RESUMO
The present case illustrates the value of multidetector CT scan and cardiac MRI for the diagnosis of a hydatid cyst of the interventricular septum of the heart. These new modalities can help both for surgery planning and follow-up.
Assuntos
Cardiomiopatias/diagnóstico , Equinococose/diagnóstico , Septos Cardíacos , Imagem Cinética por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Assistência ao Convalescente , Cardiomiopatias/epidemiologia , Cardiomiopatias/cirurgia , Diagnóstico Diferencial , Equinococose/epidemiologia , Equinococose/cirurgia , Humanos , Masculino , Cuidados Pré-OperatóriosRESUMO
Peripheral venous tumors are uncommon and their delayed clinical expression leads to poor prognosis. We report a series of 7 cases including 6 leiomyosacromas and 1 hemangioendothelioma. Duplex Doppler and MR imaging appeared to be best suited for diagnosis, allowing an evaluation of extension and an analysis of associated endoluminal thrombi. These imaging techniques help guide surgery and improve prognosis.
Assuntos
Hemangioendotelioma/diagnóstico , Leiomiossarcoma/diagnóstico , Imageamento por Ressonância Magnética , Ultrassonografia Doppler Dupla , Neoplasias Vasculares/diagnóstico , Adolescente , Adulto , Feminino , Veia Femoral/patologia , Veia Femoral/cirurgia , Hemangioendotelioma/patologia , Hemangioendotelioma/cirurgia , Humanos , Leiomiossarcoma/patologia , Leiomiossarcoma/cirurgia , Masculino , Pessoa de Meia-Idade , Células Neoplásicas Circulantes , Prognóstico , Veia Safena/patologia , Veia Safena/cirurgia , Sensibilidade e Especificidade , Taxa de Sobrevida , Neoplasias Vasculares/patologia , Neoplasias Vasculares/cirurgiaRESUMO
PURPOSE: To evaluate the safety and efficacy of a porcine-derived gelfoam, Curaspon, for the temporary occlusion of the visceral arteries. METHODS: Curaspon was used for the selective embolization of segmentary hepatic, unilateral polar renal, and single lumbar arteries of 10 pigs under general anesthesia. Sequential angiographic checks were carried out and the pigs killed between 3 days and 2 weeks later. Macroscopic and microscopic studies using standard techniques were used to evaluate the immediate efficacy of embolization, duration of and completeness of recanalization on angiography, macroscopic appearance of target-organ ischemia, and microscopic analysis of inflammatory reaction. RESULTS: Immediate arterial occlusion was obtained in all cases. Renal arteries showed a total recanalization in 63% of cases on day 7 and 100% on day 14. Total hepatic recanalization was obtained in 100% of animals on day 7. All lumbar arteries were recanalized on day 14. Microscopic analysis in the kidney revealed a mild inflammatory reaction and a progressive lysis of the Curaspon (87% of samples at day 3 showed a persistence of Curaspon and 5% at day 14). In some cases, localized and partial destruction of the arterial wall was visualized. In the liver the same patterns were observed but resolved more completely and more rapidly. CONCLUSIONS: Curaspon is an efficient material for the temporary occlusion of visceral and parietal arteries in pigs. However, arterial aneurysms were observed and a relationship of these with the material cannot be excluded.
Assuntos
Embolização Terapêutica , Esponja de Gelatina Absorvível/administração & dosagem , Animais , Artéria Hepática , Vértebras Lombares/irrigação sanguínea , Artéria Renal , Sus scrofaRESUMO
Recent articles reported excellent results in the percutaneous declotting of native fistulas for hemodialysis with use of thromboaspiration, mechanical devices, or thrombolytic drugs, with success rates ranging from 76% to 100%. These results challenge the surgical approach, the effectiveness of which is not supported by comparable publications. Although it is more difficult to declot forearm native fistulas than grafts, declotting of fistulas is more rewarding because it achieves better long-term patency (1-year primary rates as high as 50% and secondary rates of 80%). The results reported from declotting of fistulas in the upper arm are not as good. The unmasking of stenoses in close to 100% of cases warrants stenosis detection programs similar to those used for grafts.
Assuntos
Derivação Arteriovenosa Cirúrgica/efeitos adversos , Radiografia Intervencionista/métodos , Diálise Renal , Trombectomia/métodos , Trombose/terapia , Cateterismo , Antebraço/irrigação sanguínea , Humanos , Seleção de Pacientes , Sucção/instrumentação , Trombectomia/instrumentação , Trombose/etiologia , Resultado do TratamentoRESUMO
We report a case of a woman presenting with right severe buttock claudication and normal neurological and osteoarticular examination, in whom a guidewire recanalization and percutaneous transluminal angioplasty (PTA) of an occluded right superior gluteal artery (SGA) has provided relief of her symptoms. To our knowledge, this is the first report of percutaneous recanalization of the SGA. PTA can be considered the treatment of choice for buttock claudication caused by SGA stenosis or occlusion.