Browsing by Author "Valdés, Francisco"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Isquemia de extremidades inferiores secundaria a arteritis de la arteria temporal
    (2020) Zarate Bertoglio, Cristián; Martínez Ruiz-Esquide, María Eugenia; Sfeir Vottero, Pedro Ignacio; Drazic B., Obren; Vargas S., José F.; Torrealba, José; Bergoeing, Michel; Mariné, Leopoldo; Valdés, Francisco; Mertens, Renato
    Giant cell arteritis is more common in women older than 60 years, is associated with systemic inflammation symptoms and mainly involves the aortic arch and cranial arteries, specially the temporal artery. Symptomatic lower extremity arterial stenosis or occlusion is uncommon and can lead to limb loss. We report a 73-year-old woman presenting with a one-month history of lower extremity intermittent claudication of sudden onset. She also complained of fever, malaise, headache and weight loss. A non-invasive vascular study showed moderate femoral popliteal occlusive disease, with and abnormal ankle-brachial index (0.68 and 0.83 on right and left sides, respectively). An angio-computed tomography showed thickening of the aortic wall and severe stenosis in both superficial femoral arteries. Steroidal treatment was started, and a temporal artery biopsy was performed confirming giant cell arteritis. Six weeks after steroid therapy the patient had a complete remission of symptoms. A serologic exacerbation was subsequently treated with a humanized monoclonal antibody against the interleukin-6 receptor Tocilizumab, obtaining long time remission.
  • Thumbnail Image
    Item
    Late effect of an embolized coronary stent in the lower extremities
    (2025) González Urquijo, Mauricio; Valdés, Francisco; Marine, Leopoldo; Vargas, José Francisco; Bergoeing, Michel
    To report a late complication involving an embolized stent that migrated into the peripheral circulation during an emergency coronary intervention. Case Report: A 69-year-old man with a history of myocardial infarction 12 years prior, during which he experienced prolonged cardiac arrest following a failed coronary stenting attempt and subsequent aorto-coronary bypass surgery, presented to the emergency department with acute limb ischemia in the right lower limb. A CT angiogram revealed complete occlusion of the popliteal artery and a hyperdense image at the tibioperoneal trunk. Popliteal artery exploration and embolectomy successfully restored proximal blood flow; however, a firm occlusion at the tibioperoneal trunk necessitated an arteriotomy. This procedure uncovered a coronary stent adhered to the endothelium, which was removed via endarterectomy. The patient was prescribed rivaroxaban for six months. At a six-year follow-up, he remains well and asymptomatic, continuing on aspirin and a reduced dose of rivaroxaban. Conclusion: This case underscores the importance of monitoring long-term complications following coronary interventions and highlights the need for vigilance in managing patients at risk for device embolization.