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.

Guidelines on vascular access for hemodialysis from the Brazilian Society of Angiology and Vascular Surgery.

Chronic kidney disease is a worldwide public health problem, and end-stage renal disease requires dialysis. Most patients requiring renal replacement therapy have to undergo hemodialysis. Therefore, vascular access is extremely important for the dialysis population, directly affecting the quality of life and the morbidity and mortality of this patient population.

Sclerotherapy Improves Symptoms in Patients with Small and Moderate Diameter Low-Flow Vascular Malformations: A Prospective Cohort Study.

Background: Vascular malformations are rare diseases and treatment remains controversial. Sclerotherapy is accepted as a minimally invasive treatment with good results; however, some patients do not report good response to sclerotherapy, and it is not clear which variables influence treatment outcome, preventing optimal patient selection. We hypothesized that large diameter lesions have reduced efficacy and satisfaction with sclerotherapy.

Tools and scores for perioperative pulmonary, renal, hepatobiliary, hematological, and surgical site infection risk assessment: an update.

Introduction: perioperative risk assessment is essential to mitigate surgical complications, which suggests individual and collective interest since the number of surgical procedures in Brazil has been expanding steadily. The aim of this study was to summarize and detail the main calculators, indexes and scores regarding perioperative pulmonary, renal, hepatobiliary, hematological and surgical site infection risks for general non-cardiac surgeries, which are dispersed in the literature.

Method: a narrative review was performed based on manuscripts in English and Portuguese found in the electronic databases Pubmed/MEDLINE and EMBASE.

Tools and scores for general and cardiovascular perioperative risk assessment: a narrative review.

The number of surgical procedures in the world is large and in Brazil it has been expressing a growth trend higher than the population growth. In this context, perioperative risk assessment safeguards the optimization of the outcomes sought by the procedures. For this evaluation, anamnesis and physical examination constitute an irreplaceable initial stage which may or may not be followed by complementary exams, interventions for clinical stabilization and application of risk estimation tools.

Intraoperative vascular Doppler ultrasound blood flow and peak systolic velocity predict early patency in hemodialysis arteriovenous fistula.

Background: Chronic kidney disease is a major public health problem. Hemodialysis is the most common renal replacement therapy. Arteriovenous fistulas (AVF) are a possible access option, but early failure rates remain high.

Brachial vein transposition: an alternative to hemodialysis arteriovenous graft.

Background: There is currently a worldwide effort to increase the options for autogenous hemodialysis access.

Objectives: To evaluate patency and complications of brachial vein transposition compared to other autogenous hemodialysis accesses.

Methods: A retrospective evaluation of 43 patients and 45 procedures.

Risk factors for mortality among patients undergoing major amputations due to infected diabetic feet.

Background: Foot ulcers in patients with diabetes are a major public health problem and are often associated with lower limbs amputation and mortality in this population.

Objectives: To investigate the risk factors associated with mortality in patients with infected diabetic foot ulcers and major lower limb amputations.

Methods: This was an observational, retrospective, case-control study with a sample of 78 patients with infected diabetic foot ulcers who had major lower limb amputations at a Vascular Surgery Service at a university hospital.

Hybrid Treatment with Complete Transposition of Supra-Aortic Trunks versus Conventional Surgery for the Treatment of Aortic Arch Aneurysm.

Objective: The disease of the aortic arch is traditionally approached by open surgical repair requiring cardiopulmonary bypass and circulatory arrest. This study performed a retrospective analysis comparing outcomes through primary hybrid patients submitted to aortic arch surgery without cardiopulmonary bypass with patients submitted to conventional open surgery.

Methods: 25 patients submitted to the aortic arch surgery were selected in the period 2003-2012 at the Madre Teresa Hospital in the city of Belo Horizonte, Brazil; 13 of these underwent hybrid technique without cardiopulmonary bypass and 12 underwent conventional open surgery.

Bacterial genus is a risk factor for major amputation in patients with diabetic foot.

Objective: to evaluate whether bacterial genus is a risk factor for major amputation in patients with diabetic foot and infected ulcer.

Methods: we conducted a case-control, observational study of 189 patients with infected ulcers in diabetic feet admitted to the Vascular Surgery Service of the Risoleta Tolentino Neves Hospital, from January 2007 to December 2012. The bacteriological evaluation was performed in deep tissue cultures from the lesions and amputation was considered major when performed above the foot'smiddle tarsus.

Diabetic foot ulcer carries high amputation and mortality rates, particularly in the presence of advanced age, peripheral artery disease and anemia.

Introduction: Foot ulcer is also a clinical marker for limb amputation and for death in diabetic patients. The purpose of this study was to determine amputation and mortality rates and its associated factors in patients with diabetic foot ulcerations in a tertiary hospital in Brazil.

Methods: Retrospective medical records from 654 diabetic foot patients were reviewed.

Persistent fever after pacemaker lead extraction.

The implant indication of cardiac electronic devices continues to expand; therefore, we have observed increasing complications related to their removal. We describe the case of a patient who presented with prolonged bloodstream infection after having undergone removal of a pacemaker. After extensive workup for fever of unknown origin and antibiotic therapy without any improvement, it was possible to demonstrate a foreign body in the right subclavian vein and superior vena cava corresponding to the distal part of the right ventricular lead.

Incidence of deep vein thrombosis and quality of venous thromboembolism prophylaxis.

Objective: to determine the incidence of deep vein thrombosis and prophylaxis quality in hospitalized patients undergoing vascular and orthopedic surgical procedures.

Methods: we evaluated 296 patients, whose incidence of deep venous thrombosis was studied by vascular ultrasonography. Risk factors for venous thrombosis were stratified according the Caprini model.

Treatment of Hostile Proximal Necks During Endovascular Aneurysm Repair.

Endovascular aneurysm repair (EVAR) is a therapy that continues to evolve rapidly as advances in technology are incorporated into new generations of devices and surgical practice. Although EVAR has emerged as a safe and effective treatment for patients with favorable anatomy, treatment of patients with unfavorable anatomy remains controversial and is still an off-label indication for endovascular treatment with some current stent-grafts. The proximal neck of the aneurysm remains the most hostile anatomic barrier to successful endovascular repair with long-term durability.

Heel-rise test in the assessment of individuals with peripheral arterial occlusive disease.

Introduction: The heel-rise test (HRT) is a clinical instrument relevant to vascular rehabilitation that has been proposed to assess the function of the triceps surae muscle. To use HRT in the assessment of individuals with peripheral arterial occlusive disease (PAOD), its ability to detect differences in the functional performance of patients with PAOD must be verified.

Aim: To verify whether the test is sensitive in differentiating between individuals with PAOD with distinct functional capacities.