This Artículo de investigación is brought to you for free and open access by the Revistas científ... more This Artículo de investigación is brought to you for free and open access by the Revistas científicas at Ciencia Unisalle. It has been accepted for inclusion in Revista de Medicina Veterinaria by an authorized editor of Ciencia Unisalle. For more information, please contact
Objetivo. El objetivo del presente estudio fue determinar los valores morfométricos de los tendon... more Objetivo. El objetivo del presente estudio fue determinar los valores morfométricos de los tendones y ligamentos del metatarso plantar en animales clínicamente sanos. Materiales y métodos. 30 animales fueron utilizados a lo largo del estudio, se evaluaron los tendones y ligamentos del metatarso plantar empezando desde el aspecto plantaromedial de la región proximal hasta la inserción de las ramas del suspensorio en los sesamoideos. Las variables a estudiar en cada estructura fueron área transversal (cm2), ancho latero medial (ALM) (cm) y espesor dorso palmar (EDP) (cm). Resultados. Se encontró que la estructura de mayor área en las regiones proximales fue el ligamento suspensorio (0.858 cm2) seguido del Flexor digital lateral (0.759 cm2), en las regiones 1B y 2A la estructura de mayor tamaño siguió siendo el ligamento suspensorio y en la región 2B el Tendón flexor digital profundo fue la estructura de mayor tamaño (0.804 cm2). Conclusiones. El comportamiento de las variables en el ...
Journal of Vascular and Interventional Radiology, 1996
To describe early experience with an endovascular suite created for procedures requiring surgical... more To describe early experience with an endovascular suite created for procedures requiring surgical access, endograft placement, or combined surgical and interventional radiologic expertise. After examining the operating room and angiography environments, practice guidelines, state law, and regulatory agency requirements, a multidepartmental task force recommended reconfiguring an angiography suite to serve as an endovascular suite. Forty patients have been treated; 28 underwent vascular endograft placement and 12 underwent other combined procedures. Procedures included 31 femoral and axillary cutdowns; placement of one aortobifemoral graft, two iliofemoral grafts, two femoropopliteal grafts, and two femoral-femoral crossover grafts; two abdominopelvic exposures for aortic access, and five endarterectomies, including one at the carotid bifurcation performed in combination with common carotid stent placement. Three of the abdominopelvic procedures were not planned, including two emergency conversions. No patient had to be moved to an operating room. There was one major infection (2.5%), two minor wound infections (5%), and one wound with delayed healing (2.5%). Early experience with a combined surgical-interventional suite has been favorable, but a vigilant approach is warranted.
Journal of Vascular and Interventional Radiology, 2001
PURPOSE: To determine early and late outcomes of transluminal endografting (TE) in patients with ... more PURPOSE: To determine early and late outcomes of transluminal endografting (TE) in patients with abdominal aortic aneurysm (AAA), stratified by predicted risk of procedure-related mortality with conventional operation. MATERIALS AND METHODS: A retrospective study was conducted in consecutive risk-stratified AAA patients undergoing TE at a not-for-profit cardiovascular referral center from March 1994 through November 2000 with follow-up through February 2001. With use of conventional risk strata (0 ؍ low, 1 ؍ minimal, 2 ؍ moderate, and 3 ؍ high), predicted procedure-related mortalities were 0%-1% in stratum 0 (n ؍ 40), 1%-3% in stratum 1 (n ؍ 118), 3%-8% in stratum 2 (n ؍ 116), and 8%-30% in stratum 3 (n ؍ 31). Main outcome measures were: (i) TE procedural success, (ii) procedure-related mortality, (iii) major nonfatal complications, (iv) composite adverse outcome (ii ؉ iii), (v) length of stay (LOS), (vi) freedom from AAA rupture, (vii) late survival, (viii) late complications, and (ix) endoleaks and their classification and management. RESULTS: Women were significantly less likely than men to qualify for and undergo endografting: 24 of 91 (26.4%) women underwent TE, compared to 281 of 684 (41.1%) men. Of 305 attempted TE procedures, 291 (95.4%) were successful, four (1.3%) were urgently converted to open repair, and 10 (3.3%) were aborted. Procedure-related mortalities occurred in eight cases (2.6%) overall and one of 40 (2.5%), one of 118 (0.8%), four of 116 (3.4%), and two of 31 (6.5%) cases for risk strata 0-3, respectively. Perioperative survivors were significantly younger than nonsurvivors (74.3 y ؎ 9 vs 81.6 y ؎ 5.1; P ؍ .0087). Forty-six patients (15.1%) had major