Pub Date : 2024-09-03eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202301072
Marcone Lima Sobreira, Marcos Áreas Marques, Adilson Ferraz Paschoa, Alcides José Araújo Ribeiro, Ivan Benaduce Casella, Marcelo Calil Burihan, Marcelo Fernando Matielo, Rafael de Athayde Soares, Walter Junior Boin de Araujo, Edwaldo Edner Joviliano, Julio Cesar Peclat de Oliveira
Deep vein thrombosis is one of the main causes of inpatient and outpatient morbidity, both in medical and surgical patients, significantly impacting mortality statistics and requiring prompt diagnosis so that treatment can be initiated immediately. This document was prepared and reviewed by 11 specialists certified by the Brazilian Society of Angiology and Vascular Surgery, who searched the main databases for the best evidence on the diagnostic (physical examination, imaging) and therapeutic approaches (heparin, coumarins, direct oral anticoagulants, fibrinolytics) to the disease.
{"title":"Guidelines on deep vein thrombosis of the Brazilian Society of Angiology and Vascular Surgery.","authors":"Marcone Lima Sobreira, Marcos Áreas Marques, Adilson Ferraz Paschoa, Alcides José Araújo Ribeiro, Ivan Benaduce Casella, Marcelo Calil Burihan, Marcelo Fernando Matielo, Rafael de Athayde Soares, Walter Junior Boin de Araujo, Edwaldo Edner Joviliano, Julio Cesar Peclat de Oliveira","doi":"10.1590/1677-5449.202301072","DOIUrl":"https://doi.org/10.1590/1677-5449.202301072","url":null,"abstract":"<p><p>Deep vein thrombosis is one of the main causes of inpatient and outpatient morbidity, both in medical and surgical patients, significantly impacting mortality statistics and requiring prompt diagnosis so that treatment can be initiated immediately. This document was prepared and reviewed by 11 specialists certified by the Brazilian Society of Angiology and Vascular Surgery, who searched the main databases for the best evidence on the diagnostic (physical examination, imaging) and therapeutic approaches (heparin, coumarins, direct oral anticoagulants, fibrinolytics) to the disease.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287746","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}
Pub Date : 2024-08-30eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202400242
Abdalla Ahmed Eldaw Elamin, Naveen Kumar, Vijay Paul Samuel, Kumar Megur Ramakrishna Bhat
Variations in the drainage (termination) and course of the lower limb veins are not uncommon. When dissecting the left lower limb of the adult male cadaver in the vascular case described herein, a unique kind of unilateral short saphenous vein (SSV) termination was observed. It was found that the SSV had normal origin and course in the dorsum of the foot and the back of the leg, respectively. Most often the SSV terminates in the popliteal vein at the popliteal fossa. In this case, it extended upward into the back of the thigh, passing behind the sciatic nerve and then deep to it and the biceps femoris, and finally ended in the veins of the thigh. The SSV did not penetrate any structures along its course to the end, so this unusual vein appears unlikely to be associated with SSV varicose veins. For general, plastic, cardiothoracic, and vascular surgeons, our case would be of significant value.
