RESUMO
OBJECTIVE: Endovascular therapies may offer distinct advantages in acute aortic syndromes. In this paper, we present our experience with emergent endovascular repair of both abdominal and thoracic aortic ruptures and report early and midterm out comes. METHODS: Data from all patients (n=96) who were treated by endovascular procedures between 2004 to 2012 were prospectively collected and early-midterm outcomes of the emergency (e) interventions for both abdominal (EVAR) and thoracic (TEVAR) aortic ruptures (n=20) were retrospectively analysed. RESULTS: The mean age was 65 +- 11 years (range: 27-77 years)and 18 patients (90%) were male. Mean follow-up duration was 28 ± 21.2 months (range=1-57). Thirteen patients were treated by eEVAR (65%) and 7 by eTEVAR (35%). One patient who had a rupture of the aneurysm at arcus aorta level was treated by hybrid procedure (eTEVAR+ debranching).The hospital mortality rate was 20% (n=4) for all cases, 23.0% (n=3) for eEVAR and 14.2% (n=1) for eTEVAR. In the follow-up period, 3 patients (15.0%) had reinterventions. DISCUSSION: Reinterventions and the necessity of close follow-up are the disadvantages of endovascular procedures.Even if that is the case, we believe that eEVAR eTEVAR in the acute setting of ruptured aorta in patients with suitable anatomy is a lifesaving option.
Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular , Emergências , Procedimentos Endovasculares , Adulto , Idoso , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/mortalidade , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/mortalidade , Ruptura Aórtica/cirurgia , Prótese Vascular , Implante de Prótese Vascular/métodos , Procedimentos Endovasculares/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Radiografia , Reoperação , Estudos Retrospectivos , Fatores de Tempo , Resultado do TratamentoRESUMO
OBJECTIVE: The goal was to review our experience in the management of carotid body tumours. MATERIAL AND METHODS: A retrospective study was performed of patients in whom carotid body tumour was diagnosed between 1998 and 2005. Data were retrieved from hospital discharge files. RESULTS: Fourteen patients were operated on. There were five patients in Shamblin class I, 4 in class II, and 5 in class III. Duplex examination was performed in all patients. Computerized tomography scans were performed in eight (57%) patients and magnetic resonance imaging scans in five patients (36%). Angiography was performed in all patients, preoperative embolization was attempted in 5 (36%). The blood loss for these patients was not less than for those without embolization. Three patients (21%) had postoperative cranial nerve deficits. All the deficits resolved. The internal carotid artery was injured in two patients and the external carotid artery was injured in three patients (36%). No stroke occured. CONCLUSION: Surgical resection is the treatment of choice for carotid body tumours. Observation of these tumours is not recommended because progressive growth is associated with increased risk of neurological deficits. Early surgical management is recommended to avoid neurological deficit due to a Shamblin class III tumour. We also do not recommend embolization.
Assuntos
Tumor do Corpo Carotídeo/cirurgia , Adulto , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Artérias Carótidas/diagnóstico por imagem , Tumor do Corpo Carotídeo/diagnóstico , Feminino , Humanos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia DopplerRESUMO
We report a successful endovascular stent-graft treatment of a patient with type A dissection with primary entry tear at the ascending aorta. Simultaneous coronary stenting was performed. A literature review was performed and the possible use of endovascular treatment for ascending aortic dissections is discussed.
Assuntos
Aneurisma Aórtico/cirurgia , Dissecção Aórtica/cirurgia , Prótese Vascular , Stents , Idoso , Dissecção Aórtica/diagnóstico por imagem , Aneurisma Aórtico/diagnóstico por imagem , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/cirurgia , Humanos , Masculino , Radiografia , Grau de Desobstrução VascularRESUMO
Intravenous leiomyoma of the uterus is a histologically benign, smooth-muscle tumor and may extend through the inferior vena cava into the right atrium. Surgical treatment is mandatory and single-stage resection of the tumor has gained wide acceptance as a safe and easy procedure. We describe a single-stage surgical procedure for an intravenous leiomyoma extending to the right atrium diagnosed in a routine control after myomectomy.
Assuntos
Angiomioma/patologia , Angiomioma/cirurgia , Parada Cardíaca Induzida , Recidiva Local de Neoplasia/patologia , Neoplasias Uterinas/patologia , Útero/irrigação sanguínea , Útero/patologia , Veia Cava Inferior/patologia , Adulto , Procedimentos Cirúrgicos Cardíacos , Feminino , Procedimentos Cirúrgicos em Ginecologia , Átrios do Coração/patologia , HumanosRESUMO
Conventional surgical repair of ascending aortic pseudoaneurysms following prior cardiac operations is performed with a high operative mortality. We report a 67 year old female patient with an ascending aortic pseudoaneurysm detected 3 years after coronary bypass surgery. The patient was treated with ascending aortic endovascular stent graft placement and extraanatomic reconstruction of supraaortic branches without using sternotomy.