RESUMO
BACKGROUND: Acute aortic occlusion is an uncommon vascular emergency. REPORT: We report an endovascular procedure in a patient with acute aortic occlusion causing critical limb ischemia. Following thrombus debulking with AngioJet system, aortoiliac patency was achieved with bilateral iliac artery stent placement creating new aortic bifurcation. CONCLUSIONS: Pharmacomechanical thrombectomy may provide effective debulking of thrombus. It may be utilized before stenting, and may also be curative in selected cases.
Assuntos
Angioplastia com Balão/instrumentação , Aorta Abdominal , Doenças da Aorta/terapia , Arteriopatias Oclusivas/terapia , Isquemia/terapia , Extremidade Inferior/irrigação sanguínea , Stents , Trombectomia/instrumentação , Doença Aguda , Idoso de 80 Anos ou mais , Aorta Abdominal/diagnóstico por imagem , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/fisiopatologia , Aortografia , Arteriopatias Oclusivas/diagnóstico por imagem , Arteriopatias Oclusivas/fisiopatologia , Estado Terminal , Desenho de Equipamento , Humanos , Isquemia/diagnóstico por imagem , Isquemia/fisiopatologia , Masculino , Resultado do Tratamento , Grau de Desobstrução VascularRESUMO
OBJECTIVE: We compared electron microscopic histologic changes of the radial artery grafts in non-diabetic and diabetic patients. METHODS: Thirty-six patients were divided into three groups according to their diabetic status (Group I had no diabetes mellitus [DM], Group II had type two DM and HbA1c levels were <7.5%, and Group III had type 2 DM but HbA1c levels were >7.5%). Distal parts of radial artery grafts were evaluated with scanning electron microscopy in a blind fashion by two histologists. Electron microscopic scores were compared among the groups. RESULTS: Radial artery electron microscopic scores were significantly different between group 1, 2 and 1, 3 and 2, 3 (p = 0.028, p < 0.001, and p < 0.001). In linear regression analysis, duration of DM (p = 0.027) and fasting plasma glucose (p = 0.001) were found as independent risk factors for histologic changes of radial artery grafts. CONCLUSION: Duration of DM and poor glycemic control were found to be associated with radial artery electron microscopic changes. doi: 10.1111/jocs.12761 (J Card Surg 2016;31:410-415).
Assuntos
Ponte de Artéria Coronária , Doença das Coronárias/complicações , Doença das Coronárias/cirurgia , Diabetes Mellitus Tipo 2/complicações , Artéria Radial/transplante , Artéria Radial/ultraestrutura , Idoso , Diabetes Mellitus Tipo 2/metabolismo , Hemoglobinas Glicadas/metabolismo , Humanos , Modelos Lineares , Microscopia Eletroquímica de Varredura , Pessoa de Meia-IdadeRESUMO
In cases with a proximal aneurysm neck diameter of higher than 28 mm, standard endovascular aneurysm repair is considered inappropriate. In the present study, we report a successful endovascular treatment using overlapped thoracic and abdominal grafts technique in a patient whose infrarenal aneurysm neck diameter is 38.1 mm.