Browsing by Author "Carvajal Núñez, Claudia Ximena"

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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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    Manejo del aneurisma de la aorta abdominal: Estado actual, evidencias y perspectivas para el desarrollo de un programa nacional
    (2009) Marine Massa, Leopoldo Ario Fernando; Valdés Echenique, José Francisco; Mertens Martin, Renato Alfonso; Kramer Schumacher, Albrecht Helmuth; Bergoeing Reid, Michel Paul; Rivera D., Dixiana; Vergara G., Jeanette; Carvajal Núñez, Claudia Ximena
    Open and endovascular surgery are therapeutic allernatives for the treatment of abdominal aortic aneurism. The development of guidelines for its treatment requires a thorough analysis of available evidence to recommend the best treatment for each country's reality. Prospective randomized trials have shown best initial results with endovascular surgery, with higher hospital costs than open surgery. The requirement of anatomical suitability for the placement of endovascular prostheses limits the universal use of endovascular surgery. Moreover, this type of surgery needs a strict imaging and clinical follow up due to the high rates of late complications, which range from 20% to 40%. Many of these complications require further surgical interventions, elevating costs of treatment. The initial benefit of endovascular surgery is lost during long follow up as survival curves become similar to those of open surgery. Even for patients wilt a high surgical risk, the benefits of endovascular surgery are doubtful (Rev Med Chile 2009; 137; 1081-8).