Brazilian Angiology and Vascular Surgery Society Guidelines for the treatment of extracranial cerebrovascular disease.

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.

Rivaroxaban versus no anticoagulation for post-discharge thromboprophylaxis after hospitalisation for COVID-19 (MICHELLE): an open-label, multicentre, randomised, controlled trial.

Background: Patients hospitalised with COVID-19 are at risk for thrombotic events after discharge; the role of extended thromboprophylaxis in this population is unknown.

Methods: In this open-label, multicentre, randomised trial conducted at 14 centres in Brazil, patients hospitalised with COVID-19 at increased risk for venous thromboembolism (International Medical Prevention Registry on Venous Thromboembolism [IMPROVE] venous thromboembolism [VTE] score of ≥4 or 2-3 with a D-dimer >500 ng/mL) were randomly assigned (1:1) to receive, at hospital discharge, rivaroxaban 10 mg/day or no anticoagulation for 35 days. The primary efficacy outcome in an intention-to-treat analysis was a composite of symptomatic or fatal venous thromboembolism, asymptomatic venous thromboembolism on bilateral lower-limb venous ultrasound and CT pulmonary angiogram, symptomatic arterial thromboembolism, and cardiovascular death at day 35.

Medically Ill hospitalized Patients for COVID-19 THrombosis Extended ProphyLaxis with rivaroxaban ThErapy: Rationale and Design of the MICHELLE Trial.

Background: The devastating Coronavirus disease (COVID-19) pandemic is associated with a high prothrombotic state. It is unclear if the coagulation abnormalities occur because of the direct effect of SARS-CoV-2 or indirectly by the cytokine storm and endothelial damage or by a combination of mechanisms. There is a clear indication of in-hospital pharmacological thromboprophylaxis for every patient with COVID-19 after bleed risk assessment.

Inadvertent insertion of a venous catheter into the internal thoracic vein: a word of caution.

Central venous catheters are widely used in clinical practice and are linked to many types of complications, including incorrect positioning at the time the catheter is fitted. Here, the authors describe a case in which a fully implantable catheter was inadvertently positioned in the right internal thoracic vein. The complication was identified when the nursing team attempted to use the catheter.

Laparoscopic treatment of celiac axis compression by the median arcuate ligament and endovascular repair of a pancreaticoduodenal artery aneurysm: case report.

Compression of the celiac axis by the median arcuate ligament of the diaphragm can cause nonspecific symptoms such as abdominal pain, vomiting, and weight loss. There is a known association between stenosis or occlusion of the celiac trunk and aneurysms of the pancreaticoduodenal artery. Treatment strategies for patients who have this association should be selected on a case-by-case basis.

Late presentation of critical upper limb ischemia caused by pseudarthrosis of the clavicle.

Compression of the subclavian artery in the thoracic outlet is a well-known phenomenon. In rare cases, bone abnormalities, such as pseudarthrosis of the clavicle, can cause arterial compression at this level. Pseudarthrosis may develop as a result of trauma, which is the more common form, or it may be congenital.

Popliteal vein aneurysm: report of two cases.

Venous aneurysms are rare and often diagnosed incidentally. Popliteal vein aneurysms are the most common type of venous aneurysms and have a strong association with the occurrence of deep vein thrombosis and recurrent pulmonary embolism. This article reports two cases of popliteal vein aneurysms associated with deep vein thrombosis.

Anterior tibial artery entrapment syndrome: case report.

Lower extremity intermittent claudication is usually related to atherosclerotic disease. The most common non-atherosclerotic causes are arterites, chronic compartmental syndrome, bone compression, and popliteal entrapment syndrome. The authors report a case of a patient with intermittent claudication related to anterior tibial artery entrapment caused by the interosseous membrane.

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Pseudoaneurysms of the superficial temporal artery are rare events. They primarily occur in young men as a consequence of blunt head traumas. The majority of cases are asymptomatic, although there are sometimes vague symptoms.

Critical issues in vascular surgery: Education in Brazil.

Background: Vascular surgery practice and education vary widely across the globe. In Brazil, the largest and most populated country of South America, vascular surgery is an independent specialty, with >3000 practicing specialists. Vascular surgery education in Brazil consists of 6 years of medical school, followed by a 4-year residency in vascular surgery.