RESUMO
Surgery and medical treatment have been classically accepted as the therapy of choice in some diseases of the thoracic aorta. Recently, treatment with endoprosthesis has emerged as a useful technique in the pathology of the descending thoracic aorta. The type of endoprosthesis, indications and experimental and clinical results are discussed.
Assuntos
Aorta Torácica/lesões , Aorta Torácica/cirurgia , Prótese Vascular , Dissecção Aórtica/cirurgia , Aneurisma Aórtico/cirurgia , Coartação Aórtica/cirurgia , Doenças da Aorta/cirurgia , HumanosRESUMO
PURPOSE: Popliteal artery entrapment and adventitial cystic disease are the main causes of claudication in young patients. Adventitial cystic disease is a rare vascular pathology mostly affecting the popliteal artery but other localisations have been reported. Diagnosis and therapeutic management of adventitial cystic disease and particularly percutaneous aspiration are presented. MATERIALS AND METHODS: The authors report six cases (four men and two women; mean age: 55) of CAD of the popliteal artery (n = 4) and unusual cases in the femoral artery (n = 1) and in the femoral vein (n = 1) explored by sonography, computed tomography (CT), magnetic resonance imaging (MRI) and angiography. Five patients were initially treated by CT-guided aspiration and one with endoprosthesis. RESULTS: Sonography, CT or MRI are more useful to establish the diagnosis because these techniques can directly visualize the arterial wall. All these patients but one have been treated by percutaneous method with a good functional outcome but surgical intervention was necessary for two of them because of cysts recurrence. CONCLUSION: Our experience suggests that percutaneous CT-guided aspiration is the first treatment option for small cysts but close long-term follow-up is necessary to detect recurrence.
Assuntos
Cisto Popliteal/diagnóstico , Tomografia Computadorizada por Raios X , Adulto , Idoso , Feminino , Humanos , Claudicação Intermitente/etiologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Cisto Popliteal/diagnóstico por imagem , Cisto Popliteal/terapia , Estudos Retrospectivos , Ultrassonografia DopplerRESUMO
Recent years have seen the emergence of non-invasive imaging techniques for the morphological assessment of the thoracic aorta. This evolution results in an important reduction of the role of diagnostic angiography. Simultaneously, thanks to a tremendous technologic development, endovascular treatment techniques concern nowadays some pathologic conditions of the descending aorta. A number of reports using a variety of devices have been published in the literature concerning the treatment of dissection and aortic aneurysm. Based on mid-term results, endoluminal repair with use of stent-grafts is a feasible and safe alternative to surgery with a low rate of morbidity and mortality. In type B dissections with end-organ involvement, interventional radiology can be used either to fenestrate the flap or to stent the flap in branch arteries. Proper selection of patients by non-invasive imaging is fundamental for successful endoluminal treatment. However, there is still major concern with respect to long term results of these new treatments.
Assuntos
Aorta Torácica , Doenças da Aorta/diagnóstico , Doenças da Aorta/cirurgia , Adulto , Idoso , Dissecção Aórtica/diagnóstico , Dissecção Aórtica/diagnóstico por imagem , Dissecção Aórtica/cirurgia , Angiografia , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/lesões , Aorta Torácica/cirurgia , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Coartação Aórtica/diagnóstico , Coartação Aórtica/diagnóstico por imagem , Coartação Aórtica/cirurgia , Doenças da Aorta/diagnóstico por imagem , Aortografia , Arteriopatias Oclusivas/diagnóstico , Arteriopatias Oclusivas/diagnóstico por imagem , Arteriopatias Oclusivas/cirurgia , Arteriosclerose/diagnóstico , Arteriosclerose/diagnóstico por imagem , Arteriosclerose/cirurgia , Implante de Prótese Vascular , Ecocardiografia , Ecocardiografia Transesofagiana , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Radiografia Intervencionista , Radiografia Torácica , Tomografia Computadorizada por Raios XRESUMO
An uncommon systemic reaction mimicking sarcoidosis after ligament reconstruction is reported. Clinical and radiological outcome after surgical treatment led to the diagnosis of a a specific injury caused by the ligament reconstruction device.
Assuntos
Ligamento Cruzado Anterior/cirurgia , Granuloma/etiologia , Polietilenotereftalatos/efeitos adversos , Próteses e Implantes/efeitos adversos , Adulto , Granuloma de Corpo Estranho/etiologia , Humanos , Masculino , Ruptura , Sinovite/etiologiaRESUMO
Because of the risk and complications related to surgery of the aorta, the development of new, less invasive endovascular techniques has resulted in a certain enthusiasm for these new treatments on the part of physicians and industry. The insertion of aortic stents allows the treatment of almost one half of aneurysm of the infrarenal abdominal aorta and descending aorta. The results appear to demonstrate the medium-term reliability and efficacy of these new techniques with a lower morbidity-mortality rate than that of conventional surgery. However, preoperative and intraoperative imaging plays an essential role in the success of these new methods. Finally, although the medium-term results are encouraging, the long-term outcome of these new materials is unknown, which justifies close surveillance of these patients and prospective comparative studies.
Assuntos
Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Torácica/diagnóstico por imagem , Stents , Aneurisma Roto/diagnóstico por imagem , Aneurisma Roto/cirurgia , Aneurisma da Aorta Abdominal/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Humanos , Radiografia , UltrassonografiaRESUMO
This article describes an instrument for the measurement of the mirage effect as a tool to determine the molar adsorption per unit surface area Y(1) of condensable solvents in the presence of a non-condensable carrier gas. The present apparatus is a much improved version of previous prototypes developed in our laboratory and elsewhere with a higher surface bake-out temperature (150 °C rather than 40 °C), lower residual vacuum (3 Pa versus 100 Pa), greater sample surface (40 mm diameter instead of 10 mm), more powerful optical pump beam (150 W cf. 50 W), and larger saturated vapour preparation volume (4 L instead of 1 L). The new set-up also includes the in situ monitoring of the surface via a reflected HeNe laser beam for the real-time detection of the onset of condensation. Here, we give a detailed description of the various components, outline the experimental procedure, show typical results, and suggest some straightforward improvements.
