RESUMO
Two patients with cervical tracheal stenosis, following prolonged ventilatory support, underwent balloon dilatation and expandable stainless steel stent placement across the stenoses. Following the successful release of the stent, there was gradual widening of the stenosed trachea in one patient, while in the other re-stenosis occurred due to columns of tracheal tissue projecting between the limbs of the stent. In the chronically ill and debilitated, use of expandable stents provides a good alternative to complex reconstructive surgery.
Assuntos
Stents , Estenose Traqueal/terapia , Adulto , Cateterismo , Feminino , Humanos , Intubação Intratraqueal/efeitos adversos , Pessoa de Meia-Idade , Radiografia , Recidiva , Aço Inoxidável , Estenose Traqueal/diagnóstico por imagem , Estenose Traqueal/etiologiaRESUMO
PURPOSE: To analyze results of percutaneous transluminal angioplasty (PTA) for stenosis of the descending thoracic and/or abdominal aorta caused by Takayasu arteritis (TA). MATERIALS AND METHODS: Subjects were 16 patients (12 female and four male, aged 6-46 years) with symptoms of hypertension or severe bilateral lower limb claudication. Total aortography revealed stenotic lesions in the descending thoracic aorta in five, in the abdominal aorta in 10, and in both vessels in one patient. Involvement of arch vessels in four patients and of the renal artery in four patients was also noted. Double-balloon angioplasty was performed in eight patients. RESULTS: Initial technical and clinical success was 100%. The maximum follow-up period was 52 months (mean, 21 months 2 weeks). Ankle-brachial index as determined with Doppler ultrasound improved considerably in 10 patients. Three patients had symptoms of restenosis during follow-up. Cumulative patency rate by life-table analysis was 67%. CONCLUSION: PTA has a definite role in the management of TA in view of its procedural simplicity, cost-effectiveness, and results compared with surgical revascularization procedures.
Assuntos
Angioplastia com Balão , Aorta Abdominal/patologia , Aorta Torácica/patologia , Estenose da Valva Aórtica/terapia , Arterite de Takayasu/terapia , Adolescente , Adulto , Angioplastia com Balão/efeitos adversos , Angioplastia com Balão/instrumentação , Angioplastia com Balão/métodos , Estenose da Valva Aórtica/fisiopatologia , Pressão Sanguínea/fisiologia , Criança , Feminino , Seguimentos , Humanos , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Recidiva , Obstrução da Artéria Renal/patologia , Arterite de Takayasu/fisiopatologia , Grau de Desobstrução VascularRESUMO
In five patients embolization of large saccular aneurysms involving the popliteal artery, common carotid artery, arch of the aorta, and abdominal aorta was performed with custom-designed spring coils. Surgery was attempted before embolization for the aneurysm involving the popliteal artery. The other aneurysms were considered nonresectable due to their critical location. Although maximal packing of the aneurysmal sac was attempted, delayed follow-up angiography revealed displacement of the coils away from the parent vessel as well as further expansion of the residual aneurysmal sac. In these cases complete embolization of the aneurysmal sac was not possible without obstructing the parent artery.
