Jornal Vascular Brasileiro最新文献

{"title":"Indications for carotid Doppler ultrasound in asymptomatic patients - are we ordering it correctly?","authors":"Alcides Alves da Silva,&nbsp;André Brusamolin Moro,&nbsp;Jeferson Freitas Toregeani","doi":"10.1590/1677-5449.202200841","DOIUrl":"https://doi.org/10.1590/1677-5449.202200841","url":null,"abstract":"<p><strong>Background: </strong>Carotid arteries are frequently the site of pathologies, the most common being atherosclerosis, which may result in the formation of plaques, causing stenosis. Doppler ultrasound is currently the exam of choice for assessment of the carotid arteries in asymptomatic patients to screen for and diagnose vascular lesions. Current guidelines recommend screening patients who have risk factors for carotid stenosis and who are able and willing to undergo medical treatment and/or carotid intervention. Screening asymptomatic patients in the general adult population who have no significant risk factors is not recommended.</p><p><strong>Objectives: </strong>To assess whether medical experts rely on the literature to request Doppler ultrasound for screening.</p><p><strong>Methods: </strong>A retrospective selection of patients was performed based on requests for carotid ultrasound. The data collected were computed and analyzed using RStudio version 1.3.959.</p><p><strong>Results: </strong>The request was evaluated as appropriate as long as the patients presented at least one risk factor for carotid plaques. Fifty-five out of 152 patients met criteria for carotid screening. The most frequent indication in the study population was vascular check-up. Arterial hypertension was the most prevalent risk factor. Vascular surgery specialists were more likely to order the exam correctly (odds ratio for correct indications: 3.52 [CI 1.14 - 10.87], with p=0.02). The rate of correct Doppler ultrasound requests was 36% (95%CI 29 to 42%).</p><p><strong>Conclusions: </strong>An excess of requests for carotid ultrasound screening was found in this study. Vascular surgeons more often requested the test correctly.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9990462","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":"Deep venous thrombosis of the contralateral iliac vein after stenting of the iliocaval confluence: a therapeutic challenge.","authors":"Annata Teixeira Della Costa,&nbsp;Igor Rafael Sincos,&nbsp;Lorrane Vieira Siqueira Riscado","doi":"10.1590/1677-5449.202201621","DOIUrl":"https://doi.org/10.1590/1677-5449.202201621","url":null,"abstract":"<p><p>The treatment of choice for patients with symptomatic venous compression syndrome is venous stenting. However, this treatment has well-documented complications and, although rare, contralateral deep venous thrombosis is one of these complications. Our objective is to present a case of deep venous thrombosis of the contralateral iliac vein resulting from placement of the stent beyond the recommended position and the therapeutic challenge is to recanalize the vein with reconstruction of the iliocaval confluence.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9996773","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":"Surgical resection of retrohepatic inferior vena cava leiomyosarcoma without vascular reconstruction: case report.","authors":"Ian Freire Castro,&nbsp;Paulo Henrique Silva Nunes,&nbsp;Ana Camila Xavier Lopes,&nbsp;Mariana Coelho Lima,&nbsp;Régis Ponte Conrado,&nbsp;Renato Mazon Lima Verde Leal,&nbsp;Annya Costa Araújo de Macedo Goes,&nbsp;Marcelo Leite Vieira Costa","doi":"10.1590/1677-5449.202201081","DOIUrl":"https://doi.org/10.1590/1677-5449.202201081","url":null,"abstract":"<p><p>Inferior vena cava leiomyosarcoma (IVCL) is a rare malignant mesenchymal tumor. Surgical treatment is a challenge because it must combine free surgical margins with vascular reconstruction, using prosthetic or autologous grafts, primary suture, or simple ligation without vein reconstruction. The ligation option is possible thanks to the slow growth of the tumor, allowing collateral venous circulation to develop. We present a case of an IVCL treated with radical resection without vascular reconstruction. The patient was a 48-year-old female with abdominal pain in the right upper quadrant, asthenia, and postprandial dyspeptic symptoms. Abdominal tomography revealed a mass with an expansive formation located in the infrahepatic segment of the inferior vena cava and reduced vessel lumen. During surgery, vein clamping did not provoke hemodynamic repercussions, suggesting sufficient collateral circulation formation. It was decided to perform a radical resection of the entire portion of the retrohepatic vena cava and ligate the vena cava without vascular reconstruction. The patient recovered without complications.