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  1. Article ; Online: Trends in abdominal aortic aneurysm-related mortality in Brazil, 2000-2016: a multiple-cause-of-death study.

    Santo, Augusto Hasiak / Puech-Leão, Pedro / Krutman, Mariana

    Clinics (Sao Paulo, Brazil)

    2021  Volume 76, Page(s) e2388

    Abstract: Objectives: Remarkable changes in the epidemiology of abdominal aortic aneurysm (AAA) have occurred in many countries during last few decades, which have also affected Brazilian mortality concurrently. This study aimed to investigate mortality trends ... ...

    Abstract Objectives: Remarkable changes in the epidemiology of abdominal aortic aneurysm (AAA) have occurred in many countries during last few decades, which have also affected Brazilian mortality concurrently. This study aimed to investigate mortality trends related to AAA mortality in Brazil from 2000 to 2016.
    Methods: Annual AAA mortality data was extracted from the public databases of the Mortality Information System, and processed by the Multiple Cause Tabulator.
    Results: In Brazil, 2000 through 2016, AAA occurred in 69,513 overall deaths; in 79.6% as underlying and in 20.4% as an associated cause of death, corresponding to rates respectively of 2.45, 1.95 and 0.50 deaths per 100,000 population; 65.4% male and 34.6% female; 60.6% in the Southeast region. The mean ages at death were 71.141 years overall, and 70.385 years and 72.573 years for men and women, respectively. Ruptured AAA occurred in 64.3% of the deaths where AAA was an underlying cause, and in 18.0% of the deaths where AAA was an associated cause. The standardized rates increased during 2000-2008, followed by a decrease during 2008-2016, resulting in an average annual percent change decline of -0.2 (confidence interval [CI], -0.5 to 0.2) for the entire 2000-2016 period. As associated causes, shock (39.2%), hemorrhages (33.0%), and hypertensive diseases (26.7%) prevailed with ruptured aneurysms, while hypertensive diseases (29.4%) were associated with unruptured aneurysms. A significant seasonal variation, highest during autumn and followed by in winter, was observed in the overall ruptured and unruptured AAA deaths.
    Conclusions: This study highlights the need to accurately document epidemiologic trends related to AAA in Brazil. We demonstrate the burden of AAA on mortality in older individuals, and our results may assist with effective planning of mortality prevention and control in patients with AAA.
    MeSH term(s) Aged ; Aortic Aneurysm, Abdominal ; Brazil/epidemiology ; Databases, Factual ; Female ; Humans ; Hypertension ; Male
    Language English
    Publishing date 2021-01-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2182801-5
    ISSN 1980-5322 ; 1807-5932
    ISSN (online) 1980-5322
    ISSN 1807-5932
    DOI 10.6061/clinics/2021/e2388
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    Zs.B 404: Show issues Location:
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  2. Article ; Online: Imaging Signs of May-Thurner Syndrome in Asymptomatic Patients: Computed Tomography Angiography Analysis of Kidney Donors.

    Lopes, Daniel F / Zerati, Antonio E / De Luccia, Nelson / Nahas, William C / Puech-Leão, Pedro

    Annals of vascular surgery

    2022  

    Abstract: Background: The current study aimed to evaluate the distance between the right common iliac artery (RCIA) and lumbar vertebra in asymptomatic patients in order to determine whether such distance was statistically correlated with the left common iliac ... ...

    Abstract Background: The current study aimed to evaluate the distance between the right common iliac artery (RCIA) and lumbar vertebra in asymptomatic patients in order to determine whether such distance was statistically correlated with the left common iliac vein (LCIV) diameter (LCIVD) and to investigate if both measures were related to demographic characteristics and anthropometric data, such as sex, age, height, and body mass index (BMI).
    Methods: In this descriptive and uncontrolled anatomic study, data from high-definition computed tomography (CT) angiography images of living kidney donors without a medical history of chronic venous insufficiency or past deep vein thrombosis (DVT) were analyzed. The RCIA crossed over the LCIV in 311 individuals, who were then included in this study. CT scans were reviewed to measure (1) the narrowest space between the RCIA and fifth lumbar vertebral body and (2) the LCIVD. Measures were subjected to normality tests and were divided according to the sex of the study population. Correlations of measures with age, BMI, and height were calculated.
    Results: Of the 311 patients analyzed, 66.6% (n = 207) were female. The mean lumbar vertebral body-iliac artery distance (LVBIAD) was 7.2 mm, whereas the mean LCIVD was 8.5 mm; both were higher in men (P < 0.001). The statistical analysis of LVBIAD and LCIVD distributions revealed no normality pattern (P < 0.05). The analysis of the correlation between them showed a weak statistically significant relationship with age. A linear regression model considering the normality percentile interval indicated a strong positive correlation between LVBIAD and LCIVD (R
    Conclusions: The LVBIAD was <5 mm and <3 mm in 25% and 5% of asymptomatic individuals, respectively. The LCIVD correlated with the space between the RCIA and lumbar vertebra. The distance between the RCIA and lumbar vertebra and the LCIVD were higher in male subjects and older patients, but did not correlate with BMI and height.
    Language English
    Publishing date 2022-08-01
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2022.07.003
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    Zs.A 2882: Show issues Location:
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  3. Book ; Conference proceedings: Proceedings of the IV World Meeting on Impotence

