The sequelae of an undiagnosed, an insufficiently treated or unpreventable (by crush injury) com- partment or postischemic syndrome, most often after lower leg fracture or popliteal artery rupture, are caused by necrosis and contracture of the extrinsic foot muscles. The more harmless hammer toes due to contracture of the intrinsic muscles follow most often an untreated isolated foot CS induced e. g. by a calcaneal fracture. In combined CS of the lower leg and the foot or in some iso- lated cases of mainly one involved muscle we see different types of deformity (Types 1–5). The dif- ferent types are also altered by involvement of nerve damages. Due to the involved and the amount of scarred muscles we observe flexible or contract hammer toes, claw toes, hallux flexus, hallux valgus, foot equinus or the severest form of a postcompartment or postischemic pes equinovarus. Less common (16 of 66 cases) in our seria of corrections were the deformities caused by an isolated CS, such as necrosis of the anterior tibialis, long extensor or the peroneal muscles. Most surprisingly have been few cases of a functional hallux flexus or a severe hallux valgus in a boy.
- MeSH
- Diagnostic Imaging methods MeSH
- Child MeSH
- Lower Extremity surgery pathology injuries MeSH
- Adult MeSH
- Ischemia surgery diagnosis classification pathology MeSH
- Compartment Syndromes * surgery diagnostic imaging diagnosis MeSH
- Humans MeSH
- Adolescent MeSH
- Foot surgery pathology MeSH
- Clubfoot diagnosis etiology MeSH
- Treatment Outcome MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Publication type
- Review MeSH
- MeSH
- Medical History Taking * methods MeSH
- Pain diagnosis pathology MeSH
- Chronic Limb-Threatening Ischemia classification MeSH
- Diagnosis, Differential MeSH
- Lower Extremity pathology MeSH
- Edema diagnosis pathology MeSH
- Ischemia classification MeSH
- Humans MeSH
- Vascular Diseases * diagnosis etiology classification pathology MeSH
- Risk Factors MeSH
- Severity of Illness Index MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
[Systemic consequences of dialysis vascular access]
- MeSH
- Arteriovenous Shunt, Surgical * classification methods adverse effects MeSH
- Vascular Access Devices classification adverse effects MeSH
- Renal Insufficiency, Chronic complications therapy MeSH
- Dialysis * MeSH
- Hemodynamics MeSH
- Ischemia etiology classification pathology MeSH
- Humans MeSH
- Hypertension, Pulmonary etiology physiopathology MeSH
- Heart Failure etiology complications MeSH
- Cardiac Output, High etiology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- Keywords
- kritická končetinová ischemie,
- MeSH
- Chronic Disease MeSH
- Diabetic Foot diagnosis etiology therapy MeSH
- Ischemia * etiology classification therapy MeSH
- Compartment Syndromes diagnosis therapy MeSH
- Extremities blood supply physiopathology MeSH
- Humans MeSH
- Peripheral Arterial Disease diagnosis therapy MeSH
- Risk Factors MeSH
- Vasculitis diagnosis classification therapy MeSH
- Check Tag
- Humans MeSH
Orgánovocievne (orgánovovaskulárne) artériové ischemické choroby (kardiovaskulárne, cerebrovaskulárne, extremitovaskulárne, renovaskulárne, genitovaskulárne, pulmovaskulárne, mezentériovaskulárne, dermovaskulárne, okulovaskulárne, otovaskulárne, stomatovaskulárne a ďalšie) sú dôležitou manifestáciou systémovej aterosklerózy a iných artériových chorôb cievneho systému (arterioloskleróza/arteriolonekróza; diabetická makroangiopatia; diabetická mikroangiopatia; Mönckebergova medioskleróza/mediokalcinóza; arteritídy – vaskulitídy; kompresívne artériové syndrómy; fibromuskulárna dysplázia artérií; cystická degenerácia adventície artérií; artériová trombóza; artériová embólia/tromboembólia; traumatické a posttraumatické arteriopatie; fyzikálne arteriopatie; chemické a toxické arteriopatie; iatrogénne oklúzie artérií; disekcia artérií; anomálie priebehu artérií; komplikovaná artériová aneuryzma; artériovo-vénová fistula a ďalšie zriedkavejšie choroby). V článku sa analyzujú kľúčové klinicko-etiologicko-anatomicko-patofyziologické (CEAP) aspekty mezentériovaskulárnych artériových ischemických chorôb (projekt CIEVY).
