RESUMEN
AIM: The purpose of the study was to demonstrate the possibilities and efficacy of endovascular interventions in patients with visceral artery aneurysms. PATIENTS AND METHODS: From 2013 to June 2020, we performed 15 embolizations of visceral artery aneurysms in 15 patients (8 men and 7 women). The technical success rate was 100%. The patients' age varied from 32 to 71 years. In 8 cases, the aneurysm was located in the basin of the splenic artery, in 3 cases in the gastroduodenal artery, in 2 cases in the superior mesenteric artery and in 2 cases in the renal artery. Three aneurysms were classified as false, and 12 as true. All aneurysms were saccular, with their diameter ranging from 6 to 32 mm. In 2 patients aneurysms were detected after endured infective endocarditis, in 8 during examination in abdominal pain syndrome, and in 5 cases as an incidental finding while performing computed tomography of abdominal organs. One patient was subjected to embolization of the afferent vessel, two underwent implantation of stent grafts into the aneurysmal neck area, and eleven underwent aneurysmal sac embolization with microcoils. In 9 cases, embolization was performed using microcoils only in 1 case using microcoils with balloon assistance, and in 2 cases using microcoils with stent assistance. We used from 1 to 12 microcoils, with a diameter of from 2 to 30 mm. RESULTS: During endovascular embolization of visceral artery aneurysms there were no target-organ infarctions, haemorrhagic complications, nor lethal outcomes. In the early postoperative period, 7 patients developed pain syndrome. In 1 case pain syndrome was relieved by narcotic analgesics, in 4 cases by spasmolytics, and in 2 cases by a combination of spasmolytics and non-narcotic analgesics. CONCLUSION: Endovascular treatment of visceral arterial aneurysms is an efficient and safe method.
Asunto(s)
Aneurisma Falso , Aneurisma , Adulto , Anciano , Aneurisma/diagnóstico , Aneurisma/cirugía , Aneurisma Falso/diagnóstico , Aneurisma Falso/etiología , Aneurisma Falso/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Arteria Esplénica , Resultado del Tratamiento , VíscerasRESUMEN
Aneurysms and pseudoaneurysms of visceral arteries are relatively rare clinical entities and their pathogenesis has not yet been fully understood. Aneurysmal rupture appears to be a complication leading to life-threatening internal haemorrhage and is a cause of high mortality. However, advances in endovascular surgery techniques have extended the capabilities of treating aneurysms, allowing microemboli to be delivered even to the hard-to-reach portions of the vascular bed with complicated anatomy. Presented in the article is a clinical case report regarding embolization of a false aneurysm of the inferior gastrointestinal artery, separated by a microcoil, and demonstrating possibilities of endovascular superselective embolization of the target vessel.
Asunto(s)
Aneurisma Falso/diagnóstico , Embolización Terapéutica , Procedimientos Endovasculares , Arteria Hepática , Humanos , Resultado del TratamientoRESUMEN
The article presents a clinical case of embolism with bone cement of the right ventricle of the heart and pulmonary artery after percutaneous vertebroplasty in a patient aged 63 years. According to the results of a comprehensive examination using ultrasound and x-ray methods, three foreign bodies were found: in the right ventricle cavity, in the trunk of the pulmonary artery, in the branches of the left pulmonary artery. Considering the stable condition, normal blood oxygen saturation, the lack of influence of formations on intracardiac hemodynamics, it was decided to refrain from surgery, since the risk of intervention exceeded the possible benefit. Conservative treatment tactics and dynamic observation were chosen. The literature data on the frequency of such events and tactics of management of these patients are presented.
Asunto(s)
Cardiopatías , Embolia Pulmonar , Vertebroplastia , Cementos para Huesos , Humanos , Persona de Mediana Edad , Arteria PulmonarRESUMEN
Atrial fibrillation is one of most frequent heart rhythm disorders in clinical practice. In this article, we present data of review of relevant literature including consideration of prevention of thromboembolic complications. We also present our own experience of endovascular implantation of the WATCHMAN device in left atrial appendage of patients with atrial fibrillation.
Asunto(s)
Fibrilación Atrial/terapia , Desfibriladores Implantables , Procedimientos Endovasculares/métodos , Anciano , Anciano de 80 o más Años , Apéndice Atrial , Fibrilación Atrial/fisiopatología , Cateterismo Cardíaco , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The results of pulmonary embolism treatment with streptase in 76 patients are discussed. All patients had submassive or massive pulmonary embolism. 66 (86%) of patients recovered. Thrombolysis with the use of heparin was performed in 9 patients, death occurred in 5 of them. Of 20 patients treated with "Actilize", death was reported in three cases. Authors consider alteplase to be highly effective in the treatment of massive pulmonary embolism. In case of late diagnostics of pulmonary embolism, especially recurrent, thrombolytic therapy remains to be effective up to 2 weeks after primary embolization.
Asunto(s)
Fibrinolíticos/uso terapéutico , Embolia Pulmonar/tratamiento farmacológico , Activador de Tejido Plasminógeno/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Angiografía , Aspirina/administración & dosificación , Aspirina/uso terapéutico , Femenino , Fibrinolíticos/administración & dosificación , Heparina/administración & dosificación , Heparina/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Inhibidores de Agregación Plaquetaria/administración & dosificación , Inhibidores de Agregación Plaquetaria/uso terapéutico , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/diagnóstico por imagen , Embolia Pulmonar/mortalidad , Estreptoquinasa/administración & dosificación , Estreptoquinasa/uso terapéutico , Factores de Tiempo , Activador de Tejido Plasminógeno/administración & dosificación , Resultado del TratamientoRESUMEN
The experience of 3-D X-ray contrast rotational angiography use is analysed. The case examples of virtual applications use on various anatomic areas are described. Informational value of routine and 3-D angiography is comparatively evaluated. The preferences of modern technology is showed.
Asunto(s)
Angiografía/métodos , Imagenología Tridimensional/métodos , Enfermedades Vasculares/diagnóstico por imagen , Diagnóstico Diferencial , Humanos , Reproducibilidad de los ResultadosRESUMEN
The peculiarities and techniques of craniofacial identification using lifetime video and X-ray photographs presented as comparative materials are examined.
Asunto(s)
Antropología Forense/métodos , Odontología Forense/métodos , Patologia Forense/métodos , Cráneo/anatomía & histología , Cráneo/patología , Cefalometría , Huesos Faciales/anatomía & histología , Huesos Faciales/patología , Humanos , Modelos Anatómicos , Fotograbar , Federación de RusiaRESUMEN
Results of development and prospects of using new computer technologies of craniofacial personality identification based on three-dimensional simulation of identification objects are demonstrated.