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Resumen Objetivo Describir las indicaciones de colocacion de gastrostomia percutanea (GP) en pacientes mayores en un hospital universitario, las caracteristicas de los pacientes en los que se realiza, sus complicaciones a largo y corto plazo y la mortalidad asociada. Metodos Estudio descriptivo y retrospectivo de todos los pacientes mayores de 75 anos a los que se les coloco una GP en un periodo de 3 anos en la Unidad de Radiologia Vascular Intervencionista. Se estudio la indicacion del procedimiento en cada caso, revisando posteriormente en la historia clinica electronica la aparicion de complicaciones y la mortalidad durante un periodo de seguimiento de 36 meses. Resultados Pacientes: n = 74, con una edad media de 84 ± 6,1 anos, 57% mujeres. El 40% vivia en una residencia. El 80% sufria deterioro cognitivo. La principal indicacion para la colocacion de la GP fue la disfagia en la demencia avanzada (56,8%), seguida de tumores de la cavidad orofaringea (12,2%), enfermedad de Parkinson (10,8%) e ictus (9,6%). Se coloco la gastrostomia con caracter irreversible en el 90,5% de los casos. La complicacion mas frecuente fue la broncoaspiracion (32,4%). La mortalidad global fue de 59,5% con una mediana de seguimiento de 18 meses. Conclusiones La presencia de disfagia en la demencia avanzada fue la principal indicacion de realizacion de gastrostomias en mayores de 75 anos. Esta intervencion no solo no evito la aparicion de broncoaspiraciones, sino que estas representaron su complicacion mas frecuente. La mortalidad a medio plazo de los pacientes en quienes se coloca una gastrostomia es elevada.

To describe the indications of insertion of a percutaneous gastrostomy (PG) in older patients in a university hospital, as well as patient characteristics, short and long term complications, and mortality.Retrospective descriptive study of all patients over 75 years who had a PG inserted during a three year period by the Interventional Radiology Department. The indication of the procedure was reviewed, and the incidence of complications and mortality during a 36 months follow-up period were assessed through electronic medical records.The study included 74 patients, with a mean age of 84±6.1 years, and 57% were female. Furthermore, 40% lived in nursing homes and 80% had cognitive impairment. The main indications for PG insertion were dysphagia in severe dementia (56.8%), tumours of the oropharyngeal cavity (12.2%), Parkinson's disease (10.8%), and stroke (9.6%). PG was permanent in 90.5% of cases. The most common complication was aspiration pneumonia (32.4%). Overall mortality was 59.5% after a median follow-up of 18 months.Dysphagia in severe dementia was the main indication for PG in patients over 75 years. This intervention did not prevent aspiration pneumonia, which was the most common complication. Mortality in patients who have a PG was high.

Objective: To assess the results of percutaneous transparieto-hepatic dilation of benign biliary stenosis achieved over a period of 5 years. Design: A retrospective study to assess the technique, complications and the clinical, analytical and radiology results.

Aberrant right subclavian arteries occur in as much as 2% of the population. Aneurysms in this vessel are rare but exhibit a marked propensity toward rupture; therefore, early elective treatment is indicated. Transluminally placed stent-grafts offer an alternative approach to the standard surgical treatment. This type of procedure is less invasive, with less attendant risk than operative repair. Because there was no proximal neck between the aneurysm and Kommerell diverticulum in the case described herein, it was decided to perform endovascular exclusion of the aneurysm by inserting an endoprosthesis to occlude the aortic exit of the aneurysm, combined with distal ligation. A bilateral carotid/subclavian bypass was also created to preserve the function of both subclavian arteries.

Objective To assess the results of percutaneous transparieto-hepatic dilation of benign biliary stenosis achieved over a period of 5 years. Design A retrospective study to assess the technique, complications and the clinical, analytical and radiology results. Patients Data was gathered on 13 patients diagnosed in our Hospital between the years 2002 and 2006 with benign biliary stenosis and who had been treated using percutaneous dilation. Patients diagnosed with malignant disease and those who had a prosthesis were excluded. Seven of the patients had received a liver transplant. One patient had an endoscopic dilation on two occasions, with the stenosis persisting. Results A clinical and radiological improvement was observed in 60% of the cases, and an analytical improvement in 69% (61% normal). Re-stenosis occurred in 30% of the cases, of which 50% were rescue support using re-dilation. The complications presented (30.7%) were resolved conservatively. No significant differences were observed between the transplanted and the non-transplanted groups. Conclusions Transparieto-hepatic dilation of benign biliary stenosis is a fairly safe technique and has a high rate of resolution in the medium term, and avoids the use of surgery in 75% of patients. The results need to be confirmed in larger samples.