Organovascular arterial ischemic diseases (cardiovascular, cerebrovascular, extremitovascular, renovascular, genitovascular, pulmovascular, mesenterovascular, dermovascular, oculovascular, otovascular, stomatovascular etc.) are an important manifestations of systemic atherosclerosis and other arterial diseases of vascular system (arteriolosclerosis/arteriolonecrosis; diabetic macroangiopathy; diabetic microangiopathy; Mönckeberg´s mediosclerosis/mediocalcinosis; arteritis – vasculitis; syndromes of arterial compression; fibromuscular dysplasia; cystic adventitial degeneration; arterial thrombosis; arterial embolism/thromboembolism; traumatic and posttraumatic arteriopathies; physical arteriopathies; chemical and toxic arteriopathies; iatrogenic arterial occlusions; dissection of aorta and of arteries; coiling; kinking; complicated arterial aneurysms; arteriovenous fistula, rare vascular diseases). Key clinical-etiology-anatomy-pathophysiology (CEAP) aspects of the mesenteriovascular arterial ischemic diseases are discussed in this article (project Vessels).
- MeSH
- Arteries MeSH
- Endothelium, Vascular physiopathology MeSH
- Ischemia * classification MeSH
- Cardiovascular Diseases classification MeSH
- Classification MeSH
- Humans MeSH
- Vascular Diseases * diagnosis etiology classification physiopathology prevention & control therapy MeSH
- Practice Guidelines as Topic MeSH
- Check Tag
- Humans MeSH
- MeSH
- Transplantation, Autologous MeSH
- Pain MeSH
- Blood Vessels physiology drug effects MeSH
- Lower Extremity * blood supply MeSH
- Adult MeSH
- Double-Blind Method MeSH
- Wound Healing MeSH
- Ischemia * diagnosis classification physiopathology therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Vascular Diseases therapy MeSH
- Placebos MeSH
- Randomized Controlled Trials as Topic MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Stem Cell Transplantation * utilization MeSH
- Treatment Outcome MeSH
- Inflammation MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
Cíl. Cílem práce je zhodnotit výskyt pozdních komplikací a reintervencí po endovaskulární léčbě subrenálního aneuryzmatu břišní aorty stentgraftem. Materiál a metoda. Od dubna 1996 do prosince 2011 bylo na našem pracovišti léčeno 270 pacientů s aneuryzmatem břišní aorty implantaci stentgraftu, z toho bylo 233 mužů a 37 žen ve věku od 49 do 91 let. Věkový průměr byl 68,7 let. Nejméně rok po léčbě byli sledováni 204 pacienti, u nich byl hodnocen výskyt pozdních komplikací (ruptura, migrace stentgraftu, endoleak, ischemické komplikace a zánětlivé komplikace) a reintervencí. Výsledky. V souboru 204 nemocných bylo zjištěno 25 pozdních komplikací, tj. 12, 3% (25/204), a bylo provedeno 21 reintervencí, tj. 10,3 % (21/204). Z 25 komplikací byl zjištěn endoleak I. typu 5krát, endoleak II. typu se zvětšeným vakem aneuryzmatu 3krát, endoleak III. typu 4krát, endotension 3krát, migrace stentgraftu 4krát, ischemické komplikace 5krát a infekce lkrát. Endoleaky I. typu a migrace byly řešeny implantaci prodlužujícího segmentu a migrace u jednoho nemocného chirurgickou konverzí. Endoleaky III. typu byly léčeny implantaci stentgraftu a endoleaky II. typu podvazem nebo embolizací zdroje. Endotension byla řešena perkutánní punkcí vaku aneuryzmatu s aspirací jeho obsahu. U trombózy raménka byla provedena lkrát trombektomie, 2krát byl našit femoro-femorální zkřížený bypass, 1krát byla léčba konzervativní a 1krát byla provedena amputace končetiny. Infekce stentgraftu byla řešena chirurgickou konverzí. Závěr. Endovaskulární léčba aneuryzmatu břišní aorty je v našem souboru spojena s výskytem pozdních komplikací a reintervencí v 12,3 %, resp. v 10,3 %, což se shoduje s literárními údaji. Většinu těchto pozdních komplikací lze řešit endovaskulárně.
