Biomedical subjects

Mario Fava

Publications and source records attributed to Mario Fava.

8 recordsLinked to original sources

PubMed2006

[Endoluminal stent-graft placement for acute dissection of the descending aorta complicated with rupture. Report of one case].

Acute dissection of the aorta, although not common, has early and highly lethal complications. The type A dissection is treated with surgery. Patients with type B dissections are treated with surgery if they have complications like rupture, growth or visceral ischemia. Surgery, however, has complications such as spinal cord ischemia. Endovascular grafts have less mortality and complications. We report a 59 years old male patient with a type B dissection complicated with rupture. He was treated successfully with the placement of an endoluminal graft. He was discharged five days after the procedure in good conditions. After one year of follow up, the patient remains asymptomatic.

Aortic Dissection↗

PubMed2006

[Pulmonary thromboembolism treated with pharmacological thrombolysis and mechanical fragmentation. Report of one case].

Pulmonary Embolism (PE) has a wide clinical spectrum. It is imperative to detect patients with a high risk to develop right ventricular failure, because this is the main cause of death in patients with massive PE. In this group of patients, invasive therapies to relieve pulmonary obstruction and right ventricle overload should be used as soon as possible. We report a 85 years old male with massive PE treated with pharmacological thrombolysis and mechanical fragmentation with an angioplasty balloon. Pulmonary perfusion improved significantly. Afterwards, systemic anticoagulation was started and an inferior vena cava filter was installed percutaneously. The patient was discharged in good conditions, five days after admission.

Aged, 80 and over↗

PubMed2005

[Splenic artery aneurysm: case report].

Splenic artery aneurysms are rare and occur predominantly in women. Most of them are asymptomatic until rupture. We report a previously healthy 73 year-old woman who presented with non specific symptoms: dyspepsia and constipation. Laboratory tests were normal. Subsequent examinations (ultrasound and CT) showed a large aneurysm of the splenic artery without any sign of rupture. Endovascular treatment remained successfully performed using coil embolization. During a 12-months follow-up period, the patient was asymptomatic and no evidences of complications or splenic infarction were observed on CT scans.

Aged↗

PubMed2005

Massive pulmonary embolism: percutaneous mechanical thrombectomy during cardiopulmonary resuscitation.

Seven patients with massive pulmonary embolism (PE) causing cardiac arrest underwent percutaneous mechanical thrombectomy (PMT) with Hydrolyser and Oasis catheters during cardiopulmonary resuscitation (CPR). Three received adjunctive recombinant tissue plasminogen activator. Thrombectomy was successful in restoring pulmonary perfusion in six patients (85.7%). One patient died of cardiac arrest. Systolic pulmonary pressure decreased after thrombectomy from a median of 73 mm Hg (range, 63-90 mm Hg) to 42 mm Hg (range, 32-81 mm Hg; P < .05). There was one groin hematoma that required blood transfusion. In conclusion, massive PE causing cardiac arrest can be treated with PMT simultaneously with CPR maneuvers to rapidly revert circulatory collapse, with restoration of pulmonary circulation. Larger series are needed to validate this method.

Adult↗

PubMed2004

Cryoplasty for femoropopliteal arterial disease: late angiographic results of initial human experience.

PURPOSE: A new form of angioplasty, called cryoplasty, was developed to improve the late results typically associated with percutaneous transluminal angioplasty. Cryoplasty combines the dilation force of percutaneous transluminal angioplasty with the delivery of cold thermal energy to the vessel wall. This study reports the authors' early clinical experience with cryoplasty in patients with femoropopliteal disease. MATERIALS AND METHODS: Fifteen patients with femoropopliteal arterial lesions were treated with cryoplasty (CryoVascular Systems, Los Gatos, CA). Cryoplasty was performed at 6 atm of pressure and delivered at -10 degrees C for 60 seconds. The ankle-brachial index (ABI) was measured at baseline, 24 hours after cryoplasty, and at 1 and 3 months during follow-up. Repeated angiography was performed at 6 and 18 months to determine short-term and late primary patency. RESULTS: Cryoplasty was technically successful in 93% of patients (< 30% residual stenosis and less then grade C dissection). ABIs at baseline were 0.64 +/- 0.08 and improved the day after cryoplasty to 0.95 +/- 0.09 (P < .05). ABIs were well maintained at 1 and 3 months with measurements of 0.94 +/- 0.09 and 0.92 +/- 0.10, respectively (P < .05 vs baseline). Baseline angiographic diameter stenosis improved significantly immediately following cryoplasty (86% +/- 12% to 16% +/- 3%; P < .05). Angiography at 6 months revealed 0% binary restenosis and insignificant change in residual stenosis from the acute cryoplasty results (16 +/- 3% vs 21 +/- 5%; P = NS). Late angiographic follow-up at 14 months +/- 4 demonstrated primary patency of 83.3%. CONCLUSION: Cryoplasty was able to achieve substantial dilation of femoropopliteal lesions with well-preserved late angiographic patency. Cryoplasty represents a potential advance in the field of endovascular medicine.

