Jornal Vascular Brasileiro最新文献

{"title":"A proposal for the classification of early complications during percutaneous central venous access: previous note.","authors":"José da Cruz Moura Campêlo, Luís Gustavo Cavalcante Reinaldo, Alexandre da Costa Machado Matos Terceiro, Ocilio Ribeiro Gonçalves","doi":"10.1590/1677-5449.202501472","DOIUrl":"10.1590/1677-5449.202501472","url":null,"abstract":"<p><p>Central venous access is a common hospital procedure that plays an essential role in many clinical situations. Despite its widespread use, there is no standardized classification for early complications, which limits systematic analysis and development of health indicators. This study aimed to propose an objective and applicable classification for early complications of central venous access, encompassing events related to puncture and catheter positioning. This was a longitudinal observational study conducted at the Universidade Federal do Piauí teaching hospital (HU-UFPI) from October 2024 to April 2025, enrolling patients undergoing central venous access placement by the Clinical Surgery Unit team. Clinical and procedural variables were assessed, including ultrasound guidance, puncture site, catheter positioning, and post-procedure complications. The proposed classification groups complications into five categories: I, IIA, IIB, IIIA, and IIIB. In the sample (n = 35), 85.7% of observed complications were classified as category I, 11.4% as IIA, and 2,9% as IIB, with no major complications observed. The proposed classification appears to be potentially useful for standardizing the description of early complications, although the findings should be interpreted with caution due to the small sample size, absence of major complications, and single-center design.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250147"},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216324","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":"Order of resolution and recurrence of inflammatory symptoms in lipedema: a longitudinal study of 1,300 patients.","authors":"Alexandre Campos Moraes Amato, Juliana Lelis Spirandeli Amato, Daniel Augusto Benitti","doi":"10.1590/1677-5449.202600562","DOIUrl":"10.1590/1677-5449.202600562","url":null,"abstract":"<p><strong>Background: </strong>The Questionário de avaliação sintomática do lipedema (QuASiL - Lipedema Symptom Assessment Questionnaire) assesses 13 distinct inflammatory symptoms of lipedema, but whether these symptoms resolve and recur simultaneously or follow a consistent order remains unknown.</p><p><strong>Objectives: </strong>To characterize the persistence hierarchy of the 13 QuASiL inflammatory symptoms in a retrospective lipedema cohort under heterogeneous conservative treatment, using 6 complementary rank-order analyses and testing the null hypothesis that symptoms resolve with equal magnitude.</p><p><strong>Methods: </strong>This retrospective longitudinal study included 1,300 patients who were clinically diagnosed with lipedema by a vascular surgeon and who completed the QuASiL on at least 2 occasions (minimum 14-day interval; median follow-up 181 days, IQR 92-380, maximum 1,787 days). A consensus ranking was computed across all analyses. A sensitivity analysis was conducted using the conventional <i>T</i> ₀ = first visit, <i>T</i> ₁ = last visit convention, and a Kaplan-Meier survival analysis estimated the time (in absolute days) to ≥ 50% reduction from baseline per symptom.</p><p><strong>Results: </strong>The symptoms did not resolve simultaneously (Friedman χ² (12) = 168.08, p < 0.001). All 13 symptoms improved during follow-up, showing a consistent order across the 6 analyses. A slower-resolving core was identified: bruising (consensus rank 1.7), swelling (2.0), touch sensitivity (4.3), leg heaviness (4.7), and fatigue (4.7). A rapidly-responding group comprised skin irritation (66.4% proportional reduction), itching (62.0%), and walking difficulty (62.6%). Even the most resistant symptom (bruising) achieved a mean 39.1% proportional reduction, with half of patients reaching ≥ 50% improvement. During worsening, swelling and pressure/tension re-emerged first. The sensitivity analysis (T0 = first, T1 = last) produced an essentially identical ranking (Spearman ρ = 0.945, p < 10^-5). The Kaplan-Meier analysis estimated a median of 546 days for bruising vs 207 days for itching to reach ≥ 50% reduction from baseline (log-rank χ2 = 44.6, p < 10^-10); the fastest-resolving symptom was heat/burning at 203 days.