Jornal Vascular Brasileiro最新文献

{"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}

{"title":"Efficacy and safety of paclitaxel drug-coated balloon angioplasty for stenosis of hemodialysis vascular access: 6-month results from a brazilian multicenter prospective study.","authors":"Leonardo de Oliveira Harduin, Thiago Almeida Barroso, Julia Bandeira Guerra, Márcio Gomes Filippo, Leonardo Cortizo de Almeida, Carlos Alexandre Rosa Gama, Brunno Ribeiro Vieira, Renata Silveira Mello, Adriano Martins Galhardo, Jorge Paulo Strogoff-de-Matos","doi":"10.1590/1677-5449.202401032","DOIUrl":"10.1590/1677-5449.202401032","url":null,"abstract":"<p><strong>Background: </strong>Stenosis resulting from neointimal hyperplasia remains a significant concern associated with dysfunction of arteriovenous fistulas (AVF).</p><p><strong>Objectives: </strong>To investigate the safety and efficacy of paclitaxel drug-coated balloon (DCB) angioplasty for treating failing AVFs.</p><p><strong>Methods: </strong>Investigators analyzed 58 hemodialysis patients treated with Ranger^TM DCBs from December 2022 to December 2023 across four centers. Lesions treated were de novo or restenotic and located in the juxta-anastomosis, cannulation zone, and outflow segment. Patients were evaluated through physical examinations and Duplex ultrasound at 1, 3, and 6 months. The primary efficacy endpoint was target lesion primary patency at 1, 3, and 6 months, and the primary safety endpoint was freedom from serious adverse events through 30 days post-procedure. Secondary endpoints were access circuit primary patency and technical and procedural success.</p><p><strong>Results: </strong>Nine patients (16%) had thrombosed access at the initial presentation, and 31 (53%) presented with recurrent stenosis. The target lesion primary patency rate at 6 months was 85.7%, and the access circuit primary patency rate at 6 months was 67.5%. No serious adverse events, either local or systemic, were reported. Sex, age, stenosis location, type of lesion, presence of thrombosis, lesion recurrence, diabetes status, or whether post-ballooning dilation was performed did not significantly affect the 6-month target lesion primary patency.</p><p><strong>Conclusions: </strong>DCB angioplasty was shown to be safe and effective for treating peripheral stenosis in vascular access.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240103"},"PeriodicalIF":0.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467992","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":"Spontaneous aneurysm of a common digital artery: a rare entity.","authors":"Thilina Gunawardena","doi":"10.1590/1677-5449.202400832","DOIUrl":"10.1590/1677-5449.202400832","url":null,"abstract":"<p><p>Aneurysms of arteries of the hand are rarely encountered. Literature reports such aneurysms in the distal ulnar artery, the palmar artery, and the digital arteries. Most are false aneurysms involving trauma-induced defects of the vessel wall. True aneurysms with intact intimal, medial, and adventitial layers of the arterial wall are more unusual. In this case report, we present a 77-year-old previously healthy lady who was diagnosed with a true aneurysm of a common digital artery when she presented with a pulsatile lump over her left palm.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240083"},"PeriodicalIF":0.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468035","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":"Accuracy of duplex ultrasound in peripheral artery disease: a systematic review and meta-analysis.","authors":"Silfayner Victor Mathias Dias, Ronald Luiz Gomes Flumignan, Nelson Carvas, Wagner Iared","doi":"10.1590/1677-5449.202400332","DOIUrl":"10.1590/1677-5449.202400332","url":null,"abstract":"<p><p>Lower limb peripheral artery disease (PAD) is highly prevalent. Current guidelines recommend duplex ultrasound (DUS) with spectral analysis for diagnosis. This systematic review and meta-analysis assessed the diagnostic accuracy of DUS in symptomatic PAD patients. We searched electronic databases for studies comparing DUS and arteriography. Arteries were analyzed individually and grouped into segments (aorto-common femoral, femoropopliteal, below the knee, and the entire lower limb). The meta-analysis estimated sensitivity, specificity, likelihood, and diagnostic odds ratios (DOR). Fifteen studies were included, analyzing 9,067 arteries. DUS accuracy for symptomatic PAD was 0.86 (95% CI 0.81-0.90) for sensitivity and 0.95 (95% CI 0.78-0.97) for specificity. The best results were observed for the femoropopliteal segment: sensitivity 0.86 (95% CI 0.80-0.90), specificity 0.95 (95% CI 0.93-0.97). The poorest performance was observed for the below-the-knee segment: sensitivity 0.78 (95% CI 0.60-0.89), specificity 0.92 (95% CI 0.78-0.97). Most studies had high and unclear risk of bias. There is significant heterogeneity in results, with a limited number of primary studies for each arterial segment, especially for the below-the-knee segment.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20240033"},"PeriodicalIF":0.8,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467986","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":"Portal-splenic-mesenteric venous thrombosis in COVID-19 patients: a systematic review.","authors":"Ricardo Zanetti Gomes, Matheus Von Jelita Salina, Vitor Hugo Moro Pironatto, Julia Kapp Lepinski, Tiago Daniel Gueiber, Beatriz Moreira Salles Juliatto, Milena Zadra Prestes, Camila Marinelli Martins","doi":"10.1590/1677-5449.202301282","DOIUrl":"10.1590/1677-5449.202301282","url":null,"abstract":"<p><p>The COVID-19 pandemic affected millions of people worldwide. In addition to respiratory impairment, this viral infection can also provoke gastrointestinal symptoms caused by vascular disorders, such as portal-splenic-mesenteric venous thrombosis (PSMVT). This systematic review aimed to investigate the profile of patients who developed PSMVT concomitant with or after viral infection and its predominant outcomes. The database searches returned 214 articles. Of these, 40 case reports were included in the review, presenting a total of 41 cases of PSMVT addressed. Males were more prevalent (n=27; 65.85%), mean age was 51.54 years, and 19.57% had a previous history of endocrine diseases. Statistically significant relationships (p<0.05) were found between patient death and tachypnea at hospital admission (p=0.043) and between patient death and age (p=0.019). It was therefore possible to identify the main profiles and risk factors for PSMVT development and mortality of COVID-19 infected patients.