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":"23 ","pages":"e20230124"},"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 : 2024-07-08eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202301592
Lucas Dalvi Armond Rezende, Davi de Souza Catabriga, Alicia de Oliveira Pacheco, Aline de Oliveira Ramalho, Paula de Souza Silva Freitas
Low-intensity laser therapy (LILT) is commonly used as an adjuvant therapy for treating injuries. This integrative literature review was carried out in the MEDLINE, LILACS, CUMED, BDENF, SPORTDiscus, Dentistry & Oral Sciences Source, Academic Source and CINAHL databases. Among the inclusion criteria were: range from 2011 to 2021, in English, Portuguese and Spanish and any study, with the exception of preprints and books. The question was answered: "What is the effectiveness described in the literature of using low-intensity laser therapy (LILT) in the treatment of venous lesions?" The wavelength used in studies varied from 635 nm of red ray to 780 nm of infrared ray, generating healing improvement at any length. LBI presented itself as a low-cost and easy-to-apply adjuvant option, alleviating pain complaints and improving healing in patients with vasculogenic lesions.
{"title":"Use of low-level laser therapy as an adjuvant therapy for phlebostatic lesions.","authors":"Lucas Dalvi Armond Rezende, Davi de Souza Catabriga, Alicia de Oliveira Pacheco, Aline de Oliveira Ramalho, Paula de Souza Silva Freitas","doi":"10.1590/1677-5449.202301592","DOIUrl":"10.1590/1677-5449.202301592","url":null,"abstract":"<p><p>Low-intensity laser therapy (LILT) is commonly used as an adjuvant therapy for treating injuries. This integrative literature review was carried out in the MEDLINE, LILACS, CUMED, BDENF, SPORTDiscus, Dentistry & Oral Sciences Source, Academic Source and CINAHL databases. Among the inclusion criteria were: range from 2011 to 2021, in English, Portuguese and Spanish and any study, with the exception of preprints and books. The question was answered: \"What is the effectiveness described in the literature of using low-intensity laser therapy (LILT) in the treatment of venous lesions?\" The wavelength used in studies varied from 635 nm of red ray to 780 nm of infrared ray, generating healing improvement at any length. LBI presented itself as a low-cost and easy-to-apply adjuvant option, alleviating pain complaints and improving healing in patients with vasculogenic lesions.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20230159"},"PeriodicalIF":0.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11296685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889199","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 : 2024-07-08eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202301042
Alex Aparecido Cantador, Ana Terezinha Guillaumon
Background: Vascular Doppler ultrasound (DUS) has evolved over recent years because of improvements in the technology involved in the acquisition and processing of sound and image data. The method is an excellent option for use in diagnosis of peripheral arterial disease considering its availability, low cost, and absence of harmful effects. The breakdown of logistics supply chains caused by the COVID-19 pandemic caused worldwide shortages of iodinated contrast, highlighting the need to validate alternative diagnostic methods.
Objective: To use DUS for decision-making when choosing between by-pass and endovascular surgery for femoropopliteal arterial disease and compare the results to those of iodinated contrast exams.
Methods: We compared DUS with examinations using contrast for identification of stenoses/occlusions and indication of surgical treatment (by-pass vs. endovascular). In the first phase of the study the results were merely compared, DUS vs. angiotomography. Then, in the second phase, the vascular ultrasound results were used for screening between by-pass and endovascular treatment, comparing DUS with angiotomography in cases scheduled for by-pass and with arteriography in endovascular patients.
Results: In phase 1, the sensitivity of DUS compared to CT angiography was 100% for the SFA territory. When considering solely the choice of bypass vs. endovascular treatment, the results showed 100% agreement for phase 1 and 94% for phase 2.
Conclusion: Notwithstanding the sample size, the study fulfilled its objective of demonstrating the reliability of DUS for indicating the treatment choice between by-pass and endovascular surgery.
