Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 15 de 15
Filter
1.
Rev. esp. cardiol. (Ed. impr.) ; 65(8): 713-718, ago. 2012. tab
Article in Spanish | IBECS | ID: ibc-102396

ABSTRACT

Introducción y objetivos. Los pacientes con enfermedad arterial periférica tienen un elevado riesgo de complicaciones cardiovasculares y muerte. Sin embargo, la utilización de tratamientos cardiovasculares preventivos y la consecución de objetivos terapéuticos en esta población es subóptima. No existen datos que permitan conocer cuál es la tasa de utilización de este tipo de fármacos en nuestro país. Métodos. PERIFERICA es un estudio transversal, realizado de mayo a diciembre de 2009 en 440 consultas de atención primaria, medicina interna, cardiología, cirugía vascular, endocrinología y nefrología, repartidas por todo el territorio nacional. Se incluyó a pacientes de 45 o más años, con enfermedad arterial periférica y una analítica sanguínea realizada durante los últimos 6 meses. Se excluyó a los sujetos con enfermedad coronaria o cerebrovascular. Se recogieron diversas variables clínicas, antropométricas y analíticas y el tratamiento recibido. Resultados. Se incluyó a 4.087 pacientes (media de edad, 68 años; el 74% varones). La prevalencia de diabetes (50%) e hipertensión arterial (90%) era muy elevada. El 79% recibía tratamiento hipolipemiante (el 76%, estatinas); el 85,5%, antihipertensivo (el 66%, bloqueadores del sistema renina-angiotensina), y el 83%, antitrombóticos (el 75%, antiagregantes y el 11%, anticoagulantes). Un 30% tenía el colesterol unido a lipoproteínas de baja densidad < 100 mg/dl; el 29,5% tenía controlada la presión arterial y el 74,5% no fumaba. Tan sólo un 8% tenía controlados estos tres factores de riesgo cardiovascular. Conclusiones. A pesar de que existe un elevado número de pacientes con enfermedad arterial periférica que reciben tratamiento mediante fármacos con evidencias sobre la reducción de complicaciones cardiovasculares, el porcentaje de dichos pacientes que alcanza objetivos terapéuticos es muy bajo (AU)


Introduction and objectives. Patients with peripheral artery disease have a high risk of cardiovascular events and death. The rate of prescription of evidence-based cardiovascular therapies and the attainment of therapeutic goals in this population is suboptimal. There are no previous studies evaluating the rate of prescription of these therapies in our country. Methods. PERIFERICA is a cross-sectional study conducted from May to December 2009 in 440 outpatient clinics of general practitioners, internal medicine, cardiology, vascular surgery, endocrinology, and nephrology specialists throughout Spain. Subjects were included if they were aged >=45 years and had peripheral artery disease and a blood sample obtained during the previous 6 months. Patients were excluded if they had coronary or cerebrovascular diseases. Clinical and anthropometric variables and blood analysis were obtained in all participants. Results. In total, 4087 patients were included in the study (mean age, 68 years; 74% men). There was a high prevalence of diabetes (50%) and hypertension (90%); 79% of participants received lipid-lowering drugs (76% statins), 85.5% antihypertensive drugs (66% renin-angiotensin blockers) and 83% antithrombotics (75% antiplatelet drugs and 11% anticoagulants). In addition, 30% of subjects had a low-density lipoprotein cholesterol concentration n<100mg/dL, 29.5% had optimal control of blood pressure, and 74.5% did not smoke. Only 8% had a good control of all of their cardiovascular risk factors. Conclusions. Although a high percentage of subjects with peripheral artery disease receives adequate treatment with evidence-based preventive therapies, the percentage of subjects with good control of all their risk factors is low (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Peripheral Arterial Disease/diagnosis , Peripheral Arterial Disease/prevention & control , Risk Factors , /administration & dosage , /therapeutic use , Atherosclerosis/complications , Atherosclerosis/diagnosis , Smoking/epidemiology , Peripheral Arterial Disease/epidemiology , Peripheral Arterial Disease/physiopathology , Cross-Sectional Studies/methods , Cross-Sectional Studies/trends , Cross-Sectional Studies , Primary Health Care/methods , Diabetes Mellitus/prevention & control , Analysis of Variance
2.
Rev Esp Cardiol (Engl Ed) ; 65(8): 713-8, 2012 Aug.
Article in English, Spanish | MEDLINE | ID: mdl-22658690

