RESUMO
Drug-coated balloons are used widely as a form of endovascular treatment for peripheral arterial disease, to improve patency by reducing neointimal hyperplasia and restenosis. We present a rare case of acute coronary syndrome secondary to anaphylaxis after inflation of a paclitaxel-coated balloon used to treat a recurrent superficial femoral artery stenosis.
Assuntos
Anafilaxia/induzido quimicamente , Angioplastia com Balão/efeitos adversos , Angioplastia com Balão/instrumentação , Fármacos Cardiovasculares/efeitos adversos , Hipersensibilidade a Drogas/etiologia , Artéria Femoral , Síndrome de Kounis/etiologia , Paclitaxel/efeitos adversos , Doença Arterial Periférica/terapia , Dispositivos de Acesso Vascular , Idoso , Anafilaxia/diagnóstico , Anafilaxia/terapia , Fármacos Cardiovasculares/administração & dosagem , Constrição Patológica , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/terapia , Feminino , Artéria Femoral/diagnóstico por imagem , Humanos , Síndrome de Kounis/diagnóstico , Síndrome de Kounis/terapia , Paclitaxel/administração & dosagem , Doença Arterial Periférica/diagnóstico por imagem , Resultado do TratamentoRESUMO
Considerable advances have been made over the last decade in the management of patients with peripheral artery disease. Historically, endovascular treatment has been the accepted approach for short lesions and surgical bypass for long, complex femoropopliteal lesions. However, bypass surgery holds significant risk of mortality and morbidity for the patient. That toll includes prolonged hospitalization, as well as the potential for wound healing and systemic complications, all of which are intensified by the ageing population. Advances in endovascular devices, such as drug eluting stents present an alternative, minimally invasive treatment option which may more suitable for complex lesions in a high-risk population. The aim of this review is to discuss the current literature which addresses surgical bypass and drug eluting stents, particularly for the treatment of long, complex femoropopliteal disease.
Assuntos
Arteriopatias Oclusivas/terapia , Stents Farmacológicos , Artéria Femoral/cirurgia , Doença Arterial Periférica/terapia , Artéria Poplítea/cirurgia , Arteriopatias Oclusivas/cirurgia , Procedimentos Endovasculares , Humanos , Doença Arterial Periférica/cirurgiaRESUMO
INTRODUCTION: The stent assisted balloon induced intimal disruption and relamination in aortic dissection repair (STABILISE) technique is being increasingly used for the treatment of complicated aortic dissections. However, as it is a fairly recent technique, the scientific information is limited. REPORT: In this paper we report two cases of the STABILISE technique associated with procedures in the ascending aorta and supra-aortic trunks, consisting of a "frozen elephant trunk" procedure in one case and in the other, a carotid endarterectomy associated with reimplantation of the vertebral artery and partial arch debranching. DISCUSSION: In conclusion, while acknowledging the need for longer follow up and greater experience to support the safety and efficacy of this procedure, the two cases reported confirm that the STABILISE technique is a valid endovascular alternative in the treatment of complicated aortic dissections.