Publications (9)31.7 Total impact
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Article: Bifurcated endograft in aortoiliac type C and D lesions: long-term results.
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ABSTRACT: To report long-term outcome when using a bifurcated aortic endograft for treatment of aortoiliac occlusive disease (AIOD) in Trans Atlantic Inter Society Consensus (TASC) classification C and D patients. Between May 2001 and May 2009, 14 patients (11 men, 3 women) with aortoiliac TASC C and D type lesions and a mean age of 59 years ± 10 (range 41-73 years) were treated using a bifurcated aortic endograft. Although these patients were young, all were considered at high surgical risk. Patients were followed up clinically and by computed tomography (CT) every 3 months for 1 year and yearly thereafter. Endoprosthesis placement was performed in all patients with a technical success rate of 100%. There were no amputations or deaths at 30 days after the procedure. The mean follow-up was 62 months (range 11-96 months). One patient was lost during follow-up at 11 months, and another patient died of a nonrelated cause after 49 months. A single limb occlusion of the prosthesis was seen in two patients at 2 months and 7 months; both were successfully treated by intraarterial fibrinolysis. At a mean follow-up of 62 months, primary patency was 85.7%, and secondary patency was 100%. This series shows promising long-term results following the use of a bifurcated aortic endograft for treatment of AIOD TASC C and D type lesions. Bifurcated aortic endograft is a good minimally invasive alternative to open surgery in high surgical risk patients.Journal of vascular and interventional radiology: JVIR 08/2011; 22(8):1124-30. · 1.81 Impact Factor -
Article: Successful occlusion of a ruptured aortic aneurysm using the Amplatzer Vascular Plug: a technical note.
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ABSTRACT: Ruptured abdominal aortic aneurysm is related with a 100% mortality rate if left untreated. Even with surgical intervention or endovascular repair, mortality is still extremely high. However, there are conditions in which neither open surgical aneurysm repair nor endovascular aneurysm repair can be considered a viable therapeutic option because of comorbidities or anatomic reasons. We report a case of successful endovascular treatment in a patient with ruptured abdominal aortic aneurysm by occluding the abdominal aneurysm using the Amplatzer Vascular Plug (AVP II).CardioVascular and Interventional Radiology 02/2011; 34 Suppl 2:S136-41. · 2.09 Impact Factor -
Article: Middle aortic syndrome percutaneous treatment with a balloon-expandable covered stent.
Journal of the American College of Cardiology 08/2010; 56(6):521. · 14.16 Impact Factor -
Article: Non-protected carotid artery stent without angioplasty in high-risk patients with carotid and coronary artery disease undergoing cardiac surgery.
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ABSTRACT: Hemodynamic depression (HD) is a frequent complication related to carotid endartherectomy or carotid artery stenting (CAS), often not well tolerated in patients with coronary artery disease. The purpose of this study is to assess whether CAS without angioplasty is beneficial in patients with severe carotid artery disease before coronary revascularization surgery (CABG) regarding the occurrence of HD. Between October 2002 and August 2006, 39 CAS were performed in 35 patients before cardiac surgery. Outcome measures, including periprocedural and 30-day post stenting and cardiac surgery complications, were assessed. Twenty-seven patients underwent CABG and eight combined CABG and valve replacement. During or immediately after CAS there was no episode of bradycardia or hypotension necessitating medical treatment. In the period between CAS-CABG, there was no case of HD. We also found no myocardial infarction. There were five neurological complications, two of them in the period between CAS-CABG (one transitory ischemic attack (TIA) and one minor stroke) and three after CABG (one TIA and two strokes). Three of them were discharged symptom-free. CAS without angioplasty can be a safe alternative to treat patients with coexistence of carotid and cardiac disease, since does not produce hemodynamic depression, therefore diminishing the cardiac complications.Minimally invasive therapy & allied technologies: MITAT: official journal of the Society for Minimally Invasive Therapy 02/2010; 19(3):184-8. · 1.33 Impact Factor -
Article: Bifurcated endograft (Excluder) in the treatment of isolated iliac artery aneurysm: preliminary report.
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ABSTRACT: The aim of this study was to evaluate the effectiveness of endovascular repair in the treatment of isolated iliac artery aneurysm (IAA) using Excluder bifurcated endograft. Eight consecutive patients with IAA were treated during a period of 45 months using Excluder bifurcated endograft. Two patients presented with isolated IAA rupture and were treated emergently, whereas the other six patients underwent elective treatment. All aneurysms lacked sufficient proximal necks and therefore were not suitable for tubular-shaped endograft. Follow-up imaging was performed at 1 week, at every 3 months during the first year, semiannually until 2 years, and annually afterward using angio-computed axial tomography and plain films. Technical success was achieved in all patients. No mortality was seen despite two patients having IAA rupture. Follow-up (12 to 60 months) was done in all but one patient. During this period, complications were observed in three patients. One patient developed sexual impotence at 3-month follow up; one patient presented unilateral gluteal claudication after the procedure, which resolved at 3 months; and one patient developed a graft porosity-related endoleak, which was successfully managed with placement of an additional ipsilateral iliac extension. Endovascular treatment of isolated IAA using bifurcated endograft is safe and can be an alternative to surgical treatment. The benefits from decreased morbidity and mortality of endoluminal treatment of isolated IAA using bifurcated endograft outweigh the minor complications associated with this technique, which are mostly related to occlusion of hypogastric arteries.CardioVascular and Interventional Radiology 06/2009; 32(5):928-36. · 2.09 Impact Factor -
Article: Clinical follow-up in endovascular treatment for TASC C-D lesions in femoro-popliteal segment.
