Pub Date : 2024-11-01DOI: 10.1016/j.circv.2024.03.002
The high prevalence of venous insufficiency has led to an important development in its treatments. Open surgery continues to be the technique of choice in many centers due to its excellent results and low recurrence rate. The use of mini-invasive techniques provides great benefits to the patient with less risk of associated complications and an immediate return to work. We will talk about the open surgery as well as its advantages and disadvantages in relation to other less invasive procedures.
{"title":"Cirugía clásica-abierta de las várices","authors":"","doi":"10.1016/j.circv.2024.03.002","DOIUrl":"10.1016/j.circv.2024.03.002","url":null,"abstract":"<div><div>The high prevalence of venous insufficiency has led to an important development in its treatments. Open surgery continues to be the technique of choice in many centers due to its excellent results and low recurrence rate. The use of mini-invasive techniques provides great benefits to the patient with less risk of associated complications and an immediate return to work. We will talk about the open surgery as well as its advantages and disadvantages in relation to other less invasive procedures.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 287-290"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141408416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.circv.2024.06.001
Ivan García Martín
Abdominal aorta aneurysms present a high incidence in elderly population and are an important cause of morbi-mortality. The new endovascular aproach (EVAR) has allowed to treat an increasing number of patients, some of them not candidates for conventional surgery. Althouhg initial mortality with EVAR, in supra or infrarenal position, has been reduced, mid-term results are similar with both techniques. Larger and better registries are needed to determine the most cost/effective technique.
{"title":"Estado actual del tratamiento de los aneurismas de la aorta abdominal","authors":"Ivan García Martín","doi":"10.1016/j.circv.2024.06.001","DOIUrl":"10.1016/j.circv.2024.06.001","url":null,"abstract":"<div><div>Abdominal aorta aneurysms present a high incidence in elderly population and are an important cause of morbi-mortality. The new endovascular aproach (EVAR) has allowed to treat an increasing number of patients, some of them not candidates for conventional surgery. Althouhg initial mortality with EVAR, in supra or infrarenal position, has been reduced, mid-term results are similar with both techniques. Larger and better registries are needed to determine the most cost/effective technique.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 247-255"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.circv.2024.07.001
César A. Rodríguez Canedo, María Nuñez Sayar, Ander Ucelay Aristi, Alejandro Pontón Cortina
The term peripheral arterial disease (PAD) is considered a general term that encompasses a series of non-coronary arterial syndromes caused by alterations in the structure and function of the aorta and peripheral arteries, mainly due to atherosclerosis, although there are other physiopathological processes such as smoking, diabetes, arterial hypertension and hyperlipidaemia. For its diagnosis we have non-invasive methods such as the ankle-arm index that also allows us to make a prognosis and follow-up of patients with this pathology. It is important to make the differential diagnosis through anamnesis and physical examination, with other pathologies that generate intermittent claudication such as radicular pathology or musculoskeletal pathology. In terms of medical treatment, the first step is the modification of risk factors, followed by antiplatelet and anticoagulant drugs and lipid-lowering therapy with statins.
{"title":"Revisión de cirugía vascular periférica","authors":"César A. Rodríguez Canedo, María Nuñez Sayar, Ander Ucelay Aristi, Alejandro Pontón Cortina","doi":"10.1016/j.circv.2024.07.001","DOIUrl":"10.1016/j.circv.2024.07.001","url":null,"abstract":"<div><div>The term peripheral arterial disease (PAD) is considered a general term that encompasses a series of non-coronary arterial syndromes caused by alterations in the structure and function of the aorta and peripheral arteries, mainly due to atherosclerosis, although there are other physiopathological processes such as smoking, diabetes, arterial hypertension and hyperlipidaemia. For its diagnosis we have non-invasive methods such as the ankle-arm index that also allows us to make a prognosis and follow-up of patients with this pathology. It is important to make the differential diagnosis through anamnesis and physical examination, with other pathologies that generate intermittent claudication such as radicular pathology or musculoskeletal pathology. In terms of medical treatment, the first step is the modification of risk factors, followed by antiplatelet and anticoagulant drugs and lipid-lowering therapy with statins.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 230-234"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.circv.2024.03.008
Venous insufficiency represents a frequent health problem in the current population, with a great impact on the patient's quality of life. Early diagnosis and early start of treatment determines the evolution and the long-term impact on the patient. That is why we consider that; an exhaustive study of this pathology can be of vital interest. In this review we will focus on data of clinical interest and relevant diagnostics. We will talk about the medical treatment of this disease and the possible invasive approaches currently available.
