Jornal Vascular Brasileiro最新文献

{"title":"Association between Hospital Carotid Endarterectomy Procedure Volumes and In-Hospital Mortality in São Paulo State.","authors":"Renato Luís Pessôa","doi":"10.1590/1677-5449.202201642","DOIUrl":"https://doi.org/10.1590/1677-5449.202201642","url":null,"abstract":"<p><strong>Background: </strong>Previous studies indicate an inverse relationship between hospital volume and mortality after carotid endarterectomy. However, data at the level of Brazil are lacking.</p><p><strong>Objectives: </strong>To assess the relationship between hospital carotid endarterectomy procedure volumes and mortality in the state of São Paulo.</p><p><strong>Methods: </strong>Data from the São Paulo State Hospital Information System on all carotid endarterectomies performed between 2015 and 2019 were analyzed. Hospitals were categorized into clusters by annual volume of surgeries (1-10, 11-25, and ≥26). Multiple logistic regression models were used to determine whether the volume of carotid endarterectomy procedures was an independent predictor of in-hospital mortality among patients undergoing this procedure.</p><p><strong>Results: </strong>Crude in-hospital mortality was nearly 60 percent lower in patients who underwent carotid endarterectomy at the highest volume hospitals than among those who underwent endarterectomy at the lowest volume hospitals (unadjusted OR of survival to hospital discharge, 2.41; 95% CI, 1.11-5.23; p = 0.027). Although this lower rate represents 1.5 fewer deaths per 100 patients treated, high-volume centers are more likely than low-volume centers to perform elective procedures, thus the analysis did not retain statistical significance when adjusted for admission character (OR, 1.69; 95% CI, 0.74-3.87; p = 0.215).</p><p><strong>Conclusions: </strong>In a contemporary Brazilian registry, higher volume carotid endarterectomy centers were associated with lower in-hospital mortality than lower volume centers. Further studies are needed to verify this relationship considering the presence of symptoms in patients.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"22 ","pages":"e20220164"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41114661","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":"Shear wave elastography for extracranial carotid atherosclerotic plaques: technical principles and how to do it.","authors":"Pedro Luciano Mellucci, Matheus Bertanha, Rodrigo Gibin Jaldin, Winston Bonetti Yoshida, Marcone Lima Sobreira","doi":"10.1590/1677-5449.202200822","DOIUrl":"10.1590/1677-5449.202200822","url":null,"abstract":"<p><p>In the wake of studies targeting atherosclerotic plaques and searching for quantifiable variables that contribute additional information to therapeutic decision-making, plaque assessment using Shear Wave Elastography (SWE) is emerging as a reproducible and promising alternative. We used a single Logiq S8 device (General Electric, Boston, Massachusetts, United States) with an 8.5-11MHz multifrequency linear transducer at 10MHz in longitudinal section. We considered relevant criteria for image acquisition: adequate longitudinal insonation, differentiation of the intima-media complex, delineation of proximal and distal tunica adventitia and the vascular lumen, good visualization of the atherosclerotic plaque, cardiac cycle in ventricular diastole, and absence of incongruous changes. SWE is an emerging and extremely promising method for assessment of carotid plaques that may contribute to therapeutic decision-making based on characteristics related to the atherosclerotic plaque, with inter-device and inter-examiner reproducibility.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"22 ","pages":"e20220082"},"PeriodicalIF":0.8,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41144302","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":"A aorta no centro","authors":"Andre Brito-Queiroz, Grace Carvajal Mulatti, Vanessa Prado dos Santos","doi":"10.1590/1677-5449.202300891","DOIUrl":"https://doi.org/10.1590/1677-5449.202300891","url":null,"abstract":"","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67419098","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 aorta at the center.","authors":"Andre Brito-Queiroz,&nbsp;Grace Carvajal Mulatti,&nbsp;Vanessa Prado Dos Santos","doi":"10.1590/1677-5449.202300892","DOIUrl":"https://doi.org/10.1590/1677-5449.202300892","url":null,"abstract":"1 Universidade Federal da Bahia, Hospital Ana Nery, Centro de Doenças da Aorta, Salvador, BA, Brasil. 2 Universidade de São Paulo, Hospital das Clínicas, Departamento de Cirurgia Vascular e Endovascular, São Paulo, SP, Brasil. 3 Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Departamento de Anestesiologia e Cirurgia, Salvador, BA, Brasil. Financial support: None. Conflicts of interest: ABQ is a consultant at Cook Medical and GCM is a consultant at Cook Medical and Medtronic. Submitted: May 23, 2023. Accepted: June 24, 2023.","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"22 ","pages":"e20230089"},"PeriodicalIF":0.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41096995","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 platelet lymphocyte ratio and neutrophil lymphocyte ratio and clinical outcomes following carotid endarterectomy.","authors":"Vinicius Adorno Gonçalves,&nbsp;Martin Andreas Geiger,&nbsp;Danilo Augusto Sarti,&nbsp;Ana Terezinha Guillaumon","doi":"10.1590/1677-5449.202201222","DOIUrl":"https://doi.org/10.1590/1677-5449.202201222","url":null,"abstract":"<p><strong>Background: </strong>Approximately 30% of stroke cases result from carotid disease. Although several risk factors for complications after carotid endarterectomy have been identified, the existence of a biomarker that can estimate postoperative risk in these patients has not yet been proven.