Jornal Vascular Brasileiro最新文献

{"title":"Brazilian Society of Angiology and Vascular Surgery guidelines on peripheral artery disease.","authors":"Fabiano Luiz Erzinger, Afonso César Polimanti, Daniel Mendes Pinto, Gustavo Murta, Marcus Vinicius Cury, Ricardo Bernardo da Silva, Rodrigo Bruno Biagioni, Sergio Quilici Belckzac, Edwaldo Edner Joviliano, Walter Junior Boin de Araujo, Julio Cesar Peclat de Oliveira","doi":"10.1590/1677-5449.202300592","DOIUrl":"10.1590/1677-5449.202300592","url":null,"abstract":"<p><p>Patients with peripheral artery disease and generalized atherosclerosis are at high risk of cardiovascular and limb complications, affecting both quality of life and longevity. Lower limb atherosclerotic disease is associated with high cardiovascular morbidity and mortality and adequate management is founded on treatments involving patient-dependent factors, such as lifestyle changes, and physician-dependent factors, such as clinical treatment, endovascular treatment, or conventional surgery. Medical management of peripheral artery disease is multifaceted, and its most important elements are reduction of cholesterol level, antithrombotic therapy, control of arterial blood pressure, control of diabetes, and smoking cessation. Adhesion to this regime can reduce complications related to the limbs, such as chronic limb-threatening ischemia, that can result in amputation, and the systemic complications of atherosclerosis, such as stroke and myocardial infarction.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20230059"},"PeriodicalIF":0.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-sectional, multicenter study comparing sex differences in patients undergoing endovascular repair of infrarenal abdominal aortic aneurysms. Results from the São Paulo State University Provincial Hospitals Registry (RHEUNI).","authors":"Regina Moura, Edwaldo Edner Joviliano, Ana Terezinha Guillaumon, Selma Regina de Oliveira Raymundo, Ludwig Hafner, Marcone Lima Sobreira, Marcelo José de Almeida, Daniel Gustavo Miquelin, Martin Geiger, Winston Bonetti Yoshida","doi":"10.1590/1677-5449.202400042","DOIUrl":"10.1590/1677-5449.202400042","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic aneurysms (AAA) are 4-6 times more frequent among men than among women, but prognosis tends to be worse in women.</p><p><strong>Objective: </strong>To compare endovascular procedures to repair infrarenal AAA in men and women, using data from a prospective registry.</p><p><strong>Methods: </strong>This registry collected data from five university hospitals in the state of São Paulo (Brazil) from 2012 to 2022. A cross-sectional study was conducted compiling demographic data, anatomic variables (aneurysm diameter, short neck, angulated neck, calcified neck, or thrombosed neck; distal neck < 1.5 cm, and tortuous, abnormal iliac arteries), complications (leaks, conversions, and patency or stenosis of branches) and renal failure and mortality at 30 days. The chi-square test and Student's <i>t</i> test were applied with a 5% significance level. The study was approved by the Ethics Committee (process 4040-2011).</p><p><strong>Results: </strong>A total of 152 (15.9%) of the patients were women and 799 (84.0%) were men (p < 0.05). The majority were white (80.2% of the women and 87.4% of the men). Diabetes and hypertension were significantly more frequent among the women. The most prevalent shape was fusiform, particularly among the women (95.39% vs. 89.86% among men). Mean diameter was smaller among the women (5.96 cm vs. 6.49 cm; p = 0.0056). The iliac arteries were less often involved among the women (89.40% vs. 73.58%; p = 0.00001). Blood loss was greater in the men (321.40 ml vs. 168.84 ml among the women; p < 0.05). Operative mortality was similar in both sexes, but obstructions were more frequent among the women (15.2% vs. 13.51%; p = 0.017296).</p><p><strong>Conclusions: </strong>Aneurysmal diameter was smaller and obstructive complications were more frequent among women.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20240004"},"PeriodicalIF":0.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the efficacy of endovascular treatment with foam sclerotherapy for pelvic congestion syndrome with ultrasound assessment.","authors":"Natália Miranda Gava, Amanda Santana Silva, Gustavo Sasso Benso Maciel, Márcia Porto Assis, Carlos André Daher Santos","doi":"10.1590/1677-5449.202301782","DOIUrl":"10.1590/1677-5449.202301782","url":null,"abstract":"<p><strong>Background: </strong>Pelvic Congestion Syndrome is an important cause of pelvic pain in adult women, leading to reduced quality of life, absenteeism from work, anxiety, depression, and sexual disorders.</p><p><strong>Objectives: </strong>To evaluate the response to endovascular treatment for pelvic varicose veins using foam sclerotherapy and outline the profile of patients with this diagnosis followed up at the Hospital das Clínicas Cassiano Antônio Moraes, Universidade Federal do Espírito Santo, Brazil.</p><p><strong>Methods: </strong>Based on review of medical records, this retrospective descriptive study analyzes the profile and response of patients undergoing endovascular treatment for pelvic varicose veins by foam sclerotherapy. The variables analyzed include age, weight, height, body mass index, parity, pelvic pain complaints, ultrasound criteria comparing the diameter of pelvic vessels before and after the procedure, and presence of venous reflux on transvaginal Doppler ultrasound.