RESUMEN
A variant of the technique used for implantation of subclavian artery into common carotid artery is proposed with the aim of improving vertebral blood flow, particularly in cases with combined foraminal vertebral and subclavian artery lesions.
Asunto(s)
Arterias Carótidas/cirugía , Arteria Subclavia/cirugía , Arteria Vertebral/cirugía , Angiografía , Arterias Carótidas/diagnóstico por imagen , Humanos , Métodos , Arteria Subclavia/diagnóstico por imagen , Síndrome del Robo de la Subclavia/cirugía , Arteria Vertebral/diagnóstico por imagen , Insuficiencia Vertebrobasilar/cirugíaAsunto(s)
Arteriosclerosis/cirugía , Arteria Subclavia/cirugía , Arteria Vertebral/cirugía , Endarterectomía , Femenino , Humanos , Masculino , Métodos , Persona de Mediana Edad , Complicaciones Posoperatorias/mortalidad , Radiografía , Reimplantación , Riesgo , Arteria Subclavia/diagnóstico por imagen , Arteria Vertebral/diagnóstico por imagenRESUMEN
The technique used and the results obtained in 39 patients with chronic obstructive subclavian artery lesions treated by interaxillary shunts are described and the literature reviewed. The indications for this therapy appear to be well defined and to apply mainly to elderly patients, to those with evidence of return flow after carotid-subclavian bypass, and to those with upper limb ischemia from post-vertebral lesions. This type of shunt is effective, is simple to perform and possesses minimal morbidity.
Asunto(s)
Arteriopatías Oclusivas/cirugía , Arteria Axilar/cirugía , Arteria Subclavia/cirugía , Anciano , Femenino , Humanos , Masculino , Métodos , Factores de TiempoRESUMEN
Patient characteristics, types of lesion, routes of approach and techniques employed are discussed in relation to 94 cases of surgical treatment for chronic obstruction of the subclavian artery. The most frequently (60% of cases) used procedure was an extrathoracic by-pass operation, thrombo-endarterectomy being performed in 25%, réimplantations in 10%, and aortic by-pass implants in 6% of cases. Immediate and 30-day follow-up results are presented, and failures critically analyzed with regard to their relation to vascular or neurological complications, and those linked to the approach route. Conclusions to be drawn from these unsuccessful cases are exposed, as well as current tendencies in respect of indications for surgery in these lesions.
Asunto(s)
Arteriopatías Oclusivas/cirugía , Arteria Subclavia , Adulto , Anciano , Aorta/cirugía , Arteria Axilar/cirugía , Endarterectomía , Femenino , Estudios de Seguimiento , Humanos , Masculino , Métodos , Persona de Mediana Edad , Arteria Subclavia/cirugía , Trombosis/cirugía , Arteria Vertebral/cirugíaRESUMEN
Anatomical, etiopathogenic, clinical, and paraclinical aspects of vascular complication of cervical rib are discussed based on findings in 15 cases. Emphasis is placed on the value of newly available non-invasive functional tests, such as computerized angiography and particularly ultrasonography, which can modify surgical conduct. Operative technique is described, and indications for surgery and short- and long-term results obtained presented. Evaluation of results reported in the literature shows that they were excellent in 75 to 93% of cases, recent studies indicating an even higher rate of improvement.
Asunto(s)
Síndrome de la Costilla Cervical/complicaciones , Síndrome del Desfiladero Torácico/complicaciones , Enfermedades Vasculares/etiología , Adolescente , Adulto , Anciano , Angiografía , Síndrome de la Costilla Cervical/diagnóstico , Síndrome de la Costilla Cervical/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Flebografía , Tomografía Computarizada por Rayos X , Ultrasonografía , Enfermedades Vasculares/diagnóstico , Enfermedades Vasculares/cirugíaRESUMEN
The authors report 58 cases of ilio-femoral and ilio-caval thrombosis and emphasise the considerable contribution of two vascular function tests: Doppler and occlusion rheoplethysmography, which now compensate for clinical deficiencies. Nevertheless, phlebography remains essential in defining management which is based upon age, general condition, and the site and type of thrombosis (floating or adherent clot). An outline therapeutic approach is suggested on the basis of these data.