Guía para el estudio no invasivo de la isquemia crónica de los miembros inferiores / Guide for the non-invasive study of lower extremity chronic ischemia

Nuevamente, desde el Capítulo de Diagnóstico Vascular de la Sociedad Española de Angiología y Cirugía Vascularnos proponemos la actualización de una guía de diagnóstico. Concretamente, la Guía de estudio de la isquemiade miembros inferiores. Creemos que la elaboración, la difusión y la utilización de guías de todo tipo permitiráuna mayor homogenización en el uso y en la difusión de las técnicas de diagnóstico que utilizamos en nuestroquehacer diario. La homogenización permitirá una mayor fiabilidad y prestigio en estas exploraciones. Por otra parte, la naturaleza de las guías de diagnóstico requiere mucha menos renovación que otro tipo de guíasy de documentos: las exploraciones que configuran nuestro motivo de ser no suelen variar de forma profundaa lo largo del tiempo. Ahora bien, es cierto que las explicaciones pueden darse de otro modo y complementarlas ya existentes, en absoluto obsoletas. Con este espíritu hemos abordado la elaboración de esta actualización. Se ha respetado completamente la guía previa publicada en 2009. Solo nos hemos permitido reescribir, por suimportancia y por su papel como piedra angular en el estudio de la isquemia de miembros inferiores, el capítulodedicado al estudio con ecografía Doppler arterial de las extremidades inferiores, aunque siempre con una visióncomplementaria, no excluyente, a lo ya publicado hace tantos años. El resto de la guía expone tres exploracio-nes emergentes, no tratadas previamente, pues casi no existían, que pueden suponer un avance, una mejora sicabe, en el estudio arterial de las extremidades isquémicas. Se trata del tiempo de aceleración pedal, tema derabiosa actualidad, de la determinación de la presión transcutánea de oxígeno, tan importante en la patologíaisquémica del diabético, y, finalmente, de la angiografía de perfusión, técnica de diagnóstico emergente y coninfinidad de posibilidades, muchas de ellas ni siquiera estudiadas...(AU)

Once again, from the Vascular Diagnosis Chapter of the Spanish Society of Angiology and Vascular Surgery, wepropose to update a diagnostic guide. Specifically, the Lower Limb Ischemia Study Guide. We believe that theelaboration, diffusion, and use of guides of all kinds will allow a greater homogenization in the use and diffusion ofthe diagnostic techniques that we use in our daily work. Homogenization will allow greater reliability and prestigein these explorations. On the other hand, the nature of diagnostic guides requires much less renewal than other types of guides anddocuments: the examinations that make up our reason for being do not usually vary profoundly over time. Now, it istrue that the explanations can be given in another way and complement the existing ones, which are by no meansobsolete. It is in this spirit that we have approached the making of this update. The previous guideline publishedin 2009 has been fully respected. Due to its importance and its role as a cornerstone in the study of lower limbischemia, we have rewritten the chapter dedicated to the study with arterial Doppler ultrasound of the lower limbs,although always with a complementary vision, not exclusive, to what was already published so many years ago. The rest of the guide exposes three emerging explorations, not previously treated, since they hardly existed, whichmay represent an advance, an improvement, if possible, in the arterial study of ischemic extremities. It deals withpedal acceleration time, a high topic, with the determination of transcutaneous oxygen pressure, so important inthe ischemic pathology of diabetics, and, finally, with perfusion angiography, an emerging diagnostic techniquewith infinite possibilities, many of them not even studied. To carry out this work we have turned to proven professionals in each treated section. We believe that the guidewill help to better carry out our daily explorations in ischemia of the lower limbs.(AU)

Hallazgo casual de un paraganglioma paraaórtico / An incidentally discovered paraaortic paraganglioma

