Jornal Vascular Brasileiro最新文献

{"title":"Triple abdominal vascular compression: coexistence of Dunbar syndrome, Wilkie syndrome, and Nutcracker phenomenon: a case report and literature review.","authors":"Bárbara Dieck-Gutiérrez, Juan Carlos Gómez-Rodríguez, Oscar Gabriel Villamizar-Blanco, Mauricio Carlos Durango-Tirado, Wilber Edison Peña-Niño, Gabriel Arroyave-Uribe, Hernán Dario Restrepo-Restrepo, Andrés Cadavid-Congote","doi":"10.1590/1677-5449.202501632","DOIUrl":"10.1590/1677-5449.202501632","url":null,"abstract":"<p><p>Median arcuate ligament syndrome (Dunbar syndrome) is characterized by compression of the celiac trunk, causing postprandial abdominal pain and ischemic symptoms. Superior mesenteric artery syndrome (Wilkie's syndrome) results from narrowing of the aortomesenteric angle, leading to duodenal obstruction and weight loss. Nutcracker phenomenon, in turn, consists of compression of the left renal vein between the aorta and the superior mesenteric artery. While each of these entities are individually uncommon, their coexistence in a single patient is exceptionally rare and poses significant diagnostic and therapeutic challenges. We report the case of a young woman diagnosed simultaneously with all three conditions who was successfully managed through a surgical approach. Diagnostic methods and therapeutic options are discussed, highlighting the importance of maintaining a high index of suspicion for the timely and appropriate management of these uncommon compressive syndromes.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250163"},"PeriodicalIF":1.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684597","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":"The role of physical therapy in the treatment of lipedema: an integrative review of therapeutic strategies and the current clinical landscape.","authors":"Débora Aparecida Oliveira Modena, Jaqueline Munaretto Timm Baiocchi, Elaine Caldeira de Oliveira Guirro","doi":"10.1590/1677-5449.202501962","DOIUrl":"10.1590/1677-5449.202501962","url":null,"abstract":"<p><p>Lipedema is a chronic disorder characterized by a disproportionate accumulation of subcutaneous adipose tissue in the extremities, typically sparing the hands and feet. It is commonly associated with pain, hypersensitivity, easy bruising, edema, and fibrotic nodules. Despite growing awareness, there is still no consensus on evidence-based therapeutic approaches. This integrative review aimed to identify physical therapy strategies described in the scientific literature for the assessment and conservative management of lipedema. Searches were conducted in the PubMed/MEDLINE, BVS, PEDro, Embase, and Cochrane databases, followed by critical appraisal and evidence synthesis, with applicable PRISMA-ScR checklist items used as a reporting guide for the study selection process. The findings indicate that physical therapy plays a key role in conservative treatment, particularly through complete decongestive therapy, compression therapy, exercise, manual therapy, and electrophysical agents. These interventions show potential benefits in reducing pain, improving functional capacity, controlling edema, and preventing disease progression. However, the available evidence remains limited, underscoring the need for more robust clinical trials to support evidence-based physical therapy practice in the treatment of lipedema.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250196"},"PeriodicalIF":1.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684585","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":"Use of point-of-care ultrasound in the analysis of arterial abnormalities in people with chronic kidney disease on hemodialysis: a cross-sectional study.","authors":"Adson Aragão de Araújo Santos, Hellen de Carvalho Lima, Beatriz Vitória Carvalho Lordêlo, Romero Henrique de Almeida Barbosa, Ana Luisa Silveira Vieira, Matheus Rodrigues Lopes, Adirlene Pontes de Oliveira Tenório","doi":"10.1590/1677-5449.202500362","DOIUrl":"10.1590/1677-5449.202500362","url":null,"abstract":"<p><strong>Background: </strong>Individuals with chronic kidney disease (CKD) have twice the risk of peripheral arterial disease (PAD) and are more susceptible to arterial calcification. Diagnosing arterial abnormalities involves a combination of clinical assessment and noninvasive tests. The ankle-brachial index (ABI) is a cost-effective method for assessing arterial abnormalities and predicting mortality. Continuous Doppler ultrasound is the gold standard for ABI assessment due to its greater accuracy, and point-of-care ultrasound (POCUS) enables bedside measurement of this index.