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The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: Risk stratification based on Wound, Ischemia, and foot Infection (WIfI)
Critical limb ischemia, first defined in 1982, was intended to delineate a subgroup of patients with a threatened lower extremity primarily because of chronic ischemia. It was the intent of the original authors that patients with diabetes be excluded or analyzed separately. The Fontaine and Rutherford Systems have been used to classify risk of amputation and likelihood of benefit from revascularization by subcategorizing patients into two groups: ischemic rest pain and tissue loss. Due to demographic shifts over the last 40 years, especially a dramatic rise in the incidence of diabetes mellitus and rapidly expanding techn...
Source: Journal of Vascular Surgery - October 14, 2013 Category: Surgery Authors: Joseph L. Mills, Michael S. Conte, David G. Armstrong, Frank B. Pomposelli, Andres Schanzer, Anton N. Sidawy, George Andros, Society for Vascular Surgery Lower Extremity Guidelines Committee Tags: Society for Vascular Surgery® document Source Type: research
Vascular physiotherapy in treatment of chronic venous disease
ConclusionsVascular physiotherapy contributed to controlling the clinical manifestations of CVD, improving edema and JMA, and promoting improved quality of life for patients.
Source: Jornal Vascular Brasileiro - October 20, 2015 Category: Surgery Source Type: research
Concomitant Vascular Compressive Syndromes: Median Arcuate Ligament Syndrome With Nutcracker Syndrome
This article describes the presentation and management of two vascular compressive syndromes occurring within the same patient. Median arcuate ligament syndrome (MALS) presents as chronic mesenteric ischemia secondary to compression of the celiac trunk by the median arcuate ligament. Treatment by surgical decompression can provide relief. Nutcracker syndrome presents as vague flank or pelvic pain along with hematuria. It occurs secondary to compression of the left renal vein (LRV) by the superior mesenteric artery (SMA).
Source: Journal of Vascular Surgery - August 22, 2014 Category: Surgery Authors: Sina Iranmanesh, Brittny W. Howell, John J. Ricotta Tags: Abstracts from the 2014 New England Society for Vascular Surgery/Eastern Vascular Society Joint Annual Meeting Source Type: research
Postoperative Opioid Prescribing Patterns After Vascular Surgery
The objective of this study was to assess postoperative opioid prescribing patterns and use and pain control after common vascular surgery procedures to develop patient-centered best practice guidelines.
Source: Journal of Vascular Surgery - July 20, 2017 Category: Surgery Authors: Ilsley B. Colton, Mayo H. Fujii, Thomas P. Ahern, Matthew Alef, Charles Maclean, Julie A. Lahiri, Andrew C. Stanley, Georg Steinthorsson, Daniel J. Bertges Tags: Abstract from the 2017 New England Society for Vascular Surgery Annual Meeting Source Type: research
Journal of Vascular Surgery – December 2017 Audiovisual Summary
We would like to tell you about the December issue of the Journal of Vascular Surgery and some of the key articles. The first paper, by Chandra and co-authors from Stanford, entitled “Management and outcomes of symptomatic abdominal aortic aneurysms during the past 20 years,” compares symptomatic patients with abdominal aortic aneurysm (AAA), defined as those who had new onset abdominal pain or aneurysm tenderness with no rupture found by computed tomography scan or in the operating room. In these patients, the repair of AAA was primarily open from 1995 to 2004 and evolved to primarily endovascular repair during the next decade.
Source: Journal of Vascular Surgery - November 20, 2017 Category: Surgery Authors: Peter F. Lawrence Tags: Journal of Vascular Surgery – December 2017 Audiovisual Summary Source Type: research
Global vascular guidelines on the management of chronic limb-threatening ischemia
Chronic limb-threatening ischemia (CLTI) is associated with mortality, amputation, and impaired quality of life. These Global Vascular Guidelines (GVG) are focused on definition, evaluation, and management of CLTI with the goals of improving evidence-based care and highlighting critical research needs. The term CLTI is preferred over critical limb ischemia, as the latter implies threshold values of impaired perfusion rather than a continuum. CLTI is a clinical syndrome defined by the presence of peripheral artery disease (PAD) in combination with rest pain, gangrene, or a lower limb ulceration>2 weeks duration.
Source: Journal of Vascular Surgery - May 28, 2019 Category: Surgery Authors: Michael S. Conte, Andrew W. Bradbury, Philippe Kolh, John V. White, Florian Dick, Robert Fitridge, Joseph L. Mills, Jean-Baptiste Ricco, Kalkunte R. Suresh, M. Hassan Murad, GVG Writing Group Joint guidelines of the Society for Vascular Surgery, European Tags: Clinical practice guideline document Source Type: research
Survey on liquid sclerotherapy of lower limb varicose veins
CONCLUSION: Despite the fact that sclerotherapy is widely employed by Brazilian angiologists in their daily practice, the survey has shown little agreement in relevant points, such as the use of compression, release for physical activities, and sun exposure.
Source: Jornal Vascular Brasileiro - April 14, 2013 Category: Surgery Source Type: research
Analysis of the effects of aquatic exercise on the quality of life of people with chronic venous disease
Conclusions Aquatic exercises were capable of improving aspects of quality of life and of reducing pain, demonstrating that they benefit patients with CVD.
