Jornal Vascular Brasileiro最新文献

{"title":"Anatomic evaluation of the height of the carotid bifurcation by 4^th year medical students using vascular ultrasonography.","authors":"Mateus Rodrigues Alessi, Murillo Campigotto Fedatto, Marcos Correa Segalla, Camila do Valle Pavanelo, Rodrigo Barberato, Gessil Dgeovani Carlotto, Graciliano José França","doi":"10.1590/1677-5449.202401112","DOIUrl":"https://doi.org/10.1590/1677-5449.202401112","url":null,"abstract":"<p><strong>Background: </strong>The carotid bifurcation is known for its anatomical variations, involving structures that can be assessed by ultrasound examination. Knowledge of unusual anatomy is crucial in surgical procedures, directly influencing their outcomes.</p><p><strong>Objectives: </strong>To assess whether fourth-year medical students with prior training are capable of performing ultrasound examinations to compare the height of the carotid bifurcation between men and women.</p><p><strong>Methods: </strong>602 carotid bifurcations from 301 participants were identified by ultrasound examinations conducted by medical students after prior training by a professional qualified in vascular ultrasound. After each examination, the results were verified by a specialist physician. Gender, age, and bilateral measurement of the distance between the carotid bifurcation and the ear lobe were compared.</p><p><strong>Results: </strong>The students' measurements differed from the specialist physician's measurements by more than 0.2 cm in just 8 examinations. On the right side, the average height of the carotid bifurcation relative to the earlobe was 5.9 cm, compared to 5.8 cm on the left side, for the whole sample. The distance on the right side was significantly shorter among the women, with an average of 5.6 cm, compared to 6.3 cm among the men (p<0.0001). The distance on the left side was also significantly shorter in women, with an average of 5.4 cm, compared to 6.2 cm among the men (p<0.0001). The difference between sides was not statistically significant between the sexes.</p><p><strong>Conclusions: </strong>After training, medical students demonstrate high accuracy in the technique of measuring the carotid bifurcation height using vascular ultrasound. Men showed a tendency for the bifurcations to be located farther from the earlobe compared to women.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240111"},"PeriodicalIF":0.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972163","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":"Prevalence of peripheral arterial disease and its association with claudication in individuals with type 2 Diabetes Mellitus: a prospective cross-sectional study in Brazil.","authors":"Gislaine Bonete da Cruz, Cibele Teresinha Dias Ribeiro, Camila Maciel de Oliveira, Rosangela Roginski Rea, Fernando Augusto Lavezzo Dias","doi":"10.1590/1677-5449.202400852","DOIUrl":"https://doi.org/10.1590/1677-5449.202400852","url":null,"abstract":"<p><strong>Background: </strong>Few studies have described the prevalence of peripheral arterial disease (PAD) in the diabetic population of Brazil.</p><p><strong>Objectives: </strong>To evaluate the prevalence of PAD and its association with the presence of claudication and to compare risk factors for atherosclerosis between subjects with and without PAD.</p><p><strong>Methods: </strong>An analytical, observational, prospective, cross-sectional study was conducted with 150 volunteers with type 2 Diabetes Mellitus (T2DM) treated at a university endocrinology outpatient clinic (Federal University of Paraná, Curitiba, Brazil) and assessed using the ankle-brachial index (ABI) and the Edinburgh Claudication Questionnaire.</p><p><strong>Results: </strong>ABI was evaluated in 143 volunteers (7 did not meet the inclusion criteria). Six individuals had an ABI > 1.4. Excluding these cases and adopting an ABI ≤ 0.9 to identify PAD, the prevalence of PAD was 14.6% (20 of 137), 15.8% in men (6 of 38), and 14.1% in women (14 of 99). We identified twenty-five participants with borderline ABI (18.2%). Claudication was present in 25% of subjects with PAD; however, only 15% had typical claudication. A significant association with the presence of typical claudication was observed only when ABI values were stratified above or below 1.0 (p = 0.04, Fisher's exact test). Participants with PAD were older (median difference: 5.5 years, 95% CI 3.0 to 9.0, p < 0.001) and tended to have a longer duration of DM and higher BMI.</p><p><strong>Conclusions: </strong>The prevalence of PAD in T2DM volunteers with no prior screening was 14.6% and 75% were asymptomatic.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240085"},"PeriodicalIF":0.