</p><p><strong>Conclusions: </strong>In this retrospective cohort of patients under heterogeneous conservative treatment, the 13 QuASiL inflammatory symptoms improved following a consistent order across 6 independent analyses, with bruising and swelling as the most persistent symptoms.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20260056"},"PeriodicalIF":1.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216320","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":"Association between delayed thromboprophylaxis and the incidence of deep vein thrombosis in patients with pelvic trauma: a retrospective cohort adjusted for severity at a level I trauma center.","authors":"Jihad Manaf El Sayed, Guilherme Marum Olmedo, Adilia Maria Pires Sciarra, Lilian Castiglioni, Paulo César Espada","doi":"10.1590/1677-5449.202600402","DOIUrl":"10.1590/1677-5449.202600402","url":null,"abstract":"<p><strong>Background: </strong>Patients with pelvic trauma are at high risk for deep vein thrombosis (DVT), but early initiation of thromboprophylaxis may increase bleeding risk in hemodynamically unstable individuals. The optimal timing for initiation of anticoagulation remains controversial.</p><p><strong>Objectives: </strong>To evaluate whether delayed initiation of pharmacologic prophylaxis is associated with a higher incidence of DVT in patients with pelvic trauma, after adjustment for age and activation of the massive transfusion protocol.</p><p><strong>Methods: </strong>This retrospective observational cohort study was conducted at a Level I trauma center from January 2022 to December 2023. Adult patients with computed tomography-confirmed pelvic trauma who underwent Doppler ultrasonography during hospitalization were included. The primary exposure was initiation of pharmacologic prophylaxis within 48 hours (early) vs. after 48 hours (delayed). The primary outcome was occurrence of DVT during hospitalization. Multivariable logistic regression was conducted, adjusting for age and activation of the massive transfusion protocol.</p><p><strong>Results: </strong>A total of 62 patients were analyzed, with a mean age of 47.71 ± 19.91 years and predominance of male sex (66.1%). The overall incidence of DVT was 32.3% (n=20). In the bivariate analysis, DVT incidence was 35.3% in the delayed group and 28.6% in the early group (p = 0.598). In the multivariable analysis, early initiation was not independently associated with the occurrence of DVT (OR 0.65; 95% CI 0.21-2.00; p = 0.456).</p><p><strong>Conclusions: </strong>Delayed initiation of thromboprophylaxis was not independently associated with a higher incidence of DVT after adjustment for age and activation of the massive transfusion protocol.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20260040"},"PeriodicalIF":1.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216348","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":"Heel-Rise Test for functional assessment in chronic venous insufficiency: a validity study.","authors":"Marina Silva Reis, Keity Lamary Souza Silva, Antonielly Rocha de Souza Pereira, Vivian Camargo Chaves, Stefânia Guimarães Nery, Dalyla Lemos de Souza Silva, Pedro Henrique Scheidt Figueiredo, Henrique Silveira Costa","doi":"10.1590/1677-5449.202501772","DOIUrl":"10.1590/1677-5449.202501772","url":null,"abstract":"<p><strong>Background: </strong>Chronic venous insufficiency (CVI) affects the superficial and/or deep venous system and is often associated with valve abnormalities and calf pump dysfunction, including reduced lower limb strength. Assessment of calf muscle strength should be part of the clinical routine for these patients. The Heel-Rise Test (HRT) has been proposed for this purpose, but its correlation with other functional instruments remains unclear.</p><p><strong>Objectives: </strong>To verify the validity of the HRT for assessment of calf muscle strength and endurance in patients with CVI by comparing it with other functional tests.</p><p><strong>Methods: </strong>Fifty-two patients with CVI (mean age of 67.2±13.2 years, CEAP 1 to 6) were evaluated. All patients undertook the HRT and were instructed to perform maximal plantar flexions until exhaustion. The number of repetitions and the time taken to complete the test were recorded. All Sit-to-Stand test variants (STS5, STS10, STS30, STS60) were also administered. Handgrip dynamometry, the Human Activity Profile (HAP), and the CIVIQ-14 questionnaire were also administered. Correlations were analyzed using Pearson or Spearman tests.