Browsing by Author "Kramer Schumacher, Albrecht Helmuth"

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    Dolor pélvico crónico secundario a síndrome de congestión pélvica. Resultados del tratamiento endovascular de la insuficiencia venosa pelviana y várices genitales
    (SOC MEDICA SANTIAGO, 2019) Drazic Beni, Obren Danilo; Zarate Bertoglio, Cristian Fernando; Valdés Echenique, José Francisco; Mertens Martin, Renato Alfonso; Bergoeing Reid, Michel Paul; Kramer Schumacher, Albrecht Helmuth; Marine Massa, Leopoldo Ario Fernando; Vargas Serrano, José Francisco
    Background: Pelvic venous insufficiency may cause pelvic congestion syndrome that is characterized by chronic pelvic pain exacerbated by prolonged standing, sexual activity or menstrual cycle. It may be treated by embolizing the dysfunctional pelvic venous drainage and sometimes resecting vulvar, perineal and thigh varices. Aim: To assess the results of embolization of insufficient pelvic or ovarian veins on pelvic congestion syndrome. Material and Methods: Analysis of 17 female patients aged 32 to 53 years, who underwent subjected to a selective coil embolization of insufficient pelvic and/or ovarian veins through the jugular, basilic or cephalic veins. In the preoperative period, all patients had a lower extremity venous duplex pelvic ultrasound examination and some had an abdominal and pelvic CT angiogram. Results: The technical success of the procedure was 100% and no complications were registered. During a 32 month follow up, no patient had symptoms of pelvic venous insufficiency or relapse of vulvar or thigh varices. Conclusions: Embolization of insufficient pelvic and ovarian veins is a safe and successful procedure for the treatment of pelvic venous insufficiency or vulvar varices.
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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).
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    Tratamiento endovascular de transecciones agudas de la aorta descendente
    (2011) Marine Massa, Leopoldo Ario Fernando; Mertens Martin, Renato Alfonso; Valdés Echenique, José Francisco; Kramer Schumacher, Albrecht Helmuth; Bergoeing Reid, Michel Paul; Plaza De Los Reyes Z., Miguel; Fernández S., Froilán
    Background: Traumatic rupture of the thoracic aorta as a result from high-speed deceleration injury is associated with a mortality rate of 80% to 90% at the scene of the accident. Survivors usually have life-threatening injuries to other organ systems. Standard open repair is associated with a high perioperative morbidity and mortality. Endografting offers a less invasive alternative to open surgical repair. Aim: To evaluate results of endovascular management of acute traumatic descending thoracic aortic ruptures. Methods: Between August 2002 and March 2010, patients treated for this trauma were reviewed. Results: 16 patients (fourteen males mean age 42.7 +/- 15.8 years, range 24-74) underwent endovascular treatment of an acute aortic rupture. Associated traumas in fifteen patients were: severe brain (7), spleen (4), liver (1), kidney (3) and large bone (9) injuries. Motor vehicle accidents caused 13 of the injuries and fall from height 3. Rupture was diagnosed with admission CT scan and confirmed by intraoperative angiogram. Patients were treated with thoracic aortic endograft, in 11 cases the left subclavian artery was covered with no need for further revascularization. Technical success was 100%, no procedure-related mortality or paraplegia was observed. One patient died 5 days after the procedure due to severe associated injuries. During a mean follow-up of 30.8 months (range 1-80), no deaths, complications or need for further interventions presented. Conclusion: Endovascular treatment of acute traumatic aortic isthmic rupture is encouraging and compares favorably to open surgical approach with low morbidity and mortality rates.
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    Tumor del cuerpo carotídeo: A propósito de 10 casos tratados
    (2007) Soto González, Sebastián; Valdés Echenique, José Francisco; Kramer Schumacher, Albrecht Helmuth; Marine Massa, Leopoldo Ario Fernando; Bergoeing Reid, Michel Paul; Mertens Martin, Renato Alfonso; Solar González, Antonieta Alejandra; Walton Díaz, Annerleim Nylsello; Aguilera Vergara, Glenda Jeannette
    Background: Carotid body tumors arise from a cellular conglomerate located at the carotid bifurcation. Progressive enlargement can involve the arterial wall and neighbor cranial nerves. Aim: To report a series of 10 patients treated of carotid body tumors and review national experience. Patients and methods: Between 1984 and 2006 we operated 8 women and 2 men. aged 19 to 75 years. with this type of tumor. Results. The most common cause for consultation was a cervical mass in 90%, with a mean evolution lapse of 13.2 months (range 3 to 126). In all cases, diagnosis wets confirmed with angiographic imaging and. histopathology. Ten tumors were surgically removed with no complications. Eighty percent of tumors were in stage II according to Shamblin classification. During long term follow tip all patients have remained asymptomatic. Only 31 carotid body tumors have been reported in Chilean medical literature during a 43 year period. Conclusions: Paragangliomas of the carotid body can be diagnosed in clinical grounds. requiring vascular imaging. These infrequent lesions are generally benign, early surgical removal by surgeons with vascular expertise avoids neurological and or vascular complications (Rev Med Chile 2007; 135: 1414-20).