Jornal Vascular Brasileiro最新文献

{"title":"Vascular rehabilitation interventions in people with peripheral arterial disease: an integrative review.","authors":"Kauane Flechas Arruda Perdigão, Larissa Pereira Costa, Annicia Lins Freitas, José Heriston de Morais Lima, Eduardo Ériko Tenório de França, Rafaela Pedrosa","doi":"10.1590/1677-5449.202400882","DOIUrl":"10.1590/1677-5449.202400882","url":null,"abstract":"<p><strong>Background: </strong>Peripheral artery disease, which occurs due to lower limb artery disorders, is associated with high cardiovascular mortality rates. Studies show that supervised exercise is an effective option for controlling symptoms.</p><p><strong>Objective: </strong>This study identified exercise types and complementary therapies used for vascular rehabilitation in people with peripheral artery disease and discusses the best recommendations in the literature.</p><p><strong>Methods: </strong>This integrative literature review is based on studies published in the last 5 years. The search was performed in the following databases: PubMed, SciELO, LILACS (BVS), and Cochrane. In addition to supervised exercise, the interventions in the clinical trials included other approaches that contributed to patient rehabilitation. Duplicate articles, articles whose full text was unavailable, and those whose title or abstract indicated they were unrelated to the topic were excluded.</p><p><strong>Results: </strong>Nine articles were included in the analysis. The results indicate that supervised exercise is the gold standard treatment method. However, therapies such as blood flow restriction, heat therapy, hydrotherapy, and resistance training can help improve treatment adherence, and their complementary effects benefit cardiovascular and physical function.</p><p><strong>Conclusions: </strong>In patients with peripheral artery disease, exercise-based rehabilitation is fundamental. However, resistance training with blood flow restriction can optimize muscle strength, while heat therapy and hydrotherapy can act as adjuvants to exercise.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240088"},"PeriodicalIF":0.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663405","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 sexual dysfunction after abdominal aortic aneurysm repair with the type of surgical technique adopted.","authors":"Vanessa Souza Silva Medrado, Edenilson de Souza Teixeira, Hideki Zimermann Kamitani, Domingos Sávio de Oliveira E Silva, Leonardo Alves Santos, Rodrigo Mendes, Pedro Pereira Tenório","doi":"10.1590/1677-5449.202401612","DOIUrl":"https://doi.org/10.1590/1677-5449.202401612","url":null,"abstract":"","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240161"},"PeriodicalIF":0.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993592","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":"Pedal acceleration time is related to arterial stiffness in patients with chronic limb-threatening ischemia.","authors":"Daniel Mendes-Pinto, Larissa Jardim Melo, Guilherme Galvone Fonseca Costa, Izabella Campolina Santos, Ana Paula Pires Silva, Roberto Lucas Senna de Avelar, Guilherme de Castro-Santos, Maria da Glória Rodrigues-Machado","doi":"10.1590/1677-5449.202300492","DOIUrl":"10.1590/1677-5449.202300492","url":null,"abstract":"<p><strong>Background: </strong>Pedal acceleration time (PAT) is a novel indicator of peripheral arterial disease in the lower limbs. Elevated PAT values are associated with worse limb ischemia. Arterial stiffness indexes are another class of indicators recently studied in patients with chronic limb-threatening ischemia (CLTI). The correlation between PAT and arterial stiffness has not yet been established.</p><p><strong>Objectives: </strong>To analyze correlations between PAT and arterial stiffness indexes in patients with CLTI.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted of patients with CLTI from August to December of 2022. The PAT measurements were performed using a vascular ultrasound machine and stiffness indexes were measured using a brachial artery oscillometry unit. An analysis was conducted of the correlations between central blood pressure, peripheral blood pressure, arterial stiffness, and PAT.</p><p><strong>Results: </strong>A total of 55 patients were analyzed, of whom 23 were women and 83.6% had diabetes. Mean PAT was 166.6 ms; mean pulse wave velocity (PWV) was 11.8 m/s, and the mean augmentation index corrected for a heart rate of 75 beats per minute (AIx@75) was 29.8%. There were positive correlations between PAT and PWV (Spearman r = 0.69; p < 0.001) and between PAT and AIx@75 (Spearman r = 0.59, p < 0.001) and an inverse relationship with the ankle/brachial index (Spearman r = -0.79; p < 0.001).</p><p><strong>Conclusions: </strong>There is a correlation between arterial stiffness indexes and PAT in patients with CLTI. These indicators are important for quantification of limb ischemia.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20230049"},"PeriodicalIF":0.