RESUMO
Transluminal placement of a stent graft in patients with an abdominal aortic aneurysm is a new endovascular technique that offers a potentially less invasive and less risky alternative to open surgery. Complications after stent graft placement are not infrequent, but in most cases secondary endovascular intervention is successful. We describe a late major leak in the aneurysmal sac caused by a distal migration of the iliac limb of a bifurcated graft. This late complication was successfully treated by covered stent placement, excluding and thrombosing completely the reformed aneurysm.
Assuntos
Angioplastia com Balão/instrumentação , Aneurisma da Aorta Abdominal/terapia , Prótese Vascular , Reperfusão , Stents , Idoso , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aortografia , Humanos , Masculino , Falha de Prótese , Retratamento , Tomografia Computadorizada por Raios XRESUMO
The aim of this study was to describe the radiological appearance of retroperitoneal ganglioneuroma. We retrospectively reviewed seven cases of histologically proven retroperitoneal ganglioneuroma. Ultrasound and enhanced CT were obtained in all cases, and MRI in three cases. The masses were well-circumscribed, ranged in size from 5 x 3 x 3 to 10 x 6 x 4 cm. In three cases close relationships between the tumor mass and major blood vessels were noted, resulting in vessel displacement or surrounding, but without compression or occlusion. On ultrasound examination the tumor showed a heterogeneous solid echostructure. Non-enhanced CT showed homogeneous or mildly heterogeneous low attenuation, and a punctate calcification was seen in one case. Contrast uptake was absent (n = 1) or delayed (n = 6). Progressive but incomplete enhancement was observed in three cases. On MRI, T2-weighted images showed a high signal intensity. Dynamic studies depicted the same enhancement pattern as described on CT. Ganglioneuroma is a rare tumor which should nevertheless be included in differential diagnosis of retroperitoneal masses when presenting as a well-delimited tumor with possible tendency to surround or displace major blood vessels, low density on non-enhanced CT, and delayed progressive enhancement on CT and MRI.
Assuntos
Diagnóstico por Imagem , Ganglioneuroma/diagnóstico , Neoplasias Retroperitoneais/diagnóstico , Adulto , Idoso , Criança , Feminino , Humanos , Aumento da Imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
Uncommon adrenal masses include cystic lesions (hydatid cyst, endothelial cyst), solid lesions (hemangioma, ganglioneuroma, angiosarcoma, primary malignant melanoma), and solid fatty lesions (myelolipoma, collision tumor). Most of these lesions do not have specific imaging features. The liquid content of adrenal cysts is clearly demonstrated on ultrasonographic scans, computed tomographic scans, and magnetic resonance images. Nevertheless, the histologic type cannot be predicted except at some stages of hydatid disease in which pathognomonic features are present. The most typical imaging features of hemangioma are phleboliths and enhancement of peripheral vascular lakes. Ganglioneuroma has nonspecific radiologic features, but this diagnosis should be considered in cases with early enhancement of fine septa and progressive filling. The radiologic features of angiosarcoma and primary malignant melanoma are nonspecific. A macroscopic lipid content within an adrenal mass is theoretically characteristic of myelolipoma. This diagnosis should be made with caution, especially when the lipid content is not predominant, because of the possible association with an adenoma.
Assuntos
Doenças das Glândulas Suprarrenais/diagnóstico , Diagnóstico por Imagem , Adenoma/diagnóstico , Adenoma/diagnóstico por imagem , Adenoma/patologia , Doenças das Glândulas Suprarrenais/diagnóstico por imagem , Doenças das Glândulas Suprarrenais/patologia , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/patologia , Cistos/diagnóstico , Cistos/diagnóstico por imagem , Cistos/patologia , Equinococose/diagnóstico , Equinococose/diagnóstico por imagem , Equinococose/patologia , Ganglioneuroma/diagnóstico , Ganglioneuroma/diagnóstico por imagem , Ganglioneuroma/patologia , Hemangioma/diagnóstico , Hemangioma/diagnóstico por imagem , Hemangioma/patologia , Hemangiossarcoma/diagnóstico , Hemangiossarcoma/diagnóstico por imagem , Hemangiossarcoma/patologia , Humanos , Imageamento por Ressonância Magnética , Melanoma/diagnóstico , Melanoma/diagnóstico por imagem , Melanoma/patologia , Mielolipoma/diagnóstico , Mielolipoma/diagnóstico por imagem , Mielolipoma/patologia , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
We evaluated preliminary success and patency of stenting for the treatment of radiation-induced arterial diseases. Thirteen stents were placed in 8 patients to treat occlusion (n = 3), aneurysm (n = 1), residual stenosis (n = 2), multiple stenoses (n = 1), and delayed restenosis after previous balloon angioplasty (n = 1). Interventional procedure was successfully performed in 8 patients for their arterial lesions after radiotherapy. Six patients underwent interventional procedure once or twice. Two patients underwent PTA 4 times. Five of these patients demonstrated primary patency with relief of clinical symptoms with a mean follow-up of 2 years (range: 8-60 months). Clinical improvement was noted in the other patients. Our results suggest that stent placement by single or multiple techniques may have immediate effect on arterial lesions caused by radiation and can be considered as a therapeutic option of choice in these cases.