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2.
Q J Nucl Med Mol Imaging ; 56(5): 447-58, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23069924

RESUMEN

Assessing bone metastases is often beyond the scope of plain - film radiography, and nuclear imaging in particular with bone scintigraphy has proved the mainstay for detection of bony disease for over 40 years. Bone scanning with 99mTechnetium - labeled diphosphonates relies on the detection of pathological osteoblastic response elicited from malignant cells. This technique offers the advantage of whole body examination, low cost, availability and high sensitivity. However, it suffers from relative low specificity. The addition of single-photon emission computed tomography (SPECT) to bone scintigraphy has markedly improved the diagnostic benefit. Although the accuracy of SPECT is significantly higher than that of planar scintigraphy, there is still room for improvement of anatomic localization and morphological characterization, a limitation that has currently been mainly overcome with the upcoming of combined SPECT-CT (computed tomography). Positron emission tomography (PET), a modality with higher spatial resolution than that of SPECT can be particularly helpful in detecting small lesions. Moreover, PET imaging using various specific radiotracers has the advantage of detecting malignant disease in both bone and soft tissues. It is highly sensitive mainly in detecting early bone marrow as well as for diagnosing lytic bony metastases and can be also reliably used to monitor therapy response. In this review, we present the current role of SPECT and PET in the imaging of skeletal metastases from prostate cancer.


Asunto(s)
Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/secundario , Neoplasias de la Próstata/patología , Humanos , Masculino , Tomografía de Emisión de Positrones , Radiofármacos , Tomografía Computarizada de Emisión de Fotón Único , Imagen de Cuerpo Entero
3.
Eur J Radiol ; 81(10): 2737-40, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22154590

RESUMEN

BACKGROUND: The purpose of this retrospective study was to evaluate transarterial catheter embolization (TAE) for the management of hemarthrosis of the knee in 35 patients treated at two different hospitals. METHODS: From June 1998 through January 2011, 35 patients (22 men and 13 women, mean age 57 years) underwent TAE for hemarthrosis of the knee using polyvinyl alcohol particles (PVA particles), multi-curled 0.018 in. microcoils or a combination of both. In one patient a detachable microcoil was used. Hemarthrosis developed after arthroscopy in 9, after trauma in 3, after arthroplasty in 18 and after sepsis in 2 patients. 2 patients had severe gonarthrosis and in one patient hemarthrosis was due to Marfan's syndrome. Angiographies showed abnormal and increased vasculature in 23 patients, one or more pseudoaneurysms in 8 and arterio-venous fistula in 2 patients. One patient showed both, pseudoaneurysm and hypervascularization and another one pseudoaneurysm and arterio-venous fistula. RESULTS: Technical success was achieved in 100%. None of the patients developed procedure-related complications such as periarticular skin- or tissue necrosis, including a patient who underwent TAE of two different bleeding sources in two consecutive sessions. Clinical success was 93.4%. Two patients showed recurrent swelling of the knee, 377 and 824 days after TAE respectively. However, only one of them required secondary TAE because of abnormal and increased vasculature. CONCLUSIONS: In our view, TAE is the treatment of choice for the management of hemarthrosis of the knee. It is an effective and minimally invasive technique with very low complication rates.


Asunto(s)
Embolización Terapéutica/métodos , Hemartrosis/tratamiento farmacológico , Hemostáticos/uso terapéutico , Articulación de la Rodilla/efectos de los fármacos , Alcohol Polivinílico/uso terapéutico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Austria , Femenino , Hemartrosis/diagnóstico por imagen , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Radiografía , Estudios Retrospectivos , Adulto Joven
4.
Handchir Mikrochir Plast Chir ; 41(2): 112-6, 2009 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-19085823

RESUMEN

Venous malformations are constitutionally-dependent vascular anomalies. In contrast to haemangiomas, they show no spontaneous regression. We describe here the case of a 21-year-old woman with a very severe facial disfigurement caused by a large venous malformation. After intensive consultation, advice and planning, the patient decided to undergo therapy and was admitted to hospital for treatment by an interdisciplinary team, consisting of a radiologist and a plastic surgeon. Under general anaesthesia, percutaneous sclerosis was performed twice. This enabled thrombosing and subsequent extensive resection of the monstrously large tumour. The well-planned and efficiently performed surgery helped the patient to gain a significant improvement in her quality of life.