Aged↗

PubMed2004

[Congenital hepatic fibrosis. Report of five cases].

BACKGROUND: Congenital hepatic fibrosis (CHF) is an autosomic dominant disease that has been associated with polycystic kidney disease. AIM: To describe the medical management of 5 children with CHF and to evaluate the presence and extension of the associated renal disease. PATIENTS AND METHODS: Retrospective review of the medical charts of 5 children with CHF, aged 2 to 14 years. RESULTS: Three children presented autosomic recessive polycystic kidney disease, which was diagnosed before the appearance of liver disease manifestations. They presented a more severe liver damage, with a more aggressive clinical course requiring use of transjugular intrahepatic porto-systemic shunts (TIPS) or surgical porto-systemic shunts to control portal hypertension. The other two children, in whom the diagnosed was based on asymptomatic hepatomegaly, had normal renal function and structure with a more benign clinical course. CONCLUSIONS: The diagnosis of CHF should be suspected not only in children with polycystic kidney disease but in those children with persistent, hard consistency, left lobe predominance hepatomegaly.

Adolescent↗

PubMed2003

Applications of percutaneous mechanical thrombectomy in pulmonary embolism.

Percutaneous mechanical thrombectomy (PMT) has matured into a reliable and valuable therapeutic tool in acute vascular diseases. PMT devices are designed to achieve rapid clearance of acute occlusion in large arteries and veins. This article provides a summary of cumulated experience on pulmonary embolism (PE) treatment with PMT devices. PMT devices are a heterogeneous group of devices that uses different forms of energy. Most of the devices do not totally eliminate thrombus rather fragment in small particles. The rationale of PMT is based on the rapid relief of central pulmonary obstruction. PMT in massive PE provides efficacious and safe debulking of centrally located thrombus in PE, lowering pulmonary artery pressures and improving hemodynamics and blood oxygenation. This results in lowering mortality if compared with natural history of PE, and reduced procedure time if compared with pharmacological thrombolysis. The clinical indications for percutaneous intervention in PE are discussed in the text.

Equipment Design↗

PubMed2003

[Frequency of abdominal aortic aneurysms in adult population with known risk factors].

BACKGROUND: The incidence of abdominal aortic aneurysms has increased. Its predisposing factors are smoking, high blood pressure and dislipidemia. Progressive aneurysmal enlargement may lead to its rupture, which is associated to a mortality rate above 80%. AIM: To assess the prevalence of abdominal aortic aneurysms in Chilean subjects with cardiovascular risk factors. SUBJECTS AND METHODS: Through announcements in open media we invited individuals aged over 60 years, who smoked, had hypertension and/or had occlusive arterial disease, to participate in a study that included medical history and physical examination. An aortic ultrasound was performed in all subjects in whom the aorta was not palpable or there was a suspicion of dilatation. Aortic diameter over 3 cm was considered aneurysmal. RESULTS: Three hundred fifty six subjects aged 67.1 +/- 6.7 years, (73.9% males), were evaluated. The study group included 62% hypertensives, 39% with abnormal lipids and 46% smokers. Known coronary heart disease or peripheral arterial diseases were present in 14% and 10%, respectively. Ultrasound was required in 159 subjects. Aneurysms were detected in 21 persons (5.9%), 7.6% in males and 1.1% in females. The mean transverse diameter of the aneurysm was 4.1 cm (3-7.5). Aneurysm was found in 2.3% of subjects younger than 65 years and 8.3% of subjects aged over 65 years. CONCLUSIONS: In this sample the prevalence of abdominal aortic aneurysms was 5.9%, affecting predominantly males, with a notorious increase with advanced age.

Age Distribution↗