</p><p><strong>Objectives: </strong>This study aimed to investigate correlations between the platelet-lymphocyte ratio (PLR) and the neutrophil-lymphocyte ratio (NLR) and postoperative clinical outcomes in patients undergoing carotid endarterectomy.</p><p><strong>Methods: </strong>A retrospective study was conducted, including 374 patients who underwent carotid endarterectomy between 2002 and 2019 due to moderate to high extracranial internal carotid artery stenosis. Their platelet-lymphocyte ratio and neutrophil-lymphocyte ratios were obtained from the same blood samples.</p><p><strong>Results: </strong>There was a statistically significant correlation between the PLR and the occurrence of restenosis (p < 0.01) and acute myocardial infarction (AMI) after endarterectomy (p = 0.03). Additionally, there was a statistically significant correlation between the PLR and the combined outcomes stroke and/or AMI and/or death (p = 0.03) and stroke and/or AMI and/or death and/or restenosis (p < 0.01). However, there were no significant correlations between NLR and these outcomes (p = 0.05, p = 0.16).</p><p><strong>Conclusions: </strong>The platelet-lymphocyte ratio proved to be a useful test for predicting occurrence of strokes, acute myocardial infarctions, and deaths during the postoperative period after carotid endarterectomy. It was also associated with the risk of postoperative restenosis.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"22 ","pages":"e20220122"},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41145109","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 bilateral renal angiomyolipoma in a perimenopausal woman.","authors":"Ganesh Govinda Gowda,&nbsp;Maureen Tigga,&nbsp;Ravikumar Banavase Ramesh","doi":"10.1590/1677-5449.202000672","DOIUrl":"10.1590/1677-5449.202000672","url":null,"abstract":"<p><p>Renal angiomyolipoma is a benign and progressive tumor consisting of smooth muscle, fat, and vascular elements and is commonly associated with the tuberous sclerosis complex. Bilateral occurrence is rare and recent evidence suggest strong tumor positivity to female hormones with enlargement during pregnancy and oral contraceptive therapy. Treatment varies from a minimally invasive approach with selective embolization of the renal artery to partial nephrectomy or sometimes even radical nephrectomy. Presented here is a case of bilateral renal angiomyolipoma in 50-year-old lady who was successfully treated with super-selective embolization.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"22 ","pages":"e20200067"},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41127740","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":"Effects of aerobic and combined training on pain-free walking distance and health-related quality of life in patients with peripheral artery disease: a randomized clinical trial.","authors":"Eduardo Lima Garcia,&nbsp;Adamastor Humberto Pereira,&nbsp;Marcio Garcia Menezes,&nbsp;Alexandre Araújo Pereira,&nbsp;Ricardo Stein,&nbsp;Leandro Tolfo Franzoni,&nbsp;Luiz Claudio Danzmann,&nbsp;Antônio Cardoso Dos Santos","doi":"10.1590/1677-5449.202300242","DOIUrl":"10.1590/1677-5449.202300242","url":null,"abstract":"<p><strong>Background: </strong>Decreased walking ability in patients with peripheral arterial disease is often a clinical problem and limits the quality of life and daily activities of these subjects. physical exercise is important in this scenario, as it improves both the daily walking distance and the ability to withstand intermittent claudication related to the limitations of the peripheral disease.</p><p><strong>Objectives: </strong>Our aim was to compare the effects of two types of exercise training (aerobic training and aerobic training combined with resistance exercises) on pain-free walking distance (PFWD) and health-related quality of life (HRQoL) in a sample composed of patients with peripheral artery disease (PAD).</p><p><strong>Methods: </strong>Twenty patients with claudication symptoms were randomized to either aerobic control (AC) <b>N= 9,</b> or combined training (CT) N= 8, (24 sixty-minute sessions, twice a week). The total walking distance until onset of pain due to claudication was assessed using the 6-minute walk test and HRQoL was measured using the WHOQOL-bref questionnaire (general and specific domains) at baseline and after training. We used generalized estimating equations (GEE) to assess the differences between groups for the PFWD and HRQoL domains, testing the main group and time effects and their respective interaction effects. P values < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>Seventeen patients (mean age 63±9 years; 53% male) completed the study. Both groups experienced improvement in claudication, as reflected by a significant increase in PFWD: AC, 149 m to 299 m (P<0.001); CT, 156 m to 253 m (P<0.001). HRQoL domains also improved similarly in both groups (physical capacity, psychological aspects, and self-reported quality of life; P=0.001, P=0.003, and P=0.011 respectively).</p><p><strong>Conclusions: </strong>Both aerobic and combined training similarly improved PFWD and HRQoL in PAD patients. There are no advantages in adding strength training to conventional aerobic training. This study does not support the conclusion that combined training is a good strategy for these patients when compared with classic training.