Browsing by Author "Bergoeing R., Michel"

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    Interrupción de la vena cava inferior mediante filtros de inserción percutánea: Indicaciones y resultados en 287 pacientes
    (SOC MEDICA SANTIAGO, 2007) Arriagada J., Ivette; Mertens M., Renato; Valdés E., Francisco; Kramer S., Albrecht; Marine M., Leopoldo; Bergoeing R., Michel; Soto G., Sebastian; Vergara G., Jeannette; Valdebenito G., Magaly
    Background: Anticoagulation is the treatment of choice for deep vein thrombosis (DVI) and pulmonary embolism, (PE). Occasionally this treatment is contraindicated or fails to prevent PE In these patients, inferior vena caval (IVC) interruption is indicated and insertion of a filter is the most commonly performed procedure. Aim: To report the experience with IVC filters. Material and methods: Retrospective review of all medical records and operative protocols of patients subjected to IVC filter implantations. Follow up was performed by telephone contact with the patients relatives or primary physicians, ambulatory consultation or by death certificates. Results: During the period 1993-2005 we implanted IVC filters on 287 patients, 55.4% male average age, 62.1 yrs (17-99). Indications for the procedure were DVT or PE and contraindication of anticoagulation in 141 patient, (49.1%), DVT or PF and complication of anticoagulation in 65 patients (22.6%). prophylaxis in 39 patients (13.6%), PF or poor respiratory function in 31 patients (10.8%), paradoxal emboli in 4 patients (1.4%) and other causes in seven patients. All percutaneous devices were successfully inserted, There was no morbidity or mortality related to the procedure. ne most frequent access site was the internal jugular vein (66.6%). In 24 patients (8.4%) the filter was intentionally deployed above the renal veins. Six patients (2.1%) were lost to follow up after discharge. A mean follow up of 41.5 months was achieved. Ninety one patients died, with a 5 years survival of 64.7%. Symptomatic recurrent PE occurred in 6 patients (2.1%) and was The cause of death on 3 of them (1%), DVT has been detected in 22 patients (7.7%) during the follow up period. Conclusions. IVC filter implantation is a safe and effective short and long term measure to Prevent PE and its consequences.
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    Tratamiento endovascular de lesiones traumáticas de troncos supra aórticos
    (SOC CIRUJANOS CHILE, 2011) Bergoeing R., Michel; Mertens M., Renato; Marine M., Leopoldo; Valdes E., Francisco; Kraemer S., Albrecht; Sonneborn G., Ricardo
    Introducción: Las lesiones traumáticas de troncos supra aórticos (TSA) tienen elevada morbimor-talidad, y su tratamiento presenta un desafío técnico. Las técnicas endovasculares se presentan como una alternativa atractiva y de menor riesgo para su solución efectiva. Objetivos: Evaluar los resultados del tratamiento endovascular de las lesiones de TSA. Material y Método: Se revisaron retrospectivamente todos los pacientes sometidos a tratamiento endovascular de lesiones de TSA. Resultados: Entre Marzo de 2000 y Agosto de 2009 se intervinieron 8 pacientes, 6 hombres, edad promedio 33,6 años. El mecanismo traumático fue contuso en 3 y penetrante en 5. Los vasos afectados fueron arteria subclavia en 5, tronco braquiocefálico en 2 y carótida común en uno. De los pacientes con lesión subclavia, tres presentaron compromiso de plexo braquial asociado. Siete pacientes fueron tratados con implante de endoprótesis y uno mediante embolización. Un paciente requirió un stent no cubierto para tratar el colapso parcial precoz de una endoprótesis. No hubo morbilidad neurológica de novo ni mortalidad operatoria. El seguimiento clínico promedio es 24,3 meses. Dos pacientes se perdieron al seguimiento. La permeabilidad primaria asistida es 100% a 21,9 meses. Conclusiones: El tratamiento endovascular de lesiones de TSA es efectivo, con baja morbimortalidad y con buena permeabilidad a mediano plazo.
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    Uso de endoprótesis fenestrada para la reparación de aneurismas aórticos complejos: Reporte de dos casos.
    (SOC CIRUJANOS CHILE, 2011) Bergoeing R., Michel; Mertens M., Renato; Valdes E., Francisco; Marine M., Leopoldo; Kraemer S., Albrecht; Vergara M., Jeannette
    In the last decade endovascular repair of infrarenal aortic aneurysms (EVAR) has become increasingly popular. However, until recently patients with juxtarenal abdominal aortic aneurysms (JAAA) or with thoracoabdominal aortic aneurysms (TAA) were not candidates for EVAR due to the lack of an adequate landing zone to deploy the endograft. Because of considerable morbidity and mortality that traditional open surgery of these aneurysms entail, new endografts with fenestrations and branches have been developed to treat these patients. We present our initial experience with two cases, both male with coronary artery disease considered high-risk for traditional open repair. The first patient has a 4.1 cm sacular JAAA; it is repaired with a fenestrated endograft with branches for both renal arteries (RA), superior mesenteric artery (SMA) and a scallop for the celiac trunk (CT). The second patient has a 5.9 cm TAA with a previous aorto bifemoral bypass; because the CT is chronically occluded it is repaired with a fenestrated endograft with branches for both RA and SMA. In both patients post operative course was uneventful. Follow-up at 11 months and 30 days respectively, show adequate exclusion of the aneurysm with patency of all revascularized vessels. This new therapeutic procedure allows treatment of high-risk patients with complex aortic aneurysms in whom conventional repair entails a prohibitive surgical risk.