Jornal Vascular Brasileiro最新文献

True femoral circumflex artery aneurysms are a rare clinical entity. There are limited data available on their incidence, diagnosis, and management. While rare, their significance lies in potential complications such as rupture or limb-threatening ischemia. The objective of this study is to present a new case in a 56-year-old male patient who presented with an expanding mass in his right thigh caused by a 90x50x70 mm lateral circumflex femoral artery aneurysm which was compressing the common femoral vein. No other aneurysms were found. The aneurysm sac was embolized, followed by proximal ligation, achieving complete exclusion of the aneurysm. We also systematically reviewed the PubMed and Scopus databases for true circumflex artery aneurysms, finding only six case reports documented, all of which were treated with resection and ligation. While open surgery has conventionally been the primary approach, endovascular techniques may play a role in enhanced treatment for these aneurysms.

Knowledge of vascularization is essential for surgical planning and interventional procedures in the axillary region. The axillary artery gives off branches supplying the shoulder, thoracic wall, and scapula. It then continues as the brachial artery, which furnishes branches to the arm and elbow. Minor variations in these branches are common. However, dissection of a formalin-fixed right upper limb revealed an axillary artery that bifurcated into a superficial brachial artery, which did not give off any branches, and a posterior trunk, that gave rise to all the branches typically originating from the third part of the axillary artery and the brachial artery, including the subscapular artery, the humeral circumflex arteries, the deep brachial artery, and the collateral ulnar arteries. This rare vascular arrangement has not been previously described in Brazil. Awareness of these variations may prevent diagnostic errors and injuries during surgeries.

This case report presents the successful treatment of a 47-year-old male patient with a venous ulcer of the leg associated to deep and superficial venous insufficiency. The patient presented with a non-healing venous ulcer on his leg, ocher dermatitis and heaviness of the leg, which interfered with work activities. Duplex ultrasound revealed deep venous insufficiency (popliteal vein), incompetence of the great saphenous and indirect perforating veins. The treatment involved ablation of the great saphenous vein using Flebogrif®, a specific mechanochemical ablation device. Following the treatment, the patient experienced significant improvement in his symptoms and venous ulcer was completely healed 9 weeks after the procedure and one year after that. Duplex ultrasound performed after the treatment confirmed the successful closure of the great saphenous vein. This case report highlights the effectiveness of mechanochenical ablation in the management of venous ulcers, even when deep venous insufficiency is involved.

The removal of a central venous catheter can cause serious complications, such as air embolism, but there is limited evidence on effective prevention methods. This integrative review followed PRISMA guidelines and analyzed studies in English, Portuguese, and Spanish, without time restrictions, in the LILACS, Web of Science, PubMed, CINAHL, and EMBASE databases. Two studies were selected. One compared two removal methods and found that the modified technique reduced the occurrence of air embolism compared to the traditional method. The other study indicated that removal with suture over the catheter was also effective in prevention. Despite these promising findings, experimental research is needed to determine best practices. Additionally, factors such as patient positioning and maneuvers like the Valsalva maneuver should be further studied to optimize air embolism prevention.

Angioleiomyomas are rare, benign, smooth muscle tumors that occur predominantly in the lower limbs and infrequently in the upper limbs. We present a case of angioleiomyoma arising from the distal ulnar artery, presenting as a painful lesion with a 20-year history of diagnostic uncertainty. It was preoperatively misdiagnosed as an ulnar artery aneurysm. Surgical excision with primary end-to-end arterial repair was performed. Histopathological examination confirmed features consistent with a leiomyoma arising from the distal ulnar artery wall. The patient became asymptomatic following the surgery and remains pain-free at 6 months of follow-up.

A sound knowledge of variations in the branching pattern of the abdominal aorta is crucial for operative, diagnostic, and endovascular procedures. We report a unilateral anomalous lateral branch of the abdominal aorta observed during dissection classes.This anomalous branch took origin from the anterior surface of the abdominal aorta behind the left renal vein and pierced the left renal vein. After piercing the left renal vein, it traced a tortuous course through the peri-renal fat pad in front of the lower part of the left kidney. The artery then ran downward and laterally, pierced the anterior layer of thoracolumbar fascia, and continued to the posterior abdominal wall to supply its muscles. It also supplied the fat and fasciae around the kidney. Such an anomalous lateral branch could bleed significantly during renal surgery. It could also mislead radiologists during the invasive radiologic procedures.

Background: Chronic Venous Disease (CVD) of the lower extremities (LEs) is a condition with significant prevalence and hospital admission rates.

Objectives: To analyze temporal trends in hospitalization due to CVD from 2014 to 2023 in Brazil.

Methods: An ecological time series study of CVD-related hospitalization using data from the Brazilian Unified Health System. Data were analyzed using simple linear regression with annual variation (β) and percentage changes, with significance set at p < 0.05.

Results: A total of 1,091,733 CVD-related hospital admissions were recorded for the period assessed. The overall rate showed a stable trend (β = -3.233; p = 0.060), with an average of 73.98 hospital admissions per 100,000 inhabitants. Statistically significant reductions were observed in the Northeast (β = -1.275; p = 0.042), Southeast (β = -4.262; p = 0.044), and South (β = -7.282; p = 0.012) regions of Brazil. The North and Midwest regions had stable rates. Both sexes showed stable trends, although hospital admission rates were higher among women. Significant reductions were found among men aged 20 and older and among women aged 20 - 49 and 70 and older. Stable rates were observed in women aged 50-69.

Conclusions: Overall hospital admission rates for CVD in Brazil remained stable between 2014 and 2023. However, regional and age-specific differences highlight the need for targeted public health strategies, particularly for women aged 50-69 and residents of the North and Midwest regions.

Atherosclerosis is a chronic inflammation of the artery wall caused by injury to the vascular endothelium and influenced by many different risk factors. Carotid stenosis is a crucial marker of cardiovascular risk that is especially relevant among men over the age of 65. Treatment and diagnostic methods for carotid disease are the subject of debate. This integrative review analyses research on Doppler ultrasonography assessment of atherosclerotic plaques. Searches of the PubMed and SciELO databases identified 69 articles, 16 of which provided details of this method of analysis. Doppler ultrasound has become the technique most often used because it is non-invasive and provides detailed information on plaque morphology and blood flow. Doppler ultrasonography enables comprehensive evaluation of plaques, identifying their morphological characteristics and estimating the risk of complications. It is concluded that Doppler ultrasonography is essential for assessment of carotid disease, enabling a noninvasive and detailed assessment and contributing to early identification of high-risk patients and improving clinical results.

Background: Facial vascular lesions are a common situation in medical practice and can cause cosmetic concerns for patients.

Objectives: To evaluate the results of facial telangiectasia treatment using the Nd:YAG 1064nm transdermal laser.

Methods: A retrospective study was conducted in which two independent evaluators evaluated pre- and post-treatment photographic records of patients submitted to Nd:YAG 1064nm transdermal laser treatment for facial vascular lesions.

Results: Both evaluators' ratings indicated a statistically significant improvement after treatment (p<0.0001), with a moderate strength of agreement between evaluators.

Conclusions: Limitations notwithstanding, the results suggest that the use of 1064 nm Nd:YAG transdermal laser for the treatment of facial vascular lesions proved to be effective for treating facial vascular lesions.