Hippokratia 2000, 4(4):163-169
K. Papazoglou, A. Mpalitas, G. Trellopoulos, G. Sfyroeras, A. Ntinas, N. Antoniadis, H. Pezikoglou, D. Giakoustidis, E. Giakoustidis
Abstract
The aim of this study is to present the results of endovascular treatment of the AAA during two periods of time. In 5 years, 131 patients were treated for an AAA. These patients were classified in two groups: A) treatment in the first two years of practice of this method (n=50) and B) treatment the next 3 years (n=81). These groups were similar regarding the age of the patients, the risk factors, and the anatomic features of the AAA, except the cases with large angle of the proximal neck and kinking of iliac arteries which were prevailing in the second group. The used grafts during the 1st period were home made stent grafts of PTFE with a frame of Ζ Gianturco stent, and the ones used during the 2nd period were the commercial devices AneuRx (46,9%), VanGuard (4,9%), Talent (1,2%) and home made (46,9%). 44% of the grafts were tubular in the 1st period and 12,3% in the 2nd, 44% and 72,8% were bifurcated respectively. Aortoiliac with a femo-femoral bypass was used in 12,3% of the A group and 14,8% of the Β group. Local anesthesia was used in 92% of the patients of the A group and in the 67,9% of the Β group, in the remaing patients a regional anesthesia was prefered. There was an attenuation of the operational incidents (from 18% to 12%), of the postoperative complications (from 14% to 12,3%) and an imporant reduction of endoleaks (38% in A group, 11,1% in Β group). The blood transfusion and the duration of hospitalisation were similar in the two groups. The amelioration of the devices and the growing experience lead to a more reliable endovascular treatment of the AAA. Although there are still some medical complications happening mostly during the learning of this method, and some self-induced dangers, which determinate the results.Fatty infiltration of the liver occurs in response to various toxic and metabolic insults. The liver occupies a central position in lipid metabolism. Disruption of one or more steps in hepatic lipid metabolism may result in abnormal accumulation of triglycerides in the hepatocytes.
Fatty change of the liver usually is a diffuse process involving the entire organ. Focal sparing in an otherwise diffusely fatty infiltrated liver may simulate metastasis, a primary neoplasm, an abscess or other tumorous of infectious involvement of the liver.In nine patients ultrasound demonstrated fatty infiltration of the liver with diffuse increased echogenicity except for a solitary hypoechogenic area. The final diagnosis was confirmed by CT examination and the fine needle aspiration cytology and histology of these hypoechoic areas.