Aim. To evaluate the incidence of late complications and reinterventions after endovascular treatment of subrenal abdominal aortic aneurysm with stentgraft. Material and method. From April 1996 to December 2011 we treated 270 patients with abdominal aortic aneurysm endovascularly with stentgraft implantation at our department. There were 233 men and 37 women aged from 49 to 91 years. The average age was 68.7 years. 204 patients were followed for at least a year after treatment. In these patients incidence of late complications (rupture, migration, endoleak, ischemic complications and inflammatory complications) and reintervention were evaluated. Results. In a group of 204 patients 25 late complications were found, i.e. 12.3% (25/204) and 21 reinterventions were performed, i.e. 10.3% (21/204). From 25 complications there were endoleak type I 5x, endoleak type II with sac enlargement 3x, endoleak type III 4x, endotension 3x, stentgraft migration 4x, ischemic complications 5x and infection 1x. Type I endoleaks and migrations were treated with cuff implantation and with surgical conversion in 1 patient with migration. Endoleaks III were managed by stentgraft implantation and type II endoleaks with sac enlargement by ligation or embolization of source. Endotension was solved by percutaneous puncture of the aneurysm sac with content aspiration. The stentgraft arm thromboses were managed by thrombectomy 1x, femo-femoral crossover bypass was created 2x, conservative treatment 1x and leg amputation was performed 1x. Stent graft infection was managed by surgical conversion. Conclusion. Endovascular treatment of abdominal aortic aneurysm is associated with the occurrence of late complications and reintervention in 12.3% and 10.3%, which correlates with literature. Most of these late complications can be managed endovascularly.
- Keywords
- stentgraft,
- MeSH
- Aortic Aneurysm, Abdominal diagnosis complications therapy MeSH
- Angiography methods utilization MeSH
- Endoleak classification complications therapy MeSH
- Endovascular Procedures methods utilization MeSH
- Ischemia classification complications therapy MeSH
- Cardiovascular Surgical Procedures utilization MeSH
- Catheter-Related Infections complications therapy MeSH
- Humans MeSH
- Retreatment MeSH
- Tomography, X-Ray Computed methods utilization MeSH
- Postoperative Complications diagnosis therapy MeSH
- Aneurysm, Ruptured complications therapy MeSH
- Statistics as Topic MeSH
- Stents adverse effects MeSH
- Thrombosis classification complications therapy MeSH
- Outcome and Process Assessment, Health Care MeSH
- Check Tag
- Humans MeSH
Práca sa zaoberá obliterujúcimi chorobami artériového cievneho systému aorty a artérií dolných a horných končatín. V článku sa rozoberá etiológia a nová klinicko-etiologicko-anatomicko-patofyziologická (CEAP) klasifikácia končatinovocievnej ischemickej choroby.
The article describes diseases that decimate the arterial vascular system of the aorta and arteries of the lower and upper extremities. The etiology and new clinical-aetiology-anatomy-pathophysiology (CEAP) classification of extremitovascular ischemic disease („peripheral arterial disease“) are discussed.
