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Eficacia y seguridad en el tratamiento endovascular de aneurismas carotideos no rotos con diversores de flujo. Experiencia institucional
dc.contributor.advisor | Mantilla García, Daniel Eduardo | |
dc.contributor.advisor | Serrano, Sergio | |
dc.contributor.advisor | Reyes, Adriana | |
dc.contributor.author | López Callejas, Orlando | |
dc.coverage.spatial | Bucaramanga (Santander, Colombia) | spa |
dc.date.accessioned | 2022-03-01T16:02:27Z | |
dc.date.available | 2022-03-01T16:02:27Z | |
dc.date.issued | 2021-12-09 | |
dc.identifier.uri | http://hdl.handle.net/20.500.12749/15761 | |
dc.description.abstract | La aparición de aneurismas cerebrales está dada por la debilidad de la pared arterial, y su ruptura podría desencadenar una hemorragia subaracnoidea con una alta morbimortalidad lo cual hace mandatorio considerar su tratamiento, idealmente previo a dicha ruptura. Los dispositivos diversores de flujo son un stent de implantación intra-arterial considerados como una alternativa de tratamiento mínimamente invasiva que se posicionan rodeando internamente la pared del endotelio arterial con el propósito de modificar el patrón del flujo de la arteria afectada. Lo anterior, con el objetivo de reducir la entrada de sangre al aneurisma llevándolo progresivamente a su trombosis, oclusión y posteriormente disminución de tamaño permitiendo una nueva endotelización del vaso. Esta técnica endovascular es considerada actualmente a nivel mundial como la estrategia numero uno para el manejo de aneurismas carotideos complejos no rotos. Sin embargo, aún existe controversia sobre su rendimiento terapéutico debido a que se trata de una técnica reciente que requiere de una pericia y tecnología especificas. En nuestro país no existe un estudio o registro que documente dicho rendimiento en términos de eficacia y seguridad para el manejo endovascular de esta enfermedad con esta tecnología. Por lo anterior es el objetivo de los investigadores documentar los resultados de esta conducta terapéutica en la institución y la región, para establecer un referente nacional; y que permita comparar los resultados con los pioneros internacionales en el manejo de esta condición médica. Se recolectará información de todos los pacientes tratados con diversores de flujo en la institución desde el inicio de su uso en 2014 hasta 2020 con el propósito de evaluar la oclusión al año de los aneurismas tratados (eficacia) y el resultado neurológico y clínico de los pacientes (seguridad) según la escala de Rankin modificada (mRS) como desenlaces primarios de análisis de la investigación. | spa |
dc.description.tableofcontents | RESUMEN _______________________________________________________6 ABSTRACT_______________________________________________________7 1. INTRODUCCIÓN___________________________________________________8 2. DESCRIPCIÓN DEL PROYECTO……………………………...…………………...….9 2.1. PLANTEAMIENTO DEL PROBLEMA ……………………………………...…............9 2.2. JUSTIFICACIÓN .…………………………………………………………………….…12 3. MARCO TEÓRICO ……………………………………………………………………...13 4. ESTADO DEL ARTE…………………………………………………………………….23 5. PREGUNTA DE INVESTIGACIÓN…………………………………………………….28 6. HIPÓTESIS ..………………………………………………………...…………………..28 7. OBJETIVOS ..………………………………………………………...………………....29 7.1. Objetivo general..………………………………………………………………………...29 7.2. Objetivos específicos ..……………………………………………………….…...........29 8. METODOLOGÍA...……………………………………………….……………………...30 8.1 Diseño o tipo de estudio...………………………………………………………..…….30 8.2 Población y muestra.……………………………………………….…………………...31 8.3 Criterios de selección...………………………………………………………………....31 8.3.1 Criterios de inclusión...……………………………………………….….…..................31 8.3.2 Criterios de exclusión...……………………………………….……..............................31 8.4 Variables: definición y operacionalización..………………….……………………......32 8.5 Recolección de la información..………………….…………......................................32 8.6 Plan de análisis………………….…………..............................................................35 9. CONSIDERACIONES ÉTICAS ...…………….…………………………….…………37 10. RESULTADOS Y PRODUCTOS ESPERADOS ...………………….…….………..39 11. CRONOGRAMA DE ACTIVIDADES...…………….………………………………….41 12. PRESUPUESTO ...…………….………………………………………………………..42 13. REFERENCIAS BIBLIOGRÁFICAS…………………………………………….…….43 | spa |