{"title":"Estudio de la insuficiencia venosa crónica","authors":"","doi":"10.1016/j.circv.2024.03.008","DOIUrl":"10.1016/j.circv.2024.03.008","url":null,"abstract":"<div><div>Venous insufficiency represents a frequent health problem in the current population, with a great impact on the patient's quality of life. Early diagnosis and early start of treatment determines the evolution and the long-term impact on the patient. That is why we consider that; an exhaustive study of this pathology can be of vital interest. In this review we will focus on data of clinical interest and relevant diagnostics. We will talk about the medical treatment of this disease and the possible invasive approaches currently available.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 256-266"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141402325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.circv.2024.03.001
Introduction and objective
Chronic venous disease is the most common entity of vascular pathology and varicose veins originating in the saphenous trunks can cause significant morbidity. Endovascular treatment offers significant advantages, being at least as effective as surgery.
Methods
Review of thermal (laser, radiofrequency, steam and microwave) and non-thermal (cyanoacrylate, ultrasound-guided foam and mechano-chemical) endovascular techniques in the treatment of superficial venous insufficiency based on existing literature and own experience.
Results
Throughout the article, each of the techniques, their mechanism of action and the commercial devices available with standard use procedures are described. Likewise, the usual postoperative period for each of them, precautions, contraindications, results described in the literature, and frequent and uncommon complications are detailed. After the description of the techniques, the results of endovascular techniques are compared with conventional surgery (high ligation/stripping) and endovascular techniques with each other. Finally, a guide is provided for selecting the best treatment based on the characteristics of the patient, its indications and known limitations, according to the latest clinical guidelines and reviews.
Conclusions
Endovascular treatment has become the current standard. Although thermoablative techniques are the first indication, non-thermal treatments are a good alternative depending on the clinical context and some such as cyanoacrylate may become first choice therapy in the future.
{"title":"Técnicas endovasculares en el tratamiento de la insuficiencia venosa superficial. Mecanismo de acción, procedimientos, indicaciones y efectos adversos","authors":"","doi":"10.1016/j.circv.2024.03.001","DOIUrl":"10.1016/j.circv.2024.03.001","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Chronic venous disease is the most common entity of vascular pathology and varicose veins originating in the saphenous trunks can cause significant morbidity. Endovascular treatment offers significant advantages, being at least as effective as surgery.</div></div><div><h3>Methods</h3><div>Review of thermal (laser, radiofrequency, steam and microwave) and non-thermal (cyanoacrylate, ultrasound-guided foam and mechano-chemical) endovascular techniques in the treatment of superficial venous insufficiency based on existing literature and own experience.</div></div><div><h3>Results</h3><div>Throughout the article, each of the techniques, their mechanism of action and the commercial devices available with standard use procedures are described. Likewise, the usual postoperative period for each of them, precautions, contraindications, results described in the literature, and frequent and uncommon complications are detailed. After the description of the techniques, the results of endovascular techniques are compared with conventional surgery (high ligation/stripping) and endovascular techniques with each other. Finally, a guide is provided for selecting the best treatment based on the characteristics of the patient, its indications and known limitations, according to the latest clinical guidelines and reviews.</div></div><div><h3>Conclusions</h3><div>Endovascular treatment has become the current standard. Although thermoablative techniques are the first indication, non-thermal treatments are a good alternative depending on the clinical context and some such as cyanoacrylate may become first choice therapy in the future.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 267-286"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141403561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.circv.2023.11.030
Thoracoabdominal aortic aneurysms remain a challenge in cardiovascular surgery due to the complexity of the pathology, the invasiveness of surgical treatment required and common patient comorbidities. The prevalence, true and detected, of these aneurysms has increased due to increased life expectancy, improved diagnosis, and greater physician and patient awareness. They can trigger dissection or rupture, and half of all deaths are due to aortic rupture, even in aneurysms with diameters under 6 cm. The goal of treatment is to reduce the risk of adverse aortic events, such as dissection, rupture, or aortic-related death. The timing of intervention requires careful evaluation of anatomic and risk factors for future events versus operative risks. Open surgery aims to replace the aneurysmal thoracoabdominal aortic segment with a prosthetic graft anastomosed to adjacent non-aneurysmal aortic tissues, whereas endovascular repair uses stent-grafts to exclude blood flow from the aneurysmal sac. The morbidity and mortality of open surgical repair are high, especially in patients with comorbidities, and include spinal cord ischemia and renal damage. Endovascular treatment has been developed as a less invasive alternative to open surgery, with promising results in reducing hospital mortality, but its use remains experimental. The choice of treatment requires a multidisciplinary assessment of the patient's risk factors and the anatomical characteristics of the aneurysm. Hybrid treatment, combining thoracic endovascular repair with (simultaneous or deferred) open abdominal surgery, has recently been proposed, but there is still limited experience and no robust evidence for improved outcomes.