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9996777","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":"Diretrizes brasileiras de diagnóstico e tratamento de lesões vasculares traumáticas","authors":"Adenauer Marinho de Oliveira Góes Junior, José Gustavo Parreira, Gustavo Henrique Dumont Kleinsorge, Marcelo Bellini Dalio, Pedro Henrique Ferreira Alves, Francisco João Sahagoff de Deus Vieira Gomes, Walter Junior Boim de Araujo, Edwaldo Edner Joviliano, Julio Cesar Peclat de Oliveira","doi":"10.1590/1677-5449.202300421","DOIUrl":"https://doi.org/10.1590/1677-5449.202300421","url":null,"abstract":"Resumo Trauma é uma causa importante de morbimortalidade, que acomete principalmente jovens. A hemorragia incoercível é o principal mecanismo de óbito precoce nessas vítimas, e as lesões vasculares não compressíveis representam grandes desafios para os cirurgiões. O traumatismo vascular impacta diretamente a viabilidade de membros traumatizados, aumentando o risco de amputação. Nas últimas décadas, muitas condutas de diagnóstico e tratamento de lesões vasculares traumáticas foram modificadas. A angiotomografia suplantou a angiografia como padrão ouro para diagnóstico, as técnicas endovasculares foram incorporadas ao arsenal terapêutico e o conceito de “controle de danos” foi estabelecido. No entanto, há lacunas na literatura nacional sobre a normatização de condutas em trauma vascular, principalmente considerando as limitações do Brasil. Por isso, a Sociedade Brasileira de Angiologia e de Cirurgia Vascular e a Sociedade Brasileira de Atendimento Integrado ao Traumatizado revisaram a literatura disponível sobre trauma vascular e organizaram diretrizes sobre o diagnóstico e tratamento dessas lesões.","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135262481","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":"Fístula arteriovenosa ilíaca à direita por rotura de aneurisma e aneurisma de artéria ilíaca esquerda: tratamento híbrido","authors":"Adalberto Pereira de Araujo, Cristiane Ferreira de Araujo Gomes, Douglas Poschinger-Figueiredo, Carlos Felipe da Silva Delgado, Monica Rochedo Mayall, Flavia Figueira Baltharejo Campanario, Felipe Borges Fagundes","doi":"10.1590/1677-5449.202200171","DOIUrl":"https://doi.org/10.1590/1677-5449.202200171","url":null,"abstract":"Resumo A fístula arteriovenosa (FAV) é uma sequela incomum de rotura espontânea de aneurisma arterial dentro do sistema venoso adjacente. Descrevemos, em um paciente de 74 anos, o tratamento endovascular de FAV ilíaca à direita por aneurisma de artéria ilíaca comum (AIC) roto associado a aneurisma de AIC distal à esquerda, em cuja cirurgia foram preservadas as artérias lombares e mesentérica inferior por necessidade de excluir simultaneamente as artérias hipogástricas. Foram demonstrados os fenômenos na dinâmica do balanço hídrico ocorridos em decorrência da interrupção da FAV. A evolução do paciente foi benigna, com normalização das graves alterações hemodinâmicas que apresentava e com desaparecimento dos sintomas respiratórios atribuídos à hipertensão arterial pulmonar.","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136203696","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":"Endovascular repair of bilateral sciatic artery aneurysm with Covera® self expandable covered stents - case report.","authors":"Luisa Silveira Birck,&nbsp;Rodrigo Damazzini,&nbsp;Wiliam Perdomo Nunes,&nbsp;Thiago Filomena Lombard,&nbsp;Joel Alex Longhi","doi":"10.1590/1677-5449.202200642","DOIUrl":"https://doi.org/10.1590/1677-5449.202200642","url":null,"abstract":"<p><p>A persistent sciatic artery is an embryological remnant of the internal iliac artery that occurs in 0.03% to 0.06% of the population and may develop aneurysmal degeneration. Aneurysms can lead to distal embolization with increased risk of limb loss, especially if the sciatic artery is the main arterial supply to the limb. A sciatic artery aneurysm must be treated whenever diagnosed, because of the high risk of complications. Treatment options include open, endovascular, or hybrid repair. This manuscript describes a patient with bilateral persistence of the sciatic arteries, both with aneurysmal degeneration, who underwent endovascular repair with Covera^® (Bard Medical, Georgia-USA) covered stents.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9990460","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 rare cause of deep vein thrombosis: inferior vena cava agenesis.","authors":"Pablo Del Canto Peruyera,&nbsp;Manuel Javier Vallina-Victorero Vázquez","doi":"10.1590/1677-5449.202201262","DOIUrl":"https://doi.org/10.1590/1677-5449.202201262","url":null,"abstract":"<p><p>Inferior vena cava agenesis is a rare condition and is often misdiagnosed. This anomaly is asymptomatic in the majority of cases and is usually diagnosed during imaging tests carried out for other purposes. The most frequent manifestation is deep vein thrombosis (DVT) in lower limbs and anticoagulation therapy is the most frequent treatment option. Other techniques such as thrombolysis and venous bypass are also described. We report two cases diagnosed at our institution during the last year, both of which presented with an episode of DVT. We opted for indefinite anticoagulation therapy and both patients remain asymptomatic, after 1 year of surveillance in the first case and 6 months in the second, with no new episodes of DVT. Although it is not a life-threatening anomaly, it is important to make an appropriate diagnosis and provide treatment to improve the symptoms and quality of life of these patients.