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604954","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":"Peripheral tissue perfusion in individuals with and without type 2 diabetes mellitus and its associations with type 2 diabetes: a cross-sectional study.","authors":"Valéria Cristina de Faria, Juliana Simões de Alencar Fernandes, Tulio Ericles de Oliveira Cunha, Guilherme de Azambuja Pussieldi, Danielle Aparecida Gomes Pereira","doi":"10.1590/1677-5449.202301062","DOIUrl":"10.1590/1677-5449.202301062","url":null,"abstract":"<p><strong>Background: </strong>Early recognition of peripheral tissue perfusion deficits can minimize secondary complications of peripheral arterial disease in individuals with diabetes.</p><p><strong>Objectives: </strong>To compare parameters of peripheral tissue perfusion in the leg at rest and during and after progressive effort between non-diabetics and individuals with type 2 diabetes and normal ankle brachial index values, as well as to evaluate the factors associated with peripheral tissue perfusion in the leg in individuals with type 2 diabetes during progressive effort.</p><p><strong>Methods: </strong>This cross-sectional study included 31 individuals with type 2 diabetes and 31 non-diabetics. Anthropometric measurements and physical activity levels were assessed in all individuals. Peripheral tissue perfusion was analyzed using near-infrared spectroscopy during an arterial occlusion maneuver and the Incremental Shuttle Walking Test.</p><p><strong>Results: </strong>During progressive effort, the tissue oxygen saturation level was lower in the type 2 diabetes group (type 2 diabetes, 58.74 [56.27-61.74] than the non-diabetic group, 62.15 [59.09-66.49]; p = 0.005). There were significant correlations between tissue oxygen saturation during progressive effort and physical activity level (p < 0.0001; r = -0.681), total body fat percentage (p = 0.001; r = 0.590), segmental body fat percentage (p < 0.0001; r = 0.616), total skeletal muscle mass (p < 0.0001; r = -0.628), and segmental skeletal muscle mass (p = 0.001; r = -0.592).</p><p><strong>Conclusions: </strong>Individuals with type 2 diabetes and normal ankle-brachial index values had worse tissue perfusion during progressive effort than non-diabetics, and there was an association between perfusion, physical activity level, and body composition in the type 2 diabetes group.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20230106"},"PeriodicalIF":0.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604959","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 deodorant for axillary hyperhidrosis: a topic or a systemic effect? Rationale and design of the phase II today trial.","authors":"Samantha Neves, Giuliano Giova Volpiani, Alexia Paganotti, Felipe Menegueti, Ricardo Sanchez Boix, Roberto Augusto Caffaro, Vanessa Prado Dos Santos, Eduardo Ramacciotti","doi":"10.1590/1677-5449.202400982","DOIUrl":"10.1590/1677-5449.202400982","url":null,"abstract":"<p><p>Anticholinergics have been shown to enhance quality of life and reduce sweat in patients with hyperhidrosis. However, it remains unclear whether topical application specifically exerts local or systemic effects. This study's primary aim is to assess topical oxybutynin's impact on axillary hyperhidrosis. Twenty patients will be randomized into three groups. Group A will receive 2.5 mg of oral oxybutynin from day 1 to day 35 (on a variable frequency regimen). Group B will be administered a topical placebo for 35 days and Group C will receive a 10% oxybutynin topical spray, to be used twice daily for 35 days. The primary efficacy outcome will be the evaluation of the effectiveness of topical oxybutynin spray in treating hyperhidrosis. The TODAY trial will generate high-quality evidence on the effects of topical oxybutynin, assessing whether its impact is local or systemic in patients with axillary hyperhidrosis.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240098"},"PeriodicalIF":0.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515798","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":"Teleproctoring of endovascular treatment of aortic diseases in times of pandemic and war.","authors":"Fabio Augusto Cypreste Oliveira, Fabio Lemos Campedelli, Carlos Eduardo de Souza Amorelli, Ana Luiza Pereira da Silva Pozzetti, Milena Fachini Dos Santos Bossa, Priscila Cristina João","doi":"10.1590/1677-5449.202400412","DOIUrl":"10.1590/1677-5449.202400412","url":null,"abstract":"<p><p>Telemedicine encompasses various activities leveraging technology for remote health care. Surgical teleproctoring is described in the literature and has been used by some medical specialties for real-time and remote intraoperative guidance. However, there is still limited evidence on its use for the implantation of aortic endoprostheses. Technological progress and the advancement of telemedicine encourage surgical telementoring, especially in circumstances where in-person proctorship is not feasible, such as in remote areas, during pandemics and wars, and in settings lacking financial resources. In this context, we present the successful application of easily available and low-cost online teleproctoring of real-time aortic endoprosthesis implantation, addressing aortic diseases in a country experiencing social isolation due to the ongoing pandemic and war.