Asunto(s)
Mejilla , Hemangioma Cavernoso/cirugía , Neoplasias de los Labios/cirugía , Neoplasias de la Boca/cirugía , Neoplasias Nasales/cirugía , Adulto , Tomografía Computarizada de Haz Cónico , Femenino , Estudios de Seguimiento , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/patología , Hemostasis Quirúrgica , Humanos , Procesamiento de Imagen Asistido por Computador , Imagenología Tridimensional , Neoplasias de los Labios/diagnóstico , Neoplasias de los Labios/patología , Imagen por Resonancia Magnética , Neoplasias de la Boca/diagnóstico , Neoplasias de la Boca/patología , Neoplasias Nasales/diagnóstico , Neoplasias Nasales/patología , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/cirugía , Cuidados Preoperatorios , Procedimientos de Cirugía Plástica , Reoperación , Escleroterapia , Colgajos Quirúrgicos , Ultrasonografía , Adulto Joven
5.
Eur Radiol ; 17(7): 1727-37, 2007 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-17115167

RESUMEN

The aim of this retrospective study was to evaluate mid- and long-term results of endovascular stent-graft placement for emergency repair of acute traumatic thoracic aortic rupture. From 1996 through 2005, 22 consecutive patients (mean age: 38.7 years) underwent endovascular repair of acute traumatic thoracic aortic rupture located at the aortic isthmus in most cases. All patients were at high surgical risk due to severe associated injuries. The endografts were inserted via femoral or iliac artery access under fluoroscopic guidance. Follow-up was performed postinterventionally, at 6 and 12 months and yearly thereafter, and included clinical examination and computed tomography (CT) scans. Technical and clinical success rates were 86.3%. Mean follow-up was 31.7 months. Three patients developed early type I endoleak due to the inability of the rigid graft to adapt to the curved aortic contour. In two of them conversion to open surgery was necessary. One patient had late type I endoleak and died. No other complications were observed. The outcome was successful in most patients. The mid- and long-term results of our current study are promising. However, early type I endoleak represents a problem, especially in adolescent patients with a marked curvature of the aortic arch.


Asunto(s)
Angioplastia , Aorta Torácica/lesiones , Aneurisma de la Aorta Torácica/cirugía , Disección Aórtica/cirugía , Rotura de la Aorta/cirugía , Aortografía , Implantación de Prótesis Vascular , Urgencias Médicas , Procesamiento de Imagen Asistido por Computador , Imagenología Tridimensional , Stents , Tomografía Computarizada Espiral , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/mortalidad , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/mortalidad , Rotura de la Aorta/diagnóstico por imagen , Rotura de la Aorta/mortalidad , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/mortalidad , Diseño de Prótesis , Reoperación , Estudios Retrospectivos , Análisis de Supervivencia
6.
Eur J Radiol ; 59(3): 384-92, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16690239

RESUMEN

OBJECTIVE: The aim of our retrospective study was to review our single-center experience with aortic abdominal aneurysm (AAA) repair retrospectively. MATERIAL AND METHODS: From 1995 to 2005, 70 consecutive patients affected by AAA were treated by endovascular stent-graft repair. Mean follow-up was 23.9 months. Follow-up investigations were performed at 6 and 12 months and yearly thereafter. Five different stent-graft designs were compared to each other. Primary technical success (PTS), assisted primary technical success (APTS), primary clinical success (PCS) and secondary clinical success (SCS) were evaluated. RESULTS: All over PTS was achieved in 94.3%, APTS in 97.1%, PCS in 61.4%, APCS in 64.3% and SCS in 70%. There were 3 type I endoleaks, 25 type II endoleaks, 4 type III endoleaks, 8 limb problems, 5 conversions to open surgery, 10 aneurysm sac expansions and 14 device migrations. Patients with newer generation devices showed better results than patients with first generation prosthesis. In addition results were better for grafts with suprarenal fixation (versus infrarenal fixation) and grafts with barbs and hooks (versus grafts without barbs and hooks). Patients with bad anatomic preconditions showed a higher complication rate. CONCLUSION: Contrary to first generation products, new stent-graft designs show acceptable technical and clinical results in endovascular AAA aneurysm repair. However, this therapy still should be reserved only for patients with significant comorbities and suitable anatomic conditions.


