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Background: Pelvic venous insufficiency may cause pelvic congestion syndrome that is characterized by chronic pelvic pain exacerbated by prolonged standing, sexual activity or menstrual cycle. It may be treated by embolizing the dysfunctional pelvic venous drainage and sometimes resecting vulvar, perineal and thigh varices. Aim: To assess the results of embolization of insufficient pelvic or ovarian veins on pelvic congestion syndrome. Material and Methods: Analysis of 17 female patients aged 32 to 53 years, who underwent subjected to a selective coil embolization of insufficient pelvic and/or ovarian veins through the jugular, basilic or cephalic veins. In the preoperative period, all patients had a lower extremity venous duplex pelvic ultrasound examination and some had an abdominal and pelvic CT angiogram. Results: The technical success of the procedure was 100% and no complications were registered. During a 32 month follow up, no patient had symptoms of pelvic venous insufficiency or relapse of vulvar or thigh varices. Conclusions: Embolization of insufficient pelvic and ovarian veins is a safe and successful procedure for the treatment of pelvic venous insufficiency or vulvar varices.

Introducción: La insuficiencia mesentérica crónica es un diagnóstico infrecuente, generalmente secundario a enfermedad aterosclerótica, siendo considerada una enfermedad de pacientes añosos. Se sabe que la radioterapia es un factor de riesgo importante para aterosclerosis. Describimos nuestra experiencia en el manejo de la isquemia mesentérica crónica secundaria a radioterapia retroperitoneal. Materiales y métodos: Análisis retrospectivo de las fichas clínicas de los pacientes tratados en nuestro centro por insuficiencia mesentérica crónica posterior a radioterapia del territorio para-aórtico entre 1993 y 2011. Resultados: Un total de 4 pacientes de sexo masculino fueron identificados. Edad promedio: 49 ± 12 años (rango 39-65). Todos presentaron los síntomas clásicos de insuficiencia mesentérica caracterizados por dolor abdominal postprandial y baja de peso. Uno de ellos además tenía episodios repetidos de diarrea. La revascularización mesentérica se obtuvo mediante cirugía abierta o endovascular con excelentes resultados a corto y largo plazo con un seguimiento promedio de 9,3 años (rango 2-20). Discusión: El curso acelerado de la aterosclerosis posterior a radioterapia se ha descrito en múltiples territorios vasculares. Síntomas de insuficiencia mesentérica crónica pueden ser malinterpretados en estos pacientes debido a su similitud con los síntomas observados en la ileitis actínica. Un diagnóstico y tratamiento oportuno son críticos para evitar complicaciones mayores y deterioro de calidad de vida de estos pacientes. Conclusión: La insuficiencia mesentérica crónica inducida por radioterapia es una condición infrecuente. El manejo con cirugía abierta o endovascular son seguras y otorgan resolución sintomática a largo plazo. Background: Chronic mesenteric ischemia is observed in older people and is often due to atherosclerosis. Radiotherapy is an important risk factor for atherosclerosis. Aim: To report our experience with chronic mesenteric ischemia secondary to retroperitoneal radiotherapy. Material and methods: Review of medical records of four male patients aged 39 to 65 years, treated for chronic mesenteric ischemia secondary to para-aortic radiotherapy between 1993 and 2011. Results: All of them had the classic symptoms of ischemia characterized by post prandial abdominal pain and weight loss. One had also isolated diarrhea episodes. Revascularization was achieved with open or endovascular surgery, with good results during a follow up period ranging from two to 20 years. Conclusions: Surgical revascularization is a good treatment for chronic mesenteric ischemia secondary to radiotherapy

Introducción: La incidencia real de los aneurismas de arteria renal es desconocida, pero se ha estimado en aproximadamente un 1%. Normalmente los pacientes son asintomáticos y su diagnóstico es habitualmente un hallazgo de estudios de imágenes solicitados por otras causas. El riesgo principal de los aneurismas mayores de 2 cm de diámetro o aquellos en mujeres embarazadas es la rotura. caso clínico: Presentamos el caso de un hombre con diagnóstico de aneurisma complejo de arteria renal izquierda, que fue sometido a reparación exitosa mediante nefrectomía laparoscópica, cirugía de banco y autotrasplante por un equipo multidisciplinario. Introduction: True incidence of renal artery aneurysms is unknown but it has been estimated to be around 1%. They are usually asymptomatic and diagnosed through imaging studies done for other medical reasons. Those that are more than 2 cm in diameter or any aneurysm in pregnant women should be treated because of an elevated risk of rupture. We present a case of a man with a complex 2.5 cm renal artery aneurysm, successfully treated with ex vivo repair and reimplantation by a multidisciplinary team.

