{"id":1065499,"date":"2025-12-15T22:50:23","date_gmt":"2025-12-15T19:50:23","guid":{"rendered":"https:\/\/analyse.optim.biz\/?p=1065499"},"modified":"2025-12-15T22:50:23","modified_gmt":"2025-12-15T19:50:23","slug":"salvarea-unei-paciente-octogenare-de-la-amputatie-majora-la-spitalul-arcadia","status":"publish","type":"post","link":"https:\/\/analyse.optim.biz\/?p=1065499","title":{"rendered":"Salvarea unei paciente octogenare de la amputa\u021bie major\u0103, la Spitalul Arcadia"},"content":{"rendered":"<div class=\"entry-content\">\n<p>\u00a0<\/p>\n<div id=\"attachment_317867\" class=\"wp-caption alignright\"><img decoding=\"async\" aria-describedby=\"caption-attachment-317867\" loading=\"lazy\" class=\"size-medium wp-image-317867\" src=\"https:\/\/analyse.optim.biz\/wp-content\/uploads\/2025\/12\/iacob-lucian-300x197-1.png\" width=\"300\" height=\"197\" title=\"iacob-lucian-300x197-1\"><\/p>\n<p id=\"caption-attachment-317867\" class=\"wp-caption-text\"><a href=\"https:\/\/www.arcadiamedical.ro\/echipa-medicala\/iacob-lucian\"><strong>Dr. Lucian Iacob<\/strong><\/a><strong>, medic specialist Chirurgie vascular\u0103, Fellow al Boardului European de Chirurgie Vascular\u0103, <\/strong><a href=\"http:\/\/www.arcadiamedical.ro\"><strong>Arcadia<\/strong><\/a><\/p>\n<\/div>\n<p><a href=\"https:\/\/www.arcadiamedical.ro\/medinfo\/boala-arteriala-periferica-aterosclerotica-pe-intelesul-fiecarui-pacient\"><strong>Boala arterial\u0103 periferic\u0103<\/strong><\/a> (BAP) este o afec\u021biune circulatorie grav\u0103, care apare atunci c\u00e2nd vasele (arterele) care alimenteaz\u0103 membrele inferioare cu s\u00e2nge bogat \u00een oxigen se \u00eengusteaz\u0103 (stenozeaz\u0103) sau se blocheaz\u0103 (trombozeaz\u0103). Aceasta determin\u0103 o sc\u0103dere semnificativ\u0103 a fluxului sanguin, duc\u00e2nd la <strong>durere, r\u0103ni care nu se vindec\u0103 \u0219i, \u00een cazurile severe, la gangren\u0103.<\/strong><\/p>\n<p>Afec\u021biunea este mai <strong>frecvent\u0103 la persoanele \u00een v\u00e2rst\u0103 \u0219i la cele cu<\/strong><strong>factori de risc precum diabetul, fumatul, hipertensiunea, obezitatea \u0219i sedentarismul.<\/strong><\/p>\n<p>\u00a0<\/p>\n<p><strong>O interven\u021bie salvatoare pentru o pacient\u0103 octogenar\u0103, la Spitalul Arcadia<\/strong><\/p>\n<p>O pacient\u0103 octogenar\u0103 a fost diagnosticat\u0103 cu <strong>boal\u0103 arterial\u0103 periferic\u0103 \u00een stadiul 4<\/strong> \u2013 cel mai avansat stadiu al afec\u021biunii. Aceasta prezenta <strong>multiple leziuni necrotice la nivelul gambei \u0219i piciorului,<\/strong> semne clare c\u0103 \u021besuturile nu mai primeau suficient s\u00e2nge, <strong>pacienta risc\u00e2nd amputa\u021bia major\u0103.<\/strong><\/p>\n<p>\u00a0<\/p>\n<p><strong>Angiografia CT<\/strong> a ar\u0103tat <strong>multiple zone de tromboz\u0103 a arterelor de la nivelul membrului inferior,<\/strong> a\u0219adar at\u00e2t segmente femuro-poplitee, c\u00e2t \u0219i tibiale. Practic, vasele erau blocate din cauza \u00eengro\u0219\u0103rii progresive a peretelui arterial de-a lungul anilor, iar fluxul c\u0103tre picior era extrem de redus.<\/p>\n<p>\u00a0<\/p>\n<p><strong>De ce o interven\u021bie minim-invaziv\u0103 \u00een cel mai avansat stadiu al bolii arteriale periferice?