ABSTRACT
PURPOSE: To evaluate the treatment of abdominal aortic aneurysm (AAA) with use of the endoluminal Talent stent-graft (TSG). PATIENTS AND METHODS: In 10 men, AAA treatment was attempted with use of the TSG. All patients presented significant surgical risk, with chronic obstructive pulmonary disease and coronary arteriopathy. The mean age was 65.5 years (range, 57-82 years). The mean proximal neck diameter was 25.8 mm (range, 21.6-34 mm). Five of the TSGs were straight tubes and five were bifurcated systems. The main body of the TSG is made of a polyester graft material mounted on a self-expandable nitinol frame. The bifurcated system uses polytetrafluoroethylene (PTFE) material for the legs and extensions mounted on a self-expandable nitinol frame. The bifurcated grafts used a 22 to 27-F introducer and the extensions, a 18-F introducer through a surgical cutdown technique. RESULTS: The TSG system was successfully implanted in nine patients and failed in one because of dislodgment after deployment, which required conversion to surgery. Four leaks occurred initially. One was sealed off with balloon dilation at the end of the procedure, one leak was treated with an additional extension, another leak disappeared spontaneously in 30 days, and the other leak required embolization 4 weeks after discharge. Seven patients were discharged on the third day after the procedure, and two patients were discharged at 1 and 2 weeks, respectively. Blood transfusion was necessary in three patients because of hematoma at the incision site in two patients, which required surgical revision for hemostasis, and because of transoperative bleeding in one patient. Follow-up time ranged from 2 to 15 months. The only death occurred 5 days postoperatively as a consequence of ischemic colitis and multisystem organ failure in the only patient who required surgery. CONCLUSION: Treatment of AAA with the TSG system is effective for aneurysm exclusion. This device seems to provide a good alternative to surgery in patients who are otherwise considered to be at high risk for complications after direct surgical repair, but it is not without risk of complications.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Blood Vessel Prosthesis Implantation , Stents , Aged , Aged, 80 and over , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortography , Blood Vessel Prosthesis Implantation/adverse effects , Follow-Up Studies , Humans , Male , Middle Aged , Polyesters , Polytetrafluoroethylene , Postoperative Hemorrhage , Stents/adverse effects , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
A análise de filmes radiográficos rejeitados serve como parâmetro para justificar um Programa de Garantia de Qualidade (PGQ). Esta análise torna possível identificar os tipos de exames em que ocorra mais frequentemente a rejeição, o tamanho de filme mais rejeitado e a causa. Permite considerar acerca da competência do pessoal técnico envolvido, problemas nos equipamentos, revelação do filme e posicionamento do paciente.
The analisys of rejected radiographic films are used like a justification to do a Quality Control Program. This analisy makes possible to identify wich is the most rejected exam type, what size of film has greater number of rejection and the cause of that. The competence of technical people involved, troubles in the equipments, in processment of the film and how to positioning pacients can be avaluated
Subject(s)
X-Ray Film/trends , Quality of Health Care , Brazil , Equipment Failure Analysis/standards , Interpersonal RelationsABSTRACT
A importância e a obrigatoriedade da realização de testes de aceitação para equipamentos de radiologia comprovam-se na sua execução. Garantem um bom funcionamento do aparelho e a certeza de que as condições de trabalho, com qualidade, sejam plenamente satisfeitas. Permitem determinar padrões técnicos característicos de cada equipamento que servirão para um acompanhamento analítico do mesmo durante sua vida útil, garantindo a satisfação do comprador e um uso pleno do equipamento.
The importancy and necessity of the Aceptence Tests for radiological equipments are proved by their selfs. It permit a good performance of the equipment and ensure that a quality condicions work are satisfied completly. Caracteristic technical patterns are stablished for each equipment, and with this an analitcal avaluation will be done during the useful life of the equipment, it garentee a satisfaction to the owner of the equipment and the completly use of it