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240041"},"PeriodicalIF":0.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515729","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":"Infrarenal endovascular repair of abdominal aortic aneurysm with hostile aortic neck configuration by primary placement of an infrarenal Palmaz stent followed by an endoprosthesis with suprarenal fixation (the \"Neoneck\" technique).","authors":"André Pinheiro Ribeiro Alves, Queise da Costa Cettolin, Yasmin Falcon Lacerda, Mauricio de Amorim Aquino, Gustavo Dos Santos Domingues","doi":"10.1590/1677-5449.202400452","DOIUrl":"10.1590/1677-5449.202400452","url":null,"abstract":"<p><strong>Background: </strong>The Endovascular Repair (EVAR) is the first-choice technique for Abdominal Aortic Aneurysm (AAA). Treatment success is dependent on favorable anatomy and an adequate sealing zone formed by a straight aortic neck (slightly angled). Endoprostheses implanted at critical aortic angles (above 75º) may result in unfavorable results such as fracture, migration, and type Ia endoleak. The technique for creating a proximal \"Neoneck\" consists of implanting the Palmaz stent in the proximal neck of the AAA, before placement of the endoprosthesis, allowing remodeling and rectification of the aortic neck.</p><p><strong>Objectives: </strong>To describe the \"Neoneck\" technique and report the early results of three cases with rectification of the proximal neck angle using a Palmaz stent, enabling treatment in these cases with angulated necks.</p><p><strong>Methods: </strong>We analyzed data collected from patients in whom Palmaz stents were placed, constructing a proximal Neoneck, during EVAR for infrarenal AAA with very tortuous proximal aortic neck, assessing anatomy, devices and perioperative results, including success rates, complications, mortality, and patency in the short and medium term.</p><p><strong>Results: </strong>All patients presented satisfactory evolution with immediate technical success. There were no cases of migration, fracture, or type Ia endoleaks. There was evidence of aneurysmal sac reduction after six months. There were no complications related to surgical access or deaths.</p><p><strong>Conclusions: </strong>In cases of angled aortic necks, when open AAA repair is not possible, in the absence of ideal devices or in urgent cases, prior rectification of the aortic neck deploying the Palmaz stent is feasible and effective. Long-term studies are still needed to validate the technique and assess safety.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240045"},"PeriodicalIF":0.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468011","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":"Instrument for assessing surgical skills related to performing a vascular anastomosis.","authors":"Gabriela de Oliveira Buril, Joseph Monteiro de Carvalho, Vânia Dos Santos Nunes-Nogueira","doi":"10.1590/1677-5449.202400312","DOIUrl":"10.1590/1677-5449.202400312","url":null,"abstract":"<p><p>Technical skill is one of the most important components of surgical competence and must be thoroughly learned and developed over the course of surgical residency. However, there are still few instruments for directly appraising and quantifying surgical skill and the majority of centers rely on the subjective observations of tutors. The objective of this study was to conduct a scoping review on the subject of instruments for appraisal of surgical skills available for assessment of vascular anastomosis performed by vascular surgery residents. A review was conducted using the following search terms: \"educational measurement\", \"vascular surgery\", and \"internship and residency\". The initial search results comprised 616 articles. After application of the eligibility criteria, just four studies were included in the review, only one of which was conducted in Brazil. Three of the studies used Objective Structured Assessment of Technical Skill (OSATS) to assess residents. However, all used separate and different supplementary checklists for evaluation of specific skills related to anastomoses. Appropriate appraisal and precise feedback during residency training are an extremely important part of residents' training. Systematic and objective feedback enables errors to be corrected and skills to be polished. Since there is no instrument for assessment of the surgical skills needed to perform anastomosis, after completion of the review a rating instrument was proposed focused on this important skill that vascular surgery residents must acquire. The instrument comprises a compilation of the instruments reviewed and includes a proposed checklist for use in real-world settings.