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9996778","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":"Influence of atherosclerosis risk factors on the anatomical distribution of peripheral arterial disease in patients with chronic limb-threatening ischemia: a cross-sectional study.","authors":"Vanessa Prado Dos Santos,&nbsp;Camila Izabel Cerutti,&nbsp;Marcelo José Carlos Alencar,&nbsp;André Brito Queiroz,&nbsp;Lucas de Mello Ferreira,&nbsp;Cícero Fidelis,&nbsp;José Siqueira de Araújo,&nbsp;Carlos Alberto Silveira Alves","doi":"10.1590/1677-5449.202300141","DOIUrl":"https://doi.org/10.1590/1677-5449.202300141","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerosis risk factors can have different impacts on cardiovascular diseases and on the anatomical distribution of Peripheral Arterial Disease (PAD).</p><p><strong>Objectives: </strong>To study the influence of atherosclerosis risk factors on the anatomical distribution of PAD in patients with chronic limb-threatening ischemia (CLTI).</p><p><strong>Methods: </strong>We performed an observational, cross-sectional, and analytical study that included 476 hospitalized patients with CLTI due to PAD. We compared the presence of atherosclerosis risk factors (age, gender, diabetes mellitus, smoking, and hypertension) in patients with PAD involving three different anatomic areas (aortoiliac, femoropopliteal, and infrapopliteal). Multivariate analysis was performed to identify associations between atherosclerosis risk factors and PAD distribution.</p><p><strong>Results: </strong>The mean age of the 476 patients was 69 years, 249 (52%) were men, and 273 (57%) had diabetes. Seventy-four percent (353) had minor tissue loss. Multivariate analysis identified three risk factors associated with PAD anatomical distribution (gender, smoking, and DM). Women had a 2.7 (CI: 1.75-4.26) times greater chance of having femoropopliteal disease. Smokers had a 3.6-fold (CI: 1.54-8.30) greater risk of aortoiliac disease. Diabetic patients were 1.8 (CI: 1.04-3.19) times more likely to have isolated infrapopliteal occlusive disease.</p><p><strong>Conclusions: </strong>The study showed that gender, DM, and smoking impact on the anatomical distribution of PAD in patients with CLTI. Diabetic patients were more likely to have only infrapopliteal disease, women had a greater risk of femoropopliteal PAD, and smokers had a greater risk of aortoiliac occlusive disease.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10371922","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":"Endoscopic lumbar sympathectomy as a treatment option for primary erythromelalgia - case report and review.","authors":"Marcelo de Paula Loureiro,&nbsp;Pietro Maran Novais,&nbsp;João Augusto Nocera Paulin,&nbsp;Daniel Benzecry de Almeida,&nbsp;Arlindo Nascimento de Lemos","doi":"10.1590/1677-5449.202200952","DOIUrl":"https://doi.org/10.1590/1677-5449.202200952","url":null,"abstract":"<p><p>Erythromelalgia is a rare disease, involving pain, edema, redness, and hyperthermia in the limbs. It is extremely refractory to drugs, has no defined treatment, and causes psychological comorbidities in the patient. We describe a case of erythromelalgia involving a 17-year-old boy who had been suffering from the disease for almost 4 years prior to finding an effective treatment. A bilateral endoscopic lumbar sympathectomy was performed, limited to L2 and L3 resections. Four weeks after the procedure, the patient's symptoms were significantly mitigated and at 8 months follow-up he remained almost asymptomatic. Endoscopic lumbar sympathectomy was an effective treatment for primary erythromelalgia in this teenager, with exceptional reduction of his symptoms.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10026352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9159219","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":"Prolonged Doppler US-guided pneumatic compression of a radial artery pseudoaneurysm after percutaneous coronary intervention: a simple and effective solution for a rare and challenging problem","authors":"Marcos Danillo Oliveira, Pedro Perillo, Lélio Lemos Neto, Adriano Caixeta","doi":"10.1590/1677-5449.202102122","DOIUrl":"https://doi.org/10.1590/1677-5449.202102122","url":null,"abstract":"Abstract Transradial access is associated with fewer access site-related complications, earlier patient mobilization, and greater postprocedural comfort. Pseudoaneurysms are an extremely rare complication after transradial procedures and the radial artery itself is the most atypical arterial site of occurrence. We report a case in which a non-surgical, non-invasive, simple, and effective solution (prolonged pneumatic compression) was used to manage a radial artery pseudoaneurysm, a very rare and challenging complication of transradial procedures.","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136304857","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}