Introducción: los paragangliomas son tumores neuroendocrinos derivados de células cromafi nes. Son entidadesmuy infrecuentes que se localizan típicamente en el cuello o en la base del cráneo. presentamos el caso de unparaganglioma paraaórtico, una ubicación inusual que cuenta con escasos reportes en la literatura. Caso clínico: mujer de 78 años que presenta una masa retroperitoneal hallada de forma casual durante el estudiopreoperatorio de una neoplasia ginecológica. ante la sospecha de un tumor del estroma gastrointestinal o unschawnnoma retroperitoneal, se indica su extirpación quirúrgica. Durante la operación se objetiva una masa muyvascularizada adherida a la cara anterior de la aorta, cuya resección provoca en la paciente un cuadro de crisishipertensiva y taquicardia asociadas a inestabilidad hemodinámica, que cede tras completar su exéresis. el estudioanatomopatológico posterior confi rma la sospecha diagnóstica intraoperatoria de paraganglioma paraaórtico. Discusión: los paragangliomas localizados en el abdomen suelen ser productores de catecolaminas y puedendesarrollar clínica adrenérgica de forma espontánea o inducida por fármacos, ejercicio o manipulación quirúrgica,como sucedió en nuestro caso. Un diagnóstico certero es clave para planificar un tratamiento adecuado quepermita reducir las posibles complicaciones en este tipo de pacientes.(AU)

Introduction: paragangliomas are neuroendocrine tumours derived from chromaffin cells. they are very rareentities that are typically located in the neck or at the base of the skull. We present the case of a para-aortic para-ganglioma, an unusual location that has few reports in the literature. Case report: a 78-year-old woman with a retroperitoneal mass found incidentally during the preoperative study fora gynecological neoplasm. Given the suspicion of a gastrointestinal stromal tumour or a retroperitoneal schawn-noma, surgical removal of it was indicated. Intraoperatively, a highly vascularized mass adhered to the anteriorface of the aorta was observed, whose resection caused a hypertensive crisis and tachycardia associated withhemodynamic instability, which subsided after completing the exeresis. the subsequent anatomopathologicalstudy confirmed the intraoperative diagnostic suspicion of paraaortic paraganglioma. Discussion: paragangliomas located in the abdomen are usually catecholamine producers and can develop adr-energic symptoms spontaneously or induced by drugs, exercise, or surgical manipulation, as occurred in our case.an accurate diagnosis is the key to planning an appropriate treatment that allows reducing possible complicationsin this type of patient.(au)

Development of a Telemetric System for Postoperative Follow-up of Vascular Surgery Procedures: In Vitro Model.

BACKGROUND: Because of the unique electromagnetic characteristics of the magnetoelastic microwire, the changes in the pressure of a fluid will provoke a variation of the mechanical pressure on the sensor, which will cause a variation of its magnetization that will be detectable wirelessly. Thus, a wireless system can be developed for following up vascular surgery procedures. METHODS AND RESULTS: The sensor consists of a magnetoelastic microwire ring, which was integrated into an in vitro model with pulsatile flow. Different degrees of stenosis were simulated in different locations both in bovine artery as well as in a polytetrafluoroethylene anastomosis. A Fourier analysis of the registered signals and a statistical analysis using Pearson test and receiver operating characteristic (ROC) curves were made. A Pearson index of 0.945 (P<0.001) was obtained between the invasive pressure of the fluid and the power of the signal transmitted by the sensor in bovine artery. The sensor obtained very good ROC curves upon analyzing the signals registered, both in the case of preanastomotic stenosis (area under the curve [AUC], 0.98; 95% CI, 0.97-1.00), of anastomosis (AUC, 0.93; 95% CI, 0.86-0.99), as well as distal (AUC, 0.88; 95% CI, 0.79-0.98), compared to the control group. CONCLUSIONS: The magnetoelastic microwire has shown that it is capable of detecting, locating, and quantifying the degree of stenosis in bovine artery, as well as in a latero-terminal anastomosis, with a high statistical potency. For the first time, a wireless in vitro sensor has been developed for the postoperative follow-up of vascular surgery procedures.

SEA-SEACV 2015: Guía para el diagnóstico y tratamiento del aneurisma de aorta abdominal / No disponible

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Recomendaciones de la guía para el diagnóstico y tratamiento del aneurisma de aorta abdominal / Guide recommendations for diagnosis and treatment of abdominal aortic aneurysm

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Recomendaciones de la guía para el diagnóstico y tratamiento del aneurisma de aorta abdominal / Guide recommendations for diagnosis and treatment of abdominal aortic aneurysm

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Hipernefroma con trombosis tumoral de vena cava inferior / Hypernephroma with tumor thrombus of the inferior vena cava

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