{"title":"Epidemiología, diagnóstico, clasificación e indicaciones quirúrgicas actuales de los aneurismas de la aorta toracoabdominal","authors":"","doi":"10.1016/j.circv.2023.11.030","DOIUrl":"10.1016/j.circv.2023.11.030","url":null,"abstract":"<div><div>Thoracoabdominal aortic aneurysms remain a challenge in cardiovascular surgery due to the complexity of the pathology, the invasiveness of surgical treatment required and common patient comorbidities. The prevalence, true and detected, of these aneurysms has increased due to increased life expectancy, improved diagnosis, and greater physician and patient awareness. They can trigger dissection or rupture, and half of all deaths are due to aortic rupture, even in aneurysms with diameters under 6<!--> <!-->cm. The goal of treatment is to reduce the risk of adverse aortic events, such as dissection, rupture, or aortic-related death. The timing of intervention requires careful evaluation of anatomic and risk factors for future events versus operative risks. Open surgery aims to replace the aneurysmal thoracoabdominal aortic segment with a prosthetic graft anastomosed to adjacent non-aneurysmal aortic tissues, whereas endovascular repair uses stent-grafts to exclude blood flow from the aneurysmal sac. The morbidity and mortality of open surgical repair are high, especially in patients with comorbidities, and include spinal cord ischemia and renal damage. Endovascular treatment has been developed as a less invasive alternative to open surgery, with promising results in reducing hospital mortality, but its use remains experimental. The choice of treatment requires a multidisciplinary assessment of the patient's risk factors and the anatomical characteristics of the aneurysm. Hybrid treatment, combining thoracic endovascular repair with (simultaneous or deferred) open abdominal surgery, has recently been proposed, but there is still limited experience and no robust evidence for improved outcomes.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 235-246"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140467363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.circv.2024.03.010
The thoracoabdominal segment is currently treatable by endovascular techniques, making it possible to treat patients with higher surgical risk. We expose the advantages of the different configurations with fenestrations or branches. There are prefabricated prostheses on the market suitable for most patients. Knowledge of the patient's anatomical peculiarities will allow us to select patients with an adequate result in the medium and long term, as well as choose the most appropriate prosthesis.
The application of associated spinal cord protection and nephroprotection techniques complete the comprehensive approach to the patient.
{"title":"Estrategias en el tratamiento endovascular del aneurisma de aorta toracoabdominal","authors":"","doi":"10.1016/j.circv.2024.03.010","DOIUrl":"10.1016/j.circv.2024.03.010","url":null,"abstract":"<div><div>The thoracoabdominal segment is currently treatable by endovascular techniques, making it possible to treat patients with higher surgical risk. We expose the advantages of the different configurations with fenestrations or branches. There are prefabricated prostheses on the market suitable for most patients. Knowledge of the patient's anatomical peculiarities will allow us to select patients with an adequate result in the medium and long term, as well as choose the most appropriate prosthesis.</div><div>The application of associated spinal cord protection and nephroprotection techniques complete the comprehensive approach to the patient.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 6","pages":"Pages 291-294"},"PeriodicalIF":0.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141413803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.circv.2024.02.007
Dysphagia lusoria is a rare cause of dysphagia that requires a high suspicion index to make a diagnosis and management protocol as well an understanding of the underlying physiopathological and embryological mechanisms to plan an adequate surgery for a definitive treatment. Even though there is moderate experience with the management of dysphagia lusoria in its most common variant, corresponding to that arising from an aberrant right subclavian artery, there are only a few cases of dysphagia lusoria due to an aberrant left subclavian artery. Next, we describe the case of a 45-year-old male with late onset presentation of symptoms in whom we found dysphagia lusoria with aberrant left subclavian artery.
{"title":"Disfagia lusoria por arteria subclavia izquierda aberrante tratada mediante exclusión arterial y aortoplastia","authors":"","doi":"10.1016/j.circv.2024.02.007","DOIUrl":"10.1016/j.circv.2024.02.007","url":null,"abstract":"<div><p>Dysphagia lusoria is a rare cause of dysphagia that requires a high suspicion index to make a diagnosis and management protocol as well an understanding of the underlying physiopathological and embryological mechanisms to plan an adequate surgery for a definitive treatment. Even though there is moderate experience with the management of dysphagia lusoria in its most common variant, corresponding to that arising from an aberrant right subclavian artery, there are only a few cases of dysphagia lusoria due to an aberrant left subclavian artery. Next, we describe the case of a 45-year-old male with late onset presentation of symptoms in whom we found dysphagia lusoria with aberrant left subclavian artery.</p></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"31 5","pages":"Pages 222-224"},"PeriodicalIF":0.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S113400962400041X/pdfft?md5=e5bd9cc967f408cf5d3fa6b91348c754&pid=1-s2.0-S113400962400041X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140268060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号