RESUMO
The authors describe two patients who underwent transfemoral endovascular procedures followed by the use of the Angio-seal arterial percutaneous closure device. In the first patient, distal migration of the device occurred with consequent occlusion of the ipsilateral popliteal artery 2 days post procedure. In the second patient, thrombotic occlusion of the femoral artery occurred and the patient presented with acute leg ischaemia 3 weeks post procedure. Surgical removal of the closure device with consequent revascularisation of the affected leg was achieved in both patients. This report aims to alert clinicians to the possibility of device-induced arterial occlusion, dislodgment and their sequelae.
Assuntos
Arteriopatias Oclusivas/etiologia , Procedimentos Endovasculares/instrumentação , Migração de Corpo Estranho/complicações , Migração de Corpo Estranho/etiologia , Técnicas de Fechamento de Ferimentos/efeitos adversos , Técnicas de Fechamento de Ferimentos/instrumentação , Adolescente , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Abdominal aortic aneurysm (AAA) is a common and life-threatening disease characterized by progressive dilatation and rupture, and has a mortality rate of up to 90%. Surgical repair is recommended for large aneurysms, whereas small aneurysms are managed by 'watchful waiting'. The recently introduced AAA screening programs reduce aneurysm-related mortality; however, aneurysm detection leads to psychological problems and a reduced quality of life of patients. The success of pharmacological therapy for AAA in small animals continues to provide insights into the pathogenetic mechanisms of this disease. As a result, medications, such as doxycycline, roxithromycin and statins, have been used to limit the growth of AAAs in small human studies with promising results. However, randomized trials with large numbers of patients and long follow-ups are required for the thorough investigation of safe and effective medical therapies. Control of cardiovascular risk factors, particularly smoking cessation, may result in a reduced growth of the AAA and improve overall patient care.
Assuntos
Antibacterianos/uso terapêutico , Aneurisma da Aorta Abdominal/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Animais , Antibacterianos/farmacologia , Aneurisma da Aorta Abdominal/mortalidade , Aneurisma da Aorta Abdominal/fisiopatologia , Ensaios Clínicos como Assunto , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Masculino , Qualidade de Vida , Fatores de Risco , Abandono do Hábito de Fumar , Taxa de SobrevidaRESUMO
An abdominal aortic aneurysm is a permanent localized dilatation which most commonly affects the infrarenal segment of the abdominal aorta. Rupture, the most common and most fatal complication of abdominal aortic aneurysm, is an acute vascular emergency that requires an immediate life-saving operation which has a high mortality rate. Approximately 30-50% of patients with ruptured abdominal aortic aneurysm die before they reach the hospital, and 30-40% of those who reach the hospital alive die without surgical intervention (Bengtsson and Bergqvist, 1993). With an average mortality rate of 45% among patients who undergo emergency repair of ruptured abdominal aortic aneurysm, the overall mortality rate is estimated at 80-90%.
Assuntos
Aneurisma da Aorta Abdominal/diagnóstico , Ruptura Aórtica/diagnóstico , Procedimentos Cirúrgicos Vasculares/métodos , Idoso , Aneurisma da Aorta Abdominal/complicações , Aneurisma da Aorta Abdominal/cirurgia , Ruptura Aórtica/complicações , Ruptura Aórtica/cirurgia , Diagnóstico Diferencial , Diagnóstico Precoce , Humanos , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Acute aortic dissection is one of the most fatal acute cardiovascular disorders that has challenged physicians and surgeons for decades. This article provides an up-to-date overview of the aetiology, pathophysiology, diagnosis and treatment of this condition.
Assuntos
Aneurisma da Aorta Torácica , Dissecção Aórtica , Doença Aguda , Idoso , Dissecção Aórtica/classificação , Dissecção Aórtica/diagnóstico , Dissecção Aórtica/etiologia , Dissecção Aórtica/terapia , Aneurisma da Aorta Torácica/classificação , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/etiologia , Aneurisma da Aorta Torácica/terapia , Doenças do Tecido Conjuntivo/complicações , Diagnóstico Diferencial , Diagnóstico Precoce , Eletrocardiografia , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Síndrome de Marfan/complicações , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Tomografia Computadorizada por Raios XRESUMO
Acute mesenteric ischaemia is a catastrophic abdominal emergency with an extremely high mortality rate. This article discusses the aetiology, diagnosis and treatment of acute mesenteric ischaemia with emphasis on avoidance of common errors that contribute to the poor outcome inherent to this condition.