RESUMEN
BACKGROUND AND OBJECTIVE: The treatment of long chronic occlusion of peripheral arteries remains unsatisfactory. In particular occlusions of the superficial femoral artery (SFA) are not considered suitable for percutaneous interventions. It was the aim of our study to evaluate this technique, the initial technical success and the follow-up patency rates after percutaneous revascularization of long chronic occlusion of the the SFA. PATIENTS AND METHODS: 58 consecutive patients (mean age 64.8 +/- 9.7/40-80 years, 40 men/69.0%) were included. Of these patients 15 had bilateral SFA-occlusions and 14 showed additional disease in the popliteal artery. The mean occlusion length was 21.9 +/- 14.8 cm. At baseline absolute treadmill walking distance was 125 +/- 61 m. in all cases a balloon angioplasty was performed, additional excimer laser in 80.8% and stenting in 50.9%. RESULTS: A primary technical success was achieved in 89.0%. According to the American Heart Association guidelines a markedly clinical improvement was shown: +3 in 16.2%, +2 in 74.4%, +1 in 9.3% of the patients. The 12-months cumulative primary patency rate was 43.6%, primary assisted patency and secondary patency rate was 85.5% and 69.1% respectively. CONCLUSION: Long chronic occlusion can be successfully treated by percutaneous techniques. To maintain a high patency rate frequent clinical follow-up is mandatory.
Asunto(s)
Angioplastia de Balón , Arteriopatías Oclusivas/terapia , Arteria Femoral , Adulto , Anciano , Anciano de 80 o más Años , Angioplastia de Balón Asistida por Láser , Arteriopatías Oclusivas/patología , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Stents , Factores de Tiempo , Resultado del Tratamiento , Grado de Desobstrucción VascularRESUMEN
PURPOSE: We report our experience with a new percutaneous thrombectomy device for the treatment of thromboembolic occlusions of peripheral arteries. MATERIAL AND METHODS: Between November 1999 and May 2000 12 patients (10 male) with thromboembolic occlusions of peripheral arteries were treated. 8 occlusions were located in the femoral and popliteal arteries, 3 in the infrapopliteal vessels and 1 in the brachial artery. In all cases a new 6 F-catheter with a rotational screw and a suction vacuum unit was used. RESULTS: The intervention was successful in 11 patients. 1 patient with a failed procedure had a duration of occlusion > 90 days. There were no complications. All patients were discharged on the same or the following day. CONCLUSION: Percutaneous treatment with the thrombectomy device is a feasible option in a small group of patients with thromboembolic occlusions of the peripheral arteries. Often additional treatment is necessary. The major indication seems to be acute thrombosis. The procedure is easy and safe to apply.
Asunto(s)
Brazo/irrigación sanguínea , Embolia/cirugía , Pierna/irrigación sanguínea , Trombectomía/métodos , Trombosis/cirugía , Anciano , Angiografía , Angioplastia de Balón , Embolectomía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Stents , Trombectomía/instrumentación , Ultrasonografía DopplerRESUMEN
UNLABELLED: Leptin, the ob gene product, is produced by differentiated adipocytes. It functions as an afferent signal to the central nervous system indicating satiety and fat mass status. It acts upon the hypothalamic-pituitary axis. Growth hormone (GH) secretion is thought to be stimulated by leptin. Conversely, leptin secretion and ob gene expression are regulated by classical neuroendocrine networks. Whether or not acute changes of GH concentrations directly alter leptin serum levels in vivo is still debated. We investigated whether or not acute changes in GH serum concentrations during arginine infusion (0.5 g/kg b. wt.) alter leptin serum levels in 45 children and adolescents (33 M, 12 F). GH and leptin serum levels were determined at -30, 0, 30, 60, 90, 120 min after arginine infusion using specific radioimmunoassays. Leptin serum concentrations remained unaltered throughout the arginine infusion in all children and adolescents whether or not GH secretion was normal. IN CONCLUSION: (1) Acute changes of GH levels do not alter leptin serum levels during acute arginine infusions over 120 min. (2) Arginine does not acutely modulate leptin secretion.