</p><p><strong>Results: </strong>HRT repetitions correlated significantly with STS5 (r = -0.676), STS10 (r = -0.701), STS30 (r = 0.691), STS60 (r = 0.697), handgrip dynamometry (r = 0.275), HAP (r = 0.457), and CIVIQ-14 (r = -0.646). However, HRT execution time was not correlated with handgrip dynamometry or CIVIQ-14.</p><p><strong>Conclusions: </strong>The HRT is related to calf muscle strength, endurance, and functionality in patients with CVI and should be used for functional assessment of these patients.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250177"},"PeriodicalIF":1.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216290","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 angioplasty of arteriovenous fistula for hemodialysis: initial experience of a single center.","authors":"Claudia Guimarães Agle, Fábio Luis Barbosa Andrade, Ana Clarice de Carvalho Bacelar, Giovana Pires de Sousa Bonfim, Eduardo Castro de Oliveira, José Siqueira de Araujo","doi":"10.1590/1677-5449.202600222","DOIUrl":"10.1590/1677-5449.202600222","url":null,"abstract":"<p><p>Chronic Kidney Disease is a growing public health concern and arteriovenous fistulas (AVFs) are the preferred type of vascular access for hemodialysis, but venous stenosis can impair their function. Angioplasty is the first-line treatment, but availability is limited on the public health care system. This retrospective study evaluated the feasibility and early outcomes of ultrasound-guided AVF angioplasty performed at a referral center in 2024. Nine patients were recruited and followed for 3 months. Outcomes included technical success, blood flow, venous diameter, complications, and patency. Technical success was achieved in 77.8% of cases, with increased blood flow and venous diameter. Complications occurred in 66.6%, the majority minor hematomas, although two patients developed acute thrombosis. The technique was feasible and improved hemodynamic parameters, although with a non-negligible complication rate.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20260022"},"PeriodicalIF":1.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216302","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":"Carotid artery stenting with dual-layer stent implantation in a patient with complex anatomy.","authors":"Gislaine Dos Santos Rodrigues Vieira, Ana Luiza Feitosa Leite de Souza, Crislayne Dos Santos Rodrigues, João da Silva, Nelson Ogliari Rezende, William Wakasugui, Helen Caroline Magalhães Costa, Vinicius Tadeu Ramos da Silva Grillo","doi":"10.1590/1677-5449.202501192","DOIUrl":"10.1590/1677-5449.202501192","url":null,"abstract":"<p><p>Carotid atherosclerotic disease associated with hemodynamically significant stenosis is a serious condition that requires accurate diagnosis and effective treatment to prevent cardiovascular events such as stroke. Treatment strategies, including carotid angioplasty and carotid endarterectomy, have evolved considerably, providing safer and less invasive therapeutic options. This report describes the case of a male patient with dyslipidemia, hypertension, and coronary artery disease who presented with near-occlusion of the left internal carotid artery caused by a plaque with features of instability. Given the lesion's high embolic potential and the risk of embolization associated with conventional endovascular treatment, a dual-layer micromesh-covered CGuard^TM stent was used in conjunction with a distal embolic protection device. Despite the technical challenges related to the patient's vascular anatomy, the procedure was successfully completed, and the patient experienced a favorable clinical outcome, demonstrating the applicability of this technology in anatomically complex scenarios.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250119"},"PeriodicalIF":1.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944960","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":"Estetrol and its implications for contraception, venous thromboembolism, and breast cancer: an integrative review.","authors":"Marcos Arêas Marques, Suzanna Maria Viana Sanches, Monique Magnavita Borba da Fonseca Cerqueira, Marina Araujo Zulchner, André Luiz Malavasi Longo de Oliveira","doi":"10.1590/1677-5449.20260012","DOIUrl":"10.1590/1677-5449.20260012","url":null,"abstract":"<p><p>Combined oral contraceptives (COCs) provide benefits beyond contraception but are associated with risks such as venous thromboembolism (VTE) and breast cancer. This integrative review aimed to evaluate the efficacy and safety of estetrol (E4)-containing COCs regarding their risk of VTE and breast cancer. The PubMed database was searched for preclinical and clinical studies published through 2025. Data extraction followed a structured protocol, resulting in the inclusion of 15 studies in the review. Available evidence suggests that E4 has limited effects on the liver and the coagulation cascade, in addition to being associated with less breast tissue proliferation compared to other estrogens. However, clinical evidence regarding hard outcomes, including the long-term incidence of VTE and breast cancer, remains limited. Current evidence suggests a promising efficacy and safety profile but remains insufficient to rule out the risks of VTE and breast cancer.