RESUMEN
BACKGROUND: Vascular trauma comprises a diagnostic and surgical challenge. Aim of this study was to present the vascular traumas treated in our Tertiary Hospital during the last 5 years. METHODS: We retrospectively reviewed the surgical records of our vascular department and documented the site and type of vascular injuries of the extremities along with the concurrence of musculoskeletal injuries. The type and outcome of surgical interventions were also recorded. RESULTS: Fifty-eight cases of vascular trauma were recorded (39 in the upper and 19 in the lower extremities). Overall, iatrogenic traumas accounted for 41.3% of cases. The arterial injuries of the upper limb were blunt and penetrating in 27% and 67%, respectively. The most affected artery in the upper limb was the radial artery (37.8%), followed by the ulnar artery (27%) and the brachial artery (24.3%). Orthopedic injuries were recorded in 19% of patients. Management involved simple revascularization, bypass operations, patch arterioplasty and endovascular management in 48.7%, 33.3%, 5.1%, and 5.1%, respectively. The most affected site in the lower extremity was the common femoral artery (36.8%) followed by the popliteal artery (21%). Bone fractures were reported in 5 cases (26.3%). The surgical management involved bypass, simple revascularization, patch arterioplasty in 42.1%, 26.3%, and 21%, respectively. Endovascular management was performed in 10.5%. CONCLUSIONS: A considerable percentage of iatrogenic vascular injuries was recorded, affecting both the upper and lower limbs. Despite the trend toward centralization of vascular services, a basic service of vascular surgery should be available in most sites to ensure that patients with vascular injuries receive fast and appropriate care.
Asunto(s)
Extremidades/irrigación sanguínea , Enfermedad Iatrogénica , Procedimientos Quirúrgicos Vasculares , Lesiones del Sistema Vascular/cirugía , Heridas no Penetrantes/cirugía , Heridas Penetrantes/cirugía , Adulto , Anciano , Prestación Integrada de Atención de Salud , Femenino , Grecia , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Sistema Musculoesquelético/lesiones , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento , Lesiones del Sistema Vascular/diagnóstico por imagen , Lesiones del Sistema Vascular/etiología , Heridas no Penetrantes/diagnóstico por imagen , Heridas no Penetrantes/etiología , Heridas Penetrantes/diagnóstico por imagen , Heridas Penetrantes/etiologíaRESUMEN
The Ovation Alto design repositions the maximum diameter of the proximal sealing ring at 7 mm below the lowermost renal artery. Although it has been introduced to address abdominal aortic aneurysms with short necks ≥7 mm, we present further applications of Alto in other neck irregularities, presenting four representative challenging cases with a short, wide, and conical neck, as well a juxtarenal aneurysm. At 1-month follow-up, there was 100% technical and clinical success.
RESUMEN
Non-A non-B aortic dissection (AAD) is an infrequently documented condition, comprising of only a small proportion of all AADs. The unique anatomy of the aortic arch and the failure of the existing classifications to adequately define individuals with non-A non-B AAD, have led to an ongoing controversy around the topic. It seems that the clinical progression of acute non-A non-B AAD diverges from the typical type A and B dissections, frequently leading to serious complications and thus mandating early intervention. Currently, the available treatment methods in the surgical armamentarium are conventional open, endovascular techniques and combined hybrid methods. The optimum approach is tailored in every individual case and may be determined by the dissection's location, extent, the aortic diameter, the associated complications and the patient's status. The management of non-A non-B dissections still remains challenging and a unanimous consensus defining the gold standard treatment has yet to be reached. In an attempt to provide further insight into this perplexing entity, we performed a minireview of the literature, aiming to elucidate the epidemiology, clinical course and the optimal treatment modality.
RESUMEN
OBJECTIVE: Gardner's syndrome is a variant of familial adenomatous polyposis, characterized by gastrointestinal polyps, multiple osteomas, and skin and soft tissue lesions. Diagnosis by means of an understanding of its various symptoms is of great importance. CASE REPOSRT: This report presents the case of a 32-year-old man with obvious asymmetry and disfigurement on his face, due to multiple osteomas and soft tissue lesions. These clinical signs prompted us to further investigation, leading to the diagnosis of a case of Gardner's syndrome, with asymptomatic polyposis of the colon. Polyps have virtually an almost 100% risk of undergoing malignant transformation. CONCLUSION: Early diagnosis and treatment of this pathological entity are crucial, while the presence of osteomas should alert us to this diagnosis.