RESUMO
OBJECTIVE: To compare the mortality rates of patients with claudication and de novo femoropopliteal lesions treated with and without paclitaxel coated devices (PCD). BACKGROUND: A recent meta-analysis, mostly including patients with claudication and de novo femoropopliteal lesions but also with recurrent stenoses and critical limb ischemia, has shown a significant excess mortality in patients treated with PCD. METHODS: Comparison of two historical cohorts of patients presenting with claudication and de novo femoropopliteal lesions treated with and without PCD between 2008 and 2018. RESULTS: After review of 5219 arteriograms in patients presenting with peripheral artery disease, 700 consecutive patients were included consisting in 72.6% of male (n = 508). Mean age was 68.1 ± 8.5 years. 45.7% of the patients (n = 320) had a treatment including a PCD. Mean femoropopliteal lesion length was 123 ± 91 mm including 44.6% of occlusions. Patients of the control group were censored at crossover to paclitaxel when applicable. Mortality rates at 1, 2 and 5 years were 4.6%, 7.5%, 19.4% and 1.6%, 6.2%, 16.6% in the non-PCD and PCD groups respectively. The relative risks of death when using PCD were 0.35 (p = 0.03), 0.83 (p = NS) and 0.86 (p = NS) at 1, 2 and 5 years respectively. CONCLUSION: There was no excess mortality in patients with claudication and de novo femoropopliteal lesions treated with paclitaxel coated devices at 1, 2 and 5 years of follow-up in this cohort. The current study suggests that additional prospective randomized studies properly powered to study mortality are necessary.
Assuntos
Ligas , Angioplastia com Balão/instrumentação , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Oclusão de Enxerto Vascular/terapia , Falência Renal Crônica/terapia , Diálise Renal , Stents , Extremidade Superior/irrigação sanguínea , Idoso , Circulação Colateral , Feminino , Oclusão de Enxerto Vascular/diagnóstico por imagem , Oclusão de Enxerto Vascular/etiologia , Oclusão de Enxerto Vascular/fisiopatologia , Humanos , Falência Renal Crônica/diagnóstico , Desenho de Prótese , Resultado do Tratamento , Grau de Desobstrução VascularRESUMO
Hemorrhagic extension along the pulmonary arteries should be recognized as a complication of Stanford type A aortic dissection. Radiologists and other physicians with an interest in cardiothoracic imaging should be aware of this rare but life-threatening pathology. The anatomical concept of the pathology is outlined in this text, through high-quality electrocardiogram-gated computerized tomography images.
Assuntos
Aneurisma Aórtico/complicações , Aneurisma Aórtico/diagnóstico por imagem , Dissecção Aórtica/complicações , Dissecção Aórtica/diagnóstico por imagem , Eletrocardiografia , Hematoma/diagnóstico por imagem , Hematoma/etiologia , Artéria Pulmonar , Tomografia Computadorizada por Raios X/métodos , Idoso de 80 Anos ou mais , Evolução Fatal , Feminino , Humanos , Artéria Pulmonar/diagnóstico por imagem , Recusa do Paciente ao TratamentoAssuntos
Angioplastia com Balão/instrumentação , Isquemia/terapia , Extremidade Inferior/irrigação sanguínea , Doença Arterial Periférica/terapia , Stents , Veias , Doença Crônica , Feminino , Humanos , Isquemia/diagnóstico por imagem , Isquemia/fisiopatologia , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico por imagem , Doença Arterial Periférica/fisiopatologia , Desenho de Prótese , Fluxo Sanguíneo Regional , Resultado do Tratamento , Veias/diagnóstico por imagem , Veias/fisiopatologia , CicatrizaçãoRESUMO
During the past decade, cardiac magnetic resonance has gained increasing popularity in the diagnosis of hypertrophic cardiomyopathy because of its greater accuracy and better characterization of cardiac morphology compared with other imaging modalities. In this pictorial essay, a global clinical portrait of hypertrophic cardiomyopathy will be drawn. The various radiologic findings associated with each variant of hypertrophic cardiomyopathy, and the clinical edge offered by cardiac magnetic resonance will be discussed.
Assuntos
Hipertrofia Ventricular Esquerda/diagnóstico , Imageamento por Ressonância Magnética , Diagnóstico Diferencial , Ecocardiografia , Gadolínio , Humanos , Hipertrofia Ventricular Esquerda/classificação , Hipertrofia Ventricular Esquerda/fisiopatologia , Hipertrofia Ventricular Esquerda/terapia , Imageamento por Ressonância Magnética/métodosRESUMO
This article reviews the basic and clinical features of heart disease associated with carcinoid syndrome, with an emphasis on its principal imaging modalities.