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967759","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 abdominal aortic aneurysm and aortocaval fistula: a highly lethal find.","authors":"Walter Mario Ángel Jaramillo, Marby Sharyne Forero Gaviria, Romario Chanci Drago, Natalia Guzmán Arango, Natalia Barrera Cuesta, Andrés Gilberto Giraldo Echeverri, Verónica Lucía Malabet Mejía","doi":"10.1590/1677-5449.202401342","DOIUrl":"https://doi.org/10.1590/1677-5449.202401342","url":null,"abstract":"<p><p>Within the spectrum of abdominal aortic aneurysm, various complications can arise, including the development of an arteriovenous fistula connecting this major vessel to the infrarenal inferior vena cava. This report presents the case of a 70-year-old man with sudden, intense abdominal pain and syncope, found intraoperatively to have an aortocaval fistula due to a ruptured abdominal aortic aneurysm. The patient underwent emergency care, including fistula closure and placement of a Dacron aortobifemoral graft. Aortocaval fistula is a rare complication of aortic aneurysmal disease, with clinical manifestations varying depending on disease progression, leading to high morbidity and mortality both before and after surgical or interventional treatment.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240134"},"PeriodicalIF":0.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005555","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":"Treatment of aortic arch and left subclavian artery aneurysms in two stages using combined surgical approaches: case report.","authors":"Josué Song Der Wu, Lucas Porto Maurity Dias, Giuliano Giová Volpiani, Valter Castelli, Vanessa Prado Dos Santos, Luiz Eduardo Meucci Pereira Nogueira, Walkíria Hueb Bernardi, Roberto Augusto Caffaro","doi":"10.1590/1677-5449.202401272","DOIUrl":"https://doi.org/10.1590/1677-5449.202401272","url":null,"abstract":"<p><p>Aortic arch aneurysms are often asymptomatic, being diagnosed incidentally in tests such as computed tomography, magnetic resonance imaging, or echocardiogram. Conventional treatment involves thoracotomy surgery, although treatment can also be performed using endovascular techniques. This article presents a case report of a complex aneurysm of the aortic arch with involvement of the left subclavian artery. Treatment was initiated with debranching of the supra-aortic trunks by carotid-carotid and carotid-subclavian bypasses, followed by ligation of the common carotid and left subclavian arteries. A second procedure was then needed to construct a surgical vascular conduit using a Dacron graft to obtain access to the aortic arch for the stent graft delivery device, due to the narrow caliber of the external femoral and iliac arteries. This report illustrates a satisfactory outcome in a case of aortic arch aneurysm with complex anatomy.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240127"},"PeriodicalIF":0.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972181","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":"Anomalous intraosseous venous drainage of pretibial varices: case report.","authors":"Joana Storino, Ana Julia Resende Rocha, Ana Laura Decat Gonçalves, Luisa Reis Braga, Luma Pereira Brandão","doi":"10.1590/1677-5449.202400572","DOIUrl":"10.1590/1677-5449.202400572","url":null,"abstract":"<p><p>Anomalous intraosseous venous drainage causing pretibial varices is a rare and little-known cause of varicose veins in the lower limbs (LL). We report the case of a 49-year-old male patient with chronic pain associated with large pretibial varicose veins and mild edema of the left lower limb, with no skin changes or history of previous treatment. Vascular ultrasound identified a dilatated intraosseous vein of the tibia with reflux draining to an incompetent bone perforating vein and subcutaneous varicose veins. Bone perforating veins must be carefully investigated in the presence of atypical non-saphenous and recurrent varicose veins using vascular ultrasound, which demonstrates the periosteal defect in the tibia and presence of reflux that feeds the pretibial subcutaneous varicosities. Recognizing this rare entity avoids diagnostic errors and is essential for the most appropriate treatment.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240057"},"PeriodicalIF":0.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763390","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":"Variations in the branching pattern of the internal iliac artery and its implications in trauma and surgery - a South Indian cadaveric study.","authors":"Satheesha Nayak Badagabettu, Ashwini Aithal Padur, Surekha Devadasa Shetty","doi":"10.1590/1677-5449.202400752","DOIUrl":"10.1590/1677-5449.202400752","url":null,"abstract":"<p><strong>Background: </strong>The internal iliac artery (IIA) frequently shows variations in its branching pattern. Knowledge of its variations is helpful during gynecological and orthopedic surgical procedures.</p><p><strong>Objectives: </strong>To observe the branching pattern of IIA in the human pelvises and discuss its clinical implications.</p><p><strong>Methods: </strong>The study was conducted on 80 male hemipelvises (40 left halves and 40 right halves). The pelvic halves were obtained by making mid-line saw cuts through formalin embalmed adult human cadavers aged approximately 50-80 years. The IIA were dissected and cleaned. Variations of the internal iliac artery and its branches were noted. Relevant photographs were taken. Results were expressed as percentages.</p><p><strong>Results: </strong>Variations in the branching pattern were observed in 49 (61%) hemipelvises (right: 21, left: 28). Variations were more common (48%) in the branching pattern of the anterior division of IIA than the posterior division (20%). Variations of the main trunk were observed in 29% of cases. In 3% of cases, the IIA did not divide into two divisions. Among the individual branches, the iliolumbar artery showed variations in 29% of cases and the obturator artery in 25%. A common trunk of the internal pudendal and middle rectal arteries was found in 24% of cases and variations of the inferior gluteal artery were seen in 18% of cases.