ABSTRACT

INTRODUCTION AND OBJECTIVES: Patients with peripheral artery disease have a high risk of cardiovascular events and death. The rate of prescription of evidence-based cardiovascular therapies and the attainment of therapeutic goals in this population is suboptimal. There are no previous studies evaluating the rate of prescription of these therapies in our country. METHODS: PERIFERICA is a cross-sectional study conducted from May to December 2009 in 440 outpatient clinics of general practitioners, internal medicine, cardiology, vascular surgery, endocrinology, and nephrology specialists throughout Spain. Subjects were included if they were aged ≥45 years and had peripheral artery disease and a blood sample obtained during the previous 6 months. Patients were excluded if they had coronary or cerebrovascular diseases. Clinical and anthropometric variables and blood analysis were obtained in all participants. RESULTS: In total, 4087 patients were included in the study (mean age, 68 years; 74% men). There was a high prevalence of diabetes (50%) and hypertension (90%); 79% of participants received lipid-lowering drugs (76% statins), 85.5% antihypertensive drugs (66% renin-angiotensin blockers) and 83% antithrombotics (75% antiplatelet drugs and 11% anticoagulants). In addition, 30% of subjects had a low-density lipoprotein cholesterol concentration n<100 mg/dL, 29.5% had optimal control of blood pressure, and 74.5% did not smoke. Only 8% had a good control of all of their cardiovascular risk factors. CONCLUSIONS: Although a high percentage of subjects with peripheral artery disease receives adequate treatment with evidence-based preventive therapies, the percentage of subjects with good control of all their risk factors is low.


Subject(s)
Cardiovascular Agents/therapeutic use , Evidence-Based Medicine , Peripheral Arterial Disease/therapy , Adult , Aged , Blood Pressure/physiology , Cholesterol/blood , Cross-Sectional Studies , Epidemiologic Studies , Female , Goals , Humans , Male , Middle Aged , Peripheral Arterial Disease/drug therapy , Peripheral Arterial Disease/prevention & control , Risk Reduction Behavior , Spain/epidemiology
3.
Med. clín (Ed. impr.) ; 136(3): 91-96, feb. 2011. tab
Article in Spanish | IBECS | ID: ibc-85383

ABSTRACT

Fundamento y objetivos: La isquemia crítica de miembros inferiores (ICMI) es una urgencia médico-quirúrgica con una elevada morbimortalidad. Si bien su pronóstico ha mejorado durante los últimos años, no se dispone de datos en nuestro país sobre sus características clínicas, su tratamiento y su pronóstico intrahospitalario. Pacientes y método: Fueron incluidos 671 pacientes (81% varones, edad media 71,2 años) con ICMI de etiología aterosclerótica atendidos en 46 servicios de Cirugía Vascular.Resultados: La población incluida tenía una elevada prevalencia de factores de riesgo (72% hipertensos, 27% fumadores activos, 59% diabéticos) y de comorbilidad (25% enfermedad coronaria, 18% enfermedad cerebrovascular). Un 71% tenía un diagnóstico previo de enfermedad arterial periférica. Al ingreso, en un 71% se realizó algún tipo de revascularización, en un 5% amputación directa y en un 24% tratamiento conservador. Hubo 22 muertes y 49 pacientes fueron dados de alta con una amputación mayor. La presencia de gangrena fue el único factor asociado con la amputación durante el ingreso (odds ratio [OR] 2,45; intervalo de confianza del 95% [IC 95%] 1,22-4,92). La insuficiencia renal (OR 3,38; IC 95% 1,36-8,39) y la ICMI previa (OR 0,20; IC 95% 0,05-0,89) se asociaron con la mortalidad. Al alta hospitalaria, la prescripción de hipolipidemiantes fue del 59%, la de antihipertensivos del 70% y la de antiagregantes del 85%.Conclusiones: Los pacientes con ICMI atendidos en servicios de Cirugía Vascular españoles tienen una baja tasa inicial de amputaciones y de mortalidad. Sin embargo, y dado el alto riesgo cardiovascular de estos sujetos a medio plazo, se precisa mejorar la prescripción de los fármacos preventivos que reciben al alta (AU)