<\/strong><\/p>\n<p>\u00cen contextul multiplelor comorbidit\u0103\u021bi \u2013 afec\u021biuni asociate care cresc riscurile unei interven\u021bii chirurgicale clasice \u2013 pe care le prezenta pacienta, s-a ales <strong>o abordare endovascular\u0103, o metod\u0103 minim-invaziv\u0103 care presupune navigarea prin vasele de s\u00e2nge cu ajutorul unor ghiduri \u0219i catetere, sub control imagistic.<\/strong><\/p>\n<p>Prin aceast\u0103 tehnic\u0103, am reu\u0219it <strong>deblocarea mai multor segmente trombozate \u0219i restabilirea fluxului sanguin<\/strong> c\u0103tre zonele afectate. Interven\u021bia a fost realizat\u0103 cu <strong>anestezie local\u0103<\/strong> \u0219i o <strong>incizie milimetric\u0103,<\/strong> astfel av\u00e2nd un <strong>risc mult mai sc\u0103zut dec\u00e2t o opera\u021bie deschis\u0103.<\/strong><\/p>\n<p>\u00a0<\/p>\n<p><strong>Rezultatul: vindecarea bolii arteriale periferice \u00een stadiu avansat, f\u0103r\u0103 amputa\u021bie<\/strong><\/p>\n<p>Dup\u0103 doar c\u00e2teva s\u0103pt\u0103m\u00e2ni post-interven\u021bie, pacienta a prezentat o <strong>vindecare aproape complet\u0103<\/strong> a leziunilor cutanate. Circula\u021bia arterial\u0103 \u00eembun\u0103t\u0103\u021bit\u0103 a permis regenerarea \u021besuturilor \u0219i <strong>evitarea unei amputa\u021bii majore<\/strong> \u2013 din p\u0103cate, o realitate \u00een stadiul avansat al afec\u021biunii.<\/p>\n<p><strong>Aceast\u0103 evolu\u021bie pozitiv\u0103 arat\u0103 clar beneficiile pe care le pot aduce tehnicile minim-invazive \u00een tratamentul bolii arteriale periferice, \u00een special \u00een cazul pacien\u021bilor v\u00e2rstnici \u0219i fragili.<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"aligncenter size-large wp-image-317868\" src=\"https:\/\/analyse.optim.biz\/wp-content\/uploads\/2025\/12\/dr-iacob-lucian_imagine-corp-articol-1024x887-1.png\" width=\"1024\" height=\"887\" title=\"dr-iacob-lucian_imagine-corp-articol-1024x887-1\"><\/p>\n<p>\u00a0<\/p>\n<p><strong>De ce este important s\u0103 recunoa\u0219tem simptomele bolii arteriale periferice?<\/strong><\/p>\n<p>Boala arterial\u0103 periferic\u0103 debuteaz\u0103 adesea cu <strong>simptome \u201et\u0103cute\u201d sau u\u0219or de ignorat:<\/strong><\/p>\n<ul>\n<li>durere sau crampe la nivelul gambelor \u00een timpul mersului (claudica\u021bie intermitent\u0103);<\/li>\n<li>piele palid\u0103 sau cu tent\u0103 alb\u0103struie;<\/li>\n<li>r\u0103ni sau ulcera\u021bii care nu se vindec\u0103, \u00een special la degete sau c\u0103lc\u00e2i;<\/li>\n<li>\u00een cazuri avansate, necroz\u0103 sau gangren\u0103.<\/li>\n<\/ul>\n<p><strong>Depistarea timpurie este esen\u021bial\u0103.<\/strong> Un consult la medicul specialist \u00een chirurgie vascular\u0103 poate identifica afec\u021biunea \u00een faze incipiente, c\u00e2nd tratamentul este adeseori mai simplu \u0219i mai eficient.<\/p>\n<p>\u00a0<\/p>\n<p><strong>Tratamentul bolii arteriale periferice nu presupune \u00eentotdeauna opera\u021bie clasic\u0103<\/strong><\/p>\n<p>Tratamentul principal const\u0103 \u00een primul r\u00e2nd \u00een <strong>optimizarea factorilor de risc<\/strong> (exemplu: renun\u021bat la fumat) \u0219i <strong>mers pe jos<\/strong> zilnic, minimum o or\u0103 sau minimum 10.000 de pa\u0219i.<\/p>\n<p>\u00cen al doilea r\u00e2nd, vom ad\u0103uga \u0219i un <strong>tratament medicamentos,<\/strong> ce nu poate restabili un flux sanguin printr-un vas blocat, dar scade procentul de complica\u021bii \u2013 cum sunt infarctul miocardic, accidentul vascular cerebral \u0219i amputa\u021bia de membru.