident. Treatment of choice is the endovascular procedure with stent-graft. METHODS: Between 2000-2012 in General and Thoracic Surgery Department 30 patients with post-traumatic aneurysms were operated. In all cases aneurysm was located below left subclavian artery and in 63% developed during road traffic accident. RESULTS: All patients were operated on with 100% technical success and no device failure was noticed. None of patients died during the endovascular procedure and no serious complications like spinal cord ischemia was observed. In one (3%) case, where left subclavian artery was covered, stroke was diagnosed treated conservatively. CONCLUSION: At long-term follow-up, one endoleak type IA was found, solved with balloon-plasty. Two patients died due to cardiac diseases.
Subject(s)
Aorta, Thoracic/surgery , Aortic Aneurysm, Thoracic/surgery , Endovascular Procedures , Postoperative Complications , Stents/adverse effects , Wounds, Nonpenetrating/surgery , Accidents, Traffic , Aortic Dissection/surgery , Aneurysm, False/surgery , Aortic Aneurysm, Thoracic/etiology , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation , Endoleak/etiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Radiography, Thoracic , Tomography, X-Ray Computed , Treatment Outcome , Wounds, Nonpenetrating/etiologyABSTRACT
We analysed 148 patients treated surgically from 1992-1997 because of abdominal aortic aneurysm (AAA). All patients were divided into two groups: group I--118 (79.7%) patients operated with the implantation of the straight graft and group II--30(20.3%) with the bifurcated graft. The aim of the study was to analyse early (30 days after operation) complications in both groups. The mortality rate was 8.5% for group I and 26.7% for group II. The mortality was also analysed according to AAA symptoms (asymptomatic, symptomatic and ruptured). The death rate in asymptomatic patients from group I was 1.1% versus 13.3% in group II. In symptomatic patients the difference was not statistically significant--20% in group I versus 22.2% in group II. The mortality rate in patients with ruptured AAA was 50% for group I and 66.7% for group II. The early morbidity rate was significantly higher in the second group(p < 0.05) although coexisting diseases were similar for both groups. According to our material we conclude, that operation of AAA should be finished in abdomen if there is only technical possibility. It is especially important for patients with ruptured AAA.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Prosthesis Implantation , Transplants , Aged , Aged, 80 and over , Cardiac Surgical Procedures/methods , Female , Humans , Male , Middle Aged , Postoperative Complications/mortality , Prosthesis Design , Survival RateABSTRACT
Between 1992-1997 185 patients were treated in our Department because of abdominal aortic aneurysm (AAA). The aim of the study was the evaluation of frequency of hospital mortality (30 days) in patients treated because of AAA. One hundred forty eight (80%) patients were operated on and 37 (20%) were treated classically. The surgical group of 148 patients were divided into three parts: group I: 106 patients with asymptomatic AAA, group II: 24 patients with symptomatic AAA and group III: 18 patients with ruptured AAA. Straight graft was performed in 118 patients (79.7%) with hospital mortality rate 8.5% and bifurcated graft implanted in 30 patients with mortality rate 26.7%. Analysis of our material allowed to find that hospital mortality was in group I: 2.8%, group II: 20.8% and in group III: 55.6%. The main cause of deaths in patients from groups I and II was myocardial infarction and hypovolemic shock in group III. The most common postoperative general complications were cardiac and pulmonary and were significantly more often in group III (p < .05). Other not significantly registered postoperative complications as renal insufficiency were also more common in patients from group III. Analysis of our material revealed that patients with abdominal aortic aneurysm should be operated selectively, when aneurysm diameter reaches 50 mm, and optimal method is straight graft which allows to reduce to minimum postoperative complications.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Postoperative Complications , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective Studies , Risk FactorsABSTRACT
We describe a 3 patients with Wegener's granulomatosis in remission while taking cyclophosphamide and prednisone who developed upper airway obstruction. The diagnosis was confirmed by parotid gland, pharynx, kidney biopsy. The stenosis developed in the area of previously noted tracheal ulceration and responded satisfactorily to bronchoscopic dilatation. Tracheotomy for progressive upper airway obstruction has remained the mainstay of treatment and was necessary in one of cases. We presented the others techniques of treatment subglottic stenosis-the surgical intervention and carbon dioxide laser photoresection. No antineutrophil cytoplasmic antibodies were found in the patients serum. These antibodies are of auxiliary value in recognizing Wegener's granulomatosis as well as in monitoring the activity of the disease process.
Subject(s)
Granulomatosis with Polyangiitis/complications , Laser Therapy , Tracheal Stenosis/complications , Tracheal Stenosis/surgery , Adult , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Carbon Dioxide , Cyclophosphamide/administration & dosage , Cyclophosphamide/therapeutic use , Drug Therapy, Combination , Granulomatosis with Polyangiitis/drug therapy , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/therapeutic use , Male , Prednisone/administration & dosage , Prednisone/therapeutic use , Tracheal Stenosis/physiopathologyABSTRACT
In the Department of General and Thoracic Surgery between 1981 and 1992 497 patients with tracheal stenosis were treated surgically. In 19 (3.8%) cases the stenosis was after previous tracheostomy. In 469 patients (94.4%) the stenosis was caused as the result of compression by goitre and in 9 (1.8%) by neoplastic tumors of mediastinum. Most patients with tracheal stenosis were treated surgically. In 13 cases the stenosis was resected, in 3 cases T-tube was inserted and in 3 cases the stenosis was dilated. In patients with secondary stenosis due to compression by goitre subtotal thyroidectomy was performed. Early good immediate results in both groups of tracheal stenosis were obtained in 90% of cases. Late results obtained 12 months after treatment of primary tracheal stenosis and 4 to 48 months after treatment of secondary tracheal stenosis (due to goitre) revealed 90% of good results.
Subject(s)
Tracheal Stenosis/surgery , Aged , Female , Goiter/complications , Humans , Male , Mediastinal Neoplasms/complications , Middle Aged , Reoperation , Tracheal Stenosis/etiology , Treatment OutcomeABSTRACT
A patient with Wegener's granulomatosis is reported. The diagnosis was confirmed by parotid gland biopsy. The patient responded to treatment with cyclophosphamide and prednisone. After many years, urethral stricture and subglottic stenosis developed and responded satisfactorily to surgery.
Subject(s)
Granulomatosis with Polyangiitis/complications , Urethral Stricture/etiology , Adult , Bronchoscopy , Cyclophosphamide/therapeutic use , Dilatation , Granulomatosis with Polyangiitis/diagnosis , Granulomatosis with Polyangiitis/drug therapy , Humans , Laryngostenosis/etiology , Laryngostenosis/therapy , Male , Prednisone/therapeutic use , Urethral Stricture/surgeryABSTRACT
The purpose of an earlier publication [Appl. Opt. 34, 2120 (1995)], to provide an exact formulation of the scattering of beamlike radiation fields from spheres, is clarified and its relation to the treatment of this subject in two more recent publications is described. Also, an error in the reference list in the earlier publication is rectified.