</p><p><strong>Objectives: </strong>To analyze the prevalence of arterial abnormalities in individuals undergoing hemodialysis using POCUS.</p><p><strong>Methods: </strong>We conducted an observational, analytical, cross-sectional study of 85 patients on hemodialysis, using a clinical and sociodemographic questionnaire and calculating the ABI. The primary outcome was the analysis of the presence of arterial abnormalities through the measurement of ABI using the POCUS method..</p><p><strong>Results: </strong>The prevalence of ABI results suggestive of PAD and arterial calcification was 24.7% and 22.4%, respectively. Diabetes mellitus (p = 0.02) and advanced age (p = 0.01) were identified as the main risk factors for PAD.</p><p><strong>Conclusions: </strong>The POCUS-assisted assessment identified a prevalence of 24.7% for PAD and 22.4% for arterial calcification among patients with CKD. Advanced age and diabetes mellitus were the main risk factors associated with PAD. The data suggest that POCUS is an innovative approach for the bedside diagnosis of arterial abnormalities in patients on hemodialysis.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250036"},"PeriodicalIF":1.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678677","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":"Venous thromboembolism in hospitalized patients with COVID-19: clinical and laboratory characteristics at three tertiary care centers in a state capital in the Eastern Amazon.","authors":"Ester Almeida Carneiro Rodrigues da Silva, Adson Kevin Cunha Negidio, Tiago de Oliveira Vieira, Thais Pinheiro Almeida Dos Santos, Luiz Felipe Santiago Bittencourt, Paulo Martins Toscano","doi":"10.1590/1677-5449.202500762","DOIUrl":"10.1590/1677-5449.202500762","url":null,"abstract":"<p><strong>Background: </strong>To date, the COVID-19 pandemic constitutes the greatest health care challenge of the century. Its central pathophysiology involves an infectious respiratory disease caused by the SARS-CoV-2 virus with potential in the most severe cases to provoke cardiovascular complications, including venous thromboembolism (VTE).</p><p><strong>Objectives: </strong>This study describes the clinical and laboratory characteristics of hospitalized patients with VTE confirmed during a COVID-19 infection.</p><p><strong>Methods: </strong>This is an observational, longitudinal, and retrospective analytical study based on review of the medical records of patients admitted to three tertiary centers in the capital of Pará state, Brazil, with VTE diagnosed by imaging. Epidemiological and laboratory data were collected retrospectively at each health center, covering the period starting when the first case of COVID-19 was recorded and ending in July 2021.</p><p><strong>Results: </strong>VTE cases were recorded in 1.30% of medical records, with percentages varying from 0.60% to 2.25% at the different centers. Mean age, C-reactive protein, D-dimer, body mass index, and length of hospital stay were 46.35 years, 143.23 mg/L, 4.12 µg/mL, 27.65 kg/m², and 50.18 days, respectively. No significant correlations (p < 0.05) were observed between presence of VTE and any of variables studied.</p><p><strong>Conclusions: </strong>There appeared to be associations between some of the variables tested, but it was not possible to confirm any causal relationships. It is possible that epidemiological associations between COVID-19 and VTE could be measured and better explained by possible confounding factors, such as simultaneous coinfections, preexisting health conditions, and others.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250076"},"PeriodicalIF":1.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678646","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":"Endovascular management of severe renal trauma: a therapeutic challenge.","authors":"Isabela Zampirolli Leal, Renato da Silva Galvão, Gabriela de Oliveira Buril, Daniel Duarte Rolim, Carlos Castanha de Albuquerque, Alexandre José de Souza Guedes, Leucio Barros Verás, Ítalo Emmanuel Lima Ferreira","doi":"10.1590/1677-5449.202502012","DOIUrl":"10.1590/1677-5449.202502012","url":null,"abstract":"<p><p>Severe renal trauma is a rare and potentially life-threatening condition that requires rapid and individualized management. Selective embolization has proven to be an effective and minimally invasive option for hemorrhage control and renal function preservation. We present two cases of severe renal trauma, one blunt and one penetrating, successfully treated with superselective embolization. In the first case, microcoils were used for segmental branch occlusion; in the second, cyanoacrylate glue (Hystoacryl + Lipiodol, 33%) was applied. Both patients achieved hemodynamic stabilization, laboratory recovery, and preserved renal function without complications. Endovascular management proved to be a safe and decisive treatment, avoiding nephrectomy and reinforcing the essential role of interventional radiology in the management of high-complexity renal trauma.