Jornal Vascular Brasileiro最新文献

{"title":"Venous thoracic outlet syndrome in the presence of cervical rib: report of two cases.","authors":"Juliana Borges Oliveira Cano, Talita Caroline de Oliveira Valentino, Alexandre Maierá Anacleto, Augustus Cézar Polimeno, Márcia Maria Morales","doi":"10.1590/1677-5449.202501112","DOIUrl":"10.1590/1677-5449.202501112","url":null,"abstract":"<p><p>Thoracic outlet syndrome is a rare condition caused by the compression of neurovascular structures in the region between the neck and chest. The venous form accounts for 2% to 3% of cases, with deep vein thrombosis most often caused by compression of the subclavian-axillary vein segment between the first rib and the clavicle. The occurrence of a cervical rib as a cause of venous deep vein thrombosis is even rarer. In this report, we present the diagnosis, treatment, and outcome of 2 cases of venous deep vein thrombosis resulting from 2 different mechanisms. The approach was based on a review of the literature on venous thoracic outlet syndrome and cervical rib.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250111"},"PeriodicalIF":1.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216336","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":"Lipedema in a male patient: familial evidence and clinical response to nutritional intervention - case report.","authors":"Michelle Kaefer, Bruna Candia Piccoli, Sabrina Fontana de Andrade, Laura Eduarda de Oliveira, Ighor Seiji Okumura Tioda, Luisa Buhse Pasqualoto, Clóvis Paniz, José Antonio Mainardi de Carvalho","doi":"10.1590/1677-5449.202502102","DOIUrl":"10.1590/1677-5449.202502102","url":null,"abstract":"<p><p>Lipedema is a chronic adipose tissue disorder that predominantly affects women, although some rare cases do occur in men. We report the case of a 32-year-old man with symmetrical, lower-limb fat accumulation, foot sparing, pain, easy bruising, and a positive family history of lipedema. His first-degree female cousin exhibited the classic phenotype. Dual-energy X-ray absorptiometry demonstrated greater fat accumulation in the gynoid than in the android and visceral regions, reinforcing a predominantly gluteofemoral adiposity pattern. The patient underwent a 7-month personalized nutritional intervention consisting of a moderately hypocaloric, high-protein, low-glycemic diet with vitamin D supplementation and regular physical activity. This intervention was associated with reductions in anthropometric measurements and decreased pain scores on a Visual Analogue Scale. Laboratory tests revealed a preserved hypothalamic-pituitary-gonadal axis, except for mild idiopathic hyperprolactinemia that normalized during follow-up. This case highlights lipedema in men and the potential benefits of early lifestyle-based interventions.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250210"},"PeriodicalIF":1.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216284","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":"A fresh look at extended-duration anticoagulation after venous thromboembolism.","authors":"Suzanna Maria Viana Sanches, Monique Magnavita Borba da Fonseca Cerqueira, Marcos Arêas Marques","doi":"10.1590/1677-5449.202601062","DOIUrl":"10.1590/1677-5449.202601062","url":null,"abstract":"","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20260106"},"PeriodicalIF":1.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216292","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":"CREST-2 and ECST-2: are we selecting the right patients?","authors":"Marcone Lima Sobreira, Ricardo Augusto Carvalho Lujan","doi":"10.1590/1677-5449.202601332","DOIUrl":"10.1590/1677-5449.202601332","url":null,"abstract":"","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20260133"},"PeriodicalIF":1.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216312","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":"Vena cava filter placement during pregnancy: a therapeutic challenge.","authors":"Mateus Alves Borges Cristino, Ronald Luiz Gomes Flumignam, Gustavo Braga Murta, Marcos Arêas Marques","doi":"10.1590/1677-5449.202600712","DOIUrl":"10.1590/1677-5449.202600712","url":null,"abstract":"<p><p>Pulmonary embolism (PE) is the leading cause of maternal death during the antepartum-postpartum cycle in developed countries. The diagnosis of venous thromboembolism during pregnancy is complicated by the physiological changes that occur during gestation. Management with anticoagulants is the treatment of choice, while endovascular interventions are reserved for exceptional cases. We report a case of placement of a removable inferior vena cava filter (IVCF) in a pregnant woman with left iliofemoral venous thrombosis during latent labor. After delivery, the IVCF was successfully removed with no maternal or fetal complications and anticoagulation was resumed. Considering the risks associated with IVCFs in pregnant women, their use should be restricted to cases with formal contraindications to anticoagulation and high risk of PE. Additional precautions minimize fetal radiation exposure. The decision to place an IVCF during pregnancy is complex and requires interdisciplinary discussion. Further research is needed to assess its impact.