ABSTRACT
In this paper, we present a case of kidney injury as a complication of renal artery angioplasty in a 54-year-old female patient that suffered from resistant renovascular hypertension. This case emphasises the unpredictable nature of endovascular procedures, the need for careful post-procedure evaluation and the role of 'old fashioned' surgical techniques in resolving complications of endovascular procedures.
Subject(s)
Angioplasty, Balloon , Endovascular Procedures , Hypertension, Renovascular/surgery , Kidney , Nephrectomy/methods , Postoperative Hemorrhage , Renal Artery Obstruction , Renal Artery , Angioplasty, Balloon/adverse effects , Angioplasty, Balloon/methods , Endovascular Procedures/adverse effects , Endovascular Procedures/methods , Female , Humans , Hypertension, Renovascular/diagnosis , Hypertension, Renovascular/etiology , Kidney/blood supply , Kidney/surgery , Middle Aged , Multidetector Computed Tomography/methods , Postoperative Hemorrhage/diagnosis , Postoperative Hemorrhage/etiology , Postoperative Hemorrhage/surgery , Renal Artery/diagnostic imaging , Renal Artery/pathology , Renal Artery/surgery , Renal Artery Obstruction/complications , Renal Artery Obstruction/diagnosis , Renal Artery Obstruction/physiopathology , Renal Artery Obstruction/surgery , Reoperation/methods , Treatment Outcome , Ultrasonography, Doppler, Duplex/methodsABSTRACT
INTRODUCTION: In-hospital mortality of acute aortic type III dissection ranged about 12%. Complicated dissections represent about 18% of all cases, and require open surgery or TEVAR. More morphological predictors of in hospital mortality are needed to differentiate patients who should be selected for immediate, surgical or endovascular intervention. METHODS: From January 2009 to December 2014, 74 patients with acute aortic type III dissection were enrolled at Clinic of Vascular and Endovascular Surgery in Belgrade Serbia and retrospectively analyzed. Every MSCT was observed in regard to morphologic characteristics of dissection. RESULTS: By analyzing morphologic parameters in patients between survival and non-survival group only localization of intimal tear showed statistical significance (p=0,020). The size of the intimal tear didn't reach statistical significance with the tendency of doing so in a larger sample of patients (p=0,063) with the cut-off value of 9.55mm. The shape of the true lumen was on the border of statistical significance (p=0,053). CONCLUSION: Inner curvature intimal tear localization, huge intimal tear as well as elliptic shape of the true lumen together should raise awareness to a subgroup at risk for in hospital mortality. More liberal endovascular treatment in this subgroup of patients is advocated.
Subject(s)
Aorta , Aortic Aneurysm , Aortic Dissection , Blood Vessel Prosthesis Implantation/statistics & numerical data , Endovascular Procedures/statistics & numerical data , Aged , Aortic Dissection/diagnosis , Aortic Dissection/etiology , Aortic Dissection/mortality , Aortic Dissection/surgery , Aorta/diagnostic imaging , Aorta/pathology , Aortic Aneurysm/complications , Aortic Aneurysm/diagnosis , Aortic Aneurysm/surgery , Aortography/methods , Blood Vessel Prosthesis Implantation/methods , Endovascular Procedures/methods , Female , Hospital Mortality , Humans , Male , Middle Aged , Multidetector Computed Tomography/methods , Retrospective Studies , Risk Assessment/methods , Risk Factors , Serbia/epidemiology , Survival AnalysisABSTRACT
OBJECTIVE: An aortic aneurysm is a general term for an enlargement (dilation) of the aorta to greater than 1.5 times normal size. Abdominal aortic aneurysm (AAA) primarily affects the population older than 50 years, with a prevalence of approximately 5%. There are a few theories about AAA etiology. Interest in the relationship between blood type and vascular disease has been established. The aim of our study is to evaluate distribution of blood-groups among the patients with abdominal aortic aneurysm (AAA) as well as to identify any kind of relationship between blood type and AAA. MATERIALS AND METHODS: The design of our research is combination of retrospective and prospective case-control study in a sample of population of Montenegro. Statistical analysis was performed in SPPS v 20.0, using the chi-square test for independent samples, with the probability level at p < 0.05 as significant, and p < 0.01 as highly significant. RESULTS: O blood group was the most frequent among the examination group (53.11%), and A blood group was the most frequent among group without AAA (43.22%). Presence of AAA in individuals with O blood type was 1.46 higher than for the other blood types. CONCLUSIONS: This finding leads us to suspect that O blood type can be indicator for AAA.