Asunto(s)
Aneurisma de la Aorta Abdominal/terapia , Implantación de Prótesis Vascular/métodos , Prótesis Vascular , Stents , Anciano , Anciano de 80 o más Años , Angiografía de Substracción Digital , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Femenino , Humanos , Riñón/irrigación sanguínea , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Estudios Retrospectivos , Tasa de Supervivencia , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
8.
Epilepsy Behav ; 6(2): 274-8, 2005 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15710318

RESUMEN

The emergence of a sudden, global, and fully reversible amnestic state during an intracarotid amobarbital procedure (IAP) performed in a patient with a right temporal tumor is described. Forms of amnesia during the IAP are discussed, and it is argued that because of its appearance, the associated behavioral abnormalities, and EEG findings, this state was a transient global amnesia (TGA). In addition to other origins such as bitemporal lesions, increased barbiturate levels, seizures, and epileptic amnesia, TGA may triggered by stress or angiography during the IAP.


Asunto(s)
Amnesia Global Transitoria/etiología , Amobarbital/efectos adversos , Hipnóticos y Sedantes/efectos adversos , Adulto , Neoplasias Encefálicas/complicaciones , Neoplasias Encefálicas/patología , Epilepsia del Lóbulo Temporal/diagnóstico , Epilepsia del Lóbulo Temporal/etiología , Epilepsia del Lóbulo Temporal/patología , Femenino , Lateralidad Funcional , Humanos , Imagen por Resonancia Magnética/métodos , Factores de Tiempo
9.
Am Surg ; 70(12): 1039-44, 2004 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-15663041

RESUMEN

Traumatic rupture of the thoracic aorta is potentially life-threatening and leads to death in 75 to 90 per cent of cases at the time of injury. In high-risk patients, as traumatic injuries of the aorta combine with multiple associated injuries, endoluminal repair is now reported as a promising therapeutic strategy with encouraging results. This study determined the outcome of patients with traumatic thoracic aortic injury treated endovascularly during the past 7 years at our institution. Thirteen patients, 11 males and 2 females (mean age, 39 years; range, 19-82), with traumatic rupture of the otherwise unremarkable descending aorta (10 acute, 3 chronic), out of a series of 64 endovascular thoracic stent-graft procedures, were treated by implantation of Talent (n = 8), Vanguard (n = 5), and Excluder (n = 2) self-expanding devices between January 1996 and August 2003. The immediate technical success rate was 92 per cent (12/13). One patient showed a proximal endoleak type I, which was treated successfully by an additional stent-graft procedure. Secondary success rate was 100 per cent. The mortality rate was 0 per cent. Two additional stent-graft procedures were performed due to type I endoleaks after 18 and 28 months. There was no other intervention-related morbidity or mortality during the mean follow-up time of 26.4 months' (range, 6-86). Endovascular stent-graft repair of traumatic thoracic aortic injuries is a safe, effective, and low-morbidity alternative to open thoracic surgery and has promising midterm results.


Asunto(s)
Aneurisma de la Aorta Torácica/cirugía , Rotura de la Aorta/cirugía , Implantación de Prótesis Vascular/métodos , Traumatismo Múltiple/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Angioplastia/métodos , Aorta Torácica/lesiones , Aorta Torácica/cirugía , Aneurisma de la Aorta Torácica/etiología , Prótesis Vascular , Implantación de Prótesis Vascular/instrumentación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Traumatismo Múltiple/complicaciones , Estudios Retrospectivos , Stents , Resultado del Tratamiento
10.
Dig Liver Dis ; 35(10): 716-21, 2003 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-14620621

RESUMEN

BACKGROUND: In patients with malignant primary and secondary liver tumours or proximal bile duct carcinoma radical surgery is superior to all other therapeutic modalities in terms of survival and quality of life. Radical resection, however, often requires the removal of a large amount of liver parenchyma, resulting in a marked reduction of functional liver tissue with the risk of liver failure. AIM: Preoperative partial portal vein embolisation induces hypertrophy of the controlateral liver and thereby increases the safety of extended liver resections. PATIENTS AND METHODS: Between January 1997 and February 2001 we applied this strategy in 19 patients with primary and secondary nonresectable hepatobiliary malignancies, in whom the estimated amount of the remnant liver was < or =25% of the liver volume. RESULTS: The increase in volume ranged between 7 and 245%. Radical extended liver resection was performed in 13 patients (68%) without mortality. After a mean observation time of 22 months patient survival was 19 months with six tumour-related deaths during the second year after surgery. The remaining seven patients are alive and well with tumour recurrence in one. CONCLUSION: Preoperative partial portal vein embolisation allows more patients with previously unresectable liver tumours to benefit from a potentially curative resection.