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20260071"},"PeriodicalIF":1.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216274","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":"Evaluation of a clinical score to predict post-sclerotherapy hyperpigmentation compared with the Skin Hyperpigmentation Index: a prospective Skin Code study.","authors":"Renata Camila Barros Rodrigues, Samantha Neves, Eduardo Ramacciotti, Viviane Santana da Silva, Roberto Augusto Caffaro, Flávia Magalhães Silveira Magella Oliveira, Alexandre Fioranelli, Rebeca Higino Becker","doi":"10.1590/1677-5449.202501082","DOIUrl":"10.1590/1677-5449.202501082","url":null,"abstract":"<p><p>Post-sclerotherapy hyperpigmentation (PSH) is a common complication following sclerotherapy for telangiectasias and reticular veins. However, tools for pre-procedural prediction of PSH are limited, making pre-treatment identification of patients at greater risk a challenge. This research aimed to evaluate a clinical scoring system (Skin Code Score) designed to estimate the individual risk of PSH. A prospective, single-center, single-arm study was conducted. Adult female patients with telangiectasias and reticular veins were treated and evaluated for pigmentation risk using the Skin Code Score (range, 2-12 points). Hyperpigmentation was assessed at baseline and on day 30 by in-person evaluation performed by one vascular surgeon, complemented by photographic analysis conducted independently by two other vascular surgeons and one dermatologist. Skin Hyperpigmentation Index (SHI) measurements were used for objective correlation with the Skin Code Score. The Skin Code Score showed strong interobserver agreement and reproducibility (κ ≥ 0.85). Diagnostic accuracy ranged from 82.8% to 94.7% among evaluators. A score of 12 predicted PSH in up to 99.8% of cases, while a score of 8 indicated a probability of approximately 76%. The study was limited by a small sample size and its single-center design; a proportion of the assessments were conducted by photographic analysis. It is concluded that the Skin Code Score is a simple and reproducible tool for predicting PSH and could assist clinicians with pre-procedural risk stratification, patient counseling, and clinical decision-making.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250108"},"PeriodicalIF":1.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216341","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":"Case-control study on the association of angiotensin-converting enzyme gene I/D <i>rs</i>4646944 single nucleotide polymorphism and young-onset cryptogenic ischemic stroke in an Algerian cohort.","authors":"Mohamed Lebsir, Mohamed Larbi Rezgoun, Boubekeur Saddik Fekraoui, Brahim Djoudi, Yasmina Boukhenaf, Amina Ines Bernou, Karima Sifi","doi":"10.1590/1677-5449.202501422","DOIUrl":"10.1590/1677-5449.202501422","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have shown a link between the angiotensin-converting enzyme (ACE) and ischemic stroke. Cryptogenic ischemic stroke is the most commonly recorded form of ischemic stroke among young adults. The insertion/deletion (I/D) variant of <i>ACE</i> (<i>rs</i>4646994) has been linked to ischemic stroke.</p><p><strong>Objectives: </strong>We examined the potential correlation between this single nucleotide polymorphism and cryptogenic ischemic stroke in young adults.</p><p><strong>Methods: </strong>This case-control study included 42 young adults (< 50 years of age) diagnosed with cryptogenic ischemic stroke according to the TOAST classification, along with 42 healthy controls from the general population. The vascular risk factors included hypertension, diabetes mellitus, dyslipidemia, smoking, and cardiovascular diseases. Genomic deoxyribonucleic acid was extracted, and the <i>ACE rs</i>4646994 polymorphism was examined using polymerase chain reaction.</p><p><strong>Results: </strong>Younger age (p = 0.004) and female sex (p = 0.007) were significantly connected to an increased risk of stroke, contrasting with typical stroke demographics. Hypertension (p <i>=</i> 0.002) and smoking (p <i>=</i> 0.04) emerged as important, modifiable risk factors. There was no notable distinction between patients and controls regarding the frequencies of alleles and genotypes of the <i>ACE</i> I/D single nucleotide polymorphism (p > 0.05). These results were not associated with cryptogenic ischemic stroke.</p><p><strong>Conclusions: </strong>While aligning with the current literature, our results are constrained by the limited sample size, the case-control design, and the dependence on self-reported data, which could have led to bias. This genetic study of a population from eastern Algeria did not show a link between the <i>ACE</i>I/D single nucleotide polymorphism and cryptogenic ischemic stroke.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250142"},"PeriodicalIF":1.