Tratamiento endovascular de un caso de priapismo de alto flujo / Endovascular treatment of a case of high-flow priapism

Objetivo. Presentar nuestra experiencia en un caso de priapismo de alto flujo tratado con éxito mediante laembolización selectiva de la arteria cavernosa. Caso clínico. Varón de 43 años con priapismo de alto flujo secundario aun traumatismo perineal. El tiempo desde la presentación de la sintomatología hasta el momento del tratamiento fue de157 días. El diagnóstico se confirmó mediante ecografía Doppler del pene y angiorresonancia aortoilíaca. En el primermomento fue tratado con una embolización supraselectiva y se utilizó un coágulo autólogo. Tres semanas después de laprimera intervención, el priapismo reapareció. La segunda embolización se realizó con micropartículas de polivinilo y microcoils.A corto plazo, el paciente recuperó la flacidez y la erección del pene. A largo plazo mostró como única secuela unamoderada fibrosis de los cuerpos cavernosos. Conclusiones. La embolización de la arteria lacerada es un procedimientoseguro para tratar el priapismo de alto flujo y proporciona excelentes resultados

Aim. To present our experience in a case of high-flow priapism successfully treated by superselectiveembolization of the internal pudendal artery. Case report. A 43 year-old male with high-flow priapism secondary to aperineal trauma. The time from the filing of the symptoms until the time of treatment was 157 days. The diagnosis wasconfirmed by Doppler ultrasound of the penis and aorto-iliac angioresonance. The first time, it was treated bysupraselective embolization with autologous blood clot. Three weeks after the first intervention, priapism reappeared.The second embolization was performed using polyvinyl microparticles and microcoils. In the short term, the patientregained flaccidity and the erection of the penis. In the long term, the only sequel was a moderate fibrosis of the corporacavernosa. Conclusions. The embolization of the lacerated artery is a safe procedure for treating the high flow priapismand provides excellent results

Cirugía endovascular de los aneurismas aislados de la arteria hipogástrica / Endovascular surgery of isolated hypogastric artery aneurysms

Introducción. Los aneurismas aislados de la arteria hipogástrica son entidades de difícil diagnóstico. Tradicionalmente se habían tratado mediante la ligadura del origen de la hipogástrica más una endoaneurismorrafia. Caso clínico. Varón de 72 años con un aneurisma de hipogástrica de 4 cm de diámetro tratado mediante la embolización con coils metálicos del saco aneurismático y el cierre del origen de la hipogástrica con un stent cubierto de politetraflouroetileno expandido con balón. Tanto los controles inmediatos como los realizados a los seis meses mostraron una correcta exclusión del aneurisma, así como la permeabilidad de la ilíaca externa. Conclusión. Actualmente la cirugía endovascular es una alternativa menos agresiva

Introduction. Isolated hypogastric artery aneurisms are very difficult to diagnose. They have traditionally been treated by means of tying of the entrance of the hypogastric artery in addition to an endoaneurysmorrhaphy. Case report. A 72 year-old man presented a hypogastric aneurysm with a diameter of 4 cm treated by embolization of the aneurysm sack with metallic coils and the closure of the origin of the affected artery with one polytetrafluoroethylene covered stent expanded by balloon. Both controls carried out immediately and after six months show a correct exclusion of the aneurysms in addition to a functioning flow through the external iliac artery. Conclusion. Nowadays, endovascular surgery is a less aggressive method

[Popliteal artery entrapment syndrome in 3 young athletes]. / Síndrome de atrapamiento de arteria poplítea en tres jóvenes deportistas.

Three cases of entrapment of the popliteal arteries from three young patients are reported. In all cases, the symptomatology was erroneously attributed to several muscular injuries produced in practice of a sport: Basketball, Football and Roller Hockey, respectively. In all cases, symptoms were progressing for 6 months as a minimum. The roads followed by these patients until they were visited in a Vascular Surgery Department is described. Clinical picture, the results from the different examinations practiced and the applied treatments to each patients are described.

[A case of multiple arteriovenous fistulae in a postphlebitic syndrome of longterm evolution]. / Un caso de múltiples fístulas arteriovenosas en síndrome postflebítico de larga evolución.

Authors report a case of a 77-years-old man who, after an accident of traffic on 1968, presented a left ileo-femoral deep venous thrombosis. Consequently, the patient suffered and important postphlebitic syndrome, with several varicose packs which were treated by surgical procedure in other centre. During several years, patient presented severe trophic diseases. Seventeen years after the beginning of his pathology, and during an angiologic examination, multiple arteriovenous fistulas at the left ileofemoral area have been shown. An skeletalization was impossible because of the severe ulcerations of the leg; so a left iliac arterial ligature and a Dacron Banding in primitive iliac artery, reducing a 50% the diameter, were made. The postoperative result was excellent, with an spectacular reduction of the fistulous communications and a complete remission of the cutaneous ulcerations.

[Calf carotids in experimental vascular surgery]. / Carótidas de ternera en cirugía vascular experimental.

Use of calf [correction of sheep] carotids maintained on 98% glycerol is described as a material of substitution of aorta and femoral arteries in the dog, in experimental surgery. Taking, maintenance and application technics of such heterografts are described. Also, histology after 24 months following the surgical procedure was studied in 10 cases of dog aortic grafts and its results are presented.

[Thoracic sympathectomy in the surgical treatment of Raynaud's phenomenon]. / Simpatectomia torácica en el tratamiento quirúrgico del fenómeno de Raynaud.

Authors present their results from a review of 38 thoracic sympathectomies practiced since 1977 to 1987, both included, on patients affected by a Raynaud syndrome resistant to medical treatment. Results show the evident clinical improvement of such patients after surgery. In all cases, surgical approach was a Crafoord thoracotomy.

[Late vascular complication after fracture of tibia and fibula]. / Complicación vascular tardía tras fractura de tibia y peroné.

Authors present a case report of an aneurysm from Posterior Tibial artery secondary to a traffic accident with trauma on tibia and perone. First symptoms appeared four months after accident.