Manuel Miralles

Hospital Universitari i Politècnic la Fe

Resumen Introducción Los microRNA (miR) son RNA de pequeño tamaño involucrados en la regulación de numerosos procesos biológicos. Debido a su estabilidad y a su capacidad para detectarse en fluidos, se han convertido en objeto de estudio como posibles biomarcadores de diferentes patologías. Objetivo Seleccionar un número reducido de miR candidato...

Available assays for circulating levels of activated protein C (APC) are either time-consuming or difficult to use in a routine laboratory, or have a detection limit above normal levels. We have developed a simplified assay that measures both the in vivo free APC and the in vivo APC complexed to PC inhibitor (PCI). We measured APC levels, with both...

Resumen Introducción La anemia es muy frecuente en los pacientes sometidos a cirugía vascular y puede influir en los resultados postoperatorios. Objetivos Evaluar la prevalencia de anemia en los pacientes intervenidos de cirugía arterial aortoilíaca e infrainguinal. Analizar la influencia de la anemia en la aparición de complicaciones postoperato...

Access for endovascular treatment of the superficial femoral artery (SFA) is usually gained through an antegrade approach from the ipsilateral common femoral artery (CFA), or by crossing over from the contralateral CFA. In this technical note, an alternative method, based on retrograde access of the ipsilateral iliac artery (IA), and conversion int...

1. To design a volumetric method for the assessment of carotid atheromatosis (CA) based on CT angiography and three-dimensional (3D) reconstructions. 2. To analyze the accuracy and optimal threshold values to differentiate between equivalent degrees of severity by duplex scanning and CT-angiography (MIP 2D) (internal carotid artery stenosis (ICS) <...

Introduction Carotid surgery on asymptomatic patients is still controversial. Its cost-effectiveness has been questioned due to the number of patients needed to treat to prevent a stroke, especially when compared with surgery on symptomatic patients. Objectives To analyse a series of patients, in a single centre, subjected to surgery due to asympt...

Introduction 1. To analyze the risk of death, complications and in-hospital stay in patients undergoing endovascular aneurysm repair (EVAR) and open repair (OR) of ruptured abdominal aortic aneurysms (RAAA). 2. To compare the accuracy of several risk-scoring models. 3. To identify predictors of outcomes. Material and methods A multicenter and retr...

The aim of this paper was to determine prevalence, cardiovascular risk factors and association with coronary heart disease (CHD) of isolated infrapopliteal arterial disease in old-adult men. Design: cross-sectional; participants: population-based sample of 699 men aged 55 to 74 years, measurements: cardiovascular history and risk factors, electroca...

Background and objectivesCritical leg ischemia (CLI) is a medical emergency with a high morbidity and mortality. Although its prognosis has improved during the last years, there are no data on its clinical characteristics, treatment and in-hospital prognosis in our country.Patients and method671 patients (81% males, mean age 71.2 years) with athero...

Critical leg ischemia (CLI) is a medical emergency with a high morbidity and mortality. Although its prognosis has improved during the last years, there are no data on its clinical characteristics, treatment and in-hospital prognosis in our country. 671 patients (81% males, mean age 71.2 years) with atherosclerotic CLI, attended in 46 departments o...

Upper limb arterial disease is less common that of lower limb, although the reason is not known exactly. Antiphospholipid Sindrome (AFLS) characterized by thrombotic complications, counts as one of the possible etiologies. A case is reported of a 35-years-old woman with an atypical AFLS debut and the thrombotic complications including postoperative...

La thrombo-angéite oblitérante (également connue sous le nom de maladie de Buerger) est une vasculopathie inflammatoire qui affecte les artères de petit et moyen calibre et les veines des extrémités. Il n’existe pas de traitement spécifique et la seule intervention efficace consiste en l’arrêt absolu de l’intoxication tabagique. Une dysfonction end...

Thromboangiitis obliterans (also known as Buerger's disease) is an inflammatory vascular disorder that affects small and medium-sized arteries and veins in the extremities. There is no specific treatment and the only effective intervention is absolute cessation of tobacco use. Endothelial dysfunction appears to be of relevance to this condition and...

The aim of this study was to assess the accuracy of CT-angiography for identification and measurement of calcification of carotid atherosclerotic plaques and to characterise the content and distribution pattern of mineral calcium (hydroxyapatite, Ca) in carotid bifurcations and investigate its relationship with neurological symptoms. Twenty-six pat...