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216271","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":"Ruptured left gastric artery aneurysm presenting with life-threatening intraperitoneal hemorrhage: a rare vascular emergency.","authors":"Ayman Hassan Khamis Alserr, Mohammad Salem Amer, Malak Mohsin Almarhoun, Mansoor Cherumkuzhiyil Abdulla","doi":"10.1590/1677-5449.202502172","DOIUrl":"10.1590/1677-5449.202502172","url":null,"abstract":"<p><p>Visceral artery aneurysms are rare, with left gastric artery aneurysms representing a small proportion. Most are asymptomatic and incidentally detected, but rupture can lead to life-threatening intra-abdominal hemorrhage. We report a 50-year-old male presenting with sudden epigastric pain and hypovolemic shock. Imaging revealed a ruptured left gastric artery aneurysm with active bleeding and extensive hemoperitoneum. Emergency laparotomy with aneurysm excision and vessel ligation was performed successfully. The patient's postoperative course was uneventful, and follow-up imaging showed no residual aneurysm. This case underscores the need for early recognition and prompt surgical intervention to improve outcomes in this rare condition.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250217"},"PeriodicalIF":1.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216262","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":"Efficacy and safety of adipose tissue-derived cell therapy in the treatment of chronic extremity ulcers: a systematic review and meta-analysis of randomized controlled trials.","authors":"Edenilson de Souza Teixeira, Vanessa Ellen Silva Carmo, Hideki Zimermann Kamitani, Johnnatas Mikael Lopes, Sydney Correia Leão, Carlos Alberto de Lima Botelho, Pedro Pereira Tenório","doi":"10.1590/1677-5449.202501392","DOIUrl":"10.1590/1677-5449.202501392","url":null,"abstract":"<p><strong>Context: </strong>Chronic extremity ulcers represent a major clinical challenge. Adipose-derived stem cells (ADSCs) have emerged as a promising therapeutic option for wound healing; however, their efficacy and safety remain incompletely established.</p><p><strong>Objectives: </strong>To evaluate the efficacy and safety of ADSCs compared with conventional treatment.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of 11 randomized clinical trials involving 474 patients was conducted. Outcomes included healing rate, mean healing time, pain-related outcomes, and safety. Odds ratios (ORs) and weighted mean differences were used as summary effect measures.</p><p><strong>Results: </strong>Complete healing rates were significantly higher in the ADSC group than in the conventional treatment group (84.2% vs. 49.0%; OR 5.77; p < 0.00001). Healing time was reduced by 19.39 days on average in ADSC group (p = 0.0004). No statistically significant differences were observed regarding pain outcomes or complication rates (p = 0.22<b>).</b></p><p><strong>Conclusion: </strong>ADSC therapy increased healing rates and shortened healing time in patients with chronic extremity ulcers, with no evidence of a significant increase in treatment-related risks. However, the heterogeneity of the findings and the limited sample size highlight the need for studies with greater statistical power and methodological standardization to confirm these results.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250139"},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216259","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":"Topical oxybutynin antiperspirant for axillary hyperhidrosis: a phase IIb PROBE design clinical trial (TODAY trial).","authors":"Samantha Neves, Elisete Isabel Crocco, Viviane Santana da Silva, Felipe Menegueti, Alexia Paganotti, Ricardo Sanchez Boix, Nelson Wolosker, Roberto Augusto Caffaro","doi":"10.1590/1677-5449.20250065","DOIUrl":"10.1590/1677-5449.20250065","url":null,"abstract":"<p><strong>Background: </strong>Primary hyperhidrosis is a chronic condition with limited therapeutic options.</p><p><strong>Objectives: </strong>To evaluate the impact of 10% oxybutynin spray on axillary hyperhidrosis, considering both its local and systemic effects, in terms of Hyperhidrosis Disease Severity Scale (HDSS) outcomes for hyperhidrosis of the axilla and eight additional sites.</p><p><strong>Methods: </strong>Prospective phase II PROBE design trial. Adult patients with axillary hyperhidrosis were randomized to receive a 10% oxybutynin topical spray, oral oxybutynin, or placebo spray for 35 days. Efficacy was evaluated on day 35 using the HDSS and a hyperhidrosis-specific quality-of-life (QoL) assessment questionnaire.</p><p><strong>Results: </strong>17 patients were randomized. No significant differences were observed in HDSS outcomes from baseline to day 35 in any of the three groups (2.5 [2 - 4], 4 [3 - 4], 3.5 [3 - 4], p= 0.207), although a trend to improvement was noted in both treatment groups. Significant improvement in the QoL questionnaire was observed from baseline to day 35 in the oxybutynin spray group (pre-intervention QoL: 78.5 [70 - 96] and post-intervention QoL: 38.5 [32 - 67], p = 0.031).</p><p><strong>Conclusions: </strong>No differences were observed in the primary outcome. A significant improvement from baseline to day 35 was observed in the QoL questionnaire score for the oxybutynin spray group.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250065"},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216317","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}