La insuficiencia de venas perforantes es una forma de insuficiencia venosa de extremidades inferiores que se manifiesta por hiperpigmentación cutánea localizada, desarrollo de úlceras venosas o recurrencia de várices previamente operadas. Su tratamiento comprende desde cirugías cruentas como la ligadura subfascial abierta a técnicas percutáneas de radiofrecuencia o láser con resultados alejados desconocidos. Dentro de las técnicas mínimamente invasivas se encuentra la cirugía de ligadura subfascial de perforantes con mini-incisiones descrita por Queral, de eficacia demostrada y que hemos realizado y perfeccionado exitosamente en los últimos años. Se describen detalles de la técnica y de la planificación pre-operatoria de pacientes con esta patología. Perforator vein incompetence is a specific form of lower extremitiy venous insufficiency characterized by localized hyperpigmentation, venous ulceration or recurrence of varicose veins. Surgical treatment ranges from the extensive conventional open subfascial ligation to percutaneous radiofrequency or laser techniques with unknown late outcome. A minimally invasive technique of subfascial ligation through small incisions described by Queral, with acceptable results, has been successfully used and improved in recent years by our group. Details of the technique and pre-operative managment are described.

Background: Esophageal squamous cell carcinoma can spread locally to neighboring organs in the mediastinum. When it invades the aorta, the patient may develop an aorto esophageal fistula (AEF), complication that carries a high mortality rate. We report a 62-year-old male with stage IV esophageal carcinoma who, after chemo radiation treatment, developed an AEF. He was successfully treated with the use of an aortic endograft. The patient died 13 months later due to progression of his cancer, without evidence of sepsis or new bleeding episodes.

Introducción: La arteria subclavia derecha aberrante es la malformación arterial más frecuente del arco aórtico. Su diagnóstico es habitualmente un hallazgo de estudios de imágenes solicitados por otras causas pero puede tener serias complicaciones si se obtiene en forma tardía. Caso clínico: Presentamos el caso de una mujer joven con diagnóstico de arteria subclavia lusoria dilatada sometida exitosamente a tratamiento híbrido electivo. Introduction: An aberrant right subclavian artery is the most frequent aortic arch malformation. It is frequently an incidental finding of imaging studies and serious complications may arise if left untreated. Clinical case: We present a case of a young woman with a dilated aberrant right subclavian artery that was successfully treated by a hybrid approach.

La reparación endovascular de un aneurisma aórtico abdominal infrarrenal (EVAR) se ha popularizado en la última década. Sin embargo, hasta ahora los pacientes con aneurisma aórtico abdominal yuxtarrenal (AAAY) o aneurisma aórtico tóracoabdominal (AATA) no eran candidatos a EVAR por ausencia de una zona sana donde apoyar la endoprótesis tubular. La reparación convencional se asocia a una morbimortalidad considerable, por lo que se han desarrollado endoprótesis capaces de acomodar ramas de la aorta que permiten tratar estos aneurismas en forma mínimamente invasiva. Presentamos la experiencia inicial de dos casos, ambos de sexo masculino y portadores de enfermedad coronaria considerados de alto riesgo para cirugía abierta. El primero, portador de un AAAY sacular de 4,1 cm de diámetro; se repara mediante el uso de endoprótesis fenestrada con ramas a ambas arterias renales (AR), arteria mesentérica superior (AMS) y una escotadura para el tronco celíaco (TC). El otro, portador de AATA de 5,9 cm de diámetro, un puente aorto bifemoral previo y TC crónicamente ocluido; se repara con endoprótesis fenestrada con ramas para las AR y AMS. Ambos pacientes presentaron una evolución post operatoria favorable. El seguimiento a 11 meses para el primero y 30 días para el segundo demuestra exclusión del aneurisma y permeabilidad de todas las arterias revasculari-zadas. Este nuevo procedimiento terapéutico abre la posibilidad de tratar pacientes de alto riesgo, portadores de aneurismas aórticos complejos, para los que una alternativa convencional implica un alto riesgo quirúrgico. In the last decade endovascular repair of infrarenal aortic aneurysms (EVAR) has become increasingly popular. However, until recently patients with juxtarenal abdominal aortic aneurysms (JAAA) or with thoracoabdominal aortic aneurysms (TAA) were not candidates for EVAR due to the lack of an adequate landing zone to deploy the endograft. Because of considerable morbidity and mortality that traditional open surgery of these aneurysms entail, new endografts with fenestrations and branches have been developed to treat these patients. We present our initial experience with two cases, both male with coronary artery disease considered high-risk for traditional open repair. The first patient has a 4.1 cm sacular JAAA; it is repaired with a fenestrated endograft with branches for both renal arteries (RA), superior mesenteric artery (SMA) and a scallop for the celiac trunk (CT). The second patient has a 5.9 cm TAA with a previous aorto bifemoral bypass; because the CT is chronically occluded it is repaired with a fenestrated endograft with branches for both RA and SMA. In both patients post operative course was uneventful. Follow-up at 11 months and 30 days respectively, show adequate exclusion of the aneurysm with patency of all revascularized vessels. This new therapeutic procedure allows treatment of high-risk patients with complex aortic aneurysms in whom conventional repair entails a prohibitive surgical risk.