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"22 ","pages":"e20230024"},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41146180","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":"Management of traumatic superficial palmar arch pseudoaneurysm: a therapeutic challenge.","authors":"Patrick Bastos Metzger,&nbsp;Fernando Antonio Falcão Paixão,&nbsp;Sarah Fernandez Coutinho de Carvalho,&nbsp;Miguel Godeiro Fernandez,&nbsp;Simone Lessa Metzger,&nbsp;Maria Fernanda Lima Brandão,&nbsp;Rafael Borges Monteiro,&nbsp;Fabio Henrique Rossi","doi":"10.1590/1677-5449.202300732","DOIUrl":"https://doi.org/10.1590/1677-5449.202300732","url":null,"abstract":"<p><p>Pseudoaneurysm of the palmar arch is a rare entity. Diagnosis is dependent on high clinical suspicion. We present a case referred to the emergency department, with a history of glass penetrating trauma to the palmar surface with a pulsatile mass and jet bleeding. Doppler ultrasound evidenced a partially thrombosed pseudoaneurysm. A CT angiography examination showed a saccular formation arising from the superficial palmar arch. A conventional surgical approach was indicated. A clinical suspicion must be ventured to arrive at the correct diagnosis. Imaging modalities are needed to identify the pseudoaneurysm and plan the treatment course. Nonetheless, the sequence of diagnosis is individual, because further evaluation with different imaging methods may not change the rationale for the intervention. In our experience, conventional surgical removal is preferable, due to its safety and well-established outcomes.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"22 ","pages":"e20230073"},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41132032","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":"Predictive factors of infection in patients with chronic kidney disease using hemodialysis catheters.","authors":"Juliana da Costa Matos,&nbsp;Laura Lane Menezes Polsin,&nbsp;Karla Cristina Petrucelli Israel,&nbsp;Leonardo Pessoa Cavalcante","doi":"10.1590/1677-5449.202200982","DOIUrl":"https://doi.org/10.1590/1677-5449.202200982","url":null,"abstract":"<p><strong>Background: </strong>Infection is the most frequent complication of central venous catheters used for hemodialysis.</p><p><strong>Objectives: </strong>The purpose of this study was to the determine the central venous catheter-related infection rate at a dialysis center in the Brazilian state of Amazonas and to identify risk factors and the microbiological profile of the infections.</p><p><strong>Methods: </strong>This was an observational study with prospective data collection over a 12-month period by chart analysis and face-to-face interviews with patients undergoing hemodialysis using central venous catheters at a dialysis center.</p><p><strong>Results: </strong>96 central venous catheters were analyzed in 48 patients. 78 of these were non-tunneled central venous catheters (81.3%) and 18 were tunneled central venous catheters (18.7%), 53.1% of the catheters were exchanged because of infection and blood cultures were obtained from 35.2% of the patients who had catheter-related infections. Gram-negative bacteria were isolated from five of the nine blood cultures in which there was bacterial growth and Gram-positive bacteria were isolated from the other four. The most commonly isolated bacteria was <i>Staphylococcus hominis</i>, found in 22.2% of positive blood cultures.</p><p><strong>Conclusion: </strong>The overall hemodialysis venous catheter infection rate was 10.1 episodes/1000 catheter days, 15.1 episodes/1000 catheters days in non-tunneled catheters and 3.3 episodes/1000 catheters days in tunneled catheters. The infection predisposing factors identified were use of non-tunneled catheters and having 2 hemodialysis sessions per week. Regarding the microbiological profile, over half of the bacteria isolated were Gram-negative.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"22 ","pages":"e20220098"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10545231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41139284","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":"Gastrite isquêmica grave por isquemia mesentérica crônica","authors":"Bruno Moraes Ribas, Eduardo Camargo Rebolho, Guilherme Figueiró Ferronatto, Pedro Henrique Bragato, H. Akahane, E. J. D. Ramos, Thienis Maria da Costa Lima, Bárbara D’Agnoluzzo Moreira","doi":"10.1590/1677-5449.202300021","DOIUrl":"https://doi.org/10.1590/1677-5449.202300021","url":null,"abstract":"Resumo A gastrite isquêmica é uma doença rara, podendo ocorrer por insuficiência vascular focal ou sistêmica. Essa condição é raramente vista na prática médica devido à vasta rede colateral arterial do estômago pelo tronco celíaco e mesentérica superior. A apresentação clássica da isquemia crônica é formada pela tríade de dor pós-prandial, perda de peso e sopro abdominal. A intervenção está indicada naqueles pacientes sintomáticos, sendo o tratamento endovascular uma alternativa à cirurgia em pacientes com alta comorbidade, tendo bons resultados. Reportamos um caso de gastrite isquêmica grave com úlceras e sangramento que foi causado por isquemia mesentérica crônica, em uma paciente de 71 anos, com oclusão do tronco celíaco e mesentérica inferior, além de estenose crítica da superior. O diagnóstico foi confirmado por exame de imagem, e a paciente foi submetida a tratamento endovascular. Trata-se de uma condição rara de diagnóstico e tratamento desafiadores, a qual requer uma equipe multidisciplinar para o manejo adequado.","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67419093","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}