{"title":"Giacomini's vein - a report on the invaluable importance of an anomalous short saphenous vein.","authors":"Abdalla Ahmed Eldaw Elamin, Naveen Kumar, Vijay Paul Samuel, Kumar Megur Ramakrishna Bhat","doi":"10.1590/1677-5449.202400242","DOIUrl":"https://doi.org/10.1590/1677-5449.202400242","url":null,"abstract":"<p><p>Variations in the drainage (termination) and course of the lower limb veins are not uncommon. When dissecting the left lower limb of the adult male cadaver in the vascular case described herein, a unique kind of unilateral short saphenous vein (SSV) termination was observed. It was found that the SSV had normal origin and course in the dorsum of the foot and the back of the leg, respectively. Most often the SSV terminates in the popliteal vein at the popliteal fossa. In this case, it extended upward into the back of the thigh, passing behind the sciatic nerve and then deep to it and the biceps femoris, and finally ended in the veins of the thigh. The SSV did not penetrate any structures along its course to the end, so this unusual vein appears unlikely to be associated with SSV varicose veins. For general, plastic, cardiothoracic, and vascular surgeons, our case would be of significant value.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287745","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}
Pub Date : 2024-08-23eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202400212
Wallace Klein Schwengber, Claudia Carolina Schnorr, Guilherme Camargo Winckler, Ricardo Bocchese Paganella, Marco Aurélio Grudtner
Idiopathic popliteal artery pseudoaneurysms are exceedingly rare, posing significant diagnostic challenges due to their elusive etiology. This report presents the case of a 78-year-old female with no history of trauma or orthopedic procedures who was diagnosed with a large pulsatile mass in the right popliteal fossa. Arteriography confirmed a popliteal artery pseudoaneurysm. Despite extensive clinical evaluation, no causative factors were identified, suggesting an idiopathic diagnosis. The patient underwent open surgical repair using a posterior approach, during which the popliteal artery defect was closed using a bovine pericardium patch. Postoperative follow-up revealed proximal patch stenosis, necessitating angioplasty. This case underscores the need for comprehensive diagnostic evaluation of atypical pseudoaneurysm presentations and highlights the complexities involved in managing idiopathic cases, emphasizing the importance of postoperative follow-up to address potential complications.
{"title":"Popliteal artery pseudoaneurysm of spontaneous occurrence: a case report.","authors":"Wallace Klein Schwengber, Claudia Carolina Schnorr, Guilherme Camargo Winckler, Ricardo Bocchese Paganella, Marco Aurélio Grudtner","doi":"10.1590/1677-5449.202400212","DOIUrl":"https://doi.org/10.1590/1677-5449.202400212","url":null,"abstract":"<p><p>Idiopathic popliteal artery pseudoaneurysms are exceedingly rare, posing significant diagnostic challenges due to their elusive etiology. This report presents the case of a 78-year-old female with no history of trauma or orthopedic procedures who was diagnosed with a large pulsatile mass in the right popliteal fossa. Arteriography confirmed a popliteal artery pseudoaneurysm. Despite extensive clinical evaluation, no causative factors were identified, suggesting an idiopathic diagnosis. The patient underwent open surgical repair using a posterior approach, during which the popliteal artery defect was closed using a bovine pericardium patch. Postoperative follow-up revealed proximal patch stenosis, necessitating angioplasty. This case underscores the need for comprehensive diagnostic evaluation of atypical pseudoaneurysm presentations and highlights the complexities involved in managing idiopathic cases, emphasizing the importance of postoperative follow-up to address potential complications.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287749","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}
Pub Date : 2024-08-09eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202301442
Monique Magnavita Borba da Fonseca Cerqueira, Marcos Arêas Marques, Alcides José Araújo Ribeiro, Daniel Mendes-Pinto, Suzanna Maria Viana Sanches
Background: Lower limb amputation surgery is associated with a high risk of venous thromboembolism. There is evidence that pharmacological thromboprophylaxis is not widely prescribed to patients undergoing this type of procedure.
Objectives: To investigate the profile of the thromboprophylaxis practices of angiologists and vascular surgeons in Brazil during the perioperative period of lower limb amputation surgery and conduct a descriptive analysis of the findings.
Methods: This is a cross-sectional, descriptive study, with simple probabilistic sampling, carried out with angiologists and vascular surgeons working in Brazil. Data were collected through electronic questionnaires, from February to June 2023.
Results: There were 237 respondents, 58.6% of whom conduct thrombotic risk stratification. Of these, 86.3% use the Caprini score. Only 27% of participants stratify patients' bleeding risk. Low molecular weight heparin is the medication of choice for 85.7% of study participants, 78.9% of whom use a dosage of 40 IU per day. Around 46.8% use direct oral anticoagulants in addition to low molecular weight heparin and rivaroxaban is the drug they most often prescribe (94.6%). A little more than half (51.15%) routinely recommend pharmacological thromboprophylaxis until hospital discharge.
