Mechanical stress due to flexion-extension in the femoropopliteal space may cause stent failure via stent fracture and thrombosis. Wire-Interwoven self-expanding Nitinol Stents design partially mimics the reticular structure of native vessels, emphasizing radial strength, flexibility and kink resistance; these stent features can offer more chances for short and long term patency. We have evaluated 5 patients with peripheral artery disease with significant superficial femoral artery or proximal popliteal artery lesions. All patients underwent endovascular therapy with Wire-Interwoven self-expanding Nitinol Stents, with primary focus on stent patency at follow-up visits (1, 6, 12 months). The endovascular initial success was achieved in all 5 patients. Stent patency at 1-year follow-up was achieved in 3 patients (60%). 2 patients (40%) had stent thrombosis within 30 days after procedure secondary to arterial dissection at distal stent extremity and self-withdrawal dual antiplatelet therapy; subsequently target lesion revascularization with endovascular therapy and ilio-femoral bypass was performed.
Peripheral artery disease of the lower limbs is, in fact, an arterial pathology, by which the blood flow is reduced, due to the obstruction caused by the deposit of atheroma plaques.(1) This deposition occurs slowly, which leads to a slow progression of the disease, and thus, at the onset of symptomatology. The objective of the study was to make a comparison between the invasive and noninvasive paraclinical investigations performed in patients with peripheral arterial disease of the lower limbs in the E.C.C.H. Sibiu. In conclusion, between the two investigations (computed tomography angiography and digital subtraction angiography) there are no noticeable differences in the terminal aorta and iliac arteries, but in reducing the arteries calibre, the use of digital subtraction angiography is preferred, according to our study, although it is more invasive and exposed to complications.
Peripheral arterial disease (PAD) is a partial or complete occlusion of one or more arteries leading to a suppression of blood flow and ischemia. In the process of stenosis, numerous processes are described, among which, the most common being atherosclerosis, affecting the arteries of the inferior and coronary limbs. In the 60 patients investigated angio-coronarographically in the Emergency County Clinical Hospital of Sibiu with PAD, the prevalence of high blood pressure (HBP) and smoking was observed, among the risk factors, and 73.3% had one or more coronary lesions. The association of diabetes mellitus (DM) with PAD has shown an increase in the number of coronary lesions. There was also a strong positive correlation between the presence of left anterior descending artery (LAD) injuries and the stage of PAD regardless of other risk factors.
Introduction: Pericardiocentesis is a procedure performed for diagnostic and therapeutic purposes, and it consists in draining the pericardial effusion liquid in sterile conditions. The accumulation of fluid in the pericardial space may be caused by several systemic conditions, including viral or bacterial infections, autoimmune disease, cancer, as well as thyroid malfunction. A rapidly growing pericardial effusion can lead to cardiac tamponade, and consequently to acute hypodiastolic heart failure.
Case report: We report the case of a 79-year-old female, without previously known cardiovascular pathologies, who presented to the Emergency Room due to a gradual deterioration in her health status. Imaging procedures included a chest X-ray and an echocardiography that confirmed the diagnosis of pericardial effusion. Pericardiocentesis was performed using cardiac ultrasound guidance, resulting in the draining of a small quantity of yellowish, partly haemorrhagic fluid. The patient's general condition did not improve, thus another pericardiocentesis was carried out, this time with fluoroscopical and cardiac ultrasound guidance, and 1200 milliliters of sero-haemorrhagic fluid was drained. The laboratory analysis revealed that the patient had hypothyroidism, and the cytological analysis of the drained pericardial fluid excluded a neoplastic origin, tuberculosis, and other infectious etiologies. The particularity of the case consists in a pericardial effusion evolving into cardiac tamponade, for which the pericardiocentesis was guided using echocardiographic, fluoroscopic and radiologic methods, because simple ultrasound-guided drainage was not efficient.
Conclusion: The superiority of a combined imaging-guided approach in cases of pericardial effusion recommends it as an alternative to a surgical procedure, guided solely by echocardiography, which is often used in cases of unsuccessful drainage of pericar-dial effusion fluid.