dc.format.mimetype | application/pdf | spa |
dc.language.iso | spa | spa |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/2.5/co/ | * |
dc.title | Eficacia y seguridad en el tratamiento endovascular de aneurismas carotideos no rotos con diversores de flujo. Experiencia institucional | spa |
dc.type | Thesis | eng |
dc.title.translated | Efficacy and safety in the endovascular treatment of unruptured carotid aneurysms with flow diverters. institutional experience | spa |
dc.degree.name | Especialista en Radiología Intervencionista | spa |
dc.publisher.grantor | Universidad Autónoma de Bucaramanga UNAB | spa |
dc.rights.local | Abierto (Texto Completo) | spa |
dc.publisher.faculty | Facultad Ciencias de la Salud | spa |
dc.publisher.program | Especialización en Radiología Intervencionista | spa |
dc.description.degreelevel | Especialización | spa |
dc.type.driver | info:eu-repo/semantics/masterThesis | spa |
dc.type.local | Tesis | spa |
dc.type.coar | http://purl.org/coar/resource_type/c_bdcc | |
dc.subject.keywords | Medical sciences | spa |
dc.subject.keywords | Health sciences | spa |
dc.subject.keywords | Brain aneurysms | spa |
dc.subject.keywords | Hemorrhage | spa |
dc.subject.keywords | Morbidity and mortality | spa |
dc.subject.keywords | Vascular diseases | spa |
dc.subject.keywords | Intracranial aneurysms | spa |
dc.subject.keywords | Hospital care | spa |
dc.subject.keywords | Public health | spa |
dc.subject.keywords | Carotid artery | spa |
dc.identifier.instname | instname:Universidad Autónoma de Bucaramanga - UNAB | spa |
dc.identifier.reponame | reponame:Repositorio Institucional UNAB | spa |
dc.type.hasversion | info:eu-repo/semantics/acceptedVersion | spa |
dc.rights.accessrights | info:eu-repo/semantics/openAccess | spa |
dc.relation.references | 1. Brisman JL, Song JK, Newell DW. Cerebral an- eurysms. N Engl J Med. 2006;355:928-939 | spa |
dc.relation.references | 2. Rincon F, Rossenwasser RH, Dumont A. The epidemiology of admissions of nontraumatic subarachnoid hemorrhage in the United States. Neurosurgery. 2013;73:213-217. | spa |
dc.relation.references | 3. Bonneville, F., Sourour, N., & Biondi, A. (2006). Intracranial Aneurysms: an Overview. Neuroimaging Clinics of North America, 16(3), 371–382 | spa |
dc.relation.references | 4. Petridis AK, Kamp MA, Cornelius JF, Beez T, Beseoglu K, Turowski B, Steiger HJ: Aneurysmal subarachnoid hemorrhage—diagnosis and treatment. Dtsch Arztebl Int 2017; 114: 226–36 | spa |
dc.relation.references | 5. Van Gijn J, Kerr RS, Rinkeahal GJ: Subarachnoid haemorrhage. Lancet 2007; 369: 306–18 | spa |
dc.relation.references | 6. Kundra S, Mahendru V, Gupta V, Choudhary AK: Principles of neuroanesthesia in aneurysmal subarachnoid hemorrhage. J Anaesthesiol Clin Pharmacol 2014; 30: 328–37 | spa |
dc.relation.references | 7. D‘Souza S: Aneurysmal subarachnoid hemorrhage. J Neurosurg Anesthesiol 2015; 27: 222–40. | spa |
dc.relation.references | 8. Van Dijk JM, Groen RJ, Ter Laan M, Jeltema JR, Mooij JJ, Metze- maekers JD: Surgical clipping as the preferred treatment for aneurysms of the middle cerebral artery. Wien: Acta Neurochir 2011; 153: 2111–7 | spa |
dc.relation.references | 9. Lv X, Jiang C, Li Y, et al. Treatment of giant intracranial aneurysms. Interv Neuroradiol 2009; 15: 135–144 | spa |
dc.relation.references | 10. Lv, X., Yang, H., Liu, P., & Li, Y. (2016). Flow-diverter devices in the treatment of intracranial aneurysms: A meta-analysis and systematic review. The Neuroradiology Journal, 29(1), 66–71. | spa |
