RESUMEN
Polyacrylamide hydrogel (PAAG) is a filler that has been strictly prohibited in France for many years. It first appeared on the market in 1980, used as an injectable for breast and facial augmentation, mainly in Asia and Eastern Europe. Like many other materials, it has shown unfavourable results and complications due to a foreign body reaction. It was banned in 2006, but continues to be injected illegally. With the influx of migrants, we are faced with the problem of how to manage complications, which can occur more than a decade later. We report our experience of a recent case in our department that required complete removal of the product and iterative lipofilling, with a result that remains sub-optimal, and we systematically review the literature.
Asunto(s)
Mamoplastia , Femenino , Humanos , Mamoplastia/métodos , Mama/cirugía , Resinas Acrílicas/efectos adversos , InyeccionesRESUMEN
BACKGROUND: Percutaneous angioplasty of the superficial femoral artery (SFA) with paclitaxel-coated balloon, intended to reduce restenosis, has been proven safe and effective in recent randomized controlled trials. OBJECTIVE: To assess outcome results of angioplasty of the SFA with paclitaxel-coated balloon in claudicants in real-world practice of a single center. MATERIAL & METHODS: A continuous prospective cohort study of 53 claudicants (62 lower limbs) from January 2015 to December 2016. Study end points include primary patency, freedom from clinically driven target-lesion revascularization and symptom relief. RESULTS: It concerns 17 women (32%) and 36 men (68%) with a mean age of 67.8 years, suffering life-style-limiting claudication. Only short to intermediate-length stenoses or occlusions (30.6%), with a mean length of 59.6 mm were selected for percutaneous angioplasty with a paclitaxel-coated balloon. Technical success was 100%. At 16 months, primary patency attained 92.0% (3 early occlusions, 2 restenoses). There were two re-interventions at 6 and 9 months, resulting in a clinically driven target lesion revascularization rate of 3.2%. At the end of the follow-up of 16 months, all but two patients (96.2%) remained symptom-free. Two patients died during follow-up (no procedure-related deaths). CONCLUSION: Paclitaxel-coated balloon angioplasty of the SFA gives in routine clinical practice excellent midterm results, with a restenosis rate of 6.5% at 1 year. This procedure has authors' preference as first-choice technique for correction of short- and intermediate-length symptomatic stenoses of the SFA.