Conclusions: The study revealed the heterogeneous nature of conduct related to prescription of pharmacological thromboprophylaxis, highlighting the need for more studies to support prophylaxis decision-making in this patient population.
{"title":"Thromboprophylaxis in lower limb amputation surgery.","authors":"Monique Magnavita Borba da Fonseca Cerqueira, Marcos Arêas Marques, Alcides José Araújo Ribeiro, Daniel Mendes-Pinto, Suzanna Maria Viana Sanches","doi":"10.1590/1677-5449.202301442","DOIUrl":"https://doi.org/10.1590/1677-5449.202301442","url":null,"abstract":"<p><strong>Background: </strong>Lower limb amputation surgery is associated with a high risk of venous thromboembolism. There is evidence that pharmacological thromboprophylaxis is not widely prescribed to patients undergoing this type of procedure.</p><p><strong>Objectives: </strong>To investigate the profile of the thromboprophylaxis practices of angiologists and vascular surgeons in Brazil during the perioperative period of lower limb amputation surgery and conduct a descriptive analysis of the findings.</p><p><strong>Methods: </strong>This is a cross-sectional, descriptive study, with simple probabilistic sampling, carried out with angiologists and vascular surgeons working in Brazil. Data were collected through electronic questionnaires, from February to June 2023.</p><p><strong>Results: </strong>There were 237 respondents, 58.6% of whom conduct thrombotic risk stratification. Of these, 86.3% use the Caprini score. Only 27% of participants stratify patients' bleeding risk. Low molecular weight heparin is the medication of choice for 85.7% of study participants, 78.9% of whom use a dosage of 40 IU per day. Around 46.8% use direct oral anticoagulants in addition to low molecular weight heparin and rivaroxaban is the drug they most often prescribe (94.6%). A little more than half (51.15%) routinely recommend pharmacological thromboprophylaxis until hospital discharge.</p><p><strong>Conclusions: </strong>The study revealed the heterogeneous nature of conduct related to prescription of pharmacological thromboprophylaxis, highlighting the need for more studies to support prophylaxis decision-making in this patient population.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287752","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}
Pub Date : 2024-08-09eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202301622
Edward Davis, Ardeno Kristianto, Andrew Jackson Yang
Lemierre's syndrome is marked by presence of septic thrombophlebitis in the internal jugular vein. This case report describes a 57-year-old woman who presented with a progressively swelling neck with onset 1 day prior to admission. She had a history of untreated dental infection. Physical examination revealed slightly increased blood pressure, at 140/80 mmHg, and a painful, erythematous, warm swelling in the mid area of the neck. Ultrasound of the neck revealed occlusive intraluminal thrombus in the right internal jugular vein, a computed tomography (CT) scan with contrast showed that there was a blockage in the right jugular vein. The mainstay treatment for Lemierre's syndrome is antibiotics, while administration of anticoagulants remains controversial. The patient was treated conservatively, with administration of antibiotics and anticoagulant. Several days later the patient's condition had improved significantly, with less pain and reduced swelling.