Asunto(s)
Neoplasias del Sistema Biliar/terapia , Embolización Terapéutica , Neoplasias Hepáticas/terapia , Vena Porta , Neoplasias del Sistema Biliar/mortalidad , Neoplasias del Sistema Biliar/cirugía , Diatrizoato/administración & dosificación , Combinación de Medicamentos , Ácidos Grasos/administración & dosificación , Femenino , Hepatectomía , Humanos , Aceite Yodado/administración & dosificación , Neoplasias Hepáticas/mortalidad , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/cirugía , Masculino , Persona de Mediana Edad , Cuidados Preoperatorios , Glicoles de Propileno/administración & dosificación , Zeína/administración & dosificación
11.
Eur J Vasc Endovasc Surg ; 26(2): 161-5, 2003 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-12917831

RESUMEN

OBJECTIVES: to determine medium term technical and clinical success of kissing stents for aortoiliac occlusive disease. DESIGN: retrospective study. SUBJECTS: twenty-five patients presenting with intermittent claudication (IC) or critical limb ischaemia (CLI) due to aortoiliac disease (41 complex stenoses, 8 occlusions). METHODS: balloon- or self-expanding kissing stents, with or without predilatation depending upon the nature of the disease, were inserted via bilateral retrograde femoral artery punctures. Clinical examination, ABPI, exercise testing and duplex ultrasound were performed at 1, 3, 6, and 12 months, and then annually. RESULTS: technical success was achieved in 86% segments. All patients with CLI improved and 6 of 7 ulcerated limbs showed complete healing. During follow-up, 7 patients died and two patients required major amputation at 7 and 8 months. The primary assisted patency rate was 94, 91 and 65% at 6, 12, and 24 months, respectively. CONCLUSIONS: despite acceptable short-term technical and clinical success, as the medium term patency rates are clearly inferior to those of bypass surgery, the kissing stent technique should be reserved for high risk patients with a limited life expectancy.


Asunto(s)
Enfermedades de la Aorta/terapia , Arteriopatías Oclusivas/terapia , Arteria Ilíaca , Stents , Femenino , Humanos , Claudicación Intermitente/etiología , Claudicación Intermitente/terapia , Isquemia/etiología , Isquemia/terapia , Pierna/irrigación sanguínea , Masculino , Diseño de Prótesis , Resultado del Tratamiento
12.
Am Surg ; 69(6): 542-5, 2003 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12852518

RESUMEN

Endovascular stent graft repair of traumatic vessel injuries is gaining worldwide acceptance as a minimally invasive alternative to open surgical repair. However, effective endovascular repair fails if the aneurysm is not completely excluded. Conversion to open surgery may be unavoidable in such cases. Herein we describe the case of a 45-year-old man who was referred to our hospital with a pseudoaneurysm of the proximal brachiocephalic artery caused by biopsy during diagnostic medianoscopy. The pseudoaneurysm was primarily treated by stent-graft implantation into the proximal brachiocephalic artery. As a result of the unfavorable location of the lesion exclusion of the aneurysm failed and the initial therapy had to be extended to open reconstruction of the brachiocephalic artery. A bypass procedure from the aortic arch to the right common carotid artery was performed with reinsertion of the right subclavian artery to exclude the pseudoaneurysm.


