Registro de actividades de la Sociedad Española de Angiología y Cirugía Vascular, año 2013 / Activities register of the Spanish Angiology and Vascular Surgery Society in 2013

OBJETIVO: Describir la actividad asistencial del año 2013 de los Servicios/Unidades de Angiología y Cirugía Vascular en España. PACIENTES Y MÉTODOS: Estudio transversal con encuesta a 92 centros sobre procedimientos quirúrgicos y exploraciones vasculares realizados en 2013. Análisis descriptivo de resultados y comparación del ratio de actividad/100.000 habitantes con 2012. RESULTADOS: Respondieron 69 servicios (34 docentes), correspondientes a 75 centros. En 2013 se produjeron 49.206 ingresos, 36,8% urgentes y 63,2% programados, con estancia media de 7,2 días. En lista de espera, a 31/12/2013, existía predominio de afecció venosa sobre la arterial (12.410 vs. 2.199). La actividad quirúrgica en cirugía arterial en 2013 fue inferior a la de 2012 con los siguientes ratios/100.000 habitantes: 10,3 vs. 12,1 en troncos supraaórticos; 1,5 vs. 1,4 en aorta torácica; 0,31 vs. 0,33 en aorta toracoabdominal; 1,4 vs. 1,9 en arterias viscerales; 9,4 vs. 9,7 en aorta abdominal; 11,4 vs. 23,1 en sector aortoilíaco; 21,4 vs. 20,9 en sector femoropoplíteo y 9,4 vs. 13,7 en sector distal. En todas ellas, el ratio de procedimientos de cirugía convencional fue inferior, mientras que el de cirugía endovascular aumentó en algunos. En 2013 se realizaron menos accesos de hemodiálisis (19,9 vs. 24,0). La actividad en amputaciones mayores, menores y desbridamientos de pie diabético fue semejante (7,6 vs. 7,3; 11,3 vs. 11,4 y 5,6 vs. 5,6, respectivamente). La actividad en 2013 sobre varices fue igual a la de 2012 (ambas con ratio/100.000 habitantes = 66,1), si bien se realizaron más procedimientos con cirugía convencional y menos con endovascular. El ratio/100.000 habitantes de exploraciones vasculares fue superior en 2013 (764,1 vs. 697,8). CONCLUSIÓN: Con relación a 2012: ha disminuido la participación y la actividad quirúrgica arterial global, con incremento de procedimientos endovasculares en algunos territorios; la venosa global se ha mantenido, mientras que han disminuido los procedimientos endovasculares; las exploraciones vasculares han aumentado

OBJECTIVE: To describe the health-care activities carried out by the Services/Units of Angiology and Vascular Surgery in Spain in 2013. PATIENTS AND METHODS: Cross-sectional study with a survey of 92 centres on surgical procedures and vascular examinations performed in 2013. Descriptive analysis was performed on the results and a comparison was made on the ratio of activity/100,000 population with 2012. RESULTS: Responses were received from 69 services (34 teaching services), corresponding to 75 centres. In 2013 there were 49,206 admissions, of which 36.8% were emergencies and 63.2% were elective, with a mean stay of 7.2 days. As of 31 December 2013, the waiting list showed a predominance of venous over arterial pathology (12,410 vs. 2,199). Arterial surgery in 2013 was lower than in 2012, with the following ratios/100,000 population: 10.3 vs. 12.1 in the supra-aortic trunk, 1.5 vs. 1.4 in the thoracic aorta, 0.31 vs. 0.33 in the thoracic-abdominal aorta, 1.4 vs. 1.9 in visceral arteries, 9.4 vs. 9.7 in the abdominal aorta, 11.4 vs. 23.1 in the aorto-iliac segment, 21.4 vs. 20.9 in the femoro-popliteal segment, and 9.4 vs. 13.7 in the distal segment. For all of these, the ratio of conventional surgical procedures was lower, whereas that of endovascular surgery increased in some cases. In 2013 fewer haemodialysis access procedures were performed (19.9 vs. 24.0). Procedures involving major and minor amputations and diabetic foot debridement were similar (7.6 vs. 7.3, 11.3 vs. 11.4 and 5.6 vs. 5.6, respectively). Varicose vein procedures in 2013 were the same as in 2012 (both with a ratio of 66.1/100,000 population), although there were more procedures using conventional surgery and fewer with endovascular surgery. The ratio/100,000 population of vascular examinations was higher in 2013 (764.1 vs. 697.8). Conclusion : As compared to 2012, arterial surgery has decreased overall, and endovascular procedures have increased in some areas. Overall, venous surgery has remained the same, with a reduction in endovascular procedures. Vascular examinations have increased

[Multiple hydatid embolism: acute ischemia of the right lower limb. Apropos of a case]. / Embolización hidatídica múltiple: isquemia aguda de miembro inferior derecho. A propósito de un caso.

This case report presents a cardiac hydatidosis with multiple embolisms on several vascular territories, such as right popliteal artery, which was treated by embolectomy. Convenience of surgical approach, followed by medical treatment, in order to avoid a new recurrence, and periodical controls every 3-6 months (at least) during several years after disease, was evaluated.

[Treatment with Varihesive dressings of various types of leg ulcers]. / Tratamiento con apósitos de Varihesive de diferentes tipos de úlceras en extremidades inferiores.

Fourteen patients with leg ulcers of different aetiology are evaluated. The risk factors are analyzed and a complete vascular exploration of their extremities is performed and local exploration of the ulcer is carried out. Our study confirms the general opinion that healing of the foot in patients with ankle pressures of less than 50 mmHg or 70 mmHg in diabetics is very unlikely. Although, the results achieved after treatment have shown that trophic problems are not only related to arterial insufficiency. Other aspects interact with the tissue regeneration and as a consequence in the prognostic of the ulcer. It has been proved that occlusive treatment with hydrocolloid dressings has important advantages over other similar products, or compared to the conventional dressings, in the local treatment of vascular aetiological ulcers.