</p><p><strong>Results: </strong>The sample of patients analyzed had an average age of 43.3 years old, a mean of 2.95 gestations, and a mean BMI of 25.37kg/m². Ultrasound assessment after the intervention indicated a statistically significant reduction (<i>p</i>-value < 0.005) in the caliber of the parauterine vessels, with mean diameters of 6.34 mm on the right and 7.26 mm on the left before the procedure and 4.37 mm and 4.56 mm respectively afterwards.</p><p><strong>Conclusions: </strong>Foam sclerotherapy reduced the caliber of pelvic varicose veins in the study sample. The results were similar to those of other endovascular treatment methods for this comorbidity. Further prospective studies to assess the response to this intervention are necessary to establish it as an effective option for treatment of pelvic congestion syndrome.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20230178"},"PeriodicalIF":0.8,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of penetrating injuries of the retrohepatic vena cava: systematic review protocol.","authors":"Adenauer Marinho de Oliveira Góes, Simone de Campos Vieira Abib, Gustavo Henrique Dumont Kleinsorge, Daniella Adrea Araujo Rossi Vieira, Luis Carlos Uta Nakano","doi":"10.1590/1677-5449.202400032","DOIUrl":"https://doi.org/10.1590/1677-5449.202400032","url":null,"abstract":"<p><p>Injuries to the retrohepatic segment of the inferior vena cava require complex procedures, as exposure without prior vascular control can lead to uncontrollable and fatal bleeding. To achieve such control, the classic techniques of hepatic vascular exclusion and the implantation of an atriocaval shunt have been described, and more recently, endovascular strategies have been reported. However, there is no consensus in the literature regarding which of these strategies is associated with lower mortality. In order to determine which therapeutic strategy presents the lowest mortality and complication rates in the treatment of penetrating injuries to the retrohepatic segment of the inferior vena cava, a systematic review of the literature will be conducted, registered on the PROSPERO platform under the number CRD42023464133. The Cochrane Handbook for Systematic Reviews of Interventions will guide the process. Searches will be carried out in the MEDLINE/PubMed, LILACS, Embase, Scopus, and Web of Science databases. ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP) will be consulted to detect ongoing or unpublished trials. Studies will be selected based on a predefined search strategy, the number of results will be filtered using the Rayyan app, and the studies included will be independently reviewed by two authors to reach a final consensus. The qualitative analysis of the studies will be conducted using the RoB 1.0 tool.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20240003"},"PeriodicalIF":0.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to 1064 nm Nd:YAG LASER in treatment of vulvar Fordyce's Angiokeratoma: case report.","authors":"Cláudia Carvalho Sathler-Melo, Daniel Mendes-Pinto, Guilherme de Castro-Santos","doi":"10.1590/1677-5449.202301212","DOIUrl":"https://doi.org/10.1590/1677-5449.202301212","url":null,"abstract":"<p><p>Fordyce's Angiokeratoma (AKF) is a benign type of vascular lesion that affects the male and female external genitalia. Prevalence is unknown and there is no apparent hereditary component. Diagnosis can be suggested by ectoscopy, by the presence of purple, bluish, black or red papules on the vulva, clitoris, scrotum, or penis body or glans. Most patients are asymptomatic. Various methods have been used for treatment, including surgery, electrocoagulation, chemical cauterization, sclerotherapy, and LASER. The effectiveness and complications of these therapies are varied. The purpose of this article is to report the case of a 56-year-old woman with abundant and painful vulvar lesions treated with a 1064 nm Nd:YAG LASER. The 1064 nm Nd:YAG LASER proved to be a viable therapeutic option, with satisfactory results and a low rate of complications.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20230121"},"PeriodicalIF":0.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided mini-incision technique for CHIVA.","authors":"Felipe Puricelli Faccini, Marcelo Halfen Grill","doi":"10.1590/1677-5449.202201572","DOIUrl":"https://doi.org/10.1590/1677-5449.202201572","url":null,"abstract":"<p><p>CHIVA (<i>Cure Conservatrice et Hemodynamique de l'Insuffisance Veineuse en Ambulatoire</i>) is a surgical technique for varicose veins that avoids destroying the saphenous vein and collaterals. In some patients, the flush ligation of saphenous collaterals performed in the CHIVA technique may require more dissection than is desirable. This is especially valid for obese patients and thigh ligations. We report an innovative technique that uses duplex-guided puncture to bring the collateral closer to the skin and reduce the need for dissection and incision. The technique does not change any of the CHIVA principles. While the long-term results are not yet known, we expect them to be similar to normal CHIVA procedures.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20220157"},"PeriodicalIF":0.