Source: Jornal Vascular Brasileiro - May 6, 2016 Category: Surgery Source Type: research
Post-injection embolia cutis medicamentosa – Nicolau Syndrome: case report and literature review
We report on the case of a 40-year-old male who was admitted to the clinic with a large ulcer on his left buttock, 3 days after an intramuscular benzathine penicillin injection. The patient was diagnosed with Nicolau syndrome, a rare vascular complication in which a lesion develops after intramuscular injection. Symptoms are intense pain at the injection site, erythema, and livedoid dermatitis, which leads to necrosis of skin, subcutaneous tissue and muscle tissue. It was described by Nicolau after intramuscular injections of bismuth salt for syphillis therapy. Nicolau syndrome is rare, but its symptoms are devastating and...
Source: Jornal Vascular Brasileiro - May 6, 2016 Category: Surgery Source Type: research
Using vacuum therapy as an adjunctive treatment for healing of infected surgical sites
We present a case of a patient with multiple comorbidities who had undergone an aortobifemoral bypass 6 years previously and then re-intervention at the femoral anastomoses for restenosis 5 years previously. The patient presented with acute left inguinal pain and swelling and was diagnosed with a ruptured femoral pseudoaneurysm and hemodynamic instability. A repair was conducted by interposition of a silver-coated Dacron graft in the emergency room, and a large abdominal incisional hernia was repaired with synthetic mesh during the same intervention. After surgery, the patient remained intubated in intensive care for a lon...
Source: Jornal Vascular Brasileiro - February 21, 2017 Category: Surgery Source Type: research
Endovascular treatment of traumatic subclavian arteriovenous fistula: case report
Resumo Policial masculino de 47 anos foi atendido em consult ório com queixa de dispneia aos esforços, edema e dor importantes em braço direito. Relatou ferimento por arma de fogo infraclavicular direito 7 meses antes. Tomografia de tórax mostrou grande dilatação de veia subclávia, veias cervicais e de membro superior direito sem identificação da com unicação arteriovenosa. O paciente foi internado antes da data prevista para tratamento por piora clínica e foi submetido a implante de stent revestido Fluency 8x100 mm em artéria subclávia direita por técnica do varal. Angiografia de controle mostrou artéria s...
Source: Jornal Vascular Brasileiro - October 11, 2018 Category: Surgery Source Type: research
Outcomes of segmental femoral artery pseudoaneurysm in patients with Behçet’s disease: a single center’s experience
Conclusions Surgical repair with muscle flap coverage, with or without ligation of profunda femoris artery, does not affect prognosis. An alternative method for identifying healthy segments of femoral artery may be frozen section and examination of the artery to decrease the risk of recurrence at the site of anastomosis.RESUMO Contexto A doen ça de Behçet (DB) é uma enfermidade autoimune que envolve múltiplos sistemas. A manifestação arterial mais comum em pacientes com DB é o pseudoaneurisma, que tem uma frequência mais alta do que a formação de aneurismas. Objetivos Esclarecer a importância da artéria femoral...
Source: Jornal Vascular Brasileiro - November 14, 2019 Category: Surgery Source Type: research
External iliac artery endofibrosis in an elite female endurance cyclist
We report the case of a 36-year-old professional female endurance cyclist who presented with lower extremity pain during training. Right external iliac artery endofibrosis was diagnosed and the patient underwent surgical treatment. At two-months follow-up, she reported significant improvement in symptoms. This case highlights the importance of diagnosing peripheral vascular disease in young patients and athletes, who do not fit the ordinary profile of patients with atherosclerotic risk factors.Resumo A endofibrose da art éria ilíaca externa é uma doença rara que afeta atletas de resistência (endurance) de nível compe...
Source: Jornal Vascular Brasileiro - April 28, 2021 Category: Surgery Source Type: research
Correlation of clinical features with the risk of lower limb deep vein thrombosis assessed by duplex ultrasound
CONCLUSIONS: In the present study, 36.4% of the patients referred to DS had DVT. Age > 65 years, presence of limb swelling, pain, cancer, and suspected or proven PE should be considered as major risk factors for DVT. CONTEXTO: Sintomas e sinais clínicos indicativos de trombose venosa profunda (TVP) são comuns mas podem ter inúmeras causas. OBJETIVOS: 1) Identificar os sintomas mais frequentes e correlacioná-los com achados de dúplex scan (DS); 2) identificar condições clínicas de alto risco para TVP; e 3) avaliar o intervalo de tempo decorrido entre o início dos sintoma...
Source: Jornal Vascular Brasileiro - October 5, 2013 Category: Surgery Source Type: research
Giant renal artery pseudoaneurysm 18 months after blunt trauma
We describe the case of a patient who presented with a pulsatile mass in the right upper quadrant and recurrent abdominal pain 18 months after blunt trauma. Arteriography and multislice computed tomography angiography revealed a pseudoaneurysm measuring 22 cm in the right renal artery. The patient was successfully treated with conventional open surgery.Pseudoaneurismas de artéria renal são lesões vasculares pouco comuns, que geralmente demandam alto grau de suspeição, por serem de difícil diagnóstico. Considerando a baixa expectativa de resolução espontânea dos PARs pós-traumáticos, aliada ao importante risco d...
Source: Jornal Vascular Brasileiro - October 5, 2013 Category: Surgery Source Type: research