Background and objectives: Critical leg ischemia (CLI) is a medical emergency with a high morbidity and mortality. Although its prognosis has improved during the last years, there are no data on its clinical characteristics, treatment and in-hospital prognosis in our country.Patients and method: 671 patients (81% males, mean age 71.2 years) with atherosclerotic CLI, attended in 46 departments of vascular surgery were included in the study.Results: Participants had a high prevalence of cardiovascular risk factors (72% hypertensive, 27% current smokers, 59% diabetics) and comorbidity (25% coronary heart disease, 18% cerebrovascular disease). 71% had a previous diagnosis of peripheral arterial disease. Upon admission, 71% were referred for revascularization, 5% for direct amputation and 24% for conservative treatment. During hospitalization 22 patients died and 49 were discharged with a major amputation. On multivariate analysis, the only factor associated with the risk of amputation was gangrenous lesions (OR 2.45; IC95% 1.22-4.92). Factors associated with mortality were the presence of chronic renal failure (OR 3.38; IC95% 1.36-8.39) and previous CLI (OR 0.20; IC95% 0.05-0.89). At discharge, 59% received lipid lowering drugs, 70% blood-pressure lowering medications and 85% antiplatelet drugs. Conclusion: CLI patients attended in Spanish vascular surgery departments have a low amputation rate and a low hospital mortality. However, and due to their high cardiovascular risk, it is necessary to improve the prescription rate of evidence-based cardiovascular prevention therapies at discharge (AU)


Subject(s)
Humans , Ischemia/epidemiology , Peripheral Vascular Diseases/epidemiology , Arterial Occlusive Diseases/epidemiology , Diabetes Mellitus/epidemiology , Amputation, Surgical , Risk Factors
4.
Med Clin (Barc) ; 136(3): 91-6, 2011 Feb 12.
Article in Spanish | MEDLINE | ID: mdl-21056433

ABSTRACT

BACKGROUND AND OBJECTIVES: Critical leg ischemia (CLI) is a medical emergency with a high morbidity and mortality. Although its prognosis has improved during the last years, there are no data on its clinical characteristics, treatment and in-hospital prognosis in our country. PATIENTS AND METHOD: 671 patients (81% males, mean age 71.2 years) with atherosclerotic CLI, attended in 46 departments of vascular surgery were included in the study. RESULTS: Participants had a high prevalence of cardiovascular risk factors (72% hypertensive, 27% current smokers, 59% diabetics) and comorbidity (25% coronary heart disease, 18% cerebrovascular disease). 71% had a previous diagnosis of peripheral arterial disease. Upon admission, 71% were referred for revascularization, 5% for direct amputation and 24% for conservative treatment. During hospitalization 22 patients died and 49 were discharged with a major amputation. On multivariate analysis, the only factor associated with the risk of amputation was gangrenous lesions (OR 2.45; IC95% 1.22-4.92). Factors associated with mortality were the presence of chronic renal failure (OR 3.38; IC95% 1.36-8.39) and previous CLI (OR 0.20; IC95% 0.05-0.89). At discharge, 59% received lipid lowering drugs, 70% blood-pressure lowering medications and 85% antiplatelet drugs. CONCLUSION: CLI patients attended in Spanish vascular surgery departments have a low amputation rate and a low hospital mortality. However, and due to their high cardiovascular risk, it is necessary to improve the prescription rate of evidence-based cardiovascular prevention therapies at discharge.


Subject(s)
Ischemia , Leg/blood supply , Adult , Aged , Critical Illness , Female , Humans , Ischemia/diagnosis , Ischemia/mortality , Ischemia/therapy , Male , Middle Aged , Prognosis , Prospective Studies , Treatment Outcome
7.
Med Clin (Barc) ; 127(16): 605-11, 2006 Oct 28.
Article in Spanish | MEDLINE | ID: mdl-17145025