背景:近年来,由于声音和图像数据的采集和处理技术不断进步,血管多普勒超声(DUS)也在不断发展。考虑到其可用性、低成本和无有害影响,该方法是诊断外周动脉疾病的绝佳选择。COVID-19 大流行导致物流供应链断裂,造成全球碘造影剂短缺,突出了验证替代诊断方法的必要性:目的:利用 DUS 对股骨头动脉疾病选择旁路手术还是血管内手术进行决策,并将其结果与碘造影剂检查结果进行比较:我们将 DUS 与使用造影剂的检查进行了比较,以确定狭窄/闭塞和手术治疗指征(旁路手术与血管内手术)。在研究的第一阶段,我们仅比较了 DUS 与血管造影的结果。然后,在第二阶段,血管超声结果被用于旁路治疗和血管内治疗之间的筛选,在计划进行旁路治疗的病例中比较 DUS 和血管造影,在血管内治疗患者中比较动脉造影:在第一阶段,与 CT 血管造影相比,DUS 对 SFA 区域的敏感性为 100%。如果仅考虑选择旁路治疗还是血管内治疗,结果显示第一阶段的一致性为100%,第二阶段为94%:结论:尽管样本量有限,但这项研究达到了其目的,即证明了 DUS 在显示旁路手术和血管内手术治疗选择方面的可靠性。
{"title":"Comparison between vascular Doppler ultrasound and contrast exams in chronic peripheral arterial disease.","authors":"Alex Aparecido Cantador, Ana Terezinha Guillaumon","doi":"10.1590/1677-5449.202301042","DOIUrl":"10.1590/1677-5449.202301042","url":null,"abstract":"<p><strong>Background: </strong>Vascular Doppler ultrasound (DUS) has evolved over recent years because of improvements in the technology involved in the acquisition and processing of sound and image data. The method is an excellent option for use in diagnosis of peripheral arterial disease considering its availability, low cost, and absence of harmful effects. The breakdown of logistics supply chains caused by the COVID-19 pandemic caused worldwide shortages of iodinated contrast, highlighting the need to validate alternative diagnostic methods.</p><p><strong>Objective: </strong>To use DUS for decision-making when choosing between by-pass and endovascular surgery for femoropopliteal arterial disease and compare the results to those of iodinated contrast exams.</p><p><strong>Methods: </strong>We compared DUS with examinations using contrast for identification of stenoses/occlusions and indication of surgical treatment (by-pass vs. endovascular). In the first phase of the study the results were merely compared, DUS vs. angiotomography. Then, in the second phase, the vascular ultrasound results were used for screening between by-pass and endovascular treatment, comparing DUS with angiotomography in cases scheduled for by-pass and with arteriography in endovascular patients.</p><p><strong>Results: </strong>In phase 1, the sensitivity of DUS compared to CT angiography was 100% for the SFA territory. When considering solely the choice of bypass vs. endovascular treatment, the results showed 100% agreement for phase 1 and 94% for phase 2.</p><p><strong>Conclusion: </strong>Notwithstanding the sample size, the study fulfilled its objective of demonstrating the reliability of DUS for indicating the treatment choice between by-pass and endovascular surgery.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20230104"},"PeriodicalIF":0.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11296684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891554","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 : 2024-05-31eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202300942
Arno von Buettner Ristow, Bernardo Massière, Guilherme Vieira Meirelles, Ivan Benaduce Casella, Marcia Maria Morales, Ricardo Cesar Rocha Moreira, Ricardo Jayme Procópio, Tércio Ferreira Oliveira, Walter Jr Boim de Araujo, Edwaldo Edner Joviliano, Júlio Cesar Peclat de Oliveira
Extracranial cerebrovascular disease has been the subject of intense research throughout the world, and is of paramount importance for vascular surgeons. This guideline, written by the Brazilian Society of Angiology and Vascular Surgery (SBACV), supersedes the 2015 guideline. Non-atherosclerotic carotid artery diseases were not included in this document. The purpose of this guideline is to bring together the most robust evidence in this area in order to help specialists in the treatment decision-making process. The AGREE II methodology and the European Society of Cardiology system were used for recommendations and levels of evidence. The recommendations were graded from I to III, and levels of evidence were classified as A, B, or C. This guideline is divided into 11 chapters dealing with the various aspects of extracranial cerebrovascular disease: diagnosis, treatments and complications, based on up-to-date knowledge and the recommendations proposed by SBACV.
