Asymptomatic carotid stenosis in patients with intermittent claudication: epidemiological study.

AIM: The aim of this paper was to determine the prevalence of extracraneal carotid artery disease in patients with intermittent claudication, to describe classic cardiovascular risk factors in those with hemodynamically significant stenosis and to try to define subgroups at high risk, improving therefore the performance of non invasive testing. METHODS: A prospective descriptive study was conducted, with 146 patients reporting an intermittent claudication of the lower limbs and without a previous cerebrovascular event or carotid surgery. An ultrasonography examination was done. Risk factors were registed (smoking, dislipemia, arterial hypertension, diabetes mellitus), also ischemic cardiopathy and myocardial revascularization procedures. Univariate and multivariate analysis was made to define the variables associated with hemodynamically significant stenosis. RESULTS: Prevalence of hemodynamically significant stenosis was 23.2%. Smoking, dislipemia, arterial hypertension and diabetes mellitus were not significantly associated with carotid stenosis; 24.2% of patients affected of ischemic cardiopathy present a severe stenosis, and myocardial revascularization was a risk factor for carotid stenosis. CONCLUSION: Patients with claudication and ischemic miocardiopathy, especially when myocardial revascularization is needed, must be explored with carotid ultrasonography. In this patients, probably of hemodynamically significant carotid stenosis that requires treatment is more frequent.

Endovascular treatment of splenic and renal aneurysms.

Four cases (three women and one man) of embolization of visceral artery aneurysms are presented, of which two affected the splenic artery and two the renal artery. The two renal aneurysms were related to hypertension; one of the splenic aneurysms was diagnosed in the context of hypertension, and the other affected a woman of a fertile age. Microguides, microcatheters, and Guglielmi platinum coils, liberated by electrolysis, with different lengths and characteristics, were used. Also, one of the renal aneurysm cases was related to the placing of a stent due to the existence of a stenosis of the renal artery adjacent to the aneurysmatic neck. Immediate occlusion of the aneurysm was achieved in the four cases. Evaluation with nuclear magnetic resonance angiography carried out 3 months later confirmed the sealing of the aneurysm and the patency of the native artery. Currently available devices provide a good therapeutic option for the embolization of visceral aneurysms with low morbidity and mortality rates.