dc.relation.references | 11 Schievink WI. Intracranial aneurysms. N Engl J Med. 1997; 336(1):28 | spa |
dc.relation.references | 12 Lawton, M. T., & Vates, G. E. (2017). Subarachnoid Hemorrhage. New England Journal of Medicine, 377(3), 257–266. | spa |
dc.relation.references | 13 Lv, X., Jiang, C., Li, Y., Yang, X., Zhang, J., & Wu, Z. (2009). Treatment of Giant Intracranial Aneurysms. Interventional Neuroradiology, 15(2), 135–144 | spa |
dc.relation.references | 14 Shimada, T., Toyoda, K., Hagiwara, N., Sayama, T., Inoue, T., Yasumori, K., & Okada, Y. (2005). Recurrent embolic stroke originating from an internal carotid aneurysm in a young adult. Journal of the Neurological Sciences, 232(1-2), 115– 117 | spa |
dc.relation.references | 15 Martin AJ, Hetts SW, Dillon WP, Higashida RT, Halbach V, Dowd CF, et al. MR imaging of partially thrombosed cerebral aneurysms: charac- teristics and evolution. AJNR Am J Neuroradiol. 2011;32:346–351 | spa |
dc.relation.references | 16 Shimada, T., Toyoda, K., Hagiwara, N., Sayama, T., Inoue, T., Yasumori, K., & Okada, Y. (2005). Recurrent embolic stroke originating from an internal carotid aneurysm in a young adult. Journal of the Neurological Sciences, 232(1-2), 115– 117 | spa |
dc.relation.references | 17 Chen, M. L., Gupta, A., Chatterjee, A., Khazanova, D., Dou, E., Patel, H., … Kamel, H. (2018). Association Between Unruptured Intracranial Aneurysms and Downstream Stroke. Stroke, 49(9), 2029–2033. 18 Spetzler RF, McDougall CG, Zabrams- ki JM, et al. The Barrow Ruptured Aneurysm Trial: 6-year results. J Neurosurg 2015;123:609-17 | spa |
dc.relation.references | 19 Cagnazzo, F., Mantilla, D., Rouchaud, A., Brinjikji, W., Lefevre, P.-H., Dargazanli, C., … Costalat, V. (2018). Endovascular Treatment of Very Large and Giant Intracranial Aneurysms: Comparison between Reconstructive and Deconstructive Techniques—A Meta-Analysis. American Journal of Neuroradiology, 39(5), 852– 858. | spa |
dc.relation.references | 20 Briganti, F., Leone, G., Marseglia, M., Mariniello, G., Caranci, F., Brunetti, A., & Maiuri, F. (2015). Endovascular treatment of cerebral aneurysms using flow-diverter devices: A systematic review. The Neuroradiology Journal, 28(4), 365–375 | spa |
dc.relation.references | 21 Wiebers DO, Whisnant JP, Huston J 3rd, et al. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 2003;362(9378):103–110 | spa |
dc.relation.references | 22 Becske, T., Kallmes, D. F., Saatci, I., McDougall, C. G., Szikora, I., Lanzino, G., … Nelson, P. K. (2013). Pipeline for Uncoilable or Failed Aneurysms: Results from a Multicenter Clinical Trial. Radiology, 267(3), 858–868. PUFS | spa |
dc.relation.references | 23 Kallmes, D. F., Hanel, R., Lopes, D., Boccardi, E., Bonafe, A., Cekirge, S., … Lylyk, P. (2014). International Retrospective Study of the Pipeline Embolization Device: A Multicenter Aneurysm Treatment Study. American Journal of Neuroradiology, 36(1), 108–115. INTERPER | spa |
dc.relation.references | 24 Hanel, R. A., Kallmes, D. F., Lopes, D. K., Nelson, P. K., Siddiqui, A., Jabbour, P., … Puri, A. S. (2019). Prospective study on embolization of intracranial aneurysms with the pipeline device: the PREMIER study 1 year results. Journal of NeuroInterventional Surgery, neurintsurg–2019–015091. PREMIER | spa |
dc.relation.references | 25 Texakalidis P, Bekelis K, Atallah E, Tjoumakaris S, Rosenwasser RH, Jabbour P. Flow diversion with the pipeline embolization device for patients with intracranial aneurysms and antiplatelet therapy: a systematic literature review. Clin Neurol Neurosurg. 2017;161:78-87 | spa |
dc.relation.references | 26 Hyodo, A. Eric M. Deshaies, Christopher S. Eddleman, and Alan S, Boulos, (Eds): handbook of neuroendovascular surgery. Acta Neurochir 154, 1537–1538 (2012). | spa |
