Publications by authors named "Marcelo B Dalio"

Background: Multicenter studies conducted in developed countries demonstrated that custom-made devices are safe, effective, and durable for treating complex abdominal aneurysms. However, the situation in developing countries, such as Brazil, is different. Funding and time to have the endoprosthesis delivered are the major concerns.

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A persistent sciatic artery (PSA) is a rare congenital vascular anomaly, with an estimated prevalence ranging from 0.01% to 0.05%.

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Thoracic outlet syndrome (TOS) is observed more frequently in women, although the exact causes of this sex disparity remain unclear. By investigating the three types of TOS-arterial, neurogenic, and venous-regarding symptoms, diagnosis, and treatment, this article aims to shed light on the current understanding of TOS, focusing on its variations in women.

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Background: Surgical treatment of symptomatic extracranial carotid stenosis is well established for preventing neurological events and should adhere to optimal quality standards. However, there is growing concern as to whether results of controlled trials are replicable in real-world settings.

Objectives: To assess a symptomatic carotid stenosis population that underwent surgery and its short-term outcomes in a real-world context at a professional training center.

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Trauma is a leading cause of death, permanent disability, and health care cost worldwide. The young and economically active are the most affected population. Exsanguination due to noncompressible torso hemorrhage is one of the most frequent causes of early death, posing a significant challenge to trauma and vascular surgeons.

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The great saphenous vein is the optimal conduit for infrapopliteal bypass surgery in chronic limb-threatening ischemia. A prosthetic bypass graft is an acceptable option when the autologous vein is unavailable and the anatomy is not favorable for endovascular therapy. However, the low patency rate of prosthetic grafts calls for adjunct strategies to improve the outcomes.

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Article Synopsis
  • Venous thromboembolism is a significant issue in hospitalized patients, with a worldwide prophylaxis adequacy rate around 50%, indicating a gap between guidelines and practice.
  • A study at a tertiary university hospital assessed the adequacy of risk stratification and prophylactic measures, analyzing data from 400 patients split between surgical and clinical groups.
  • Results showed a risk stratification adequacy of 50.8% overall, with surgical patients at 39.1% and clinical patients at 59.3%, whereas the prophylaxis adequacy was higher at 71.5% overall, suggesting better adherence to prophylaxis recommendations compared to global standards.
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Background: In-stent restenosis remains a common and important complication after endovascular treatment of superficial femoral artery peripheral artery disease. It occurs in 14 to 35% of cases in 1 year and there is still no efficient treatment for this condition. Paclitaxel-coated balloons have shown promising results.

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Background: Transfemoral carotid artery stenting (TF-CAS) and carotid endarterectomy (CEA) are alternative strategies for stroke prevention in patients with atherosclerotic carotid disease. Because their main objective is to prevent future ischemic events, regular reassessment of the outcomes is mandatory for providing the best therapy. The purpose of this study was to describe the practice and the outcomes of TF-CAS and CEA in symptomatic patients in public university hospitals in Brazil, using data from a prospective multicentric registry.

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Background: Inpatient consultations are a fundamental component of practice in tertiary care centers. However, such consultations demand resources, generating a significant workload.

Objectives: To investigate the profile of inpatient consultations requested by other specialties and provided by the Vascular and Endovascular Surgery team at an academic tertiary hospital.

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The arterial form of thoracic outlet syndrome is rare and is associated with anatomic anomalies, generally a cervical rib. It has a varied range of manifestations. The aim of this article is to describe two cases with different clinical presentations: microembolization and aneurysm.

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Background: Arterial thoracic outlet syndrome (aTOS) is characterized by compression of the subclavian artery as it exits the thoracic girdle. Chronic and repetitive compression leads to several degrees of arterial wall damage. The treatment is varied and depends on the presentation severity.

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A ruptured abdominal aortic aneurysm after endovascular aneurysm repair with an arteriovenous fistula between the aneurysm sac and a retroaortic left renal vein is an extremely rare complication. This case describes an 81-year-old man who developed an aorto-left renal vein fistula owing to a type IB endoleak 2 years after endovascular aneurysm exclusion. The leak was repaired with a left endograft limb extension.