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urgent endovascular treatment of juxtarenal aneurysm using a parallel grafts technique.","authors":"Fábio Augusto Cypreste Oliveira, Bruno Campos Coelho, Marina Balestra, Juliana Caetano Barreto Cypreste Oliveira, Maria Cunha Ribeiro Amorelli, Davi Douglas Heckmann, Carlos Eduardo de Sousa Amorelli, Fábio Lemos Campedelli","doi":"10.1590/1677-5449.202000282","DOIUrl":"10.1590/1677-5449.202000282","url":null,"abstract":"<p><p>Abdominal aortic aneurysms can constitute a therapeutic challenge in several anatomical scenarios, making endovascular treatment more complex. A juxtarenal abdominal aortic aneurysm (JR-AAA) is defined by the absence of a proximal landing zone in the infrarenal segment and, therefore, techniques must be used to obtain an adequate neck for fixing the endoprostheses without provoking occlusion of renal arteries and visceral branches. The parallel grafts technique, physician-modified stent-graft, industry customized endoprostheses, and off-the-shelf branched endoprosthesis are techniques used in abdominal aneurysms with inadequate proximal neck, but each technique has its indications, limitations, and risks. In this therapeutic challenge, we present a case of urgent endovascular treatment of a JR-AAA using a parallel grafts technique, with good medium-term results, and discuss the therapeutic options.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20200028"},"PeriodicalIF":0.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regarding the article \"Entrustable Professional Activities (EPAs) for the residency program in vascular surgery\".","authors":"Jorge Luis Carrera Martínez","doi":"10.1590/1677-5449.202400072","DOIUrl":"10.1590/1677-5449.202400072","url":null,"abstract":"","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20240007"},"PeriodicalIF":0.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual effects and long-term outcomes of endoscopic lumbar sympathectomy for plantar hyperhidrosis in men: a cross-sectional study.","authors":"Marcelo de Paula Loureiro, Pietro Maran Novais, Ruimário Machado Coelho, João Augusto Nocera Paulin","doi":"10.1590/1677-5449.202400142","DOIUrl":"https://doi.org/10.1590/1677-5449.202400142","url":null,"abstract":"<p><strong>Background: </strong>Plantar hyperhidrosis (PHH) is a disease with high psychosocial impact, and endoscopic lumbar sympathectomy (ELS) has been shown to be the best choice for treatment, but with some concerns such as compensatory sweating (CS) and sexual effects (SE), particularly in men.</p><p><strong>Objectives: </strong>The aim of this study is to evaluate the long-term effectiveness of ELS for controlling PHH in men, its side effects, and perceived sexual modifications.</p><p><strong>Methods: </strong>A cross-sectional study including only male patients operated for PHH with ELS between 2014-2022 at a private practice. During remote interviews, patients were asked about symptoms before and after ELS and about the postoperative effects on PHH. They were also objectively asked about any SE during the postoperative period. Validated quality of life for hyperhidrosis and erectile function questionnaires were also administered.</p><p><strong>Results: </strong>10 male patients averaging 4.26±2.86 years post-ELS were interviewed. Eight of them (80%) achieved complete response (≥80% of sweat reduction) in the first month after surgery and this response was maintained up to the interview date. Two patients had partial response. In six patients, CS occurred, with 5 reporting it as non-troublesome. Six patients reported some type of SE, but none reported erectile dysfunction. Regarding the functional results, all patients rated ELS from good (10%) to very good (30%) or excellent (60%).</p><p><strong>Conclusions: </strong>Endoscopic lumbar sympathectomy was effective for treatment of plantar hyperhidrosis in these patients, improving their quality of life and providing lasting PHH control, with some transient sexual dysfunctions that did not impair their sexual life.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20240014"},"PeriodicalIF":0.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignant transformation of a long-term ulcer in a patient with leprosy sequelae: a case report.","authors":"Aline Gabriele Etur Dos Santos, Antônio Augusto Moreira","doi":"10.1590/1677-5449.202400442","DOIUrl":"https://doi.org/10.1590/1677-5449.202400442","url":null,"abstract":"<p><p>Marjolin's ulcer (MU) is a rare condition defined as a malignant skin tumor arising from chronic wounds and inflammation. The most common histological findings in MUs are squamous cell carcinomas (SCC) (or spinocellular carcinomas [SPC]), such as basal cell carcinomas (BCC) and malignant melanomas (MM). The aim of this study is to report the case of a patient with sequelae of leprosy who presented malignant transformation in a long-standing ulcer on the right leg, thereby contributing to understanding of the progression and significance of early diagnosis of MU. The MU was diagnosed by incisional biopsy of the lesion and upon obtaining a positive result the patient was referred to an oncology service. Treatment of MU is multidisciplinary and surgical excision is the first therapeutic option. Proper management and surveillance of chronic ulcers by the healthcare team are necessary for early recognition of MU.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20240044"},"PeriodicalIF":0.8,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}