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1.
J Vasc Access ; 22(1): 129-134, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32524867

RESUMO

BACKGROUND: Kidney allograft resistive index (RI) is prognostic for graft and recipient survivals. Recipient hemodynamics could influence RI. In particular, dialysis arteriovenous fistula (AVF) has been involved in heart function changes, reversible after AVF ligation. Knowledge about AVF and RI is lacking. In this study, we prospectively evaluated RI changes after AVF ligation in kidney transplanted patients. METHODS: We enrolled 22 stable transplanted patients. Mean RI was measured before AVF ligation (T0), 18 to 24 h (T1) and 6 months (T6) after surgery; mean blood pressure (mBP), heart rate (HR), serum creatinine (sCr), estimated glomerular filtration rate (eGFR), 24 h proteinuria (24 h-P), immunosuppressive drug blood levels (IS) and antihypertensive drugs were also recorded. RESULTS: AVF ligation was performed 3.1 years (IQR: 2.1-3.8) after transplantation. Median AVF flow (Qa) was 1868 mL/min (IQR: 1538-2712) and 8 AVF were classified as high flow (Qa ≥ 2 L/min). At baseline, median sCr was 1.32 mg/dL (IQR: 1.04-1.76) and median eGFR was 57.1 mL/min. Median RI was 0.71 at T0, 0.69 at T1, 0.66 at T6. RI reduction at T1 and T6 was statistically significant (p < 0.05 and p < 0.001 respectively); in particular, 90.4% of patients had persistently improved values at T6. Furthermore, mBP increased while HR decreased. These changes were independent from sCr, 24 h-P, IS, antihypertensive drugs number, Qa and AVF type. CONCLUSIONS: AVF ligation improves kidney allograft RI; it may reflect better kidney perfusion.


Assuntos
Derivação Arteriovenosa Cirúrgica , Sobrevivência de Enxerto , Hemodinâmica , Transplante de Rim , Circulação Renal , Diálise Renal , Adulto , Idoso , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Derivação Arteriovenosa Cirúrgica/mortalidade , Velocidade do Fluxo Sanguíneo , Feminino , Humanos , Transplante de Rim/efeitos adversos , Transplante de Rim/mortalidade , Ligadura , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fluxo Sanguíneo Regional , Fatores de Tempo , Resultado do Tratamento , Resistência Vascular
2.
Ann Vasc Surg ; 29(8): 1659.e1-7, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26256709

RESUMO

We report a case of a metachronous common iliac artery and the internal iliac artery (IIA) aneurysm developed 8 years after an aortobi-femoral bypass for treatment of abdominal aortic aneurysm associated at chronic occlusion of the right iliac axis. To exclude the metachronous aneurysm on the left iliac axis and to maintain the pelvic circulation, an external to IIA endografts were positioned ("U stent-graft technique"). At 6-month follow-up, the computed tomography scan showed patency of the endografts, of the bypass and of the IIA, without endoleak, or other adverse events.


Assuntos
Implante de Prótese Vascular , Prótese Vascular , Procedimentos Endovasculares , Aneurisma Ilíaco/diagnóstico , Aneurisma Ilíaco/cirurgia , Stents , Idoso , Humanos , Aneurisma Ilíaco/etiologia , Masculino
4.
J Vasc Surg ; 52(1): 212-5, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20471777

RESUMO

This report describes the case of a 60-year-old woman with a history of hysterectomy for myomas, totally asymptomatic, with incidental evidence of a pelvic intracaval mass extending to the right atrium. She underwent a staged procedure (sternothomic and abdominal) through a thoracolaparotomic approach in circulatory arrest and deep hypothermia. Using a one-stage surgical approach, we were able to withdraw one portion of the mass from the right atrium and another from the abdominal inferior vena cava, thus minimizing the risk of unexpected venous or atrial wall injury during surgical manipulation.


Assuntos
Veia Ilíaca/cirurgia , Leiomiomatose/cirurgia , Procedimentos Cirúrgicos Torácicos , Neoplasias Uterinas/cirurgia , Veia Cava Inferior/cirurgia , Biópsia , Ponte Cardiopulmonar , Parada Circulatória Induzida por Hipotermia Profunda , Feminino , Átrios do Coração/patologia , Átrios do Coração/cirurgia , Humanos , Veia Ilíaca/diagnóstico por imagem , Veia Ilíaca/patologia , Achados Incidentais , Leiomiomatose/diagnóstico por imagem , Leiomiomatose/patologia , Pessoa de Meia-Idade , Invasividade Neoplásica , Esternotomia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Neoplasias Uterinas/patologia , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/patologia
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