RESUMO
AIM: We report the prevalence of flash pulmonary edema in patients consecutively referred for balloon angioplasty of uni- or bilateral renal artery stenosis (PTRA), and describe the characteristics of this special fraction of the patients. We further report two unusual cases. METHODS AND MATERIAL: Review of medical records from 60 patients consecutively referred for uni- or bilateral PTRA from 2004-2005 in Copenhagen County. RESULTS: Eight out of 60 patients had one or more episodes of flash pulmonary edema before PTRA. Compared with the remaining patients, they had a higher prevalence of bilateral stenosis (50% vs 27%) and coronary artery disease (75% vs 28%). However, only one of eight had severe systolic dysfunction of the left ventricle. After PTRA, two recurrences of flash pulmonary edema were observed. One was caused by severe restenosis and did not recur after aorto-renal bypass surgery. The other one was caused by rapid atrial fibrillation and did not recur after pacemaker and medical treatment. CONCLUSION: Flash pulmonary edema can be observed in patients with unilateral as well as bilateral stenosis. The prognosis is usually excellent upon treatment of the stenoses. Recurrences are rare unless restenosis occurs, and therefore, regular control, e.g. by Doppler-ultrasound examination is recommended.
Assuntos
Edema Pulmonar/etiologia , Obstrução da Artéria Renal/complicações , Idoso , Angioplastia com Balão , Fibrilação Atrial/complicações , Feminino , Humanos , Hipertrofia Ventricular Esquerda/complicações , Masculino , Pessoa de Meia-Idade , Edema Pulmonar/epidemiologia , Edema Pulmonar/fisiopatologia , Edema Pulmonar/terapia , Obstrução da Artéria Renal/epidemiologia , Obstrução da Artéria Renal/fisiopatologia , Obstrução da Artéria Renal/terapia , Estudos Retrospectivos , Prevenção Secundária , Síndrome , Ultrassonografia Doppler , Enxerto VascularRESUMO
In this case report the treatment of a young man with bilateral iliaco-femoral DVT and vena cava aplasia is presented. The patient was treated with catheter-directed thrombolysis; the catheters were introduced in the thrombus of both legs via v. popliteae. The treatment led to almost complete thrombus resolution and no valvular incompetence at three months follow-up. In our opinion this treatment should be offered even in complex cases of acute proximal deep venous thrombosis.