Introdução A trombocitopenia induzida pela heparina (TIH) é uma complicação pouco frequente, mediada por imunoglobulinas e não dose-dependente. A suspeita de TIH secundária a profilaxia com heparinas raramente é considerada, embora as suas complicações possam ser igualmente graves. Caso clínico Homem de 52 anos de idade submetido electivamente a t...

Introduction. Heparin-induced thrombocytopenia (HIT) is an infrequent complication mediated by immunoglobulins and is not dosage dependent. Suspecting HIT to be secondary to prophylaxis with heparins is rarely considered, although its complications can be just as serious. Case report. A 52-year-old male who was electively submitted to a transpositi...

Introdução A descoberta de uma patologia subjacente da artéria renal, como consequência do desenvolvimento de explorações morfológicas pouco invasivas, pode supor no futuro um aumento da incidência da cirurgia extra-corpórea renovascular. Objectivo Revisão da nossa casuística em cirurgia ex-vivo em aneurismas da artéria renal (AAR) e avaliação det...

Introduction. The discovery of an underlying pathology affecting the renal artery, as a consequence of the development of non-invasive morphological explorations, may, in the future, lead to an increase in the incidence of extracorporeal renovascular surgery. Aims. The purpose of this study was to conduct a survey of our case mix of patients submit...

Endoluminal procedures are not particularly aggressive and, despite their lower permeability rates, can be used as an alternative to revascularisation with bypass techniques. Nevertheless, two basic issues must be addressed of both options are to be evaluated from a reasonable viewpoint. First, what immediate and long-term permeability from the pro...

Introdução. Os paragangliomas são tumores neuroectodérmicos poum frequentes, de carácter neurosecretor em 5% dos casos, que se associam a outras tumefacções endócrinas múltiplas. Mostram tendência para se tornarem malignos em 10% dos casos e possuem marcada apresentação familiar. Apresentamos um caso de paraganglioma localizado no corpo carotídeo (...

To assess the reporting quality variation of the abstracts accepted for oral presentation at the National Meetings of the SEACV (Sociedad Española de Angiologíay Cirugía Vascular, Spanish Society for Angiology and Vascular Surgery) during the last 10 years.Material and methods150 abstract forms were randomly selectedfrom the 1991-2000 period. All t...

Introduction. The paragangliomas are uncommon neuroectodermal tumours which are neurosecretory in 5% of cases, and associated with other multiple endocrine tumours. In 10% of the cases they become malignant, with a marked familial tendency. We report a case of paragangliomas of the carotid body (chemodectoma) associated with a paraganglioma in the...

Objectives. To assess the reporting quality variation of the abstracts accepted for oral presentation at the National Meetings of the SEACV (Sociedad Española de Angiología y Cirugía Vascular, Spanish Society for Angiology and Vascular Surgery) during the last 10 years. Material and methods. 150 abstract forms were randomly selected from the 1991-2...

Objectivo Avaliar a utilidade da angiografiapor ressonânciamagnética (ARM), com contraste defase e aquisição tridimensional (PC 3D), na detecção da estenose da arteria renal (EAR), comparando os seus resultados com os da ecografiaDoppler (ED) e angiografiapor subtracção digital intra-arte-rial (ASDIA). Doentes e métodos 33 doentes consecutivos com...

No presente artigo extraem-se, a partir dos dados e das experiências expostas, umasérie de conceitos gerais que se destacaram ao longo do texto sob a forma de considerares e recomendações para a utilização da ecografia Dopplerno exame da patologia vascular renal e seguimento da revascularização renal. No entanto, é necessário, recordar que os proto...

Pathologic remodeling of the extracellular matrix is a critical mechanism in the development and progression of abdominal aortic aneurysms (AAAs). Although angiotensin-converting enzyme (ACE) inhibitors are known to alter vascular wall remodeling in other conditions, their effects on AAAs are unknown. In this study we assessed the effect of ACE inh...

Objective. To evaluate the usefulness of magnetic resonance angiography (MRA), using phase contrast and three dimensional acquisition (PC3D) in the detection of renal artery stenosis (RAS), comparing these results with those obtained using eco-Doppler (ED) and intra-arterial digital subtraction angiography (IADSA). Patients and methods. Thirty thre...

Both aortoiliac occlusive disease (AIOD) and abdominal aortic aneurysm disease (AAA) are traditionally considered degenerative conditions that are caused by atherosclerosis. Although it is becoming apparent that the pathophysiology of each condition has its own determinants, inflammation is thought to play a role in each. The purpose of this study...

Cyclooxygenase, either the cox1 or cox2 isoform, controls synthesis of prostaglandin E2 (PGE2), which regulates expression of matrix metalloprotease-9 (MMP-9). PGE2 and MMP-9 are elevated in aortic aneurysms. The mechanisms and time course of the inhibition of aneurysm expansion with a nonspecific cyclooxygenase inhibitor, indomethacin, were determ...