Open and endovascular surgery are therapeutic alternatives for the treatment of abdominal aortic aneurism. The development of guidelines for its treatment requires a thorough analysis of available evidence to recommend the best treatment for each country's reality. Prospective randomized trials have shown best initial results with endovascular surgery, with higher hospital costs than open surgery. The requirement of anatomical suitability for the placement of endovascular prostheses limits the universal use of endovascular surgery. Moreover, this type of surgery needs a strict imaging and clinical follow up due to the high rates of late complications, which range from 20% to 40%. Many of these complications require further surgical interventions, elevating costs of treatment. The initial benefit of endovascular surgery is lost during long follow up as survival curves become similar to those of open surgery. Even for patients with a high surgical risk, the benefits of endovascular surgery are doubtful.

Background: Inferior vena cava (IVC) filters are used to prevent massive pulmonary embolism in cases where anticoagulation is contraindicated or has failed. It is usually implanted below the renal veins. In a few cases it is necessary to deploy the filter above them, with theoretical rísk of secondary renal failure. Aim: To report the experience with filters located above the renal veins. Patients and Methods: Medical records of all patients with percutaneous suprarenal filters are reviewed. Results: Between May 1993 and May 2007, 361 percutaneous IVC filter procedures were performed. In thirty patients aged 19 to 77 years (average 48years, 50% males), they were placed in suprarenalposition (8,3%). Suprarenal IVC filters were implanted in patients with extensive caval thrombosis, renal vein thrombosis extending to cava, displacement of previous IVC filters and double IVC system. Jugular vein approach was the access of choice. Technical success was 100%, no death or pulmonary embolism occurred. Patients were followed from 1 to 165 months (average 57 months). Eight deaths were recorded, five in patients with cáncer No patient had renal failure on follow up (average creatinine 0.90+0,26 mg/dL). Three patients developed a new deep vein thrombosis (10%), without pulmonary embolism. Conclusions: In this retrospective analysis of patients, suprarenal placement of IVC filters was not associated to secondary renal failure, and showed good short and long term results.

Background: Dissections that involve the ascending aorta are classified as type A, regardless of the site of the primary intimal tear, and all other dissections as type B. Type B dissections can have fatal ischemic and hemorrhagic complications. In the chronic state, dilatation and rupture can be mortal. Endovascular surgery is a therapeutic alternative, considering the high rate of complications of conventional surgery Aim: To report the results of endovascular treatment of type B aortic dissection. Material and methods: Report of 36 treated patients (30 males) aged 43 to 87 years, with a type B aortic dissection. Seventy eight percent were hypertensive and 39% smoked. The diagnosis was conñrmed by CAT sean. Acute patients were treated for complications and chronic patients, for dilatation. In the operating room, an endoprothesis was placed through the femoral artery, to cover the tear. The tear was located and the lumens were differentiated using angiography and transesophageal echocardiography. Results: All procedures were successful. In 16 acute dissections the indications were malperfusion syndrome or unmanageable hypertension in seven patients and imminent rupture or persistent pain in nine. Twenty chronic patients were operated due to dilatation (mean 6 cm). One patient died due to cardiac failure. One patient had a transient paraparesia and two had pulmonary embolism. No patient died in a follow up períod ranging from 2.5 to 74 months. Four patients required a new aortic endovascular procedure due to progressive dilatation or endoleak. Conclusión: Endovascular treatment of type B aortic dissection has good immediate andlong term results.