Asunto(s)
Aneurisma Falso/etiología , Aneurisma Falso/cirugía , Biopsia/efectos adversos , Implantación de Prótesis Vascular/métodos , Tronco Braquiocefálico/lesiones , Mediastinoscopía/efectos adversos , Angioplastia/métodos , Humanos , Masculino , Persona de Mediana Edad , Reoperación , Sarcoidosis Pulmonar/patología , Stents
13.
Eur Radiol ; 12(12): 2890-4, 2002 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-12439566

RESUMEN

Our objective was to develop and evaluate a non-invasive device for rigid immobilisation during extremity angiography. The patented BodyFix immobilisation device (Medical Intelligence, Schwabmünchen, Germany) consists of a vacuum pump connected to special cushions and a plastic foil that covers the body part to be immobilised. First, the patient's extremity is covered by a thin plastic bag and then wrapped in one of the cushions, placed on the top of the therapy couch, and covered with the plastic foil. The air is evacuated from the cushion under the covering foil by the vacuum pump, resulting a hardening of the cushion and thus immobilisation of the patient's extremity. The rigid immobilisation resulted in a complete absence of motion artefacts in the majority of patients. No pixeling of the images was required in any of the 100 patients vs 32% in the control group. Repetition of series could be avoided in all cases and a substantial increase in the quality of the images was obtained. Setup of the device takes an additional 1-2 min. Vacuum immobilisation allows for comfortable, effective immobilisation during digital subtraction angiography, eliminating motion artefacts. This device has become an indispensable tool in daily clinical routine at our department.


Asunto(s)
Inmovilización/fisiología , Extremidad Inferior/diagnóstico por imagen , Extremidad Inferior/fisiopatología , Dispositivos de Fijación Ortopédica , Intensificación de Imagen Radiográfica/instrumentación , Vacio , Adulto , Anciano , Anciano de 80 o más Años , Artefactos , Medios de Contraste/administración & dosificación , Diseño de Equipo/economía , Diseño de Equipo/instrumentación , Estudios de Factibilidad , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Dispositivos de Fijación Ortopédica/economía , Dolor/etiología , Enfermedades Vasculares Periféricas/complicaciones , Enfermedades Vasculares Periféricas/fisiopatología , Enfermedades Vasculares Periféricas/terapia , Intensificación de Imagen Radiográfica/economía , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
14.
Eur J Neurol ; 9(4): 389-99, 2002 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-12099924

RESUMEN

The influence of the treatment modalities (clipping/coiling) on the incidence of vasospasm and ischaemic infarction in aneurysm patients is still judged controversially. The purpose of this study was to analyse and compare retrospectively cerebral vasospasm and ischaemic infarction, as well as neurological deficits and outcome within a large population of clipped and coiled patients with ruptured and unruptured aneurysms. Within a 2-year period, a total of 144 interventions (53 clipping/91 coiling) entered the study. Daily bilateral transcranial Doppler sonographic monitoring was performed to observe vasospasm development. All cerebral computed tomography (cCT) and magnetic resonance imaging (MRI) scans were reviewed with respect to occurrence and localization of ischaemic infarctions. Focal neurological deficits were recorded and clinical outcome was evaluated using the Glasgow Outcome Scale. Statistical analysis included the use of multivariate logistic regression models to find determinants of vasospasm, ischaemic infarction and neurological deficits. Altogether, vasospasm was detected after 77 (53.5%) interventions, 61.8% in females (P < 0.01). Clipped patients significantly more often exhibited vasospasms (69.8 vs. 44.0%, P < 0.005) and were treated 1 week longer at the intensive care unit (P < 0.005). Seventy-seven patients (53.5%) developed ischaemic infarctions, 62.3% after clipping and 48.4% after coiling (P > 0.05). In the multivariate analysis, aneurysm-rupture was the strongest predictor for vasospasm and vasospasm was the strongest predictor for infarction. Neurological deficits at discharge (46.5%) were independent of treatment modality, the same applied for the mean Glasgow Outcome Scores. There was no significant difference in mortality between surgical and endovascular treatment (9.4 vs. 12.1%). Whilst the vasospasm incidence was significantly higher after surgical treatment, ischaemic infarctions were only slightly more frequent. The incidence of neurological deficits and clinical outcome was similar in both treatment groups.


Asunto(s)
Isquemia Encefálica/epidemiología , Infarto Cerebral/epidemiología , Aneurisma Intracraneal/cirugía , Complicaciones Posoperatorias/epidemiología , Vasoespasmo Intracraneal/epidemiología , Adulto , Encefalopatías/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Instrumentos Quirúrgicos , Resultado del Tratamiento
15.
Handchir Mikrochir Plast Chir ; 34(6): 403-9, 2002 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-12601609

RESUMEN

We report on a 36-year-old male patient with a congenital arterio-venous malformation (type C) of the hand. Symptoms onset was three years ago with an ulcer on the tip of the left middle finger, with the fingers and the palm of the hand turning increasingly livid. The shunt-volume in the area of an arterio-venous fistula was 70 ml/min, there was also involvement of the third metacarpal bone. Increasing pain from the index to the ring fingers with no tendency of healing in the middle finger were indications for surgical intervention. In view of the diffuse expansion to all the tissue layers and the danger of peripheral circulatory disturbance and associated necrosis if embolisation was performed, the entire middle finger along with the third metacarpal bone was resected, and the index and the ring fingers were also amputated. Seven months postoperatively, the patient had no pain, had good grip function and was able to use his hand freely in his job as a labourer.


