Browsing by Author "Kramer, Albrecht"
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- ItemArterial thoracic outlet syndrome : A 32-year experience(2013) Mariné M., Leopoldo; Valdés Echeñique, José Francisco; Mertens Martín, Renato; Kramer, Albrecht; Bergoeing Reid, Michel Paul; Urbina, Jesús
- ItemEndovascular repair of abdominal aortic aneurysm.: Results in 80 consecutive patients(2006) Valdes, Francisco; Mertens, Renato; Kramer, Albrecht; Bergoeing, Michel; Marine, Leopoldo; Canessa, Roberto; Huete, Alvaro; Vergara, Jeanette; Valdebenito, Magaly; Rivera, DixianaBackground: Endovascular repair of abdominal aortic aneurysms (AAA) avoids laparotomy, shortens hospital stay and reduces morbidity and mortality related to surgical repair allowing full patient recovery in less time. Aim: To report short and long term results of endovascular repair of AAA in 80 consecutive patients treated at our institution. Patients and Methods: Between September 1997 and February 2005, three women and 77 men with a mean age 73.6 +/- 7.7 years with AAA 5.8 +/- 1.0 cm in diameter, were treated. The surgical risk of 38% of patients was grade III according to the American Society Anesthesiologists classification. Each procedure was performed in the operating room, under local or regional anesthesia, with the aid of digital substraction angiography. The endograft was deployed through the femoral artery (83,7016 bifurcated 16.3% tubular graft). A femoro-femoral bypass was required in 11.3% of cases. Follow-tip included a spiral CT scan at 1, 6 and 12 months postoperatively, and then annually). Results. Endovascular repair was successfully completed in 79/80 patients (98.7% technical success). The procedures lasted 147 +/- 71 min. Length of stay in the observation unit was 20.6 +/- 73.5 h. Blood transfusion was required in 10%. Sixty two percent of the patients were discharged before 72 h. One patient died 8 days after surgery due to a myocardial infarction (1.3%. During follow-up (3-90 months), 1 patient developed late AAA enlargement due to a type I endoleak, requiring a new endograft. No AAA rupture was observed. Survival at 4 years was 84.2% (SE = 9.2). Endovascular re-intervention free survival was 82.7% (SE = 9.5). Conclusion: Endovascular surgery allows affective exclusion of AAA avoiding progressive enlargement and/or rupture and is a good alternative to open repair Close and frequent postoperative follow up is mandatory.
- ItemEndovascular treatment of cystic adventitial disease of the popliteal artery(2013) Mertens Martín, Renato; Bergoeing Reid, Michel Paul; Mariné M., Leopoldo; Valdés Echeñique, José Francisco; Kramer, Albrecht
- ItemExtra anatomical revascularization and endovascular stent-grafting for thoracoabdominal aneurysm repair. Report of four cases(2007) Mertens, Renato; Valdes, Francisco; Kramer, Albrecht; Marine, Leopoldo; Bergoeing, Michel; Sagues, Rodrigo; Huete, Alvaro; Vergara, Jeannette; Valdebenito, MagalySurgical treatment of thoracoabdominal aneurysms is a big technical challenge with a high rate of complications and mortality. It requires a large exposure and transient interruption of vital organ perfusion during its repair. Endovascular repair is a less invasive alternative available over the last decade. We report four male patients aged 44 to 76 years, with thoracic aortic aneurysms and involvement of visceral aorta, treated with a two stage procedure. During the first stage, a retrograde revascularization of the superior mesenteric and renal arteries from the infrarenal aorta was done, associated in two cases to a concomitant repair of an infrarenal aortic aneurysm. In the second stage, an endovascular graft was placed through the femoral artery, from the segment proximal to the aneurysm to the infrarenal aorta, above the origin of the visceral artery reconstructions, excluding the aneurysm from circulation. In one patient, both stages were concomitant and in three the second stage was delayed. One patient presented a postoperative bleeding that required reintervention without adverse consequences. No patient died, presented paraplegia or deterioration of renal function. After follow up of 6 to 20 months, there is no evidence of aneurysm growth or complications derived from the procedure.
- ItemInitial clinical experience using the low-profile altura endograft system with double D-shaped proximal stents for endovascular aneurysm repair(2018) Krievins, Dainis; Kramer, Albrecht; Savlovskis, Janis; Oszkinis, Georgij; Debus, E. Sebastian; Oberhuber, Alexander; Zarins, Christopher K.
