Browsing by Author "Quizhpe Rivera, Arturo Ricardo"

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    Angioplastia primaria con trombectomía versus angioplastia primaria convencional en pacientes con infarto agudo del miocardio con elevación del segmento s-t. Hospital José Carrasco Arteaga. Cuenca, 2009- 2016
    (Universidad de Cuenca, 2018-11-11) Calle Samaniego, Edison Damian; Quizhpe Rivera, Arturo Ricardo; Morales Sanmartín, Jaime Rodrigo
    BACKGROUND During primary angioplasty (PA) in patients with ST-segment elevation myocardial infarction (STEMI), intracoronary thrombi may embolize into the microcirculation and increase the size of infarction, a phenomenon that can be reduced by thrombectomy, however recent studies have not shown improvement in coronary reperfusion and major clinical events, so its routine use is controversial. METHOD A sample of 206 patients with STEMI from the registry of the Ecuadorian Institute of Social Security, 107 in the PA with thrombectomy group and 99 in the PA conventional group, were included. The objective was to compare coronary reperfusion (ST-segment resolution, final TIMI 3 flow, no reflow and recovery of the left ventricular ejection fraction) and major clinical events (cardiac death, non-cardiac death, perforation, stent thrombosis, stroke, major bleeding, reinfarction, cardiogenic shock, emergency revascularization, NYHA 4 heart failure) at 30 days. During the analysis we used chi squared, analysis of variance, relative risk and confidence interval (CI) 95% and a level of significance <0.05. RESULTS The ST-segment resolution ocurred in 29.9% of patients in the PA with thrombectomy group versus 43.3% in the PA conventional group (RR 0.68, 95% CI: 0.47-0.99, P: 0 , 04). Death from cardiac causes ocurred in 4.7% of patients in the AP with thrombectomy group versus 13.1% in the PA conventional group (RR 0.35, 95% CI: 0.13 - 0.96 P: 0.032). The other parameters of reperfusion and major clinical events did not have difference. CONCLUSIONS Thrombectomy was not associated with improvement in coronary reperfusion however it decreased cardiac death.
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    Implante de nueve stents farmacológicos para el tratamiento de una paciente diabética con enfermedad coronaria multiarterial
    (Universidad de Cuenca. Facultad de Ciencias Médicas, 2010-04) Quizhpe Rivera, Arturo Ricardo; Maldonado, Galo; Abizaid, Alexandre; Ribamar Costa, Jose de; Souza nunez, Paulo Márcio; Ferez, Fausto; Mattos, Luis Alberto; Sousa, Amanda; Sousa, J. Eduardo; Staico, Rodolfo
    The incidence of diabetes mellitus has continuously risen in the recent years. Patients with this chronic condition have a higher risk to develop coronary artery disease. Unfortunately, due to the frequent diffuse involvement of multiple vessels, the long term outcomes after percutaneous intervention, either with catheter-balloon or bare metal stent, has always been poor and frequently inferior to cardiac surgery in this subset of patients. Recently, the introduction of drug-eluting stents (DES) has brought enthusiasm to treat percutaneously patients with more complex disease. In this manuscript we report a successful percutaneous approach of an insulin dependent diabetic patient treated with multiple DES (Taxus™, Boston Scientific).