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240031"},"PeriodicalIF":0.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468016","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 relationship between abdominal aortic aneurysm diameter and its risk factors: a retrospective cohort study.","authors":"João Victor Domiciano Martins, Rodrigo Mendes, Ronald Luiz Gomes Flumignan, Luiz Carlos Uta Nakano, Jorge Eduardo de Amorim, Henrique Jorge Guedes","doi":"10.1590/1677-5449.202301102","DOIUrl":"10.1590/1677-5449.202301102","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic aneurysm is defined as a focal and persistent dilatation of the abdominal portion of the aorta to a diameter ≥50% larger than the diameter of adjacent segments and involving all three layers of the vessel wall.</p><p><strong>Objectives: </strong>To evaluate whether risk factors (diabetes mellitus, hypertension, dyslipidemia, smoking, and age) influence aneurysm expansion.</p><p><strong>Methods: </strong>This is a retrospective observational study of a series of cases that included 299 patients treated from January 2007 to January 2020, separated into exposed and unexposed groups by risk factors. Student's <i>t</i> test was used to assess whether mean aneurysm diameters showed statistically relevant differences between groups. A multivariate regression analysis was also conducted with the same groups.</p><p><strong>Results: </strong>Smokers had larger aneurysms than those who had never smoked (p=0.002) and than former smokers (p<0.01) and patients ≤65 years old had larger diameters compared to patients aged 66 to 75 years old (p=0.0226). There were no significant correlations with the other risk factors (diabetes mellitus, dyslipidemia, hypertension). Multivariate regression analysis confirmed the same result, but with a coefficient of determination of 0.0608. Furthermore, smokers, patients with hypertension, patients with dyslipidemia, and patients without diabetes had higher frequencies of much larger aneurysm diameters.</p><p><strong>Conclusions: </strong>It was observed that age ≤65 years and current smoking were related to greater aneurysm diameter. In contrast, the same statistical relationship was not observed for hypertension, absence of diabetes, or dyslipidemia, since there was a greater frequency of discrepant values for these groups. Studies are needed with a more comprehensive analysis of determinants of aneurysm diameter.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20230110"},"PeriodicalIF":0.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468004","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":"Post-saphenous vein ablation compression therapy practices: a study among members of the Brazilian society of angiology and vascular surgery.","authors":"Fabricio Duarte, Flavia Del Castanhel, Marcondes Antônio de Medeiros Figueiredo, Getúlio Rodrigues de Oliveira","doi":"10.1590/1677-5449.202301822","DOIUrl":"10.1590/1677-5449.202301822","url":null,"abstract":"<p><strong>Background: </strong>Despite considerable study, there is still no consensus defining the ideal compression regimen after ablation of the great saphenous vein with radio frequency or endolaser.</p><p><strong>Objective: </strong>To identify the Brazilian Society of Angiology and Vascular Surgery members' current compression therapy practices after ablation of the great saphenous vein.</p><p><strong>Methods: </strong>A multiple-choice electronic questionnaire on post-endovenous ablation compression was developed and made available on-line to Brazilian vascular surgeons for 60 days.</p><p><strong>Results: </strong>A total of 430 responses were received, 362 (84.2%) of which were considered valid. Laser ablation was the predominant technique (73.5%) and the majority of procedures were conducted in hospitals or day hospitals. Ninety-four percent of the surgeons treated associated varicose veins in the same procedure, for which phlebectomy was the technique most employed. After ablation of the great saphenous vein, 99% of the surgeons applied compression immediately; 34.3% used 35 mmHg compression stockings, 26% preferred crepe bandages, and 12.4% opted for 20-30 mmHg compression stockings, with an average duration of 2.79 (±2 days). After this period, 88.4% used additional compression, with 20-30 mmHg compression stockings (80.9%) and an average duration of 39.3 (±24.0 days).</p><p><strong>Conclusions: </strong>Compression therapy is widely employed after thermal ablation of the great saphenous vein. Practice immediately after ablation was divergent, but after the initial phase, the majority of surgeons prescribed additional compression, predominantly using 20-30 mmHg stockings.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20230182"},"PeriodicalIF":0.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468031","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}