- ItemInsuficiencia mesentérica crónica luego de radioterapia para aórtica(2015) Vargas Serrano, José Francisco; Mertens Martín, Renato; Bergoeing Reid, Michel Paul; Kramer, Albrecht; Mariné M., Leopoldo; Valdés Echeñique, José Francisco
- ItemManagement of Carotid Bifurcation Tumors : 30-Year Experience(2016) Torrealba Fonck, José Ignacio; Valdés Echeñique, José Francisco; Kramer, Albrecht; Mertens Martín, Renato; Bergoeing Reid, Michel Paul; Mariné M., Leopoldo
- ItemOne-Year Analysis of the Prospective Multicenter SENTRY Clinical Trial : Safety and Effectiveness of the Novate Sentry Bioconvertible Inferior Vena Cava Filter(2018) Dake, Michael D.; Murphy, Timothy P.; Kramer, Albrecht; Darcy, Michael D.; Sewall, Luke E.; Curi, Michael A.; Johnson, Matthew S.; Arena, Frank; Swischuk, James L.; Gary M. Ansel; Silver, M.; Saddekni, S.; Brower, J.; Mendes, R.
- ItemOpen Surgery for Ruptured Abdominal Aortic Aneurysm-38 Years Experience at an Academic Center in Chile(2020) Mariné M., Leopoldo; Valdés Echeñique, José Francisco; Mertens Martín, Renato; Kramer, Albrecht; Vargas Rojas, Francisco Ignacio; Bergoeing Reid, Michel Paul; Torrealba Fonck, José Ignacio; Urbina, Jesús
- ItemPercutaneous Femoropopliteal Bypass: 2-Year Results of the DETOUR System(2022) Halena, Grzegorz; Krievins, Dainis K.; Scheinert, Dierk; Savlovskis, Janis; Szopinski, Piotr; Kramer, Albrecht; Ouriel, Kenneth; Schmidt, Andrej; Zdunek, Michal; Lyden, Sean P.Purpose: This study investigated the 2-year safety and effectiveness of the PQ Bypass DETOUR system as a percutaneous femoropopliteal bypass. Materials and Methods: Seventy-eight patients with 82 long-segment femoropopliteal lesions were enrolled in this prospective, single-arm, multicenter study. The DETOUR system deployed Torus stent grafts directed through a transvenous route. Eligible patients included those with lesions of >10 cm and average of 371 +/- 55 mm. Key safety endpoints included major adverse events (MAEs) and symptomatic deep venous thrombosis in the target limb. Effectiveness endpoints included primary patency defined as freedom from >= 50% stenosis, occlusion, or clinically-driven target vessel revascularization (CD-TVR), primary assisted, and secondary patency. Results: Chronic total occlusions and severe calcium occurred in 96% and 67% of lesions, respectively. Core laboratory-assessed total lesion length averaged 371 +/- 51 mm with a mean occlusion length of 159 +/- 88 mm. The rates of technical and procedural success were 96%, with satisfactory delivery and deployment of the device without in-hospital MAEs in 79/82 limbs. The MAE rate was 22.0%, with 3 unrelated deaths (4%), 12 CD-TVRs (16%), and 1 major amputation (1%). Deep venous thrombosis developed in 2.8% of target limbs, and there were no reported pulmonary emboli. Primary, assisted primary, and secondary patency rates by the Kaplan-Meier analysis were 79 +/- 5%, 79 +/- 5%, and 86 +/- 4%, respectively. Conclusions: The PQ Bypass DETOUR system is a safe and effective percutaneous alternative to femoropopliteal open bypass with favorable results through 2 years. The DETOUR system provides a durable alternative to conventional endovascular modalities and open surgery for patients with long, severely calcified, or occluded femoropopliteal lesions.
- ItemResults of the surgical management of abdominal aortic eurysms in 80 patients over 80 years of age(2003) Valdés E., Francisco; Bergoeing Reid, Michel Paul; Kramer, Albrecht; Mertens Martin, Renato; Canessa, Roberto; Lema F., Guillermo; Garayar Pulgar, Bernardita; Urzua Urzua, JorgeBackground: Abdominal aortic aneurysms (AAA) may be lethal unless appropriately and timely treated. Since age is a surgical risk, octogenarians are usually not considered as candidates for surgical intervention. Aim: To asses surgical complications and mortality in octogenarians treated for AAA. Subjects and Methods: Patients aged 80 years older, treated consecutively between 1984-2001 were retrospectively analyzed. Results: Sixty one patients were male, and their age ranged from 80 to 95 years. All were treated with open surgery. The operation was elective in 58 and as an emergency in 22 patients (symptomatic or ruptured AAA). Aortic diameter was 6.8+/-1.4 cm in asymptomatic patients and 7.7+/-1.8 cm in emergency cases (p=0.024). Thirty days postoperative mortality was 5.1% in elective surgery compared to 40.6% in emergency operations (p < 0.01). Five years survival rate was 44.7% in asymptomatic patients compared to 10.4% in the emergency cases (p < 0.023). Conclusions: Elective surgery for asymptomatic AAA can be performed with low operative mortality in octogenarians. However, surgery in emergency cases has an 8 fold increase in risk. Accordingly, octogenarian patients should be considered for elective AAA repair in a selective basis.