{"title":"There is no well-being without oral health: a case report of Lemierre's syndrome due to neglected odontogenic infection.","authors":"Edward Davis, Ardeno Kristianto, Andrew Jackson Yang","doi":"10.1590/1677-5449.202301622","DOIUrl":"https://doi.org/10.1590/1677-5449.202301622","url":null,"abstract":"<p><p>Lemierre's syndrome is marked by presence of septic thrombophlebitis in the internal jugular vein. This case report describes a 57-year-old woman who presented with a progressively swelling neck with onset 1 day prior to admission. She had a history of untreated dental infection. Physical examination revealed slightly increased blood pressure, at 140/80 mmHg, and a painful, erythematous, warm swelling in the mid area of the neck. Ultrasound of the neck revealed occlusive intraluminal thrombus in the right internal jugular vein, a computed tomography (CT) scan with contrast showed that there was a blockage in the right jugular vein. The mainstay treatment for Lemierre's syndrome is antibiotics, while administration of anticoagulants remains controversial. The patient was treated conservatively, with administration of antibiotics and anticoagulant. Several days later the patient's condition had improved significantly, with less pain and reduced swelling.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287751","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}
Pub Date : 2024-08-09eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202301392
Lucas Victoy Guimarães Zengo, Maria Vitoria Bandeira Liebich, Larissa Rossi, Giuliana Rossato Biezus, Jeferson Freitas Toregeani, Jong Hun Park
Aneurysms of the splenic artery are the third most common type of intra-abdominal aneurysms and the most common type of visceral aneurysms. Portal hypertension is a significant risk factor for development of these aneurysms. We report the case of a white, female, 52-year-old patient with multiple splenic artery aneurysms and hypersplenism secondary to portal hypertension and cirrhosis. Abdominal angiotomography identified six splenic aneurysms. In this scenario, an endovascular intervention was scheduled to conduct embolization using controlled release coils and Onyx™ embolization agent. The three largest aneurysms were treated. Control angiographs showed good exclusion of the aneurysms. The endovascular technique therefore proved to be a good choice considering the patient's comorbidities and blood disorders. In this case, the procedure was successful. There were no immediate or long-term complications. The patient recovered well and is in clinical follow-up.
{"title":"Embolization of multiple splenic artery aneurysms in a patient with hypersplenism due to portal hypertension: a case report.","authors":"Lucas Victoy Guimarães Zengo, Maria Vitoria Bandeira Liebich, Larissa Rossi, Giuliana Rossato Biezus, Jeferson Freitas Toregeani, Jong Hun Park","doi":"10.1590/1677-5449.202301392","DOIUrl":"https://doi.org/10.1590/1677-5449.202301392","url":null,"abstract":"<p><p>Aneurysms of the splenic artery are the third most common type of intra-abdominal aneurysms and the most common type of visceral aneurysms. Portal hypertension is a significant risk factor for development of these aneurysms. We report the case of a white, female, 52-year-old patient with multiple splenic artery aneurysms and hypersplenism secondary to portal hypertension and cirrhosis. Abdominal angiotomography identified six splenic aneurysms. In this scenario, an endovascular intervention was scheduled to conduct embolization using controlled release coils and Onyx™ embolization agent. The three largest aneurysms were treated. Control angiographs showed good exclusion of the aneurysms. The endovascular technique therefore proved to be a good choice considering the patient's comorbidities and blood disorders. In this case, the procedure was successful. There were no immediate or long-term complications. The patient recovered well and is in clinical follow-up.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287743","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}
A 47-year-old male presented with a right-sided Shamblin type 2 carotid body tumor measuring 5*5 cm. After preoperative embolization, a sub adventitial resection of the tumor was done. He was discharged after postoperative day 5 and presented again to emergency 10 days later with a bleeding pseudoaneurysm at the surgical site causing dysphagia and dyspnea. He was taken for emergency exploration of the surgical wound and, intraoperatively, it was observed that the proximal ends of the internal carotid artery and external carotid artery close to the bifurcation were forming a pseudoaneurysm, 1 cm distal to the common carotid artery. The external carotid artery was ligated and a common carotid to internal carotid artery bypass was done with a reversed saphenous vein graft. He recovered well in the postoperative period and was discharged on day 7. Pseudoaneurysm formation following carotid body tumor resection is extremely rare and has only been reported thrice in the literature.
