Jornal Vascular Brasileiro最新文献

{"title":"Prognostic factors for femoropopliteal vascular injuries: surgical decisions matter","authors":"Adenauer Marinho de Oliveira Góes Junior, Fernanda Beatriz Araújo de Albuquerque, Matheus Oliveira Feijó, Flávia Beatriz Araújo de Albuquerque, Luciana Roberta do Vale Corrêa, Mariseth Carvalho de Andrade","doi":"10.1590/1677-5449.202300502","DOIUrl":"https://doi.org/10.1590/1677-5449.202300502","url":null,"abstract":"Abstract Background Lower limbs are frequently involved in vascular trauma, but it is still not clear which factors lead to unfavorable clinical outcomes. Objectives To determine the clinical profile of patients with femoropopliteal injuries, the trauma mechanisms, and treatment and identify which factors led to unfavorable outcomes. Methods A retrospective study based on the medical records of patients treated from 2017 to 2021. The following data were assessed: sex, age, distance to reach the hospital, trauma mechanism, hypovolemic shock, additional injuries, treatment of vascular injuries, whether fasciotomy was needed, inappropriate intraoperative decisions, and injury severity score. Need for surgical reintervention, amputation, and death were defined as unfavorable outcomes. Univariate, bivariate, and logistic regression analyses were conducted. Results The sample comprised 94 patients; 83% were men; mean age was 30.8 years; combined arterial and venous injuries prevailed (57.5%); and superficial femoral vessels were the most affected (61.7%). Penetrating mechanisms prevailed (80.9%). Arterial injuries were most frequently treated with venous graft (59.6%) and venous injuries underwent ligation (81.4%). In 15% of cases, inappropriate surgical decisions were detected; most often use of the ipsilateral great saphenous vein for arterial reconstruction. Unfavorable outcomes occurred in 44.7%: surgical reintervention was necessary in 21.3% and limb amputation in 25.5%, while 9.5% of the patients died. Conclusions These injuries mainly involved young men, victims of gunshot wounds. Superficial femoral vessels were the most injured; concomitant non-vascular trauma was frequent, mainly fractures. Inappropriate surgical decisions increased the need for reinterventions by 34 times. Need for fasciotomy, presence of fracture/dislocation, blunt trauma mechanism, and popliteal artery injury increased the risk of amputation.","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135658967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazilian guidelines on diagnosis and management of traumatic vascular injuries","authors":"Adenauer Marinho de Oliveira Góes Junior, José Gustavo Parreira, Gustavo Henrique Dumont Kleinsorge, Marcelo Bellini Dalio, Pedro Henrique Ferreira Alves, Francisco João Sahagoff de Deus Vieira Gomes, Walter Junior Boim de Araujo, Edwaldo Edner Joviliano, Julio Cesar Peclat de Oliveira","doi":"10.1590/1677-5449.202300422","DOIUrl":"https://doi.org/10.1590/1677-5449.202300422","url":null,"abstract":"Abstract Trauma is a leading cause of death, permanent disability, and health care cost worldwide. The young and economically active are the most affected population. Exsanguination due to noncompressible torso hemorrhage is one of the most frequent causes of early death, posing a significant challenge to trauma and vascular surgeons. The possibility of limb loss due to vascular injuries must also be considered. In recent decades, the approach to vascular injuries has been significantly modified. Angiotomography has become the standard method for diagnosis, endovascular techniques are currently incorporated in treatment, and damage control, such as temporary shunts, is now the preferred approach for the patients sustaining physiological derangement. Despite the importance of this topic, few papers in the Brazilian literature have offered guidelines on vascular trauma. The Brazilian Society of Angiology and Vascular Surgery has developed Projetos Diretrizes (Guideline Projects), which includes this publication on vascular trauma. Since treating trauma patients is a multidisciplinary effort, the Brazilian Trauma Society (SBAIT) was invited to participate in this project. Members of both societies reviewed the literature on vascular trauma management and together wrote these guidelines on vascular injuries of neck, thorax, abdomen, and extremities.","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135260825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines on vascular access for hemodialysis from the Brazilian Society of Angiology and Vascular Surgery","authors":"Leonardo de Oliveira Harduin, Thiago Almeida Barroso, Julia Bandeira Guerra, Marcio Gomes Filippo, Leonardo Cortizo de Almeida, Guilherme de Castro-Santos, Fabio Augusto Cypreste Oliveira, Douglas Eduardo Tavares Cavalcanti, Ricardo Jayme Procopio, Eduardo Cavalcanti Lima, Matheus Eduardo Soares Pinhati, Jose Maciel Caldas dos Reis, Barbara D’Agnoluzzo Moreira, Adriano Martins Galhardo, Edwaldo Edner Joviliano, Walter Junior Boim de Araujo, Julio Cesar Peclat de Oliveira","doi":"10.1590/1677-5449.202300522","DOIUrl":"https://doi.org/10.1590/1677-5449.202300522","url":null,"abstract":"Abstract Chronic kidney disease is a worldwide public health problem, and end-stage