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ABSTRACT: To demonstrate the technical success and clinical follow-up after endovascular treatment of femoropopliteal segment TASC II C and D lesions. From July 2002 to February 2007, 234 limbs in 190 patients with femoropopliteal segment TASC II C (n = 112) and D (n = 122) lesions were treated. Endovascular treatment consisted of PTA, fibrinolysis and PTA, subintimal recanalization and PTA, and finally stent graft. Patients were clinically evaluated at 30 days, 3, 6 month, and at 1 year in the outpatient setting with clinical examination and ankle-brachial indices (ABI). In the case of stent placement, additional ultrasound evaluation was performed at 12, 24, and 48 month. 49.5% of procedures were performed on patients with lifestyle-limiting claudication (IC) and 50.5% were performed for critical limb ischemia (CLI). Technical success, defined as successful recanalization and treatment of the occluded vessel, was achieved in 97% of cases. Periprocedural mortality was 3.15% and all deaths occurred in the CLI group. A follow-up 13 +/- 6 months and was achieved in 76%. During the follow-up, clinical outcome for IC group and clinical CLI group was asymptomatic 72% vs. 29.8%, symptomatic with clinical improvement 22% vs. 33.7%, and major amputation 3% vs. 23.3%. The majority of claudicating patients with femoropopliteal TASC II C and D lesions will benefit from the endovascular treatment. Patient presenting CLI have a worse outcome, nevertheless the endovascular treatment can delay amputation, preserving the native vessel and does not impede surgical bypass if needed. For this reason, we consider that endovascular treatment may be the first choice treatment even in femoropopliteal TASC II C and D lesions.Catheterization and Cardiovascular Interventions 05/2009; 73(5):701-5. · 2.29 Impact Factor -
Article: Bilateral hypogastric artery occlusion in endovascular repair of abdominal aortic aneurysms and its clinical significance.
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ABSTRACT: Endovascular treatment of aortoiliac aneurysms near or involving the hypogastric artery (HGA) requires HGA occlusion before endografting to avoid retrograde filling of the aneurysm. The purpose of this study is to evaluate clinical outcomes of bilateral HGA occlusion and determine if benefits gained by endovascular aneurysm repair (EVAR) outweigh the morbidity associated with the procedure. Between 1999 and 2004, 128 patients with abdominal aortic aneurysm (AAA) were treated with bifurcated endograft placement. Bilateral coverage or embolization of HGAs was performed in 14 patients (10.9%). Embolization was achieved by deployment of coils and coverage was accomplished by extending the endoprosthesis into the external iliac artery. Clinical follow-up and computed tomographic angiography were performed at 1, 3, 6, 9, and 12 months and annually thereafter to detect potential aneurysm growth and endoleaks. During follow-up (range, 1-72 months), buttock claudication was noted in four patients (28.6%), including unilateral claudication in two and bilateral claudication in two. One patient experienced claudication longer than 12 months, which resolved within 18 months. De novo erectile dysfunction was seen in one patient, and pelvic ischemia was not found in any patient. There was no evidence of endoleak, aneurysm enlargement, or death associated with HGA occlusion. In our series, complications of bilateral HGA occlusion before EVAR were moderate and resolved over time. The benefits gained from EVAR outweigh the clinical problems caused by bilateral HGA occlusion, as there are no technical complications added to the EVAR procedure.Journal of Vascular and Interventional Radiology 01/2008; 18(12):1481-6. · 2.08 Impact Factor -
Article: Balloon-assisted coil placement in wide-neck bifurcation aneurysms by use of a new, compliant balloon microcatheter.
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ABSTRACT: Two types of balloon are usually employed to perform balloon-assisted coil placement in cerebral aneurysms: oval, guide-dependent balloons for sidewall aneurysms and round balloons for bifurcation aneurysms. We report on the use of a new, more compliant, guide-dependent oval balloon microcatheter to seal wide-neck bifurcation aneurysms with coils during endovascular occlusion.American Journal of Neuroradiology 24(6):1222-5. · 2.93 Impact Factor -
Article: Intraarterial administration of Abciximab for thromboembolic events occurring during aneurysm coil placement.
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ABSTRACT: Platelet-derived thrombi may occur during intracranial aneurysm coiling. We report a series of 13 patients treated with intraarterial Abciximab for thrombus formation complicating aneurysm coiling. Four patients were treated for acutely ruptured aneurysms. Three procedures consisted of the retreatment of previously coiled aneurysms. Six patients had asymptomatic untreated aneurysms. Abciximab was administered intraarterially through a microcatheter as a bolus of 4-10 mg over a period of 10-20 minutes. All patients underwent postthrombolysis control angiography. They also underwent immediate pre- and postoperative cranial CT. In 10/13 cases, the thrombi developed without coil protrusion into the parent artery. In one case, the thrombus was generated from the guiding catheter and embolized remote from the aneurysm site. In one case, the thrombus developed before any coil placement. In another patient, a coil loop protruded into the parent artery favoring a heightened thrombotic state. Arterial thrombi were totally occlusive in two patients, whereas in the remaining 11 cases, the thrombi were not totally obstructive. Complete recanalization was achieved in 92% (12/13) of cases within 20-30 minutes. Incomplete arterial reopening was noted in one case, in which a thrombus fragment embolized distally, causing cerebral infarction. There were no Abciximab-related intracranial hemorrhages. Intraarterial Abciximab was effective in this series for the treatment of thrombotic complications occurring during aneurysm coiling.American Journal of Neuroradiology 24(10):2039-43. · 2.93 Impact Factor
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2009
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Universidad de Las Palmas de Gran Canaria
Las Palmas de Gran Canaria, Canary Islands, Spain
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