颅外脑血管疾病一直是全世界深入研究的课题,对血管外科医生来说至关重要。本指南由巴西血管学和血管外科学会(SBACV)编写,取代了 2015 年指南。非动脉粥样硬化性颈动脉疾病未纳入本文件。本指南旨在汇集该领域最有力的证据,以帮助专科医生在治疗决策过程中进行决策。本指南采用 AGREE II 方法和欧洲心脏病学会系统进行推荐和证据分级。本指南分为 11 章,涉及颅外脑血管疾病的各个方面:诊断、治疗和并发症,以最新知识和 SBACV 提出的建议为基础。
{"title":"Brazilian Angiology and Vascular Surgery Society Guidelines for the treatment of extracranial cerebrovascular disease.","authors":"Arno von Buettner Ristow, Bernardo Massière, Guilherme Vieira Meirelles, Ivan Benaduce Casella, Marcia Maria Morales, Ricardo Cesar Rocha Moreira, Ricardo Jayme Procópio, Tércio Ferreira Oliveira, Walter Jr Boim de Araujo, Edwaldo Edner Joviliano, Júlio Cesar Peclat de Oliveira","doi":"10.1590/1677-5449.202300942","DOIUrl":"10.1590/1677-5449.202300942","url":null,"abstract":"<p><p>Extracranial cerebrovascular disease has been the subject of intense research throughout the world, and is of paramount importance for vascular surgeons. This guideline, written by the Brazilian Society of Angiology and Vascular Surgery (SBACV), supersedes the 2015 guideline. Non-atherosclerotic carotid artery diseases were not included in this document. The purpose of this guideline is to bring together the most robust evidence in this area in order to help specialists in the treatment decision-making process. The AGREE II methodology and the European Society of Cardiology system were used for recommendations and levels of evidence. The recommendations were graded from I to III, and levels of evidence were classified as A, B, or C. This guideline is divided into 11 chapters dealing with the various aspects of extracranial cerebrovascular disease: diagnosis, treatments and complications, based on up-to-date knowledge and the recommendations proposed by SBACV.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20230094"},"PeriodicalIF":0.8,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11296686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889198","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 : 2024-05-17eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202300872
Eliud Garcia Duarte, Cicero Fidelis Lopes, Danilo Roberto Fadel Gaio, Jamil Victor de Oliveira Mariúba, Lorena de Oliveira Cerqueira, Marcos Antonio Bonacorso Manhanelli, Tulio Pinho Navarro, Aldemar Araújo Castro, Walter Jr Boim de Araujo, Hermelinda Pedrosa, Júnio Galli, Nelson de Luccia, Clayton de Paula, Fernando Reis, Milton Sérgio Bohatch, Tércio Ferreira de Oliveira, Amanda Fernandes Vidal da Silva, Júlio Cesar Peclat de Oliveira, Edwaldo Édner Joviliano
The diabetic foot interacts with anatomical, vascular, and neurological factors that challenge clinical practice. This study aimed to compile the primary scientific evidence based on a review of the main guidelines, in addition to articles published on the Embase, Lilacs, and PubMed platforms. The European Society of Cardiology system was used to develop recommendation classes and levels of evidence. The themes were divided into six chapters (Chapter 1 - Prevention of foot ulcers in people with diabetes; Chapter 2 - Pressure relief from foot ulcers in people with diabetes; Chapter 3 -Classifications of diabetic foot ulcers; Chapter 4 - Foot and peripheral artery disease; Chapter 5 - Infection and the diabetic foot; Chapter 6 - Charcot's neuroarthropathy). This version of the Diabetic Foot Guidelines presents essential recommendations for the prevention, diagnosis, treatment, and follow-up of patients with diabetic foot, offering an objective guide for medical practice.