- MeSH
- Arterial Occlusive Diseases etiology classification MeSH
- Arteries pathology injuries MeSH
- Arteriosclerosis Obliterans etiology MeSH
- Arteriosclerosis etiology physiopathology MeSH
- Arteritis etiology classification MeSH
- Atherosclerosis etiology classification physiopathology MeSH
- Vascular Fistula etiology classification MeSH
- Diabetic Angiopathies etiology classification physiopathology MeSH
- Lower Extremity blood supply physiopathology MeSH
- Fibromuscular Dysplasia etiology MeSH
- Upper Extremity blood supply physiopathology MeSH
- Ischemia etiology classification MeSH
- Coronary Thrombosis etiology MeSH
- Humans MeSH
- Monckeberg Medial Calcific Sclerosis etiology MeSH
- Terminology as Topic MeSH
- Thromboembolism etiology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
V populaci nemocných s diabetes mellitus je výskyt ischemické srdeční choroby (ICHS) mnohonásobně zvýšen oproti obecné populaci, a to mnohdy již před manifestací diabetu. Týká se to i chronických forem ischemické choroby, z nichž němá ischémie je formou pro diabetiky typickou; vzhledem k vysoké prevalenci nemoci v populaci je však i mnohdy těžká angina pectoris bez možnosti další intervenční léčby častým problémem. Angina pectoris zůstává diagnózou především klinickou, ke zpřesnění diagnózy a optimalizaci dalšího postupu přetrvává význam zátěžových testů a nepochybně bude vzrůstat role moderních zobrazovacích metod: výpočetní tomografie a magnetické rezonance, což umožní lepší selekci nemocných ke katetrizačnímu vyšetření-ošetření. V rozsáhlé části článku věnované léčbě je kladen důraz na antianginózní látky, a to nejen na nitráty, betablokátory a kalciové antagonisty, ale i na nové molekuly, které byly do klinické praxe uvedeny na přelomu tisíciletí.
The incidence of ischemic heart disease (IHD) in patients with diabetes mellitus is manifold higher compared to general population, and often occurs even before the manifestation of diabetes. This applies also to chronic forms of ischemic disease, from which silent ischemia is a typical form in patients with diabetes, given the high disease prevalence in the population, however, even an often severe angina pectoris without a possibility of further intervention treatment is a frequent problem. Angina pectoris remains primarily a clinical diagnosis, to improve diagnosis and optimize following procedures the importance of stress tests persists and the role of modern imaging techniques: computer tomography and magnetic resonance will undoubtedly increase, allowing better selection of patients for catheterization examination-treatment. In an extensive section of this article devoted to treatment an emphasis on anti-angina substances is made, not only on nitrates, beta-blockers and calcium antagonists, but also on new molecules that have been introduced into clinical practice on the turn of the millennium.
- MeSH
- Benzazepines administration & dosage pharmacology therapeutic use MeSH
- Adrenergic beta-Antagonists pharmacology therapeutic use MeSH
- Calcium Channel Blockers pharmacology therapeutic use MeSH
- Chest Pain diagnosis etiology MeSH
- Chronic Disease therapy MeSH
- Diabetes Mellitus MeSH
- Diagnostic Techniques, Cardiovascular classification utilization MeSH
- Diagnosis, Differential MeSH
- Nitrates administration & dosage pharmacology therapeutic use MeSH
- Drug Therapy methods MeSH
- Myocardial Ischemia diagnosis etiology therapy MeSH
- Ischemia etiology classification complications MeSH
- Comorbidity MeSH
- Quality of Life MeSH
- Humans MeSH
- Mortality trends MeSH
- Prevalence MeSH
- Prognosis MeSH
- Trimetazidine administration & dosage pharmacology therapeutic use MeSH
- Life Style MeSH
- Check Tag
- Humans MeSH
Správné načasování revaskularizace a débridementu u pacientů s chronickou kritickou končetinovou ischemií je pro další osud postižené končetiny velmi důležité. Cílem článku je upozornit na význam včasného cévního vyšetření a terapie u pacientů s ischemickou chorobou dolních končetin a definovat stavy, kdy je bezprostřední provedení débridementu nezbytné. Své zkušenosti autoři doplňují prezentací kazuistiky.
Good timing of revascularization and debridement in patients with chronic critical limb ischemia is very important for the future of the effected limb. The aim of the article is to stress the importance of the early assessment of the vessels and the treatment of patients with ischemic peripheral disease of lower extremities, and to define the conditions where the immediate debridement is necessary. A case study that illustrates the experiences of the authors is included.