dc.relation.references | 27 Asaithambi G., Adil M. M., Chaudhry S. A., Qureshi A. I. Incidences of unruptured intracranial aneurysms and subarachnoid hemorrhage: results of a statewide study. Journal of vascular and interventional neurology. 2014;7(3):14–17. | spa |
dc.relation.references | 28 Williams LN, Brown RD Jr. Management of unruptured intracranial aneurysms [published correction appears in Neurol Clin Pract. 2014 Apr;4(2):98]. Neurol Clin Pract. 2013;3(2):99-108. doi:10.1212/CPJ.0b013e31828d9f6b | spa |
dc.relation.references | 29 Ravindran, K., Salem, M. M., Alturki, A. Y., Thomas, A. J., Ogilvy, C. S., & Moore, J. M. (2019). Endothelialization following Flow Diversion for Intracranial Aneurysms: A Systematic Review. American Journal of Neuroradiology | spa |
dc.relation.references | 30 Becske, T., Kallmes, D. F., Saatci, I., McDougall, C. G., Szikora, I., Lanzino, G., … Nelson, P. K. (2013). Pipeline for Uncoilable or Failed Aneurysms: Results from a Multicenter Clinical Trial. Radiology, 267(3), 858–868. | spa |
dc.contributor.cvlac | Mantilla García, Daniel Eduardo [0001437130] | spa |
dc.contributor.googlescholar | Mantilla García, Daniel Eduardo [PUqdPK8AAAAJ&hl=es&oi=ao] | spa |
dc.contributor.scopus | Mantilla García, Daniel Eduardo [56641574500] | spa |
dc.subject.lemb | Ciencias médicas | spa |
dc.subject.lemb | Enfermedades vasculares | spa |
dc.subject.lemb | Aneurismas intracraneales | spa |
dc.subject.lemb | Atención hospitalaria | spa |
dc.subject.lemb | Salud pública | spa |
dc.subject.lemb | Arteria carótida | spa |
dc.identifier.repourl | repourl:https://repository.unab.edu.co | spa |
dc.description.abstractenglish | The appearance of cerebral aneurysms is given by the weakness of the arterial wall, and their rupture could trigger subarachnoid hemorrhage with high morbidity and mortality, which makes it mandatory to consider their treatment, ideally prior to said rupture. Flow diverter devices are an intra-arterial implantation stent considered as a minimally invasive treatment alternative that are positioned internally surrounding the wall of the arterial endothelium with the purpose of modifying the flow pattern of the affected artery. The foregoing, with the aim of reducing the inflow of blood to the aneurysm, progressively leading it to thrombosis, occlusion and subsequently a reduction in size, allowing a new endothelialization of the vessel. This endovascular technique is currently considered worldwide as the number one strategy for the management of complex unruptured carotid aneurysms. However, there is still controversy about its therapeutic performance because it is a recent technique that requires specific expertise and technology. In our country there is no study or registry that documents this performance in terms of efficacy and safety for the endovascular management of this disease with this technology. Therefore, it is the objective of the researchers to document the results of this therapeutic behavior in the institution and the region, to establish a national reference; and that allows comparing the results with the international pioneers in the management of this medical condition. Information will be collected from all patients treated with flow diverters in the institution from the start of its use in 2014 to 2020 with the purpose of evaluating the occlusion of the treated aneurysms at one year (efficacy) and the neurological and clinical outcome of the patients. (safety) according to the modified Rankin scale (mRS) as primary outcomes of research analysis. | spa |
dc.subject.proposal | Ciencias de la salud | spa |
dc.subject.proposal | Aneurismas cerebrales | spa |
dc.subject.proposal | Hemorragia | spa |
dc.subject.proposal | Morbimortalidad | spa |
dc.type.redcol | http://purl.org/redcol/resource_type/TM | spa |
dc.rights.creativecommons | Atribución-NoComercial-SinDerivadas 2.5 Colombia | spa |
dc.coverage.campus | UNAB Campus Bucaramanga | spa |
dc.description.learningmodality | Modalidad Presencial | spa |