Introducción: La reparación endovascular de aneurismas abdominales e ilíacos requiere de la introducción de dispositivos de alto calibre (> 16 F) mediante denudación de arterias femorales. Mediante una variación técnica, el sistema de sutura arterial percutanea Prostar-XL® (Abbott, EEUU) permite el acceso arterial percutaneo evitando la denudación. Objetivo: Analizar la experiencia inicial en el tratamiento percutaneo de aneurismas del territorio aorto-ilíaco. Material y Método: Revisión de las historias clínicas y base de datos de pacientes tratados con sutura arterial percutanea, entre octubre de 2003 y abril de 2008. Resultados: Tratamos 22 pacientes con esta técnica (20 hombres y 2 mujeres). Dieciséis portadores de aneurisma aórtico abdominal, 3 aneurismas ilíacos, 2 reparaciones de endofuga y un aneurisma hipogástrico. La edad promedio fue 72,6 años (rango 56-86). Se utilizó el sistema Prostar XL® para sutura percutanea en 37 arterias femorales. La anestesia más utilizada fue peridural en el 50% de los pacientes. En 7 casos (31,8%) se efectuó la operación exclusivamente con anestesia local. El diámetro de los dispositivos de endoprótesis fue de 16 a 23 F. Se obtuvo éxito técnico en 34 cierres (92%). Tres arterias requirieron reparación quirúrgica tradicional. No hubo mortalidad operatoria. Durante el seguimiento (promedio 12,6 meses, rango 1-53) no se registraron falsos aneurismas femorales ni infección. Discusión: El cierre percutaneo en la reparación endovascular de aneurismas aorto-ilíacos es un procedimiento mínimamente invasivo, seguro y efectivo, que permite eventualmente el uso de anestesia local. Introduction: Endovascular repair of aortic (AAA) and iliac artery aneurysms requires introduction and deployment of large bore devices (> 16 F) through surgical exposure of the femoral artery. The Prostar XL ® arterial suture system allows the introduction of such devices without the need for surgical exposure. Aim: To report our initial experience with percutaneous arterial closure during aneurysm endografting. Methods: We reviewed records and datábase of patients treated with this technique between October2003 and April 2008. Results: We treated 22 patients with this technique (20 men and 2 women, average age 72 years). Sixteen had AAA, 3 iliac artery aneurysm, 1 hypogastric aneurysm and two for endoleak repair. The percutaneous closure device was used in 37 femoral arteries. In 7 patients (31,8%) the operation was completed entirely under local anaesthesia. The diameter of the devices ranged between 16 and 23 F. Technical success was obtained in 34 arteries (92%). Three arteries required surgical repair due to inadequate haemostasis (sheaths 18, 21, and 21 F). There was no operative mortality. During follow-up (mean 12,6 months, range 1-53) no false aneurysm or infection at the puncture site has been registered and the patients remain free of complications. Discussion: Percutaneous arterial closure in endovascular aneurysm repair is a safe, minimally invasive and effective procedure which allows resolving theses serious conditions in selected patients.

Background: Carotid body tumors arise from a cellular conglomerate located at the carotid bifurcation. Progressive enlargement can involve the arterial wall and neighbor cranial nerves. Aim: To report a series of 10 patients treated of carotid body tumors and review national experience. Patients and methods: Between 1984 and 2006, we operated 8 women and 2 men, aged 19 to 75 years, with this type of tumor. Results: The most common cause for consultation was a cervical mass in 90%, with a mean evolution lapse of 13.2 months (range 3 to 126). In all cases, diagnosis was confirmed with angiographic imaging and histopathology. Ten tumors were surgically removed with no complications. Eighty percent of tumors were in stage II according to Shamblin classification. During long term follow up all patients have remained asymptomatic. Only 31 carotid body tumors have been reported in Chilean medical literature during a 43 year period. Conclusions: Paragangliomas of the carotid body can be diagnosed in clinical grounds, requiring vascular imaging. These infrequent lesions are generally benign, early surgical removal by surgeons with vascular expertise avoids neurological and or vascular complications