ABSTRACT

BACKGROUND AND OBJECTIVE: Even though atherosclerosis is a systemic disease, few prospective studies have evaluated in a thorough and systematic manner the whole vascular tree in patients with clinical damage of different territories. PATIENTS AND METHOD: Prospective protocolized study of 269 consecutive patients younger than 70, attended because of symptomatic arteriosclerosis of any territory -53% coronary (CHD), 32% cerebrovascular (CVD), 15% peripheral (PVD)-. Patients underwent evaluation of risk factors and their control, systematic non-invasive study of the vascular tree (Doppler-ultrasound) and comparison between groups according to the index territory. RESULTS: Even though all risk factors were represented in the 3 groups, male sex, smoking and diabetes were more frequent in PVD and dyslipemia was more common in CHD (p < 0.05) Abdominal aortic diameter and carotid intima-media thickness were similar for all groups, while the number of carotid plaques was higher in PVD. CHD patients more often presented left ventricular hypertrophy and reduced ejection fraction. PVD patients showed a marked reduction of the ankle-brachial index as well as increased C-reactive protein and homocysteine (p < 0.05). Severe unsuspected vascular lesions were found in 13% of cases (95% confidence interval, 9.5-17.6%). Risk factor control was better for CHD, followed by CVD and PVD, but was globally poor. CONCLUSIONS: The systematic evaluation of the vascular tree detects generalized atherosclerotic lesions, in some cases severe and clinically unsuspected. New markers to identify patients at very high risk are necessary. Peripheral vascular disease identifies a group of patients of particular risk. Risk factor control is deficient, particularly among PVD patients.


Subject(s)
Arteriosclerosis/diagnostic imaging , Arteriosclerosis/epidemiology , Aged , Anthropometry , Atherosclerosis/diagnostic imaging , Atherosclerosis/epidemiology , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/epidemiology , Female , Humans , Intracranial Arteriosclerosis/diagnostic imaging , Intracranial Arteriosclerosis/epidemiology , Male , Middle Aged , Peripheral Vascular Diseases/diagnostic imaging , Peripheral Vascular Diseases/epidemiology , Prospective Studies , Risk Factors , Ultrasonography
8.
Med. clín (Ed. impr.) ; 127(16): 605-611, oct. 2006. tab, graf
Article in Es | IBECS | ID: ibc-049707

ABSTRACT

Fundamento y objetivo: Aunque la aterosclerosis es una enfermedad generalizada del árbol vascular, existen escasos estudios prospectivos que evalúen transversalmente de modo extenso a pacientes con afectación clínica de diferentes territorios. Pacientes y método: Se ha realizado un estudio prospectivo protocolizado de 269 pacientes consecutivos menores de 70 años atendidos por aterosclerosis sintomática de cualquier territorio ­en un 53% coronario (CI), en un 32% cerebral (VC) y en un 15% periférico (VP)­. Se evaluaron los factores de riesgo y su control, y se realizó un estudio sistemático no invasivo del árbol vascular (ecografía Doppler) con una comparación entre los grupos según el territorio índice. Resultados: Aunque todos los factores de riesgo estaban representados en los 3 grupos, el sexo masculino, el tabaquismo y la diabetes fueron más frecuentes en VP y la dislipemia en CI (p < 0,05). El diámetro de la aorta abdominal y el grosor carotídeo mediointimal fueron similares en los 3 grupos, si bien el número de placas carotídeas fue superior en VP. CI presentó más frecuentemente hipertrofia ventricular y disminución de la fracción de eyección. VP presentó un índice tobillo-brazo notablemente inferior, junto con valores más elevados de proteína C reactiva y homocisteína (p < 0,05). Se descubrieron lesiones vasculares graves no sospechadas en un 13% de los pacientes (intervalo de confianza del 95%, 9,5-17,6%). El control de los factores de riesgo fue mejor en CI, seguido por VC y VP, si bien globalmente fue deficiente. Conclusiones: El estudio sistemático del árbol vascular detecta lesiones aterosclerosas generalizadas, no sospechadas clínicamente, en algunos casos graves. Son necesarios marcadores que permitan identificar a los pacientes de muy alto riesgo. La enfermedad vascular periférica identifica a un grupo de pacientes de especial riesgo vascular. El grado de control de los factores de riesgo es deficiente, especialmente en VP