<\/p>\n<p>La cele dou\u0103 metode de tratament non-chirurgicale (conservatoare), se recomand\u0103 \u00een stadii avansate \u0219i cel <strong>chirurgical<\/strong> (denumit general \u201erevascularizare arterial\u0103\u201d). Acesta poate fi <strong>deschis (clasic), minim-invaziv (endovascular) sau o combina\u021bie \u00eentre cele dou\u0103 (hibrid).<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>Tehnicile endovasculare<\/strong> se remarc\u0103 \u00een portofoliul chirurgului vascular prin faptul c\u0103 pot fi o alternativ\u0103 eficient\u0103 cu riscuri minime. Acestea includ:<\/p>\n<ul>\n<li>balonare \u0219i dilatare a arterelor \u00eengustate (angioplastie cu balon);<\/li>\n<li>montare de stenturi pentru a men\u021bine vasele deschise;<\/li>\n<li>tromboliz\u0103 sau aspira\u021bie a cheagurilor;<\/li>\n<li>aterectomii sau litotri\u021bii;<\/li>\n<li>proceduri combinate, adaptate fiec\u0103rui pacient.<\/li>\n<\/ul>\n<p>\u00a0<\/p>\n<p><strong>Speran\u021b\u0103 prin inova\u021bie: tratamentul endovascular<\/strong><\/p>\n<p>Cazul acestei paciente octogenare ne arat\u0103 c\u0103 v\u00e2rsta nu este o condamnare, iar progresele \u00een chirurgia vascular\u0103 pot oferi solu\u021bii salvatoare minim-invazive chiar \u0219i \u00een cazuri complexe. <strong>Tratamentele endovasculare pot preveni suferin\u021ba, amputa\u021biile \u0219i chiar salva vie\u021bi<\/strong> \u2013 cu condi\u021bia ca afec\u021biunea s\u0103 fie corect diagnosticat\u0103 \u0219i tratat\u0103 la timp.<\/p>\n<p>\u00a0<\/p>\n<p>Dac\u0103 ave\u021bi dureri la mers sau r\u0103ni care nu se vindec\u0103, nu le ignora\u021bi. Consulta\u021bi un medic specialist \u00een chirurgie vascular\u0103. Pentru program\u0103ri, ave\u021bi la dispozi\u021bie num\u0103rul de telefon <strong>0232 920, Call Center Arcadia.<\/strong><\/p>\n<p><a href=\"http:\/\/www.arcadiamedical.ro\">www.arcadiamedical.ro<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u00a0 Dr. Lucian Iacob, medic specialist Chirurgie vascular\u0103, Fellow al Boardului European de Chirurgie Vascular\u0103, Arcadia Boala arterial\u0103 periferic\u0103 (BAP) este o afec\u021biune circulatorie grav\u0103, care apare atunci c\u00e2nd vasele (arterele) care alimenteaz\u0103 membrele inferioare cu s\u00e2nge bogat \u00een oxigen se \u00eengusteaz\u0103 (stenozeaz\u0103) sau se blocheaz\u0103 (trombozeaz\u0103). Aceasta determin\u0103 o sc\u0103dere semnificativ\u0103 a fluxului sanguin, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1065500,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[89],"tags":[174],"class_list":["post-1065499","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-romania","tag-suceavanews-ro"],"_links":{"self":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts\/1065499","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1065499"}],"version-history":[{"count":0,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts\/1065499\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/media\/1065500"}],"wp:attachment":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1065499"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1065499"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1065499"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}