Browsing by Author "Vergara G., Jeannette"

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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 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, Claudia
    Background: 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).
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    Tratamiento 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., Magaly
    Background: 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.