Background and objective: Even though atherosclerosis is a systemic disease, few prospective studies have evaluated in a thorough and systematic manner the whole vascular tree in patients with clinical damage of different territories. Patients and method: Prospective protocolized study of 269 consecutive patients younger than 70, attended because of symptomatic arteriosclerosis of any territory ­53% coronary (CHD), 32% cerebrovascular (CVD), 15% peripheral (PVD)­. Patients underwent evaluation of risk factors and their control, systematic non-invasive study of the vascular tree (Doppler-ultrasound) and comparison between groups according to the index territory. Results: Even though all risk factors were represented in the 3 groups, male sex, smoking and diabetes were more frequent in PVD and dyslipemia was more common in CHD (p < 0.05) Abdominal aortic diameter and carotid intima-media thickness were similar for all groups, while the number of carotid plaques was higher in PVD. CHD patients more often presented left ventricular hypertrophy and reduced ejection fraction. PVD patients showed a marked reduction of the ankle-brachial index as well as increased C-reactive protein and homocysteine (p < 0.05). Severe unsuspected vascular lesions were found in 13% of cases (95% confidence interval, 9.5-17.6%). Risk factor control was better for CHD, followed by CVD and PVD, but was globally poor. Conclusions: The systematic evaluation of the vascular tree detects generalized atherosclerotic lesions, in some cases severe and clinically unsuspected. New markers to identify patients at very high risk are necessary. Peripheral vascular disease identifies a group of patients of particular risk. Risk factor control is deficient, particularly among PVD patients


Subject(s)
Male , Female , Aged , Humans , Arteriosclerosis/epidemiology , Arteriosclerosis , Coronary Artery Disease/epidemiology , Coronary Artery Disease , Intracranial Arteriosclerosis/epidemiology , Intracranial Arteriosclerosis , Prospective Studies , Risk Factors , Anthropometry
10.
Rev Esp Cardiol ; 58(12): 1403-10, 2005 Dec.
Article in Spanish | MEDLINE | ID: mdl-16371199

ABSTRACT

INTRODUCTION AND OBJECTIVES: Peripheral arterial disease (PAD) frequently coexists with coronary artery disease. Our objective was to determine the prevalence of traditional and emergent cardiovascular risk factors in patients with acute coronary syndrome (ACS), with or without PAD. PATIENTS AND METHOD: A prospective study of 141 consecutive patients (< 70 years old) admitted to our hospital with ACS was performed. PAD was diagnosed when the ankle-brachial index (ABI) was < or = 0.9. Traditional cardiovascular risk factors were evaluated. C-reactive protein, homocysteine, amyloid A, lipoprotein (a), fibrinogen, apolipoprotein A1, and apolipoprotein B100 serum levels, and microalbuminuria were measured. Specific genotypes were also determined. RESULTS: Patients were divided into two groups according to whether PAD was present (37 patients, 26% of total, ACS-PAD group) or absent (104 patients, ACS group). In the ACS-PAD group, patients were older, and diabetes and hypertension were significantly more common. Moreover, levels of C-reactive protein (3.1 mg/L vs 2.18 mg/L; P<.05), homocysteine (11.45 mmol/L vs 9.4 mmol/L; P<.01), amyloid A (5.2 mg/mL vs 3.7 mg/mL; P<.05), and microalbuminuria (4.89 mg/L vs 3.1 mg/L; P<.05) were significantly higher in this group. Logistic regression analysis showed that poorly controlled diabetes (OR = 6.3; 95% CI, 1.1-36.7), time-dependent tobacco exposure (OR = 1.5 per decade; 95% CI, 1.2-2.0), and high pulse pressure (OR = 1.9 per 10 mmHg; 95% CI, 1.3-2.7) were independent predictors of the presence of PAD. CONCLUSIONS: Several traditional and emergent cardiovascular risk factors were more prevalent in patients with acute coronary syndrome and peripheral arterial disease. Moreover, some factors were independent predictors of peripheral arterial disease.


Subject(s)
Coronary Disease/diagnosis , Peripheral Vascular Diseases/diagnosis , Adult , Aged , Blood Chemical Analysis , Coronary Disease/blood , Coronary Disease/epidemiology , Female , Humans , Male , Middle Aged , Peripheral Vascular Diseases/blood , Peripheral Vascular Diseases/epidemiology , Prevalence , Prospective Studies , Risk Factors , Spain/epidemiology
11.
Rev. esp. cardiol. (Ed. impr.) ; 58(12): 1403-1410, dic. 2005. tab
Article in Es | IBECS | ID: ibc-041946