{"title":"Ruptured carotid artery pseudoaneurysm following excision of a carotid body tumor: a rare complication managed successfully with surgery and literature review.","authors":"Basil Babu, Divij Jayant, Arunanshu Behera, Cherring Tandup, Swapnesh Kumar Sahoo, Vipul Thakur","doi":"10.1590/1677-5449.202301702","DOIUrl":"https://doi.org/10.1590/1677-5449.202301702","url":null,"abstract":"<p><p>A 47-year-old male presented with a right-sided Shamblin type 2 carotid body tumor measuring 5*5 cm. After preoperative embolization, a sub adventitial resection of the tumor was done. He was discharged after postoperative day 5 and presented again to emergency 10 days later with a bleeding pseudoaneurysm at the surgical site causing dysphagia and dyspnea. He was taken for emergency exploration of the surgical wound and, intraoperatively, it was observed that the proximal ends of the internal carotid artery and external carotid artery close to the bifurcation were forming a pseudoaneurysm, 1 cm distal to the common carotid artery. The external carotid artery was ligated and a common carotid to internal carotid artery bypass was done with a reversed saphenous vein graft. He recovered well in the postoperative period and was discharged on day 7. Pseudoaneurysm formation following carotid body tumor resection is extremely rare and has only been reported thrice in the literature.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287750","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}
Pub Date : 2024-08-09eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202301512
Paulo Henrique Alves Togni, André Luís Santos Vaz Leite, Marcela Prando Sampaio, Beatriz Camargo Castro, Henrique Tomaz Rodrigues, Guilherme Augusto Paro
Persistent sciatic artery is a rare congenital anomaly, with few cases described in the literature. This study presents a case of this embryological variation observed in a patient's lower limb circulatory system. The anatomical description is based on a review of medical records and imaging exams. This case report describes a 63-year-old female patient admitted to the emergency department complaining of severe pain in the right lower limb, with a cold, pale extremity and ecchymosis on the dorsum of the foot. Duplex ultrasound showed no detectable flow in the anterior tibial and fibular arteries and a tardus parvus pattern in the posterior tibial artery. The patient developed loss of movement and fixed cyanosis in the right foot and was referred for urgent thromboembolectomy. However, adequate reperfusion was not seen after the procedure. Angiotomography was performed on the first postoperative day, showing bilateral persistence of the sciatic artery, with aneurysmal degeneration, partially thrombosed, and no opacification of the arterial system downstream of the aneurysm. By the third postoperative day, the patient had developed areas of dry necrosis in the limb, with no perfusion to the ankle, and underwent transfemoral amputation. Despite being a rare condition, it is of great clinical importance because of the high complication rates.
{"title":"Case report: persistent bilateral complete sciatic artery associated with aneurysmal degeneration.","authors":"Paulo Henrique Alves Togni, André Luís Santos Vaz Leite, Marcela Prando Sampaio, Beatriz Camargo Castro, Henrique Tomaz Rodrigues, Guilherme Augusto Paro","doi":"10.1590/1677-5449.202301512","DOIUrl":"https://doi.org/10.1590/1677-5449.202301512","url":null,"abstract":"<p><p>Persistent sciatic artery is a rare congenital anomaly, with few cases described in the literature. This study presents a case of this embryological variation observed in a patient's lower limb circulatory system. The anatomical description is based on a review of medical records and imaging exams. This case report describes a 63-year-old female patient admitted to the emergency department complaining of severe pain in the right lower limb, with a cold, pale extremity and ecchymosis on the dorsum of the foot. Duplex ultrasound showed no detectable flow in the anterior tibial and fibular arteries and a tardus parvus pattern in the posterior tibial artery. The patient developed loss of movement and fixed cyanosis in the right foot and was referred for urgent thromboembolectomy. However, adequate reperfusion was not seen after the procedure. Angiotomography was performed on the first postoperative day, showing bilateral persistence of the sciatic artery, with aneurysmal degeneration, partially thrombosed, and no opacification of the arterial system downstream of the aneurysm. By the third postoperative day, the patient had developed areas of dry necrosis in the limb, with no perfusion to the ankle, and underwent transfemoral amputation. Despite being a rare condition, it is of great clinical importance because of the high complication rates.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287741","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}
Pub Date : 2024-08-09eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202301242
Ahmed Ali Ali, Eman Elsayed Sakr
A 42-year-old male with ischemic cardiomyopathy presented with acute bilateral femoral artery embolization. After management with embolectomy and fasciotomy in both femoral arteries, transthoracic echocardiography revealed two pedunculated highly mobile left ventricle (LV) thrombi. Given the procedural risk, anticoagulation therapy was recommended over surgery. However, the bleeding risk impeded the continuation of anticoagulation, which increased the thrombus size. Multiorgan failure and disseminated intravascular coagulopathy followed and the patient died. We also systematically reviewed the PubMed and Scopus databases for pedunculated LV thrombi cases and retrieved 74 and 63 reports respectively. Of these, 37 relevant reports (45 cases) plus 11 reports from the manual search were included for data extraction, a total of 56 cases besides our case. Based on the etiologies and risks, LV thrombi are predictable and preventable, especially after ischemic events. A clear diagnostic algorithm and vigilant follow-up are needed as well as multidisciplinary management once a diagnosis is confirmed.