{"title":"Brazilian Society of Angiology and Vascular Surgery 2023 guidelines on the diabetic foot.","authors":"Eliud Garcia Duarte, Cicero Fidelis Lopes, Danilo Roberto Fadel Gaio, Jamil Victor de Oliveira Mariúba, Lorena de Oliveira Cerqueira, Marcos Antonio Bonacorso Manhanelli, Tulio Pinho Navarro, Aldemar Araújo Castro, Walter Jr Boim de Araujo, Hermelinda Pedrosa, Júnio Galli, Nelson de Luccia, Clayton de Paula, Fernando Reis, Milton Sérgio Bohatch, Tércio Ferreira de Oliveira, Amanda Fernandes Vidal da Silva, Júlio Cesar Peclat de Oliveira, Edwaldo Édner Joviliano","doi":"10.1590/1677-5449.202300872","DOIUrl":"10.1590/1677-5449.202300872","url":null,"abstract":"<p><p>The diabetic foot interacts with anatomical, vascular, and neurological factors that challenge clinical practice. This study aimed to compile the primary scientific evidence based on a review of the main guidelines, in addition to articles published on the Embase, Lilacs, and PubMed platforms. The European Society of Cardiology system was used to develop recommendation classes and levels of evidence. The themes were divided into six chapters (Chapter 1 - Prevention of foot ulcers in people with diabetes; Chapter 2 - Pressure relief from foot ulcers in people with diabetes; Chapter 3 -Classifications of diabetic foot ulcers; Chapter 4 - Foot and peripheral artery disease; Chapter 5 - Infection and the diabetic foot; Chapter 6 - Charcot's neuroarthropathy). This version of the Diabetic Foot Guidelines presents essential recommendations for the prevention, diagnosis, treatment, and follow-up of patients with diabetic foot, offering an objective guide for medical practice.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20230087"},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141156810","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 : 2024-05-10eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202301502
Paulo Henrique Alves Togni, Ernani Alves de Oliveira, Eduardo Milani Mora, Paulo Eduardo Borher Moreira, Bruno Previdelli Coghi, Guilherme Augusto Paro
Persistent double dorsal aorta is an extremely rare congenital anomaly, with only 13 cases published to date. The objective of this study is to present this embryological variant as observed in the abdominal aorta of a patient. The anatomical description was written up on the basis of a review of electronic medical records and imaging exams. The patient in this case was an elderly 79-year-old man who presented at emergency with pain at rest in the left lower limb. He was admitted and laboratory tests and imaging exams were ordered. The variation was an imaging finding observed on angiotomography, consisting of complete separation of the abdominal aorta into two portions - a ventral and a dorsal, with different calibers - at the level of the third lumbar vertebra. There was also an anomalous origin of the inferior mesenteric artery.