</p><p><strong>Conclusions: </strong>The study showed a high rate of occurrence of variant IIA branching patterns. Understanding the anatomical variations of the IIA and its branches is essential to minimize intraoperative blood loss and other complications during pelvic surgeries.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240075"},"PeriodicalIF":0.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763456","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":"Clinical decision making in healthcare: the importance of best evidence.","authors":"Ronald Luiz Gomes Flumignan, Renato Delascio Lopes","doi":"10.1590/1677-5449.202401302","DOIUrl":"10.1590/1677-5449.202401302","url":null,"abstract":"","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240130"},"PeriodicalIF":0.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719236","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":"Terapeutic challenge: vena cava filter retrieval four years after implantation.","authors":"José Júlio Bechir Maués, Karen Falcão Britto, Sara Oliveira Rocha","doi":"10.1590/1677-5449.202301382","DOIUrl":"10.1590/1677-5449.202301382","url":null,"abstract":"<p><p>Vena cava filters are used to treat deep vein thrombosis and pulmonary embolism. Despite the extensive literature on these filters, there is still no reliable evidence that they improve clinical results or mortality in patients with deep vein thrombosis. There are also increasing reports of complications from indiscriminate use, with a complication rate of approximately 19%. Complications include penetration into the vein wall, involvement of adjacent organs, fracture, embolization of filter fragments, and deep vein thrombosis. We describe the successful removal of a vena cava filter 4 years after implantation for inferior vena cava thrombosis. The procedure was performed using common endovascular surgery devices.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20230138"},"PeriodicalIF":0.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663396","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":"Variations in the origin, course and branching pattern of the radial artery along with clinical correlations: narrative review.","authors":"Rajani Singh","doi":"10.1590/1677-5449.202400152","DOIUrl":"10.1590/1677-5449.202400152","url":null,"abstract":"<p><p>The radial artery most often arises from the brachial artery in the cubital fossa, lying deep to the brachioradialis in the upper part and superficial in the lower part. Recently, the radial artery has increasingly been used for coronary procedures. However, the radial artery is observed to vary in origin, course, and branching pattern. Precise knowledge of these parameters is essential for successful outcomes. Considering the immense clinical significance associated with this artery, this study was conducted. The aim is to expound the details of the radial artery and to highlight the associated implications, serving as a ready reference for vascular surgeons. The study was conducted using various databases and various terms related to the radial artery were used to search the literature. The literature reveals that the radial artery varies in origin, course, and branching pattern and information on these parameters will help vascular surgeons to carry out various procedures with minimum complications.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240015"},"PeriodicalIF":0.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663400","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 web: a little-known etiology of recurrent stroke - case report.","authors":"Nathalia Santana Moreda, Henrique Alves de Almeida, Vinicius Tadeu Ramos da Silva Grillo","doi":"10.1590/1677-5449.202401262","DOIUrl":"10.1590/1677-5449.202401262","url":null,"abstract":"<p><p>Carotid web is a rare and poorly understood condition associated with cryptogenic and recurrent acute ischemic stroke in young patients without atherosclerotic risk factors. We describe the case of a 58-year-old female patient with hypertension and dyslipidemia who had recurrent ischemic strokes for 5 years. Presence of carotid web was suggested by Doppler ultrasonography and confirmed by digital subtraction angiography. The patient underwent endarterectomy and, due to satisfactory internal carotid reflux, it was decided not to use a temporary vascular shunt. Endarterectomy and arteriorrhaphy with a bovine pericardium patch were performed. Although carotid web can be seen with imaging exams, detection can be challenging and it can mimic other conditions, such as arterial dissection, non-calcified atherosclerotic plaque, and intraluminal thrombus. The ease with which it can go unnoticed or misdiagnosed highlights the need to understand this disease.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240126"},"PeriodicalIF":0.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663376","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}