RESUMEN
In the last years, several randomized and multicenter trials have been performed to evaluate the benefit of carotid endarterectomy (CE) in the carotid stenosis. To determine whether CE could be performed safely at hospitals not included in international trials, the results of 193 consecutive CEs performed during a 10-year period at a medical center of our environment were reviewed. A 65.8% of CEs were performed on symptomatic patients, 68.5% of whom had stenosis superiores to 70%. Among asymptomatic patients, 89.4% had stenosis superiores to 70%. Three patients died. Besides there were five nonfatal neurologic complications (one reversible ischemic neurologic deficit, one minor stroke and three major strokes). The mortality rate was 1.5%, the rate of mayor neurologic morbidity and mortality was 3.1% and the rate of total neurologic morbidity and mortality was 4.1%. These data demonstrate that CE can be performed with safety at Divisions of Vascular Surgery of our environment.
Asunto(s)
Estenosis Carotídea/cirugía , Endarterectomía Carotidea , Anciano , Isquemia Encefálica/etiología , Estenosis Carotídea/complicaciones , Trastornos Cerebrovasculares/etiología , Endarterectomía Carotidea/efectos adversos , Endarterectomía Carotidea/mortalidad , Endarterectomía Carotidea/estadística & datos numéricos , Estudios de Evaluación como Asunto , Femenino , Hospitales Universitarios/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Seguridad , Índice de Severidad de la Enfermedad , España , Resultado del TratamientoRESUMEN
La formación de un pseudoaneurisma es una de las complicaciones tardías posibles y no infrecuentes de la reparación abierta de las coartaciones de aorta y que comporta una alta morbimortalidad. Presentamos un caso de pseudoaneurisma de aorta torácica con clínica de hemoptisis masiva que fue tratado con éxito mediante la implantación de una endoprótesis aórtica tipo Zenith TX2 (Cook). En la discusión se comentan los diversos factores predictores de la aparición de estos pseudoaneurismas, el seguimiento preciso para diagnosticarlos a tiempo y las posibilidades terapéuticas actuales a la hora de abordar esta grave complicación tardía (AU)
The pseudoaneurysm develop is a late complication of coarctation open repair and bear high morbility and mortality. We show a thoracic aortic pseudoaneurysm case with massive hemoptysis treated with Zenith TX2 (Cook) stent-graft repair. We speak about predictors of this pseudoaneurysm formation, follow up and therapeutic possibilities for approach this problem (AU)