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250201"},"PeriodicalIF":1.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678714","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":"Gestrinone, lipedema, and the limits of theoretical extrapolation in clinical practice: a critical narrative review.","authors":"Marcelo Fernandes Lima","doi":"10.1590/1677-5449.202502402","DOIUrl":"10.1590/1677-5449.202502402","url":null,"abstract":"<p><p>Lipedema is a chronic inflammatory disorder of adipose tissue that predominantly affects women and is characterized by disproportionate subcutaneous fat accumulation, pain, spontaneous bruising, and significantly impaired quality of life. Although hormonal influences on its pathophysiology have been increasingly recognized, evidence-based treatment options remain limited. Recently, gestrinone has been proposed as an off-label therapy based on hormonal mechanistic hypotheses. A critical narrative review of the literature was conducted using international databases to identify clinical or pharmacological evidence supporting its use in lipedema. No clinical trials, observational studies, case series, or case reports directly evaluating this therapy were identified. Existing proposals rely exclusively on theoretical extrapolations lacking clinical validation. Therefore, current evidence does not support the use of gestrinone in the treatment of lipedema, and its use should be considered experimental until adequately designed clinical studies are available.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250240"},"PeriodicalIF":1.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678671","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":"Observational anatomic study of ascending lumbar veins in human cadavers.","authors":"Felipe de Azevedo Correa Assumpção, Natália Santos Dos Anjos, Carlos Adriano Silva Dos Santos","doi":"10.1590/1677-5449.202501552","DOIUrl":"10.1590/1677-5449.202501552","url":null,"abstract":"<p><strong>Background: </strong>The ascending lumbar veins (ALVs) and their continuations in the thorax as veins of the azygos and hemiazygos system constitute one of the main routes of collateral circulation in the caval system. However, there is some doubt about their efficiency, primarily with regard to the direction of flow and the presence or absence of valves in their lumina.</p><p><strong>Objectives: </strong>To conduct an anatomic study of the ALVs, noting the frequency, number, and types of valves present and the morphometry, tributaries, surrounding structures, drainage, and continuation of the ALVs.</p><p><strong>Methods: </strong>This is a descriptive anatomic study conducted with 15 human cadavers and a total of 30 dissections.</p><p><strong>Results: </strong>Six valves and four septa were observed. The ALVs most frequently drained into the common iliac vein (CIV) and in 40% of cases they did not continue longitudinally beyond the fourth lumbar vertebra. Muscular tributaries were the most frequent type. Mean ALV diameter was 2.75 mm on the right and 3.65 mm on the left. The ALVs were located lateral to the vertebral bodies and intervertebral discs; medial to the psoas major muscle and obturator nerve; posterior to the pelvic and abdominal lymph node chains and the CIV; and anterior to the transverse processes of the lumbar vertebrae.</p><p><strong>Conclusions: </strong>Considering the presence of valves and septa in the ALVs and the fact that they did not always extend beyond the fourth lumbar vertebra, it can be concluded that the ALVs cannot always be defined as routes of collateral circulation with ascending and descending flow supporting the caval system.