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20260012"},"PeriodicalIF":1.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930001","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":"Unilateral unusual branching pattern of the axillary artery: a case report.","authors":"Mamta Bishnoi, Monica Baxla, Swati Yadav, Vidhu Dhawan","doi":"10.1590/1677-5449.20250188","DOIUrl":"10.1590/1677-5449.20250188","url":null,"abstract":"<p><p>The axillary artery is the continuation of the subclavian artery in the upper limb on both the sides of the human body. The axillary artery gives off six branches along with two terminal branches, but manifests various branching patterns, knowledge of which is useful for clinicians. A formalin fixed donated cadaver was used and the axillary region was dissected according to Cunningham's Manual of Practical Anatomy. This case report describes a unilateral common trunk arising from the second part of the axillary artery, giving off lateral thoracic, posterior circumflex humeral, circumflex scapular, and thoracodorsal arteries. The present study also presents an embryological interpretation of the current variation. These variations are accidental findings discovered during dissection, but knowledge of them is useful for clinicians performing any surgical procedures in the axillary region.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250188"},"PeriodicalIF":1.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930082","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":"Successful management of anastomotic false aneurysm after a femoro-popliteal bypass with percutaneous injection of fibrin sealant.","authors":"Thilina Gunawardena, Nuwan Anupama, Feros Mohomed","doi":"10.1590/1677-5449.20250241","DOIUrl":"10.1590/1677-5449.20250241","url":null,"abstract":"<p><p>Anastomotic false aneurysms are rare after autologous vein bypass. However, such lesions have the potential for life or limb-threatening complications, and their management can be extremely challenging. Here, we describe a 62-year-old male patient who developed a false aneurysm at the proximal anastomosis after a femoro-popliteal bypass. His left upper limb cephalic vein had been used as the conduit. The false aneurysm was successfully managed by percutaneous injection of fibrin sealant. This report aims to highlight this rare complication and its successful percutaneous management, with preservation of the bypass graft.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250241"},"PeriodicalIF":1.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930055","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":"Combined treatment with Nd:YAG laser and polidocanol foam sclerotherapy in venous malformation of the hand: case report.","authors":"Helena de Oliveira Santos, Genaro Fahrnholz Buonsante, Marina Araujo Zulchner, Marcos Arêas Marques","doi":"10.1590/1677-5449.202501902","DOIUrl":"10.1590/1677-5449.202501902","url":null,"abstract":"<p><p>Venous malformations of the hand represent a clinical and therapeutic challenge due to anatomical complexity and functional and aesthetic impact. We report the case of a 13-year-old female patient with a venous malformation of the hand, treated with a combined approach using Nd:YAG 1064 nm transdermal laser and 1% polidocanol foam sclerotherapy. The combination of photocoagulation and sclerotherapy proved safe and effective in a superficial and localized lesion. This case underscores the relevance of combined therapy as a minimally invasive alternative for venous malformations of the hand, highlighting the importance of individualized treatment according to lesion location, depth, and extent.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250190"},"PeriodicalIF":1.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684555","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}