The methodology applied to the evaluation of the IMAS hospital information system is proposed as a systematic and practical approach to assess clinical information systems from the point of view of the medical user.

Patients with severe stenoses of the carotid and renal arteries define a population at high risk but most of them are asymptomatic. Here arises the question of who must be tested and what would be the actual utility of a screening program in the general or selected populations. The aim of this study was to assess the efficacy of a duplex-based scre...

Objective: To determine the value of magnetic angloresonance (MAR) in grading carotid stenosis, comparing it with color Doppler and intraarterial digital subtraction angiography (IADSA). Material and methods: A comparative study using color Doppler and MAR was carried out in 84 patients with carotid lesions. Fifty-two of the patients under were a a...

To evaluate the utility of renal duplex scanning and the captopril test in the detection and functional assessment of renovascular disease, by comparing their results with those of angiography and captopril isotopic renography (CIR). Sixty hypertensive patients with aortoiliac disease and 16 with clinically suspected renovascular hypertension (RVH)...

To evaluate the utility of renal duplex scanning and the captopril test in the detection and functional assessment of renovascular disease, by comparing their results with those of angiography and captopril isotopic renography (CIR). Sixty hypertensive patients with aortoiliac disease and 16 with clinically suspected renovascular hypertension (RVH...

Our purpose was to assess the accuracy and optimal threshold values of the Doppler parameters of the renal arteries and parenchyma for detecting renal artery stenosis (RAS) greater than 60% and occlusion. Renal duplex ultrasonography and standard angiographic studies of the renal arteries were performed in 78 patients for comparative analysis. Thre...

Objectives: To evaluate the usefulness of a quality control program of the Vascular Laboratory based on: 1. Analysis of the explorers accuracy with regard to the angiography in biennial terms. 2. Readjustment of the criteria established for the discrimination of the different degrees of pathology. 3. Relation cost-effectiveness of the screening pro...

To determine the utility of renal duplex sonography in the detection of vascular complications in renal grafts. 45 patients with a median post-transplant follow-up of 39.3 +/- 28.8 months were evaluated. The renal artery maximum systolic velocity (SVmax) and the renal artery/iliac artery Svmax ratio (RIR) were utilized to detect stenosis. The SVmax...

To study the collateral pathways recruited after occlusion of the internal carotid artery (ICA), and to evaluate its influence on the impairment of hemispheric blood flow supply and development of low flow infarcts. 38 patients with ICA occlusion (18 asymptomatic; five transient ischaemic attacks; and 15 strokes) were included. Infarcts on cerebral...

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We have a limited knowledge of the incidence, natural history and complications of aneurysms of the segmental branches of renal arteries. Two young female patients with intimal fibrodysplasia and aneurysms of the segmental branches of renal arteries are described. The presenting features were hypertension and hematuria. The diagnosis was achieved t...

The purpose of this study was to assess the accuracy of Duplex scanning in detecting renovascular disease and to compare it with angiography, renal scintigraphy and captopril test for plasma renin activity and isotopic renography. A Duplex scan was performed in 92 renal arteries (46 patients) and compared to angiography. Three degrees of stenoses w...

It is the purpose of this report to focus attention on the clinical usefulness of Renal Duplex for the diagnosis of patients with vasculo-renal diseases in terms of: 1. Accuracy of Duplex/Angiography in the measurement of the renal stenosis degree. 2. Correlationship between Duplex ans Isotopic Renogram with respect to the study of the parenchyma's...

RESUMEN La sección traumática de la aorta descendente es una complicación grave de los traumatismos torácicos que requiere un diagnóstico y repara-ción precoz dada su alta mortalidad. Entre 1988 y 1990, hemos tenido ocasión de intervenir 3 pacientes me-diante la técnica de clampaje aórtico directo. En dos casos se produjo parada cardíaca peroperato...

Traumatic section of descendent aorta, severe complication of a thoracic traumatism, requires an early recognition and restoration because its high mortality rate. Between 1988 and 1990, three patients underwent surgical approach, by direct aortic clamping [correction of clamplaje], at our Service. In two cases, a heart stoppage appeared during the...

Ergotism is a rare disorder, generally caused by iatrogenia after the administration of drugs containing ergotamine derivates. Two cases of ischemic incidents at the extremities caused by a chronic intoxication with ergotamine tartrate, after its prolonged administration in therapeutical doses as a treatment for hemicrany, are reported. A short bib...