Pseudooclusión carotídea: un concepto a tener en cuenta en el ictus agudo / Carotid pseudo-occlusion: A concept to consider in acute stroke

No disponible

Tratamiento de fístulas carótido-cavernosas / Treatment of carotid-cavernous fistulas

Objetivos. Valorar los resultados del tratamiento de 33 pacientes con fístula carótido-cavernosa (FCC) de acuerdo con criterios clínicos y angiográficos. Material y métodos. De enero de 1993 a diciembre de 2003, 33 pacientes fueron diagnosticados y tratados de FCC en nuestro hospital. Se realizó examen clínico y angiografía antes y después del tratamiento. Las modalidades terapéuticas disponibles son el tratamiento conservador, mediante compresiones, y el tratamiento intervencionista, con distintos procedimientos según la vía de abordaje y el material de embolización empleados. Resultados. De las 11 FCC directas, una fue tratada de forma conservadora y 10 se sometieron a procedimientos de embolización. La vía de abordaje fue transarterial en 5, transvenosa en 2 y en 3 se utilizaron ambas, consiguiendo la desaparición de los síntomas en el 90% de los pacientes. De las 22 FCC indirectas o durales, 6 fueron tratadas de forma conservadora, con óptimo resultado, mientras que las 16 restantes se embolizaron, 11 por vía transarterial y 5 combinando los accesos transarterial y transvenoso. La terapia endovascular logró la desaparición completa de los síntomas en 9 pacientes y parcial en 7. Sólo se produjo una complicación transitoria. Conclusiones. La adecuada selección tanto del tipo de tratamiento (conservador o intervencionista), como del procedimiento (vía de abordaje y material de embolización), caso de que fuera necesario, optimiza los resultados en el manejo de pacientes con FCC

Objectives. To evaluate the results of the treatment of 33 patients with carotid-cavernous fistula (CCF) with respect to clinical and angiographic criteria. Material and methods. From January 1993 to December 2003, 33 patients were diagnosed with CCF and treated at our hospital. All patients underwent clinical examination and angiography before and after treatment. Available treatment modalities were conservative treatment, consisting of compressions, and interventional treatment, with different procedures depending on the approach and the materials employed for embolization. Results. Of the 11 direct CCFs, one received conservative treatment and 10 underwent embolization procedures. An arterial approach was used in 5 cases, a venous approach in 2, and a combined venous-arterial approach in the remaining 3, with symptoms disappearing in 90% of the patients. Of the 22 indirect or dural CCFs, 6 received conservative treatment, with optimal results, and the remaining 16 underwent embolization (11 using an arterial approach and 5 using a combined venous-arterial approach). Endovascular treatment brought about the complete disappearance of symptoms in 9 patients and partial disappearance in 7. Only one transitory complication was observed. Conclusions. The appropriate selection of both the type of treatment (conservative vs. interventional) and the interventional procedure (approach and material for embolization), yields optimal results in the management of patients with CCF

[Treatment of carotid-cavernous fistulas]. / Tratamiento de fístulas carótido-cavernosas.

OBJECTIVES: To evaluate the results of the treatment of 33 patients with carotid-cavernous fistula (CCF) with respect to clinical and angiographic criteria. MATERIAL AND METHODS: From January 1993 to December 2003, 33 patients were diagnosed with CCF and treated at our hospital. All patients underwent clinical examination and angiography before and after treatment. Available treatment modalities were conservative treatment, consisting of compressions, and interventional treatment, with different procedures depending on the approach and the materials employed for embolization. RESULTS: Of the 11 direct CCFs, one received conservative treatment and 10 underwent embolization procedures. An arterial approach was used in 5 cases, a venous approach in 2, and a combined venous-arterial approach in the remaining 3, with symptoms disappearing in 90% of the patients. Of the 22 indirect or dural CCFs, 6 received conservative treatment, with optimal results, and the remaining 16 underwent embolization (11 using an arterial approach and 5 using a combined venous-arterial approach). Endovascular treatment brought about the complete disappearance of symptoms in 9 patients and partial disappearance in 7. Only one transitory complication was observed. CONCLUSIONS: The appropriate selection of both the type of treatment (conservative vs. interventional) and the interventional procedure (approach and material for embolization), yields optimal results in the management of patients with CCF.

[Thromboangiitis obliterans with cerebral involvement]. / Tromboangeítis obliterante con isquemia cerebral.

We report the case of a male with Buerger's disease and neurologic involvement. Cerebral arteriography showed multiple distal arterial obliterans with left-sided Moya-moya phenomena. Thromboangiitis obliterans is a chronic segmental occlusive disease affecting medium-sized and small arteries and veins throughout the body. Neurologic signs are rare, occurring in fewer than 2 % of cases, and most often found on the cortical surface and adjacent territories. We review the most common signs of this entity and its main diagnostic difficulties.