Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Implantación de Prótesis Vascular/instrumentación , Prótesis Vascular , Procedimientos Endovasculares/instrumentación , Isquemia/etiología , Extremidad Inferior/irrigación sanguínea , Falla de Prótesis , Stents , Enfermedad Aguda , Anciano , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aortografía/métodos , Implantación de Prótesis Vascular/efectos adversos , Procedimientos Endovasculares/efectos adversos , Humanos , Isquemia/diagnóstico por imagen , Isquemia/cirugía , Masculino , Diseño de Prótesis , Reoperación , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
INTRODUCTION: Central venous catheter placement is an effective alternative vascular access for dialysis in patients with chronic renal failure. The purpose of this study was to evaluate the insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations in terms of efficacy of the procedure and early complications. MATERIALS AND METHODS: Between 2008 and 2010, the vascular access team of our hospital placed 409 central venous catheters in patients with chronic renal failure. The procedure was performed using the Seldinger blind technique. In 18 (4.4%) cases it was impossible to advance the guidewire, and so the patients were transported to the angiography suite. RESULTS: Using the angiographic technique, the guidewire was advanced in order to position the central venous catheter. The latter was inserted into the subclavian vein in 12 (66.6%) cases, into the internal jugular vein in 4 (22.2%) and into the femoral vein in 2 (11.1%) cases. There was only one complicated case with severe arrhythmia in 1 (5.5%) patient. CONCLUSION: Our results suggest that insertion of central venous catheters using angiographic techniques in hemodialysis patients with previous multiple catheterizations is a safe and effective procedure with few complications and high success rates.
Asunto(s)
Cateterismo Venoso Central/estadística & datos numéricos , Fallo Renal Crónico/epidemiología , Fallo Renal Crónico/rehabilitación , Radiografía Intervencional/estadística & datos numéricos , Diálisis Renal/estadística & datos numéricos , Trombosis de la Vena/epidemiología , Trombosis de la Vena/prevención & control , Adulto , Anciano , Angiografía/estadística & datos numéricos , Comorbilidad , Femenino , Grecia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Reoperación/estadística & datos numéricos , Medición de Riesgo , Resultado del Tratamiento , Trombosis de la Vena/diagnóstico por imagenRESUMEN
We report a case of a ruptured para-anastomotic aortic aneurysm treated with implantation of a bifurcated stent-graft. A 72-year-old patient, who had undergone aortobifemoral bypass for aortoiliac occlusive disease 16 years ago, presented with a ruptured para-anastomotic aortic aneurysm. A bifurcated stent-graft was successfully deployed into the old bifurcated graft. This is the first report of a bifurcated stent-graft being placed through an "end-to-side" anastomosed old aortobifemoral graft. Endovascular treatment of ruptured para-anastomotic aortic aneurysms can be accomplished successfully, avoiding open surgery which is associated with increased mortality and morbidity.