ABSTRACT
Los autores de este artículo, con base en su experiencia personal, que supera las tres décadas (1991-2021) y el medio centenar de pacientes (53 con 58 paragangliomas carotídeos y 5 casos bilaterales), explican cómo realizan la resección quirúrgica del paraganglioma carotídeo. En esta segunda parte, menos frecuente, se exponen los aspectos técnicos y tácticos de la resección-reparación arterial (eje carotídeo) como parte de la resección de ciertos paragangliomas carotídeos. Aunque siguen patrones estándares, los autores muestran aspectos personales de la técnica quirúrgica que implementan actualmente.(AU)
The authors of this article, based on their personal experience that exceeds three decades (1991-2021) and fifty patients (53 with 58 carotid paragangliomas and 5 bilateral cases), indicate how they perform surgical resection. In this second part, which is less frequent, the technical (and tactical) aspects of arterial resection-repair (carotid axis) are exposed as part of the resection of certain carotid paragangliomas. Although they follow standard patterns, the authors show personal aspects of the surgical technique that they currently implement.(AU)
Subject(s)
Humans , Paraganglioma , Carotid Body Tumor/diagnosis , Carotid Body Tumor/surgery , Vascular Grafting , Carotid Arteries/surgery , Carotid Artery Injuries , Blood Vessels/anatomy & histology , Lymphatic Vessels/anatomy & histology , Cardiovascular System , Lymphatic SystemSubject(s)
Humans , Prosthesis Design , Blood Vessel Prosthesis/history , Aneurysm/history , Aneurysm/surgery , Aortic Aneurysm, Abdominal/history , Allografts , Inpatients , Treatment Outcome , Cardiovascular System , Lymphatic Vessels/anatomy & histology , Blood Vessels/anatomy & histology , Lymphatic SystemABSTRACT
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.
Subject(s)
Aneurysm, False/etiology , Axillary Artery/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Endovascular Procedures/adverse effects , Femoral Artery/surgery , Vascular System Injuries/etiology , Wounds, Nonpenetrating/etiology , Adult , Aged , Aged, 80 and over , Aneurysm, False/diagnostic imaging , Aneurysm, False/surgery , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis Implantation/methods , Computed Tomography Angiography , Endovascular Procedures/instrumentation , Endovascular Procedures/methods , Female , Humans , Male , Middle Aged , Polytetrafluoroethylene , Prosthesis Design , Risk Factors , Stents , Treatment Outcome , Vascular System Injuries/diagnostic imaging , Vascular System Injuries/surgery , Wounds, Nonpenetrating/diagnostic imaging , Wounds, Nonpenetrating/surgeryABSTRACT
El acné es una de las dermatosis más frecuentes en todo el mundo y una de las patologías más comunes en adolescentes y adultos jóvenes. Se trata de una enfermedad inflamatoria crónica de las unidades pilosebáceas que, clínicamente, puede presentarse como seborrea, comedones, pápulas eritematosas, pústulas y nódulos. Las formas graves de acné pueden afectar muchos aspectos de la vida de una persona, y provocar que haya mucha vergüenza y estrés. El acné conglobata, específicamente, es una forma muy severa de acné noduloquístico en el que las lesiones inflamatorias predominan y funcionan juntas y a menudo forman exudados o sangran. Esta tipología del acné puede causar cicatrices extensas. Se presenta el reporte de un caso clínico de un paciente con acné conglobata que acudió a cuatro consultas médicas, cuyo resultado permitió conocer la efectividad de la medicina homeopática.