Surgical treatment of thoracoabdominal aneurysms is a big technical challenge with a high rate of complications and mortality. It requires a large exposure and transient interruption of vital organ perfusion during its repair. Endovascular repair is a less invasive alternative available over the last decade. We report four male patients aged 44 to 76 years, with thoracic aortic aneurysms and involvement of visceral aorta, treated with a two stage procedure. During the first stage, a retrograde revascularization of the superior mesenteric and renal arteries from the infrarenal aorta was done, associated in two cases to a concomitant repair of an infrarenal aortic aneurysm. In the second stage, an endovascular graft was placed through the femoral artery, from the segment proximal to the aneurysm to the infrarenal aorta, above the origin of the visceral artery reconstructions, excluding the aneurysm from circulation. In one patient, both stages were concomitant and in three the second stage was delayed. One patient presented a postoperative bleeding that required reintervention without adverse consequences. No patient died, presented paraplegia or deterioration of renal function. After follow up of 6 to 20 months, there is no evidence of aneurysm growth or complications derived from the procedure

Background: Endovascular repair of abdominal aortic aneurysms (AAA) avoids laparotomy, shortens hospital stay and reduces morbidity and mortality related to surgical repair, allowing full patient recovery in less time. Aim: To report short and long term results of endovascular repair of AAA in 80 consecutive patients treated at our institution. Patients and Methods: Between September 1997 and February 2005, three women and 77 men with a mean age 73.6±7.7 years with AAA 5.8±1.0 cm in diameter, were treated. The surgical risk of 38% of patients was grade III according to the American Society of Anesthesiologists classification. Each procedure was performed in the operating room, under local or regional anesthesia, with the aid of digital substraction angiography. The endograft was deployed through the femoral artery (83.7% bifurcated, 16.3% tubular graft). A femoro-femoral bypass was required in 11.3% of cases. Follow-up included a spiral CT scan at 1, 6 and 12 months postoperatively, and then annually. Results: Endovascular repair was successfully completed in 79/80 patients (98.7% technical success). The procedures lasted 147±71 min. Length of stay in the observation unit was 20.6±13.5 h. Blood transfusion was required in 10%. Sixty two percent of the patients were discharged before 72 h. One patient died 8 days after surgery due to a myocardial infarction (1.3%). During follow-up (3-90 months), 1 patient developed late AAA enlargement due to a type I endoleak, requiring a new endograft. No AAA rupture was observed. Survival at 4 years was 84.2% (SE =9.2). Endovascular re-intervention free survival was 82.7% (SE =9.5). Conclusion: Endovascular surgery allows effective exclusion of AAA avoiding progressive enlargement and/or rupture and is a good alternative to open repair. Close and frequent postoperative follow up is mandatory

Background: Mortality of traumatic aortic lesions is over 80%. A group of those who survive, develop a chronic pseudo aneurism, usually asymptomatic, that is detected during imaging studies. Since conventional surgical treatment of traumatic aortic lesions has a great mortality, endovascular treatment has been used as an alternative treatment in the last decade. Aim: To report our experience with endovascular treatment of traumatic aortic lesions. Patients and methods: Report of seven patients aged 22 to 65 years, with traumatic aortic lesions. Under general anesthesia an endovascular prosthesis was inserted through the femoral artery. Results: No complications were observed in the postoperative period, and after a follow up ranging from 4 to 40 months, no endoleaks or other complications have been detected. Conclusions: Endovascular treatment of traumatic aortic lesions has good immediate and midterm results

Abdominal aortic aneurysms (AAA) may be lethal unless appropriately and timely treated. Since age is a surgical risk, octogenarians are usually not considered as candidates for surgical intervention. Aim: To asses surgical complications and mortality in octogenarians treated for AAA. Subjects and Methods: Patients aged 80 years older, treated consecutively between 1984-2001 were retrospectively analyzed. Results: Sixty one patients were male, and their age ranged from 80 to 95 years. All were treated with open surgery. The operation was elective in 58 and as an emergency in 22 patients (symptomatic or ruptured AAA). Aortic diameter was 6.8±1.4 cm in asymptomatic patients and 7.7±1.8 cm in emergency cases (p=0.024). Thirty days postoperative mortality was 5.1% in elective surgery compared to 40.6% in emergency operations (p

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 (Rev Méd Chile 2003; 131: 741-7)

