RESUMEN
Organic molecules containing fluorine and sulfur atoms represent a large percentage of approved pharmaceuticals. Those with combination of both S and F atoms in their structure such as Xtandi, approved in 2012 for prostate cancer, indicates the importance of synthetic methods that accommodates both atoms in an organic moiety. In this study, a novel aspect of sulfoxonium ylide reactivity was explored, unveiling a streamlined and mild synthesis method for gem-difluorinated keto-sulfoxides. Our protocol offers a direct and practical approach to prepare these compounds in 14-80 % chemical yields, that were represented by 21 examples. NMR studies and Hammett correlations gave strong evidence about the mechanism of this transformation.
RESUMEN
In recent decades, the increasing complexity of arterial bypasses in the management of chronic limb-threatening ischemia has spurred the development of alternative techniques, such as revascularization of genicular arteries. Few publications on this technique can be found in the literature, and its use has been restricted to specialized vascular groups. This article describes the case of a patient with extensive femorotibial occlusive disease who received a collateral artery bypass, using the deep femoral artery as a donor, the cephalic vein as an alternative autogenous substitute, and the descending genicular artery as a recipient. Bypass to the descending genicular artery, although underutilized, is an effective option and increases the possibility of limb salvage in the management of chronic limb-threatening ischemia.
Asunto(s)
Arteria Femoral/cirugía , Isquemia/cirugía , Extremidad Inferior/irrigación sanguínea , Enfermedad Arterial Periférica/cirugía , Injerto Vascular , Venas/cirugía , Anciano , Enfermedad Crónica , Circulación Colateral , Femenino , Arteria Femoral/diagnóstico por imagen , Arteria Femoral/fisiopatología , Humanos , Isquemia/diagnóstico por imagen , Isquemia/fisiopatología , Enfermedad Arterial Periférica/diagnóstico por imagen , Enfermedad Arterial Periférica/fisiopatología , Flujo Sanguíneo Regional , Resultado del Tratamiento , Venas/diagnóstico por imagen , Venas/fisiopatologíaRESUMEN
ABSTRACT: In recent decades, the increasing complexity of arterial bypasses in the management of chronic limb-threatening ischemia has spurred the development of alternative techniques, such as revascularization of genicular arteries. Few publications on this technique can be found in the literature, and its use has been restricted to specialized vascular groups. This article describes the case of a patient with extensive femorotibial occlusive disease who received a collateral artery bypass, using the deep femoral artery as a donor, the cephalic vein as an alternative autogenous substitute and the descending genicular artery as a recipient. Bypass to the descending genicular artery, although underutilized, is an effective option and increases the possibility of limb salvage in the management of chronic limb-threatening ischemia.