{"title":"Left ventricle pedunculated thrombi risks and outcomes: a case report and literature review.","authors":"Ahmed Ali Ali, Eman Elsayed Sakr","doi":"10.1590/1677-5449.202301242","DOIUrl":"https://doi.org/10.1590/1677-5449.202301242","url":null,"abstract":"<p><p>A 42-year-old male with ischemic cardiomyopathy presented with acute bilateral femoral artery embolization. After management with embolectomy and fasciotomy in both femoral arteries, transthoracic echocardiography revealed two pedunculated highly mobile left ventricle (LV) thrombi. Given the procedural risk, anticoagulation therapy was recommended over surgery. However, the bleeding risk impeded the continuation of anticoagulation, which increased the thrombus size. Multiorgan failure and disseminated intravascular coagulopathy followed and the patient died. We also systematically reviewed the PubMed and Scopus databases for pedunculated LV thrombi cases and retrieved 74 and 63 reports respectively. Of these, 37 relevant reports (45 cases) plus 11 reports from the manual search were included for data extraction, a total of 56 cases besides our case. Based on the etiologies and risks, LV thrombi are predictable and preventable, especially after ischemic events. A clear diagnostic algorithm and vigilant follow-up are needed as well as multidisciplinary management once a diagnosis is confirmed.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287747","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}
Pub Date : 2024-08-09eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202301752
Giselly Rosa Modesto Pereira, André Ricardo Araújo da Silva, Claudia Escórcio Gurgel do Amaral Pitanga, Jocemir Ronaldo Lugon
The first case of COVID-19 was detected in Dec 2019, in China. The disease shortly evolved into a pandemic and imposed an unparalleled health and social burden on mankind. Severe forms of COVID-19 mainly affect adults, especially the elderly and those with comorbidities. We report a severe case of COVID-19 in a previously healthy 12-year-old female who was admitted to the emergency room on May 26, 2020, with fever, abdominal pain, vomiting, and diarrhea. During the hospital stay, she tested positive for SARS-CoV-2 and developed multiple organ failure and catastrophic thrombotic events resulting in bilateral amputation of legs and fingers. She was discharged from the hospital for outpatient follow-up after 107 days. By the time this report was written, the patient was undergoing prosthesis prescription and training and regaining her independence to walk.
{"title":"Catastrophic thrombotic events with partial bilateral amputation of legs and fingers in a 12-year-old girl with COVID-19 in Brazil: case report.","authors":"Giselly Rosa Modesto Pereira, André Ricardo Araújo da Silva, Claudia Escórcio Gurgel do Amaral Pitanga, Jocemir Ronaldo Lugon","doi":"10.1590/1677-5449.202301752","DOIUrl":"https://doi.org/10.1590/1677-5449.202301752","url":null,"abstract":"<p><p>The first case of COVID-19 was detected in Dec 2019, in China. The disease shortly evolved into a pandemic and imposed an unparalleled health and social burden on mankind. Severe forms of COVID-19 mainly affect adults, especially the elderly and those with comorbidities. We report a severe case of COVID-19 in a previously healthy 12-year-old female who was admitted to the emergency room on May 26, 2020, with fever, abdominal pain, vomiting, and diarrhea. During the hospital stay, she tested positive for SARS-CoV-2 and developed multiple organ failure and catastrophic thrombotic events resulting in bilateral amputation of legs and fingers. She was discharged from the hospital for outpatient follow-up after 107 days. By the time this report was written, the patient was undergoing prosthesis prescription and training and regaining her independence to walk.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287742","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}