complications. Composite adverse outcome was worse for patients in stratum 3 than those in stratum 1 (P ؍ .0296) and those in strata 0, 1, and 2 combined (P ؍ .026). Procedure-related mortality declined with institutional experience, from 4% among the first 100 patients undergoing TE to 1% among the last 105. For strata 0-3, median LOS were 2, 3, 3, and 4 days, respectively. Seventy patients (22.9%) had 75 endoleaks, of which 30 necessitated additional procedures, 17 self-resolved, and 22 were untreated as of March 1, 2001. Five patients with endoleak died of unrelated causes. One late-onset type IA endoleak (26 mo) resulted in the only AAA rupture and death in the follow-up period among the 291 patients who underwent successful transluminal endograft implantation. Actuarial survival rates at 1 year after TE were 90.3% ؎ 1.9% for the overall study group and 97.5% ؎ 2.5%, 94% ؎ 2.5%, 86.9% ؎ 3.3%, and 81.3% ؎ 7.7% for risk strata 0-3, respectively. At 5 years, overall actuarial survival was 69.6% ؎ 6.1%. Thirty-eight late deaths were attributable to post-TE AAA rupture (n ؍ 1), AAA rupture late after failed TE with no further treatment (n ؍ 1), other cardiovascular disorders (n ؍ 7), cancer (n ؍ 15), other causes (n ؍ 10), and unknown causes (n ؍ 4). Late deaths occurred in risk strata 0-3 at the following rates: two of 40 (5%), 10 of 118 (8.5%), 16 of 116 (13.8%), and 10 of 31 (32.3%), respectively (stratum 0 vs stratum 3, P ؍ .0017; stratum 1 vs stratum 3, P ؍ .003). CONCLUSIONS: TE is safe and confers durable protection against AAA rupture in treated populations. Still, protection is not absolute in patients with endoleaks, because late AAA enlargement and even rupture can occur. Given current knowledge, technology, and practice, careful patient selection and close surveillance of patients after implantation of transluminal endografts is essential.
This Artículo de investigación is brought to you for free and open access by the Revistas científ... more This Artículo de investigación is brought to you for free and open access by the Revistas científicas at Ciencia Unisalle. It has been accepted for inclusion in Revista de Medicina Veterinaria by an authorized editor of Ciencia Unisalle. For more information, please contact
Objetivo. El objetivo del presente estudio fue determinar los valores morfométricos de los tendon... more Objetivo. El objetivo del presente estudio fue determinar los valores morfométricos de los tendones y ligamentos del metatarso plantar en animales clínicamente sanos. Materiales y métodos. 30 animales fueron utilizados a lo largo del estudio, se evaluaron los tendones y ligamentos del metatarso plantar empezando desde el aspecto plantaromedial de la región proximal hasta la inserción de las ramas del suspensorio en los sesamoideos. Las variables a estudiar en cada estructura fueron área transversal (cm2), ancho latero medial (ALM) (cm) y espesor dorso palmar (EDP) (cm). Resultados. Se encontró que la estructura de mayor área en las regiones proximales fue el ligamento suspensorio (0.858 cm2) seguido del Flexor digital lateral (0.759 cm2), en las regiones 1B y 2A la estructura de mayor tamaño siguió siendo el ligamento suspensorio y en la región 2B el Tendón flexor digital profundo fue la estructura de mayor tamaño (0.804 cm2). Conclusiones. El comportamiento de las variables en el ...
Journal of Vascular and Interventional Radiology, 1996
To describe early experience with an endovascular suite created for procedures requiring surgical... more To describe early experience with an endovascular suite created for procedures requiring surgical access, endograft placement, or combined surgical and interventional radiologic expertise. After examining the operating room and angiography environments, practice guidelines, state law, and regulatory agency requirements, a multidepartmental task force recommended reconfiguring an angiography suite to serve as an endovascular suite. Forty patients have been treated; 28 underwent vascular endograft placement and 12 underwent other combined procedures. Procedures included 31 femoral and axillary cutdowns; placement of one aortobifemoral graft, two iliofemoral grafts, two femoropopliteal grafts, and two femoral-femoral crossover grafts; two abdominopelvic exposures for aortic access, and five endarterectomies, including one at the carotid bifurcation performed in combination with common carotid stent placement. Three of the abdominopelvic procedures were not planned, including two emergency conversions. No patient had to be moved to an operating room. There was one major infection (2.5%), two minor wound infections (5%), and one wound with delayed healing (2.5%). Early experience with a combined surgical-interventional suite has been favorable, but a vigilant approach is warranted.