renal disease requires dialysis. Most patients requiring renal replacement therapy have to undergo hemodialysis. Therefore, vascular access is extremely important for the dialysis population, directly affecting the quality of life and the morbidity and mortality of this patient population. Since making, managing and salvaging of vascular accesses falls within the purview of the vascular surgeon, developing guideline to help specialists better manage vascular accesses for hemodialysis if of great importance. Thus, the objective of this guideline is to present a set of recommendations to guide decisions involved in the referral, evaluation, choice, surveillance and management of complications of vascular accesses for hemodialysis.","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135261019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurofibromatosis type 1, fibromuscular dysplasia, and ischemic stroke: an association lost in time? A case report.","authors":"Igor Oliveira da Fonseca,&nbsp;Gustavo José Luvizutto,&nbsp;Isaac Pantaleão Souza,&nbsp;André Petean Trindade,&nbsp;Carlos Clayton Macedo de Freitas,&nbsp;Rodrigo Bazan,&nbsp;Gabriel Pinheiro Modolo","doi":"10.1590/1677-5449.202201182","DOIUrl":"https://doi.org/10.1590/1677-5449.202201182","url":null,"abstract":"<p><p>Neurofibromatosis Type 1 (NF1) is a rare cause of ischemic stroke (IS) in the general population. We report a case of a young patient with NF1 in whom IS was caused by fibromuscular dysplasia. An angiographic study demonstrated occlusion in the right internal carotid artery (ICA), just after its origin, and the left ICA, just before the intracranial portion, and brain magnetic resonance imaging showed the limits of an area of brain infarction in the right frontoparietal region. Despite these concomitant neuroimaging findings, this association is rare, and it is difficult to establish the contribution to the outcome made by each of these diseases, which treatment is the best to implement, or what prognosis is.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10259178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9635609","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":"Comparative study of angiographic changes in diabetic and non-diabetic patients with peripheral arterial disease.","authors":"Giovanni Ortale Trainotti,&nbsp;Jamil Victor Mariúba,&nbsp;Matheus Bertanha,&nbsp;Marcone Lima Sobreira,&nbsp;Ricardo de Alvarenga Yoshida,&nbsp;Rodrigo Gibin Jaldin,&nbsp;Paula Angeleli Bueno de Camargo,&nbsp;Winston Bonetti Yoshida","doi":"10.1590/1677-5449.202000531","DOIUrl":"https://doi.org/10.1590/1677-5449.202000531","url":null,"abstract":"<p><strong>Background: </strong>Diabetics are at 5-15 times greater risk of developing peripheral arterial disease (PAD) and few studies have compared risk factors and distribution and severity of arterial changes in diabetics compared with non-diabetics.</p><p><strong>Objectives: </strong>To compare angiographic changes between diabetic and non-diabetic patients with advanced PAD and correlate them with risk factors.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted of consecutive patients undergoing lower limb arteriography for PAD (Rutherford 3-6) using TASC II and Bollinger et al. angiographic scores. Exclusion criteria were upper limb angiographies, unclear images, incomplete laboratory test results, and previous arterial surgeries. Statistical analyses included chi-square tests, Fisher's test for discrete data, and Student's <i>t</i> test for continuous data (significance level: p < 0.05).</p><p><strong>Results: </strong>We studied 153 patients with a mean age of 67 years, 50.9% female and 58.2% diabetics. A total of 91 patients (59%) had trophic lesions (Rutherford 5 or 6) and 62 (41%) had resting pain or limiting claudication (Rutherford 3 and 4). Among diabetics, 81.7% were hypertensive, 29.4% had never smoked, and 14% had a history of acute myocardial infarction. According to the Bollinger et al. score, infra-popliteal arteries were more affected in diabetics, especially the anterior tibial artery (p = 0.005), while the superficial femoral artery was more affected in non-diabetics (p = 0.008). According to TASC II, the most severe angiographic changes in the femoral-popliteal segment occurred in non-diabetic patients (p = 0.019).</p><p><strong>Conclusions: </strong>The most frequently affected sectors were the infra-popliteal sectors in diabetics and the femoral sector in non-diabetics.