ABSTRACT

Introducción y objetivos. La enfermedad arterial/vascular periférica frecuentemente se asocia con enfermedad coronaria. El objetivo es evaluar la prevalencia de factores de riesgo cardiovascular tradicionales y emergentes entre pacientes con síndrome coronario agudo (SCA) con o sin enfermedad vascular periférica. Pacientes y método. Realizamos un estudio prospectivo en 141 pacientes (< 70 años) que ingresaron consecutivamente por síndrome coronario agudo. El diagnóstico de enfermedad arterial periférica (EVP) se basó en un índice tobillo-brazo ≤ 0,9. Se evaluaron los factores de riesgo cardiovascular tradicionales y se midieron las concentraciones séricas de proteína C reactiva, homocisteína, amiloide A, lipoproteína (a), fibrinógeno, apolipoproteína A1 y B100, y microalbuminuria. Además, se determinaron varios genotipos. Resultados. Los pacientes fueron estratificados en 2 grupos de acuerdo con la presencia (n = 37, el 26% del total, grupo SCA-EVP) o ausencia (n = 104, grupo SCA) de enfermedad arterial periférica. Los pacientes del grupo SCA-EVP eran más viejos y tenían una significativa mayor prevalencia de diabetes e hipertensión. Las concentraciones de proteína C reactiva, homocisteína, amiloide A y microalbuminuria fueron significativamente mayores en el grupo SCA-EVP (3,1 frente a 2,18 mg/l [p < 0,05]; 11,45 frente a 9,4 mmol/l [p < 0,01]; 5,2 frente a 3,7 mg/ml [p < 0,05], y 4,89 frente a 3,1 mg/l [p < 0,05], respectivamente). El análisis de regresión logística mostró que la diabetes mal controlada, la exposición al tabaco tiempo-dependiente y la presión de pulso fueron predictores independientes de la presencia de EVP. Conclusiones. Varios factores de riesgo cardiovascular tradicionales y emergentes son más prevalentes en pacientes con SCA y enfermedad arterial periférica, y algunos de ellos son predictores independientes de ésta


Introduction and objectives. Peripheral arterial disease (PAD) frequently coexists with coronary artery disease. Our objective was to determine the prevalence of traditional and emergent cardiovascular risk factors in patients with acute coronary syndrome (ACS), with or without PAD. Patients and method. A prospective study of 141 consecutive patients (< 70 years old) admitted to our hospital with ACS was performed. PAD was diagnosed when the ankle-brachial index (ABI) was ≤ 0.9. Traditional cardiovascular risk factors were evaluated. C-reactive protein, homocysteine, amyloid A, lipoprotein (a), fibrinogen, apolipoprotein A1, and apolipoprotein B100 serum levels, and microalbuminuria were measured. Specific genotypes were also determined. Results. Patients were divided into two groups according to whether PAD was present (37 patients, 26% of total, ACS-PAD group) or absent (104 patients, ACS group). In the ACS-PAD group, patients were older, and diabetes and hypertension were significantly more common. Moreover, levels of C-reactive protein (3.1 mg/L vs 2.18 mg/L; P<.05), homocysteine (11.45 mmol/L vs 9.4 mmol/L; P<.01), amyloid A (5.2 mg/mL vs 3.7 mg/mL; P<.05), and microalbuminuria (4.89 mg/L vs 3.1 mg/L; P<.05) were significantly higher in this group. Logistic regression analysis showed that poorly controlled diabetes (OR = 6.3; 95% CI, 1.1-36.7), time-dependent tobacco exposure (OR = 1.5 per decade; 95% CI, 1.2-2.0), and high pulse pressure (OR = 1.9 per 10 mmHg; 95% CI, 1.3-2.7) were independent predictors of the presence of PAD. Conclusions. Several traditional and emergent cardiovascular risk factors were more prevalent in patients with acute coronary syndrome and peripheral arterial disease. Moreover, some factors were independent predictors of peripheral arterial disease


Subject(s)
Adult , Aged , Middle Aged , Humans , Coronary Disease/complications , Peripheral Vascular Diseases/complications , Peripheral Vascular Diseases/diagnosis , Acute Disease , Risk Factors , Prospective Studies , Logistic Models , Prevalence , Genetic Markers
12.
Ann Vasc Surg ; 19(3): 421-4, 2005 May.
Article in English | MEDLINE | ID: mdl-15864476

ABSTRACT

We present a case of a lumbar pseudoaneurysm in a 62-year-old patient with myelofibrosis (agnogenic myeloid metaplasia). The patient was submitted to two anesthetic infiltrations for lumbar pain and one biopsy of a suspected hematopoietic site. Subsequently, a 4.5 cm lumbar pseudoaneurysm was diagnosed. The pseudoaneurysm was thrombosed with 1 ml (500 IU) thrombin injection with a successful clinical result. We discuss different treatment options along with several issues related to the most frequent complication of this technique, namely, native artery thrombosis.


