RESUMO
The authors describe a young woman who developed severe toxemia during pregnancy, requiring emergency lower segment cesarian section at 27 weeks of gestation. Postpartum angiography showed a discrete stenotic lesion of the abdominal aorta proximal to the origin of the renal artery. Angioplasty was performed, followed by the insertion of a wall stent at the site of the stenosis. Her hypertension control improved dramatically after the stenting. This is, so far, the first reported case using a wall stent following angioplasty to relieve abdominal aortic stenosis due to Takayasu's arteritis.
Assuntos
Angioplastia com Balão , Doenças da Aorta/terapia , Complicações Cardiovasculares na Gravidez/terapia , Stents , Arterite de Takayasu/complicações , Adulto , Aorta Abdominal , Doenças da Aorta/etiologia , Feminino , Humanos , Gravidez , Arterite de Takayasu/diagnósticoRESUMO
We describe our experience with the ChoiCE PT (Boston Scientific Corporation, MN) guidewire, which resulted in perforation of the distal coronary artery in two instances. This newly introduced guidewire differs from earlier guidewires in its ability to cross lesions in tortuous arteries. However, when it buckles deep in the coronary artery, perforation can easily result. While the ChoiCE PT guidewire is a useful addition to our armamentarium in interventional procedures, it should be treated with care.
Assuntos
Angioplastia Coronária com Balão/instrumentação , Tamponamento Cardíaco/etiologia , Doença das Coronárias/terapia , Vasos Coronários/lesões , Idoso , Tamponamento Cardíaco/diagnóstico por imagem , Angiografia Coronária , Doença das Coronárias/diagnóstico por imagem , Desenho de Equipamento , Falha de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Stents , Propriedades de SuperfícieRESUMO
BACKGROUND: Dyslipoproteinaemia is an important risk factor for cardiovascular disease in uraemic patients on continuous ambulatory peritoneal dialysis (CAPD). Lovastatin is an HMG Coenzyme A reductase inhibitor which is useful in treating non-uraemic patients with hypercholesterolaemia. AIMS: We conducted a single blind cross-over study versus placebo in 10 CAPD patients to examine the effect of lovastatin (20-40 mg) on the serum lipid profile and its safety in uraemic patients. METHODS: Treatment phases were of eight weeks' duration. Each four weeks' measurements were made of serum total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), VLDL-cholesterol (VLDL-C), Apolipoprotein A1 & B (Apo A1 & Apo B) and Lipoprotein (a). After eight weeks, lovastatin significantly reduced TC by 29% from 6.7 +/- 0.3 (mean +/- S.E.M.) to 4.8 +/- 0.1 mmol/L, LDL-C by 41% from 4.6 +/- 0.3 to 2.7 +/- 0.1 mmol/L and Apo B by 32% from 116 +/- 7 to 78 +/- 3 mg/dl (p < 0.01). HDL-C increased by 8% from 1.2 +/- 0.1 to 1.3 +/- 0.2 mmol/L after eight weeks' therapy (p < 0.05). TG decreased by 18% from 1.9 +/- 0.4 to 1.6 +/- 0.3 mmol/L (p < 0.05). There was no significant difference in changes of other lipid profiles between placebo and drug. No adverse effects of the drug were noted during treatment and the liver function and muscle enzymes were not significantly altered by either drug therapy or placebo. RESULTS: Lovastatin appears to be a safe and useful drug in effectively treating dyslipoproteinaemia in CAPD patients.
Assuntos
Hipercolesterolemia/tratamento farmacológico , Hipertrigliceridemia/tratamento farmacológico , Lipídeos/sangue , Lovastatina/uso terapêutico , Diálise Peritoneal Ambulatorial Contínua , Uremia/terapia , Feminino , Humanos , Hipercolesterolemia/complicações , Hipertrigliceridemia/complicações , Masculino , Pessoa de Meia-Idade , Método Simples-Cego , Uremia/complicaçõesRESUMO
We describe a patient on anticoagulant therapy with massive retroperitoneal and intraperitoneal bleeding complicating femoral catheterization. Balloon tamponade of the actively bleeding femoral artery was effective in sealing off the leakage after failed surgical exploration.