{"title":"Case report: persistent double dorsal aorta.","authors":"Paulo Henrique Alves Togni, Ernani Alves de Oliveira, Eduardo Milani Mora, Paulo Eduardo Borher Moreira, Bruno Previdelli Coghi, Guilherme Augusto Paro","doi":"10.1590/1677-5449.202301502","DOIUrl":"10.1590/1677-5449.202301502","url":null,"abstract":"<p><p>Persistent double dorsal aorta is an extremely rare congenital anomaly, with only 13 cases published to date. The objective of this study is to present this embryological variant as observed in the abdominal aorta of a patient. The anatomical description was written up on the basis of a review of electronic medical records and imaging exams. The patient in this case was an elderly 79-year-old man who presented at emergency with pain at rest in the left lower limb. He was admitted and laboratory tests and imaging exams were ordered. The variation was an imaging finding observed on angiotomography, consisting of complete separation of the abdominal aorta into two portions - a ventral and a dorsal, with different calibers - at the level of the third lumbar vertebra. There was also an anomalous origin of the inferior mesenteric artery.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20230150"},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141156900","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 : 2024-03-25eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202300772
Karlene Thayane Barros da Silva, Marcos Antonio Bonacorso Manhanelli, José Francisco Moron Morad, Fábio Linardi, José Augusto Costa
Background: Arterialization of the dorsal venous arch of the foot is a technique indicated in cases of critical lower limb ischemia that do not have a distal bed that is adequate to enable conventional treatment such as revascularization, angioplasty, or clinical treatment.
Objectives: The purpose of this study is to present the result of arterialization of the venous arch of the foot in 16 patients who underwent treatment with this technique.
Methods: This is a cross-sectional retrospective descriptive analytical study based on a review of the medical records of 16 patients who underwent arterialization of the dorsal venous arch of the foot for limb salvage from January 2016 to January 2021.
Results: Four (25%) of the 16 patients who underwent arterialization of the venous arch of the foot underwent a major amputation during the same hospital stay and one patient (6.25%) had a major amputation within 6 months. The other 11 patients (68.75%) had their limbs preserved, with 10 undergoing minor amputations (toes and forefoot) and one patient having no additional procedures.
Conclusions: We conclude that the technique of arterialization of the dorsal venous arch of the foot should be considered in selected cases. It is a valid alternative for limb salvage when conventional treatment is impossible.
{"title":"Superficial venous arterialization with the great saphenous vein <i>in situ</i>: a single-center experience.","authors":"Karlene Thayane Barros da Silva, Marcos Antonio Bonacorso Manhanelli, José Francisco Moron Morad, Fábio Linardi, José Augusto Costa","doi":"10.1590/1677-5449.202300772","DOIUrl":"10.1590/1677-5449.202300772","url":null,"abstract":"<p><strong>Background: </strong>Arterialization of the dorsal venous arch of the foot is a technique indicated in cases of critical lower limb ischemia that do not have a distal bed that is adequate to enable conventional treatment such as revascularization, angioplasty, or clinical treatment.</p><p><strong>Objectives: </strong>The purpose of this study is to present the result of arterialization of the venous arch of the foot in 16 patients who underwent treatment with this technique.</p><p><strong>Methods: </strong>This is a cross-sectional retrospective descriptive analytical study based on a review of the medical records of 16 patients who underwent arterialization of the dorsal venous arch of the foot for limb salvage from January 2016 to January 2021.</p><p><strong>Results: </strong>Four (25%) of the 16 patients who underwent arterialization of the venous arch of the foot underwent a major amputation during the same hospital stay and one patient (6.25%) had a major amputation within 6 months. The other 11 patients (68.75%) had their limbs preserved, with 10 undergoing minor amputations (toes and forefoot) and one patient having no additional procedures.</p><p><strong>Conclusions: </strong>We conclude that the technique of arterialization of the dorsal venous arch of the foot should be considered in selected cases. It is a valid alternative for limb salvage when conventional treatment is impossible.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20230077"},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335744","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 : 2024-03-25eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202300172
Drako de Amorim Souza, Pedro Victor Freitas Medrado, Vinícius Alves Santos, Carolline Xavier de Aguiar, Guilherme Souza Silva, Lucas Pereira Pintos de Sousa, Yasmin Bione Diniz Amando, Paulo Fernandes Saad
Currently, the standard non-invasive test for diagnosing Peripheral Arterial Disease is the Ankle-Brachial Index. However, this test becomes unfeasible in a certain population. New evidence proposes the pedal acceleration time, an ultrasound index, as an alternative test. An integrative bibliographic review was carried out between June 3, 2022 and January 8, 2023, to investigate this new index as a tool to assess foot perfusion. Papers published in English, Portuguese, or Spanish between 2012 and 2022 were searched on PubMed, Google Scholar, and Scielo, using the keywords "Peripheral Arterial Disease" AND "Acceleration Time" AND (Pedal OR Plantar). Research that didn't assess foot perfusion using the methods of interest or did not present human data and also case series or reports were excluded. Seven out of the sixty-six articles identified in the searches were selected for the review, all of which had notable methodological limitations. Pedal acceleration time seems to be able to diagnose and stratify and may reflect prognosis.
