RESUMEN
A native arteriovenous fistula is the most preferred type of a permanent vascular access (PVA) amongst the patients on programmed haemodialysis. Complications of vascular accesses leading to their lost with time would eventually and unavoidably result in exhaustion of the vascular recourses of the patient thus creating posing a problem while forming yet another PVA. Taking into consideration vitally important necessity of carrying out haemodialysis procedures for these patients, vascular surgeons have to search for alternative variants of access to the vascular bed. According to the KDOQI guidelines, in case of full loss of suitable vessels on upper limbs, formation of PVA may be possible in the area of the femur and in the upper third of the chest, predominantly with the use of a prosthesis as a shunt. Presented in the article are different variants of PVA whose creation was dictated by impossibility of using standard approaches to treatment of such patients.
Asunto(s)
Derivación Arteriovenosa Quirúrgica , Implantación de Prótesis Vascular , Fallo Renal Crónico/terapia , Diálisis Renal/métodos , Extremidad Superior , Derivación Arteriovenosa Quirúrgica/instrumentación , Derivación Arteriovenosa Quirúrgica/métodos , Prótesis Vascular , Implantación de Prótesis Vascular/instrumentación , Implantación de Prótesis Vascular/métodos , Humanos , Flujo Sanguíneo Regional/fisiología , Extremidad Superior/irrigación sanguínea , Extremidad Superior/cirugía , Grado de Desobstrucción VascularRESUMEN
The presence of a permanent vascular access (PVA) is the pledge of successful treatment of patients being on chronic haemodialysis (CD). Creation and maintenance of a functioning PVA is the priority task of vascular and endovascular surgeons, nephrologists and specialists of haemodialysis departments. According to the KDOQI guidelines, the most preferable type of PVA is a native arteriovenous fistula (AVF). As an alternative it is possible to use a synthetic prosthesis for creating an arteriovenous shunt (AVS) or implantation of a central venous catheter (CVC). Various complications of vascular accesses leading to their loss create the necessity of forming just another PVA, thus negatively influencing the life span and quality of life of this cohort of patients. Improving surgical technique and approaches to treatment, as well as carrying out dynamic monitoring of the condition of the created PVA make it possible to considerably decrease the incidence rate of such complications and to improve the quality of medical care rendered.
Asunto(s)
Derivación Arteriovenosa Quirúrgica , Fallo Renal Crónico/terapia , Calidad de Vida , Diálisis Renal , Derivación Arteriovenosa Quirúrgica/métodos , Derivación Arteriovenosa Quirúrgica/psicología , Humanos , Diálisis Renal/métodos , Diálisis Renal/psicologíaRESUMEN
A false aneurysm of visceral arteries is a life-threatening pathology sufficiently difficult to treat. Open operations are characterised by a large scope, considerable surgical injury and accompanied by a high rate of serious complications. The development of the technology of superselective catheterization of blood vessels, creation of specialized microcatheters, glue composites and various types of spirals made it possible to treat this severe pathology without resorting to open operations. The work deals with a brief literature review concerning epidemiology, methods of diagnosis and treatment of pseudoaneurysms of visceral arteries, followed by presenting three clinical case reports concerning successful treatment of posttraumatic false aneurysms of the right hepatic and splenic arteries, as well as an aneurysm of the renal artery. Both immediate and remote results of endovascular interventions in these patients are followed up, demonstrably showing possibilities of endovascular technologies in treatment of the pathology involved.
Asunto(s)
Aneurisma Falso , Procedimientos Endovasculares/métodos , Arteria Hepática/cirugía , Arteria Renal/cirugía , Arteria Esplénica/cirugía , Traumatismos Abdominales/complicaciones , Adulto , Anciano , Aneurisma Falso/diagnóstico , Aneurisma Falso/etiología , Aneurisma Falso/fisiopatología , Aneurisma Falso/cirugía , Angiografía/métodos , Embolización Terapéutica/métodos , Femenino , Gastrectomía/efectos adversos , Arteria Hepática/diagnóstico por imagen , Arteria Hepática/fisiopatología , Humanos , Masculino , Arteria Renal/diagnóstico por imagen , Arteria Renal/fisiopatología , Esplenectomía/efectos adversos , Arteria Esplénica/diagnóstico por imagen , Arteria Esplénica/fisiopatología , Resultado del TratamientoRESUMEN
Presented herein is a case report concerning successful treatment of the post-traumatic pathological anastomosis between the left external iliac artery and iliac vein using the stent-graft Jostent-graft. The anastomosis emerged after gunshot injury to the abdominal cavity.
Asunto(s)
Traumatismos Abdominales/complicaciones , Fístula Arteriovenosa/cirugía , Implantación de Prótesis Vascular/instrumentación , Arteria Ilíaca/lesiones , Arteria Ilíaca/cirugía , Vena Ilíaca/lesiones , Stents , Heridas por Arma de Fuego/complicaciones , Traumatismos Abdominales/diagnóstico por imagen , Traumatismos Abdominales/cirugía , Adulto , Angiografía , Fístula Arteriovenosa/diagnóstico por imagen , Fístula Arteriovenosa/etiología , Estudios de Seguimiento , Humanos , Arteria Ilíaca/anomalías , Vena Ilíaca/anomalías , Masculino , Diseño de Prótesis , Heridas por Arma de Fuego/diagnóstico por imagen , Heridas por Arma de Fuego/cirugíaRESUMEN
The paper analyses vazaprostan administration to 88 patients with lower limb arteriosclerosis obliterans. Effectiveness of the drug is assessed in concordance with initial grade of ischemia.
Asunto(s)
Alprostadil/análogos & derivados , Alprostadil/uso terapéutico , Arteriosclerosis Obliterante/tratamiento farmacológico , Arteriosclerosis Obliterante/cirugía , Vasodilatadores/uso terapéutico , Anciano , Alprostadil/economía , Arteriosclerosis Obliterante/economía , Femenino , Gastos en Salud , Humanos , Isquemia/economía , Isquemia/terapia , Masculino , Persona de Mediana Edad , Vasodilatadores/economíaAsunto(s)
Enfermedades de la Aorta/diagnóstico , Arteriopatías Oclusivas/diagnóstico , Pierna/irrigación sanguínea , Aorta Abdominal , Enfermedades de la Aorta/terapia , Arteriopatías Oclusivas/terapia , Arterias , Centros de Día , Humanos , Plexo Lumbosacro/cirugía , Simpatectomía , Procedimientos Quirúrgicos VascularesAsunto(s)
Aorta Abdominal/cirugía , Aneurisma de la Aorta Abdominal/cirugía , Prótesis Vascular/métodos , Radiografía Intervencional/métodos , Anciano , Aorta Abdominal/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Estudios de Seguimiento , Humanos , Masculino , UltrasonografíaRESUMEN
In 72 patients with obliterative atherosclerosis of the arteries of the lower extremities and diabetes mellitus, the lumbar sympathectomy was performed. A good result was noted in 35 of them, amputation of the extremity was performed in 8 patients. Lumbar sympathectomy is indicated to the patients in initial stages of the disease.