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Article Synopsis
  • Postendarterectomy carotid pseudoaneurysms are rare and can be treated with endovascular methods, which are less invasive and have minimized complication risks.
  • The challenge arises when the patient has a highly angulated aortic arch (type III), making it difficult to navigate endovascular devices.
  • This case demonstrates successful treatment of a carotid pseudoaneurysm using transcervical access to place an endograft directly into the carotid artery.
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Objective: to evaluate the incidence, epidemiological characteristics, diagnosis and evolution of patients who returned to the emergency care units of the Albert Einstein Hospital in São Paulo/SP with signs and symptoms suggestive of colonoscopy complications up to 30 days after the procedure.

Methods: we conducted a retrospective, uni-institutional study of patients submitted to colonoscopy in 2014 who returned to the Emergency department (ED) within 30 days after the procedure.

Results: 8968 patients underwent colonoscopies, 95 (1.

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Objective: The objective of this study was to analyze the effect of graduated compression stockings (GCS) on venous lower limb hemodynamics in healthy amateur runners.

Methods: Ten runners were evaluated during rest and after a 10-km run without and with knee-high GCS of 20 to 30 mm Hg. Air plethysmography evaluated venous filling index (VFI), ejection fraction, and residual volume fraction (RVF) in both limbs.

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Background: Analyze the association of lower limb edema with venous reflux in healthy primigravidae during pregnancy and in the postpartum.

Methods: Cohort with primigravidae evaluated in the three trimesters of pregnancy and postpartum. Edema was assessed by physical examination.

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Background: Analyze the effects of ischemic postconditioning on skeletal muscle injury and apoptosis produced by partial ischemia and reperfusion in rats.

Materials And Methods: An experimental study was designed using 70 Wistar rats divided in 3 groups: Sham; Control-submitted to ischemia and reperfusion; and Postconditioning-submitted to ischemia and reperfusion with ischemic postconditioning. Subgroups (n = 10) were divided by duration of ischemia (4, 5, or 6 hr).

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We describe the case of a 12-year-old girl who presented at the emergency department with hemorrhagic acute abdomen, an abdominal pulsating mass and hemodynamic instability. A diagnosis of ruptured right iliac artery aneurysm was confirmed and an emergency open repair procedure was performed with extra-anatomic reconstruction, using a small-caliber synthetic graft, compatible with her anatomy. The treatment was successful and the child was doing well at short-term follow-up.

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Objective Analyse venous haemodynamics in healthy primigravidae during pregnancy and in the postpartum. Methods Cohort with primigravidae evaluated in the three trimesters of pregnancy and postpartum. Duplex evaluated venous diameters and reflux; air plethysmography evaluated venous filling index, ejection fraction, residual volume fraction and outflow fraction in both limbs.

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Article Synopsis
  • Air plethysmography is a non-invasive method that measures volume changes in the legs to assess venous reflux and obstruction, providing important insights into venous health.
  • It quantitatively evaluates key aspects of venous function, including valve performance, calf muscle pump efficiency, and blockage in veins, and its results align well with both clinical observations and hemodynamic data.
  • Though its clinical applications have been validated, air plethysmography is primarily used in research settings to study chronic venous diseases, treatment outcomes, and various physiological effects related to venous health.
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Background: Endovascular aneurysm repair (EVAR) has become the preferred approach for the treatment of infrarenal abdominal aortic aneurysm (IRAAA) in detriment of open surgical repair (OSR). EVAR results in lower mortality rates within 30 days, but rates tend to be the same after longer periods. Moreover, reduced use of hospital resources with EVAR does not necessarily offset the costs of the endoprosthesis.

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Cystic adventitial disease is a rare entity that most often involves the popliteal artery. It rarely occurs in veins. Its etiology is unknown.

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Background: The endovascular approach has shown high initial technical success rates, good patency rates, and minimal complications in treating transplant renal artery stenosis (TRAS). The objective of this study was to describe our experience with an endovascular approach to TRAS.

Material And Methods: We performed a retrospective single-institutional review of all kidney transplant procedures performed at our institution from September 2009 to September 2014.

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Article Synopsis
  • Penetrating aortic ulcer (PAU) is a serious condition where an ulcer damages the aortic wall, leading to high risks of rupture, reported at up to 38%.
  • A unique case of a PAU is presented in which it caused an aortogastric fistula, resulting in severe internal bleeding.
  • Despite immediate treatment through thoracic endovascular aortic repair, the patient ultimately died from hypovolemic shock.
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