{"title":"Duplex ultrasound and pedal acceleration time as tools to evaluate foot perfusion: a literature review.","authors":"Drako de Amorim Souza, Pedro Victor Freitas Medrado, Vinícius Alves Santos, Carolline Xavier de Aguiar, Guilherme Souza Silva, Lucas Pereira Pintos de Sousa, Yasmin Bione Diniz Amando, Paulo Fernandes Saad","doi":"10.1590/1677-5449.202300172","DOIUrl":"10.1590/1677-5449.202300172","url":null,"abstract":"<p><p>Currently, the standard non-invasive test for diagnosing Peripheral Arterial Disease is the Ankle-Brachial Index. However, this test becomes unfeasible in a certain population. New evidence proposes the pedal acceleration time, an ultrasound index, as an alternative test. An integrative bibliographic review was carried out between June 3, 2022 and January 8, 2023, to investigate this new index as a tool to assess foot perfusion. Papers published in English, Portuguese, or Spanish between 2012 and 2022 were searched on PubMed, Google Scholar, and Scielo, using the keywords \"Peripheral Arterial Disease\" AND \"Acceleration Time\" AND (Pedal OR Plantar). Research that didn't assess foot perfusion using the methods of interest or did not present human data and also case series or reports were excluded. Seven out of the sixty-six articles identified in the searches were selected for the review, all of which had notable methodological limitations. Pedal acceleration time seems to be able to diagnose and stratify and may reflect prognosis.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20230017"},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335741","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 : 2024-03-25eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202300442
Marcelo Calil Burihan, Silvio Antonio Garbelotti, Paulo Laino Cândido, Rodrigo Barbosa de Souza, Osvaldo Pelozo, Aluisio Andrade, Marco Antonio De Angelis
We present two cases of multiple anatomical variations of the renal and gonadal vessels. The first case presented duplication of the renal vein and the presence of an accessory renal artery. However, the most interesting fact, in this case, was that the right gonadal vein emptied into the inferior right renal vein instead of ending in the inferior vena cava as would typically be the case. In the second case, we also found an accessory renal artery and the right gonadal vein emptied at the exact junction between the right renal vein and the inferior vena cava. Clinicians and surgeons should be familiar with anatomical variations to provide an accurate diagnosis during preoperative studies and to avoid surprises in abdominal surgical procedures.
{"title":"Multiple variation of right renal and gonadal vascularization: report of two cases.","authors":"Marcelo Calil Burihan, Silvio Antonio Garbelotti, Paulo Laino Cândido, Rodrigo Barbosa de Souza, Osvaldo Pelozo, Aluisio Andrade, Marco Antonio De Angelis","doi":"10.1590/1677-5449.202300442","DOIUrl":"10.1590/1677-5449.202300442","url":null,"abstract":"<p><p>We present two cases of multiple anatomical variations of the renal and gonadal vessels. The first case presented duplication of the renal vein and the presence of an accessory renal artery. However, the most interesting fact, in this case, was that the right gonadal vein emptied into the inferior right renal vein instead of ending in the inferior vena cava as would typically be the case. In the second case, we also found an accessory renal artery and the right gonadal vein emptied at the exact junction between the right renal vein and the inferior vena cava. Clinicians and surgeons should be familiar with anatomical variations to provide an accurate diagnosis during preoperative studies and to avoid surprises in abdominal surgical procedures.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20230044"},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335743","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 : 2024-03-25eCollection Date: 2024-01-01DOI: 10.1590/1677-5449.202300542
José Maciel Caldas Dos Reis, Flávio Roberto Cavalleiro de Macêdo Ribeiro, Glauco Dos Santos Melo, Humberto Balbi Reale, Mariseth Carvalho de Andrade
Background: The preferred vascular access for hemodialysis is a native arteriovenous fistula (AVF) because it offers the best results in the short and long terms, lower morbidity and mortality, and has additional advantages in relation to central venous catheters or arteriovenous grafts. However, obesity can present an additional challenge because of the barrier of subcutaneous cellular tissue covering the surface of the vein to be punctured.
