Browsing by Author "Arriagada Jorquera, Ivette Andrea"

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    Filtros de vena cava inferior en posición suprarrenal
    (2008) Marine Massa, Leopoldo Ario Fernando; Mertens Martin, Renato Alfonso; Kramer Schumacher, Albrecht Helmuth; Valdés Echenique, José Francisco; Bergoeing Reid, Michel Paul; Arriagada Jorquera, Ivette Andrea; Vergara González, Teresa Jeanette; Carvajal Núñez, Claudia Ximena
    Background: Inferior vena cava (IVC) filters are used to prevent massive pulmonary embolism in cases where anticoagulation is contraindicated or has failed. It is usually implanted below the renal veins. In a few cases it is necessary to deploy the filter above them, with theoretical risk of secondary renal failure. Aim: To report the experience with filters located above the renal veins. Patients and Methods: Medical records of all patients with percutaneous suprarenal filters are reviewed. Results: Between May 1993 and May 2007, 361 percutaneous IVC filter procedures were performed. In thirty patients aged 19 to 77 years (average 48 years, 50% males), they were placed in suprarenal position (8.3%). Suprarenal IVC filters were implanted in patients with extensive caval thrombosis, renal vein thrombosis extending to cava, displacement of previous IVC filters and double IVC system. Jugular vein approach was the access of choice. Technical success was 100%, no death or pulmonary embolism occurred. Patients were followed from 1 to 165 months (average 57 months). Eight deaths were recorded, five in patients with cancer. No patient had renal failure on follow up (average creatinine 0.90 +/- 0,26 mg/dL). Three patients developed a new deep vein thrombosis (10%), without pulmonary of IVC filters was not associated to secondary renal failure, and showed suprarenal placement of IVC filters was not associated to secondary renal failure, and showed good short and long term results (Rev Med Chile 2008; 136: 1535-41).
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    Tratamiento endovascular de la disección aórtica tipo B mediante endoprótesis
    (2008) Mertens Martin, Renato; Arriagada Jorquera, Ivette Andrea; Valdés Echeñique, José Francisco; Kramer, Albrecht; Mariné M., Leopoldo; Bergoeing Reid, Michel Paul; Braun Jones, Sandra; Godoy Jorquera, Iván Esteban; Córdova Alvestegui, Samuel Edmundo; Huete Garín, Álvaro; Vergara G., Jeannette; Carvajal Núñez, Claudia
    Background: Dissections that involve the ascending aorta are classified as type A, regardless of the site of the primary intimal tear, and all other dissections as type B. Type B dissections can have fatal ischemic and hemorrhagic complications. In the chronic state, dilatation and rupture can be mortal. Endovascular surgery is a therapeutic alternative, considering the high rate of complications of conventional surgery. Aim: To report the results of endovascular treatment of type B aortic dissection. Material and methods: Report of 36 treated patients (30 males) aged 43 to 87 years, with a type B aortic dissection. Seventy eight percent were hypertensive and 39% smoked. The diagnosis was confirmed by CAT scan. Acute patients were treated for complications and chronic patients, for dilatation. In the operating room, an endoprothesis was placed through the femoral artery, to cover the tear. The tear was located and the lumens were differentiated using angiography and transesophageal echocardiography. Results: All procedures were successful. In 16 acute dissections the indications were malperfusion syndrome or unmanageable hypertension in seven patients and imminent rupture or persistent pain in nine. Twenty chronic patients were operated due to dilatation (mean 6 cm). One patient died due to cardiac failure. One patient had a transient paraparesia and two had pulmonary embolism. No patient died in a follow up period ranging from 2.5 to 74 months. Four patients required a new aortic endovascular procedure due to progressive dilatation or endoleak. Conclusion: Endovascular treatment of type B aortic dissection has good immediate and long term results (Rev Méd Chile 2008; 136: 1431-8).