Journal of Vascular and Interventional Radiology, 2001
PURPOSE: To determine early and late outcomes of transluminal endografting (TE) in patients with ... more PURPOSE: To determine early and late outcomes of transluminal endografting (TE) in patients with abdominal aortic aneurysm (AAA), stratified by predicted risk of procedure-related mortality with conventional operation. MATERIALS AND METHODS: A retrospective study was conducted in consecutive risk-stratified AAA patients undergoing TE at a not-for-profit cardiovascular referral center from March 1994 through November 2000 with follow-up through February 2001. With use of conventional risk strata (0 ؍ low, 1 ؍ minimal, 2 ؍ moderate, and 3 ؍ high), predicted procedure-related mortalities were 0%-1% in stratum 0 (n ؍ 40), 1%-3% in stratum 1 (n ؍ 118), 3%-8% in stratum 2 (n ؍ 116), and 8%-30% in stratum 3 (n ؍ 31). Main outcome measures were: (i) TE procedural success, (ii) procedure-related mortality, (iii) major nonfatal complications, (iv) composite adverse outcome (ii ؉ iii), (v) length of stay (LOS), (vi) freedom from AAA rupture, (vii) late survival, (viii) late complications, and (ix) endoleaks and their classification and management. RESULTS: Women were significantly less likely than men to qualify for and undergo endografting: 24 of 91 (26.4%) women underwent TE, compared to 281 of 684 (41.1%) men. Of 305 attempted TE procedures, 291 (95.4%) were successful, four (1.3%) were urgently converted to open repair, and 10 (3.3%) were aborted. Procedure-related mortalities occurred in eight cases (2.6%) overall and one of 40 (2.5%), one of 118 (0.8%), four of 116 (3.4%), and two of 31 (6.5%) cases for risk strata 0-3, respectively. Perioperative survivors were significantly younger than nonsurvivors (74.3 y ؎ 9 vs 81.6 y ؎ 5.1; P ؍ .0087). Forty-six patients (15.1%) had major complications. Composite adverse outcome was worse for patients in stratum 3 than those in stratum 1 (P ؍ .0296) and those in strata 0, 1, and 2 combined (P ؍ .026). Procedure-related mortality declined with institutional experience, from 4% among the first 100 patients undergoing TE to 1% among the last 105. For strata 0-3, median LOS were 2, 3, 3, and 4 days, respectively. Seventy patients (22.9%) had 75 endoleaks, of which 30 necessitated additional procedures, 17 self-resolved, and 22 were untreated as of March 1, 2001. Five patients with endoleak died of unrelated causes. One late-onset type IA endoleak (26 mo) resulted in the only AAA rupture and death in the follow-up period among the 291 patients who underwent successful transluminal endograft implantation. Actuarial survival rates at 1 year after TE were 90.3% ؎ 1.9% for the overall study group and 97.5% ؎ 2.5%, 94% ؎ 2.5%, 86.9% ؎ 3.3%, and 81.3% ؎ 7.7% for risk strata 0-3, respectively. At 5 years, overall actuarial survival was 69.6% ؎ 6.1%. Thirty-eight late deaths were attributable to post-TE AAA rupture (n ؍ 1), AAA rupture late after failed TE with no further treatment (n ؍ 1), other cardiovascular disorders (n ؍ 7), cancer (n ؍ 15), other causes (n ؍ 10), and unknown causes (n ؍ 4). Late deaths occurred in risk strata 0-3 at the following rates: two of 40 (5%), 10 of 118 (8.5%), 16 of 116 (13.8%), and 10 of 31 (32.3%), respectively (stratum 0 vs stratum 3, P ؍ .0017; stratum 1 vs stratum 3, P ؍ .003). CONCLUSIONS: TE is safe and confers durable protection against AAA rupture in treated populations. Still, protection is not absolute in patients with endoleaks, because late AAA enlargement and even rupture can occur. Given current knowledge, technology, and practice, careful patient selection and close surveillance of patients after implantation of transluminal endografts is essential.
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