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20230128"},"PeriodicalIF":0.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414340","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":"Brazilian Consensus Statement on Lipedema using the Delphi methodology.","authors":"Alexandre Campos Moraes Amato, Ana Paula Rolim Maia Peclat, Rodrigo Kikuchi, Antonio Carlos de Souza, Mariana Thalyta Bertolin Silva, Roney Hans Prager de Oliveira, Daniel Augusto Benitti, Julio Cesar Peclat de Oliveira","doi":"10.1590/1677-5449.202301832","DOIUrl":"10.1590/1677-5449.202301832","url":null,"abstract":"<p><p>Lipedema, historically underrecognized, has recently gained attention due to advancements in research and growing public awareness. The Brazilian Consensus Statement on Lipedema, developed by the Brazilian Society of Angiology and Vascular Surgery, aims to establish clear recommendations for the diagnosis, treatment, and management of lipedema. Using the Delphi methodology, experts elaborated 90 statements about lipedema, which were then evaluated by a panel of 113 professionals. The statements were analyzed using SurveyMonkey, with a 75% agreement threshold required for their inclusion in the consensus statement. Most statements achieved significant consensus, with only 9 topics requiring further investigation. This consensus statement highlights the complexity of lipedema, the effectiveness of conservative treatment over surgery, the need for multidisciplinary approaches, and the importance of awareness to reduce underdiagnosis and stigma. It also underscores the ongoing need for research to develop more effective management strategies.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"24 ","pages":"e20230183"},"PeriodicalIF":0.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414338","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":"Andexanet alfa for oral fxa inhibitor-associated major acute intracerebral hemorrhage: insights into clinically relevant thromboembolic events from the ANNEXA-I study.","authors":"Mateo Porres-Aguilar, Luis Antonio Meillon-Garcia, João Carlos de Campos Guerra","doi":"10.1590/1677-5449.202401332","DOIUrl":"10.1590/1677-5449.202401332","url":null,"abstract":"","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20240133"},"PeriodicalIF":0.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046609","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":"Lipedema: exploring pathophysiology and treatment strategies - state of the art.","authors":"Fabio Kamamoto, Jaqueline Munaretto Timm Baiocchi, Bernardo Nogueira Batista, Renan Diego Américo Ribeiro, Débora Aparecida Oliveira Modena, Vitor Cervantes Gornati","doi":"10.1590/1677-5449.202400252","DOIUrl":"10.1590/1677-5449.202400252","url":null,"abstract":"<p><p>Lipedema is characterized by abnormal fat deposition in areas such as the arms, hips, buttocks, and thighs, sparing the hands and feet. Symptoms include pain, bruising, edema, and subcutaneous nodules, which resist traditional interventions such as diet and exercise. Despite increasing recognition, comprehensive understanding, including pathophysiological, clinical, and therapeutic aspects, has not been fully achieved. This review aims to fill gaps in knowledge of this field, to support more informed management of lipedema. This narrative review provides a deeper understanding of lipedema treatment, addressing pathophysiology and therapeutic options. The data reveal advances in knowledge, especially regarding conservative and surgical treatments, focusing on improving quality of life. However, scientific evidence supporting the safety and efficacy of various treatments is lacking. Additional research is needed to ensure safety and to enhance efficacy of management of this complex condition.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20240025"},"PeriodicalIF":0.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046726","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":"Techniques for randomization and allocation for clinical trials.","authors":"Anna Carolina Miola, Ana Cláudia Cavalcante Espósito, Hélio Amante Miot","doi":"10.1590/1677-5449.202400462","DOIUrl":"10.1590/1677-5449.202400462","url":null,"abstract":"<p><p>Intervention studies require all participants to originate from the same population, with random allocation to intervention groups to ensure comparability. Randomization is crucial for minimizing confounding factors, allowing differences in outcomes to be attributed to the intervention. Simple randomization performs well for large samples (>100 per group), but smaller samples may require block or stratified randomization to balance group sizes and covariates. When randomization isn't feasible, quasi-randomized methods (e.g., based on dates or enrollment order) can help but must compensate with multivariate adjustments. Moreover, blinding and allocation concealment enhance internal validity and reproducibility. Allocation concealment (e.g., sealed envelopes) prevents bias during participant assignment while blinding mitigates detection and performance biases. Precise methodological descriptions in clinical trial registrations and publications enhance study reliability and reproducibility, highlighting the importance of rigorous planning and transparent reporting in intervention research. This article reviews the key concepts of randomization, blinding, and allocation concealment in interventional studies.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20240046"},"PeriodicalIF":0.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046728","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}