Síndrome de Paget-Schroetter: a favor del tratamiento médico / No disponible

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Accidentes neurológicos tras esclerosis de varices: a propósito de un caso / Neurological accidents after sclerosis of varicose veins: Presentation of a case

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Tratamiento con trombina de seudoaneurisma femoral poscateterismo en neonato / Treatment of a postcatheter femoral pseudoaneurysm with thrombin in a newborn

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Aortoenteric fistula arising as a complication of endovascular treatment of abdominal aortic aneurysm.

Estimates of the incidence of aortoenteric fistula as a sequela of surgery of the aorta range 1-2%. This complication is less common in patients who have had an aortic endograft implanted for aortoiliac aneurysm. We present three cases of aortoenteric fistula complicating endovascular treatment of abdominal aortic aneurysm (3/423 patients, 0.7% in our series).

Leiomiomatosis intravenosa con extensión cardíaca. Caso clínico y revisión de la bibliografía / Intravenous leiomyomatosis with extension into the heart. A case report and review of the literature

Introducción. La leiomiomatosis intravenosa (LIV) es un tumor poco frecuente que puede crecer a través devena cava inferior hasta extenderse a las cavidades cardíacas derechas. Es un tumor originado por las células de músculoliso y normalmente se encuentra confinado al sistema venoso pélvico. Se han descrito no más de 100 casos de LIV,de los cuales, tan sólo 30 presentaban afectación cardíaca. Aunque histológicamente es benigno, la afectación de las cavidadescardíacas derechas puede producir síntomas graves como síncopes y arritmias, y en algunos casos puede llegara producir la muerte súbita. Caso clínico. Mujer de 40 años con extensión cardíaca y que no presentaba síntomas previos.La extensión del tumor se producía tanto por ambas venas ilíacas internas como por la vena ovárica izquierda, algo quetan sólo se había descrito en otros dos casos anteriormente. La escisión quirúrgica se realizó en un único tiempo quirúrgicomediante circulación extracorpórea y abordaje abdominal y torácico. Conclusión. A pesar de ser un tumor poco frecuente,el retraso en la presentación de los síntomas (incluso 20 años) puede infravalorar su incidencia. Dado el gravecuadro clínico que puede provocar, su tratamiento es en todos los casos la extirpación quirúrgica, lo que supone un importantereto para el cirujano vascular. La escasa incidencia de la LIV y el tipo de extensión del tumor en este caso clínicolo hacen realmente excepcional

Introduction. Intravenous leiomyomatosis (IVL) is a rare tumour that may spread along the inferior venacava until it reaches the cavities on the right-hand side of the heart. It is a tumour that has its origins in smooth musclecells and is normally restricted to the pelvic venous system. No more than 100 cases of IVL have been reported, of whichonly 30 presented cardiac involvement. Although histologically it is benign, the involvement of the right cavities of theheart can give rise to severe symptoms such as syncopes and arrhythmias and in some cases it can even lead to suddendeath. Case report. A 40-year-old female with extension to the heart and who had no previous symptoms. The tumourspread along both the internal iliac veins and the left ovarian vein, something which had only previously been reportedin two other cases. Surgical excision was performed in a single session of surgery by means of a heart-lung bypass andusing an abdominal and thoracic approach. Conclusions. Despite being an infrequent tumour, its incidence may beunderestimated due to the fact that its symptoms often appear very late on in the course of the disease (up to 20 years).Given the severe clinical features that it may cause, its treatment always involves surgical removal, which is animportant challenge for the vascular surgeon. The low incidence of IVL and the type of extension of the tumour in thiscase make it truly exceptional

Combined surgical and endovascular repair of a ruptured bilateral aortoiliac aneurysm.

Aortoiliac aneurysms are frequent entities that have very important clinical implications, especially in the younger patients. We are asked not only to save lives by preventing the rupture or repairing those that are already ruptured but also to provide an acceptable quality of life in the postoperative period. Endovascular approaches certainly give us such an expectative but are not clearly indicated in our younger patients and cannot be used routinely in those aneurysms with a yuxtarrenal origin. This is the case report of a young man with a yuxtarrenal aortoiliac inflammatory aneurysm that was treated by the interposition of an aortobifemoral bypass with the addition of endovascular devices in the hypogastric vessels to preserve the pelvic blood flow; they contribute to seal the common iliac aneurysms. This approach was useful to avoid complications during a difficult iliac dissection and was permeable within 1 year of the operation. Durability must be assessed.

Aneurisma subclavio. Hallazgo casual y tratamiento endovascular / Subclavian aneurysm. A chance finding and endovascular treatment

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Pseudoaneurisma de la arteria peronea tras la embolectomía con catéter de balón / Pseudoaneurysms in the fibular artery following embolectomy with a balloon catheter

Introducción. Los pseudoaneurismas de la arteria peronea son una patología rara asociada a traumatismos de la pierna, a cirugía traumatológica o a lesiones de la pared arterial secundarias a embolectomía con balón. Pueden ser asintomáticos o, por el contrario, debutar con dolor y sensación de masa, lo que puede asociar una fístula arteriovenosa o un síndrome compartimental. El tratamiento endovascular mediante embolización representa una solución novedosa a este tipo de lesiones. Caso clínico. Mujer de 71 años que con el diagnóstico de isquemia arterial aguda en el miembro inferior derecho de probable origen cardioembólico fue intervenida de tromboembolectomía transfemoral derecha; recuperó los pulsos distales y fue dada de alta a los cinco días de la intervención. Acudió al servicio de urgencias a los 10 días del alta con clínica de dolor en la región aquílea del miembro inferior derecho y edema, y mediante eco-Doppler se diagnosticó un pseudoaneurisma de la arteria peronea derecha. Se le realizó arteriografía a través de la arteria femoral contralateral; se cateterizó selectivamente la arteria peronea, que confirmó la presencia del pseudoaneurisma, y se procedió a su embolización con coils

Introduction. Pseudoaneurysms of the fibular artery are a rare pathological condition associated with traumatic injuries to the legs, trauma surgery or lesions in the walls of the artery secondary to balloon embolectomies. They can be asymptomatic or, in contrast, they may begin with pain and the presence of a mass, which can be associated to an arteriovenous fistula or compartment syndrome. Endovascular treatment by embolisation is a novel solution to this type of lesion. Case report. We report the case of a 71-year-old female who was diagnosed as having acute arterial ischaemia in the lower right limb that probably had cardioembolic origins; the patient was submitted to a right transfemoral thromboembolectomy. Distal pulses were restored and she was discharged from hospital five days after the operation. She visited the emergency department again 10 days after discharge with symptoms of pain in the Achilles region of the right lower limb and oedema; Doppler ultrasound recording was used to reach a diagnosis of pseudoaneurysm of the right fibular artery. Arteriography was performed through the contralateral femoral artery; the fibular artery was selectively catheterised, which confirmed the presence of a pseudoaneurysm and this was then embolised using coils