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250155"},"PeriodicalIF":1.1,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404684","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":"Open surgical repair of a loop-forming extracranial internal carotid artery aneurysm: a case report and literature review.","authors":"Cigdem Tel Ustunisik, Omer Faruk Soydas, Lara Yagci, Berk Arapi, Ozan Onur Balkanay, Deniz Göksedef, Suat Nail Omeroglu","doi":"10.1590/1677-5449.202501182","DOIUrl":"10.1590/1677-5449.202501182","url":null,"abstract":"<p><p>Extracranial carotid artery aneurysms (ECCA) are rare vascular lesions that may be asymptomatic or present with compression-related symptoms, depending on their size and location. Etiologies include trauma, congenital anomalies, inflammation, atherosclerosis, or prior interventions. Major complications involve cranial nerve compression, rupture, and cerebral thromboembolism. Diagnostic and therapeutic management can be challenging, with treatment options including conservative follow-up, endovascular intervention, or open surgery. We present the case of a 76-year-old woman admitted with visual disturbances and a palpable mass on the left side of her neck. Radiological imaging revealed a 2 cm aneurysm with loop formation in the left internal carotid artery. The aneurysm was treated with open surgical aneurysmectomy and end-to-end anastomosis without grafting. Postoperative recovery was uneventful. Open surgical repair remains a safe and effective treatment, particularly in anatomically complex cases in which endovascular techniques are not feasible due to arterial tortuosity.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250118"},"PeriodicalIF":1.1,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015456","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":"Pulsatile tinnitus due to intracranial arteriovenous fistula indirectly identified by carotid Doppler ultrasound.","authors":"André Câmara Matoso Chacon, Ricardo de Alvarenga Yoshida, Sally Tan, Samantha LaFotaine, Prakash Vishwanathan, Tulio Brasileiro Silva Pacheco, Gutenberg do Amaral Gurgel","doi":"10.1590/1677-5449.202500462","DOIUrl":"10.1590/1677-5449.202500462","url":null,"abstract":"<p><p>Pulsatile tinnitus is a specific type of sound caused by vascular anomalies, usually associated with turbulent blood flow, secondary to high-output stenosis or arterial tortuosity. These alterations can produce rhythmic sounds that compromise patients' quality of life. This report describes the case of a 51-year-old woman with pulsating tinnitus in her right ear for 18 months. No significant changes were identified on arterial computed tomography angiography or cranial magnetic resonance angiography due to the non-completion of the joint venous phase. Carotid Doppler ultrasound showed abnormal flow in the right external carotid artery, with a decreased resistance index, suggesting an arteriovenous fistula. Cerebral angiography confirmed the diagnosis, showing communication between external carotid artery branches and intracranial veins. The patient underwent endovascular treatment with embolization, resulting in complete resolution of symptoms and normalization of Doppler parameters at 24-month follow-up.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250046"},"PeriodicalIF":1.1,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015472","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":"Psychological stress affecting the size and resolution of an intermittent post-traumatic vascular lesion of the temporalis muscle.","authors":"Harshit Arora, Vasudha Sharma, Lavanya Arora, Waryaam Singh, Rajesh Pasricha","doi":"10.1590/1677-5449.202501052","DOIUrl":"10.1590/1677-5449.202501052","url":null,"abstract":"<p><p>Vascular anomalies are disorders of arteries or veins which are further sub-classified as vascular malformations or vascular tumors. Vascular malformations are attributed to disorderly vascular morphogenesis, trauma, or hormonal imbalances. We present a rare case of a patient in their 30s who presented to the outpatient department with a localized post-traumatic soft tissue swelling in the temporalis region, which was soft and non-pulsatile with occurrences in periods of acute emotional stress, followed by spontaneous resolution when the same was negated by the patient. The diagnosis was established on the basis of magnetic resonance imaging and contrast enhanced computed tomography. We add to the existing limited literature on intramuscular vascular malformations of the temporalis muscle and highlight the effect of emotional stress and anxiety on vascular anomalies.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"25 ","pages":"e20250105"},"PeriodicalIF":1.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838070","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}