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9925060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10745500","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":"Atividades Profissionais Confiáveis (APCs) para os programas de residência em cirurgia vascular","authors":"Marcos Aurélio Perciano Borges, Ricardo André Viana Barros, Alcides José Araújo Ribeiro, Vanessa Dalva Guimarães Campos","doi":"10.1590/1677-5449.202300751","DOIUrl":"https://doi.org/10.1590/1677-5449.202300751","url":null,"abstract":"","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136304298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of rare visceral aneurysms on 92,833 CAT scans (2005-2021)","authors":"Sergio Quilici Belczak, Nathalia Almeida Cardoso da Silva, Matheus Toledo Nora, Paula Ribeiro do Prado Chadud, Luciana Helena Benetti, Camila de Freitas Corrêa, Adriano Tchibana, Ricardo Aun","doi":"10.1590/1677-5449.202300742","DOIUrl":"https://doi.org/10.1590/1677-5449.202300742","url":null,"abstract":"Abstract Background Studies on the prevalence of rare visceral aneurysms are still scarce and the few studies that have focused on these aneurysms present prevalence rates in groups of patients with visceral aneurysms, but little is known about their prevalence in the general population. Objectives To assess the prevalence of rare visceral aneurysms on CAT scans performed for diagnosis and follow-up of patients with other vascular pathologies. Methods This cross-sectional study began by accessing all reports from CAT scans performed between January 2005 and July 2021 at a private hospital of excellence located in the city of São Paulo. A software program for pre-indexed reports was used to search the Radiological Information System (RIS) database to identify reports of patients with intra-abdominal aneurysms. Results CAT scan reports from 92,883 patients were accessed. Of these, 2,597 (2.795%) showed intra-abdominal aneurysms, 937 (1.063%) of which were visceral, including 158 (0.171%) rare visceral aneurysms, which were more frequent among male patients and in the following segments: celiac trunk (0.098%), superior mesenteric (0.033%), left gastric (0.010%), pancreatic-duodenal (0.009%), and gastroduodenal arteries (0.005%) and the pancreatic arch (0.004%). Lower prevalence was found in other segments. Additional findings revealed concomitance of rare visceral aneurysms with other intra-abdominal aneurysms ranging from 11.11% to 66.67%. Conclusions The prevalence of rare visceral aneurysms in a large population undergoing CAT scan was 0.171%, with greater involvement in male patients.","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136305562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The emotional impact on patients of venous thromboembolism.","authors":"Alcides José Araújo Ribeiro,&nbsp;Marcos Arêas Marques","doi":"10.1590/1677-5449.202201511","DOIUrl":"https://doi.org/10.1590/1677-5449.202201511","url":null,"abstract":"","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9925058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10745499","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":"Squamous cell carcinoma on an arteriovenous fistula scar: case report.","authors":"Vinicius Tadeu Ramos da Silva Grillo,&nbsp;Pedro Luciano Mellucci,&nbsp;Marina Moraes Lopes Soares,&nbsp;Nathalia Dias Sertorio,&nbsp;Rodrigo Gibin Jaldin,&nbsp;Marcone Lima Sobreira,&nbsp;Eloisa Bueno Pires de Campos,&nbsp;Matheus Bertanha","doi":"10.1590/1677-5449.202200622","DOIUrl":"https://doi.org/10.1590/1677-5449.202200622","url":null,"abstract":"<p><p>The main type of access used for hemodialysis is the arteriovenous fistula (AVF) because it offers superior patency and lower complication rates when compared to other hemodialysis accesses. We report the case of a 69-year-old female patient with chronic kidney disease on dialysis secondary to hypertensive nephrosclerosis with a radiocephalic AVF in the left upper limb created 9 years previously. Two years previously, she had undergone a kidney transplant and was taking immunosuppressants. A crusted lesion developed on her left forearm with onset 3 months before presentation and she underwent an excisional biopsy that revealed a well-differentiated and superficially invasive squamous cell carcinoma, with lateral and deep surgical margins free from neoplasia. At 1-year follow-up, the patient showed no signs of neoplastic recurrence.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9990461","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":"Dunbar syndrome - case report.","authors":"Sarah Maria Lemos de Campos,&nbsp;Rafael Prado Pessoa,&nbsp;João Paulo de Araújo Pelegrini,&nbsp;Henrique Fernandes Silveira,&nbsp;Maria Fernanda Lopes Diniz,&nbsp;Maria Passos Bianchini,&nbsp;Leonardo Soares Lopes,&nbsp;Marcus Eduardo Valadares Meireles Martins da Costa","doi":"10.1590/1677-5449.202300301","DOIUrl":"https://doi.org/10.1590/1677-5449.202300301","url":null,"abstract":"<p><p>Dunbar syndrome is diagnosed by excluding other possible causes of abdominal pains. Surgical treatment comprises complete dissection of the ligament and the surrounding nerve ganglion. This report describes the case of a previously healthy 45-year-old male patient who presented with epigastric abdominal pain irradiating to the back and weakness. Initially, abdominal computed tomography was ordered, showing arteriopathy of the celiac trunk and mesenteric artery with stenosis. The patient underwent surgical treatment because of the refractory pain, but findings were nonspecific. It was necessary to continue workup with serial angiotomography to follow the case. After around 6 months, thickening of the arcuate ligament was found, with compression of the proximal third of the celiac trunk and 80% stenosis. The patient therefore underwent laparoscopy to relieve celiac trunk compression, with satisfactory postoperative recovery.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9999217","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}