Objectives: The authors review their experience with excision of subcutaneous tissue (lipectomy) overlying upper arm cephalic vein arteriovenous fistulas in obese patients.
Methods: Consecutive vascular access patients undergoing lipectomy for cannulation with difficult access because of vein depth were reviewed. Cephalic vein depth was measured by ultrasound in all cases.
Results: Twenty-two patients were reviewed (15 men and 7 women), with a mean body mass index of 34.0 kg/m2 (range: 28-40 kg/m2). Mean age was 58.4 years. The mean preoperative vein depth of 7.9 mm (range: 7.0-10.0 mm) was reduced to 4.7 mm (range: 3.0-6.0 mm) (P 0.01). The mean follow-up period for patients was 13.2 months. Four patients were lost to follow-up and four died during the period due to causes unrelated to vascular access.
Conclusions: Obesity should not be a limiting factor to creation of a native AVF, since lipectomy is a relatively simple option for superficialization, enabling functioning native and deep arteriovenous fistulas in obese patients.
{"title":"Lipectomy as an alternative for superficialization of autologous AVF in obese patients: experience of a referral center in Amazon.","authors":"José Maciel Caldas Dos Reis, Flávio Roberto Cavalleiro de Macêdo Ribeiro, Glauco Dos Santos Melo, Humberto Balbi Reale, Mariseth Carvalho de Andrade","doi":"10.1590/1677-5449.202300542","DOIUrl":"10.1590/1677-5449.202300542","url":null,"abstract":"<p><strong>Background: </strong>The preferred vascular access for hemodialysis is a native arteriovenous fistula (AVF) because it offers the best results in the short and long terms, lower morbidity and mortality, and has additional advantages in relation to central venous catheters or arteriovenous grafts. However, obesity can present an additional challenge because of the barrier of subcutaneous cellular tissue covering the surface of the vein to be punctured.</p><p><strong>Objectives: </strong>The authors review their experience with excision of subcutaneous tissue (lipectomy) overlying upper arm cephalic vein arteriovenous fistulas in obese patients.</p><p><strong>Methods: </strong>Consecutive vascular access patients undergoing lipectomy for cannulation with difficult access because of vein depth were reviewed. Cephalic vein depth was measured by ultrasound in all cases.</p><p><strong>Results: </strong>Twenty-two patients were reviewed (15 men and 7 women), with a mean body mass index of 34.0 kg/m<sup>2</sup> (range: 28-40 kg/m<sup>2</sup>). Mean age was 58.4 years. The mean preoperative vein depth of 7.9 mm (range: 7.0-10.0 mm) was reduced to 4.7 mm (range: 3.0-6.0 mm) (<i>P</i> 0.01). The mean follow-up period for patients was 13.2 months. Four patients were lost to follow-up and four died during the period due to causes unrelated to vascular access.</p><p><strong>Conclusions: </strong>Obesity should not be a limiting factor to creation of a native AVF, since lipectomy is a relatively simple option for superficialization, enabling functioning native and deep arteriovenous fistulas in obese patients.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20230054"},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335742","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}