Asunto(s)
Amputación Quirúrgica , Malformaciones Arteriovenosas/cirugía , Dedos/irrigación sanguínea , Mano/irrigación sanguínea , Isquemia/cirugía , Adulto , Diagnóstico por Imagen , Estudios de Seguimiento , Fuerza de la Mano/fisiología , Humanos , Masculino , Complicaciones Posoperatorias/fisiopatología
16.
J Arthroplasty ; 16(8): 1075-7, 2001 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-11740767

RESUMEN

We report a patient who underwent revision hip arthroplasty with preoperative radiation after a septic loosening of the primary hip prosthesis. Subsequently the patient presented with a dislocation of the hip. During the closed reduction with general anesthesia, a rupture of the arteria profunda femoris occurred. The patient was treated by angiographic obliteration of the arteria profunda femoris followed by an open reduction and augmentation of the acetabular component.


Asunto(s)
Arterias/lesiones , Artroplastia de Reemplazo de Cadera , Luxación de la Cadera/terapia , Manipulación Ortopédica/efectos adversos , Infecciones Relacionadas con Prótesis/radioterapia , Anciano , Femenino , Luxación de la Cadera/etiología , Humanos , Falla de Prótesis , Infecciones Relacionadas con Prótesis/tratamiento farmacológico , Reoperación , Factores de Riesgo , Rotura
18.
J Endovasc Ther ; 8(4): 380-9, 2001 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-11552730

RESUMEN

PURPOSE: To evaluate the efficacy of transluminal stent-graft placement in aortic aneurysms using postoperative enhanced spiral computed tomographic (CT) volumetric measurements of the aneurysm sac, the intra-aneurysmal vascular channel (IAVC), the thrombus, and the stent-graft. METHODS: Among 53 patients (45 men; mean age 74 years, range 59-85) who underwent elective endovascular aortic aneurysm repair, 37 patients with 27 abdominal and 10 thoracic aortic aneurysms completed at least a 6-month follow-up that included computerized CT volumetric analysis prior to discharge and at 3, 6, 12, 24, and 36 months. A variety of bifurcated (n = 23) and tube (n = 14) stent-grafts were observed for signs of endoleak and aneurysm enlargement. RESULTS: Mean follow-up was 16 months (range 6-48). Total aneurysm volumes and thrombus volumes decreased, whereas IAVC and stent-graft volumes increased over time. Between the postoperative and 12-month imaging studies, reductions in total aneurysm (p 0.011) and thrombus (p < 0.001) volumes were significant. No statistically significant difference in volume changes for the aneurysm sac (p = 0.555) or the thrombus (p = 0.920) was found when comparing the 24 patients without primary leak to the 12 with primary type-II leak. In all 5 cases with secondary leak, the volume of the aneurysm sac increased after initial shrinkage. CONCLUSIONS: Postoperative CT volumetric analysis is an effective tool for evaluating the outcome of endovascular aortic aneurysm repair. Thrombus volume measurements are more accurate than total aneurysm volumes. In patients in whom contrast agents are contraindicated, volume measurements can also be obtained without the use of contrast.


Asunto(s)
Angioplastia , Aneurisma de la Aorta Abdominal/cirugía , Aneurisma de la Aorta Torácica/cirugía , Tomografía Computarizada por Rayos X , Factores de Edad , Anciano , Anciano de 80 o más Años , Aneurisma de la Aorta Abdominal/complicaciones , Aneurisma de la Aorta Abdominal/diagnóstico , Aneurisma de la Aorta Torácica/complicaciones , Aneurisma de la Aorta Torácica/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Trombosis/diagnóstico , Trombosis/etiología , Factores de Tiempo , Resultado del Tratamiento
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