Subject(s)
Aneurysm, False/etiology , Hemostatics/administration & dosage , Thrombin/administration & dosage , Aneurysm, False/diagnostic imaging , Biopsy, Needle/adverse effects , Hemostatics/therapeutic use , Humans , Injections , Lumbosacral Region , Male , Middle Aged , Thrombin/therapeutic use , Ultrasonography, Interventional
13.
Vascular ; 12(2): 136-9, 2004 Mar.
Article in English | MEDLINE | ID: mdl-15248645

ABSTRACT

The management of primary subclavian-axillary vein thrombosis is controversial. Indications and time of operative or endovascular intervention after successful thrombolysis remain unresolved. To improve the long-term functional outcomes in patients with primary subclavian-axillary vein thrombosis, early reestablishment of venous patency and prevention of recurrent thrombosis are required. We present a case in which, after catheter-directed thrombolysis, positional venography showed costoclavicular compression of the subclavian vein. At the time of surgical thoracic outlet decompression, transluminal venous angioplasty was performed.


Subject(s)
Angioplasty, Balloon/methods , Intraoperative Care/methods , Thoracic Outlet Syndrome/surgery , Venous Thrombosis/therapy , Adult , Axillary Vein/diagnostic imaging , Humans , Male , Radiography , Subclavian Vein/diagnostic imaging , Thrombolytic Therapy , Venous Thrombosis/diagnostic imaging
14.
Ann Vasc Surg ; 16(3): 363-7, 2002 May.
Article in English | MEDLINE | ID: mdl-11957015

ABSTRACT

Abdominal aortic coarctation and renal artery stenosis associated with neurofibromatosis is an unusual cause of renovascular hypertension in children and young adults. Sustained hypertension despite pharmacological treatment carries significant end-organ deterioration, failure to thrive, and potentially lethal complications. Timely arterial reconstruction can render these children normotensive, allowing normal development and reducing long-term morbidity. Progression of the arterial occlusive process, however, may occur after surgery. Therefore, careful follow-up is mandatory following aortorenal reconstruction in children with neurofibromatosis.


Subject(s)
Aorta, Abdominal , Aortic Coarctation/complications , Hypertension, Renovascular/etiology , Neurofibromatosis 1/complications , Renal Artery Obstruction/complications , Child , Female , Humans , Pregnancy , Renal Artery/diagnostic imaging , Renal Artery Obstruction/diagnostic imaging , Tomography, X-Ray Computed
15.
Semin Vasc Surg ; 15(1): 27-33, 2002 Mar.
Article in English | MEDLINE | ID: mdl-11840423

ABSTRACT

Conservative hemodynamic surgery for varicose veins is a minimally invasive, nonablative technique that preserves the saphenous vein and helps avoid excision of varicosities. It represents a physiologic approach to the surgical treatment of varicose veins based on knowledge of the underlying venous pathophysiology gained through detailed duplex scanning. A change in venous hemodynamics is attained through fragmentation of the blood column by interruption of the refluxing saphenous trunks, closure of the origin of the refluxing varicose branches, and preservation of the communicating veins that drain the incompetent varicose veins into the deep venous system. After surgery, varicose veins regress through a reduction in hydrostatic pressure and efficient emptying of the superficial system by the musculo-venous pump. Obvious advantages of this technique are that it is done in an ambulatory setting, minimizes the risk of surgical complications, and permits a rapid return to full activity. The long-term hemodynamic improvement and recurrence rate of this technique remain to be established.


Subject(s)
Hemodynamics/physiology , Varicose Veins/physiopathology , Varicose Veins/surgery , Vascular Surgical Procedures , Humans , Varicose Veins/pathology
SELECTION OF CITATIONS
SEARCH DETAIL
...