ABSTRACT
Os autores relatam um caso de abordagem mista para o tratamento endovascular de doença oclusiva da artéria tibial anterior por acesso pedioso retrógrado, no qual a abordagem tradicional anterógrada foi inadequada em vencer uma oclusão. A técnica parece oferecer uma opção para procedimentos endovasculares, que objetivam o tratamento de lesões da artéria tibial anterior em que a via anterógrada convencional mostre-se inadequada.
The authors report the case of mixed approach for endovascular treatment of occlusive disease of the anterior tibial artery by retrograde pedal artery access where the traditional antegrade approach failed to overcome a segmental occlusion. The technique seems to offer an option for endovascular procedures aimed at treating occlusion of the anterior tibial artery in cases where the conventional antegrade approach demonstrates to be inappropriate.
Subject(s)
Humans , Female , Aged , Angioplasty , Arterial Occlusive Diseases/physiopathology , Arterial Occlusive Diseases/rehabilitation , Endovascular Procedures , Tibial Arteries , Angiography , Coronary Disease , Diabetes Mellitus/rehabilitation , Hypertension , Perna/blood supplyABSTRACT
UNLABELLED: The most devastating consequence of vascular disease of the lower extremity is amputation. Although considered as the end of the efforts of the vascular procedures, it should not be considered the end of medical treatment of the patient. The purpose of this study was to determine the situation of patients who suffered a major amputation of the lower leg due to ischemic vascular disease, at least two years after this event. PATIENTS AND METHODS: Forty-eight patients who had major amputation had their chart reviewed and were contacted to inform about the current conditions of rehabilitation. In case of death, the causes of dismissal were obtained. The degree of rehabilitation was compared to the preoperative level of selfishness. RESULTS: Before amputation, 15 patients had an independent life, 21 could walk up to 500 meters, seven were confined to a wheel-chair or used crutches and five were bedridden. At least two years later, 54.2% of the patients died and only nine were fully rehabilitated (18.8% of all the patients and 40.9% of the living patients). CONCLUSIONS: Patients who suffer amputation due to vascular disease do have a low survival rate after two years. Among the survivors, only few patients do have clinical conditions to regain a regular situation of autonomy.