- ItemTécnica de ligadura subfascial mini-invasiva de venas perforantes de las piernas(2014) Mariné M., Leopoldo; Tapia, R.; Bergoeing Reid, Michel Paul; Mertens Martín, Renato; Vargas Serrano, José Francisco; Valdés Echeñique, José Francisco; Kramer, Albrecht
- ItemTratamiento endovascular de fístula aorto esofágica secundaria a cáncer de esófago. Caso clínico(2013) Bergoeing Reid, Michel Paul; Mertens Martín, Renato; Mariné M., Leopoldo; Valdés Echeñique, José Francisco; Kramer, Albrecht; Nervi Nattero, Bruno; Borghero Ríos, Yerko Orestes
- ItemTratamiento 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, ClaudiaBackground: 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).
- ItemTratamiento endovascular del trauma de aorta descendente(2005) Mertens Martin, Renato; Valdés Echeñique, José Francisco; Kramer, Albrecht; Bergoeing Reid, Michel Paul; Zalaquett Sepúlveda, Ricardo; Baeza Prieto, Cristian Rafael; Moran Velásquez, Sergio; Irarrázaval Llona, Manuel José; Becker Rencoret, Pedro Antonio; Huete Garín, Álvaro; Vergara G., Jeannette; Valdebenito G., MagalyBackground: Mortality of traumatic aortic lesions is over 80%. A group of those who survive, develop a chronic pseudo aneurism, usually asymptomatic, that is detected during imaging studies. Since conventional surgical treatment of traumatic aortic lesions has a great mortality, endovascular treatment has been used as an alternative treatment in the last decade. Aim: To report our experience with endovascular treatment of traumatic aortic lesions. Patients and methods: Report of seven patients aged 22 to 65 years, with traumatic aortic lesions. Under general anesthesia an endovascular prosthesis was inserted through the femoral artery. Results: No complications were observed in the postoperative period, and after a follow up ranging from 4 to 40 months, no endoleaks or other complications have been detected. Conclusions: Endovascular treatment of traumatic aortic lesions has good immediate and midterm results.
- ItemTratamiento híbrido de arteria subclavia derecha aberrante(2013) Vargas Serrano, José Francisco; Mertens Martín, Renato; Sánchez C., Gonzalo; Bergoeing Reid, Michel Paul; Kramer, Albrecht; Mariné M., Leopoldo; Valdés, Francisco E.
- ItemUso de endoprótesis bifurcada ilíaca para revascularización hipogástrica durante tratamiento de aneurisma aorto-ilíaco(2010) Mertens Martin, Renato; Kramer, Albrecht; Valdés Echeñique, José Francisco; Mariné M., Leopoldo; Bergoeing Reid, Michel PaulUna anatomía desfavorable es un obstáculo a vencer con el tratamiento endovascular del aneurisma aorto-ilíaco. La presencia de aneurisma ilíaco bilateral es frecuente y amenaza la adecuada fijación distal de una endoprótesis. Esta condición puede ser manejada: a) aumentando el diámetro del dispositivo a nivel ilíaco, con limitaciones en las medidas disponibles; b) embolización hipogástrica bilateral, aceptando una morbimortalidad mayor; c) combinando un abordaje quirúrgico retroperitoneal para revascularizar una arteria hipogástrica, aumentando el impacto del procedimiento; d) mediante revascularización retrógrada unilateral desde la arteria ilíaca externa ipsilateral con otra endoprótesis. Recientemente se ha descrito el uso de endoprótesis ramificadas, que requieren un despliegue complejo, pero permiten revascularizar una o ambas arterias hipogástricas en forma anterógrada y estable. Reportamos el caso de un paciente de sexo masculino y 57 años, de alto riesgo para cirugía convencional, portador de un aneurisma pequeño de aorta abdominal y aneurismas ilíaco común bilateral e hipogástrico izquierdo. Fue tratado mediante despliegue de una endoprótesis bifurcada ilíaca, revascularizando la arteria hipogástrica derecha y embolizando la izquierda aneurismática, asociado a implante de una endoprótesis aórtica convencional, también bifurcada. El paciente evoluciona sin complicaciones, con claudicación glútea izquierda leve en disminución y preservación de su función sexual. Una tomografía axial computada demuestra exclusión efectiva de sus aneurismas. Esta nueva técnica permite tratar de manera segura a pacientes portadores de aneurisma ilíaco bilateral en forma endo-vascular, manteniendo perfusión de la circulación pelviana y disminuyendo el impacto de un procedimiento convencional en pacientes de alto riesgo.