Background: The natural history of aneurysms ends in rupture and death. In 1990 the first endovascular exclusion of an aneurysm, using an endoluminal graft implanted through the femoral arteries was performed. More recently, the same procedure has been used for aneurysms of the thoracic aorta. Aim: To report our experience with endovascular treatment of thoracic aorta aneurysms. Material and methods: Analysis of 14 patients (nine male), aged 30 to 79 years, treated between May 2001 and August 2002. Results: The mean diameter of the aneurysms was 6.9 cm. The etiology was atherosclerotic in nine patients. The Excluder device (Goreâ) was preferentially used. There was no operative mortality or paraplegia. One patient had a transient leg monoparesis that reverted completely. No patient had type I endoleaks. Two patients had type II endoleaks on discharge, that sealed spontaneously. In a follow up, ranging from 2 to 17 months, one patient died of a bronchopneumonia and no aneurysm rupture has been detected. Conclusions: The short term results of endoluminal treatment of thoracic aorta aneurysms are excellent. This treatment is less invasive and has less complications than conventional surgery (Rev Méd Chile 2003; 131: 617-22)

The traditional treatment of traumatic lesions of the aortic arch branches requires extended surgical exposures, not exempt of morbidity and mortality. Over the last decade, devices that allow a minimally invasive treatment, have been developed. The vessel can be repaired without direct exposure, using an endovascular procedure. We report three patients with traumatic pseudoaneurysms of the left subclavian, brachiocephalic and left common carotid arteries, respectively. All lesions were successfully repaired with the insertion of an endograft. Although long term results of these procedure are unknown, repair of a future stenosis or occlusion is less complicated than the treatment required by the original lesion. Endoluminal repair appears as a safe, efficient and less invasive treatment for these lesions. (Rev Méd Chile 2002; 130: 1027-32)

The traditional treatment of traumatic lesions of the aortic arch branches requires extended surgical exposures, not exempt of morbidity and mortality. Over the last decade, devices that allow a minimally invasive treatment, have been developed. The vessel can be repaired without direct exposure, using an endovascular procedure. We report three patients with traumatic pseudoaneurysms of the left subclavian, brachiocephalic and left common carotid arteries, respectively. All lesions were successfully repaired with the insertion of an endograft. Although long term results of these procedure are unknown, repair of a future stenosis or occlusion is less complicated than the treatment required by the original lesion. Endoluminal repair appears as a safe, efficient and less invasive treatment for these lesions. (Rev Méd Chile 2002; 130: 1027-32)

In 1991, a technique to exclude aortic aneurysms from circulation inserting an endoluminal graft through the femoral artery, was described. This procedure, usually used for elective abdominal aneurysms, can also be used in the thoracic aorta. We report a 41 years old male with a Marfan syndrome, presenting with a descending aorta aneurysm that ruptured to the mediastinum and pleural cavity. He was compensated hemodynamically and an endovascular stent-graft was deployed at the ruptured zone, through the femoral artery. The postoperative evolution of the patient was uneventful. This technique will allow a less invasive treatment of ruptured aortic aneurysms (Rev Méd Chile 2001; 129: 1439-43)

The treatment of superior vena cava syndrome is usually oriented to the underlying cause, that can be too slow in emergency cases. We report a 49 years old woman with a multiple myeloma that was admitted due to a superior vena cava syndrome caused by a central venous catheter used for chemotherapy for 20 weeks. She was successfully treated with thrombolysis, angioplasty and stent placement. The patient died 7 months later due to the underlying disease. Long term catheters are the responsible for 20 to 30% of superior vena cava syndromes. Endovascular treatment of the syndrome is successful in 60 to 100% of cases with a symptomatic relapse in 4 to 45% of patients. (Rev Méd Chile 2001; 129: 421-6)

The treatment of superior vena cava syndrome is usually oriented to the underlying cause, that can be too slow in emergency cases. We report a 49 years old woman with a multiple myeloma that was admitted due to a superior vena cava syndrome caused by a central venous catheter used for chemotherapy for 20 weeks. She was successfully treated with thrombolysis, angioplasty and stent placement. The patient died 7 months later due to the underlying disease. Long term catheters are the responsible for 20 to 30% of superior vena cava syndromes. Endovascular treatment of the syndrome is successful in 60 to 100% of cases with a symptomatic relapse in 4 to 45% of patients. (Rev Méd Chile 2001; 129: 421-6)