    Puech-Leão, Pedro

    Rio de Janeiro, Brazil, 1990

    (International journal of impotence research ; 2, Suppl. 2)

    1990  

    Event/congress World Meeting on Impotence (4, 1990, RiodeJaneiro)
    Author's details ed. by Pedro Puech-Leão
    Series title International journal of impotence research ; 2, Suppl. 2
    Collection
    Keywords Impotence / congresses
    Size 480 S. : Ill., graph. Darst.
    Publisher Smith-Gordon
    Publishing place London
    Publishing country Great Britain
    Document type Book ; Conference proceedings
    HBZ-ID HT003879543
    Database Catalogue ZB MED Medicine, Health

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    In stock of ZB MED Cologne/Königswinter

    Shelf markLoan statusLocation
    Zs A 2910 -2,Suppl.2- verfügbar in Königswinter Königswinter

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  4. Article ; Online: Trends in abdominal aortic aneurysm-related mortality in Brazil, 2000-2016

    Augusto Hasiak Santo / Pedro Puech-Leão / Mariana Krutman

    Clinics, Vol

    a multiple-cause-of-death study

    2021  Volume 76

    Abstract: OBJECTIVES: Remarkable changes in the epidemiology of abdominal aortic aneurysm (AAA) have occurred in many countries during last few decades, which have also affected Brazilian mortality concurrently. This study aimed to investigate mortality trends ... ...

    Abstract OBJECTIVES: Remarkable changes in the epidemiology of abdominal aortic aneurysm (AAA) have occurred in many countries during last few decades, which have also affected Brazilian mortality concurrently. This study aimed to investigate mortality trends related to AAA mortality in Brazil from 2000 to 2016. METHODS: Annual AAA mortality data was extracted from the public databases of the Mortality Information System, and processed by the Multiple Cause Tabulator. RESULTS: In Brazil, 2000 through 2016, AAA occurred in 69,513 overall deaths; in 79.6% as underlying and in 20.4% as an associated cause of death, corresponding to rates respectively of 2.45, 1.95 and 0.50 deaths per 100,000 population; 65.4% male and 34.6% female; 60.6% in the Southeast region. The mean ages at death were 71.141 years overall, and 70.385 years and 72.573 years for men and women, respectively. Ruptured AAA occurred in 64.3% of the deaths where AAA was an underlying cause, and in 18.0% of the deaths where AAA was an associated cause. The standardized rates increased during 2000-2008, followed by a decrease during 2008-2016, resulting in an average annual percent change decline of -0.2 (confidence interval [CI], -0.5 to 0.2) for the entire 2000-2016 period. As associated causes, shock (39.2%), hemorrhages (33.0%), and hypertensive diseases (26.7%) prevailed with ruptured aneurysms, while hypertensive diseases (29.4%) were associated with unruptured aneurysms. A significant seasonal variation, highest during autumn and followed by in winter, was observed in the overall ruptured and unruptured AAA deaths. CONCLUSIONS: This study highlights the need to accurately document epidemiologic trends related to AAA in Brazil. We demonstrate the burden of AAA on mortality in older individuals, and our results may assist with effective planning of mortality prevention and control in patients with AAA.
    Keywords Abdominal Aortic Aneurysm ; Mortality Trends ; Cause of Death ; Seasonality ; Medicine (General) ; R5-920
    Subject code 310
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher Elsevier España
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Editor's Choice - In Hospital and Long Term Outcomes After Repair of Subclavian and Axillary Artery Injuries.

    Torres, Inez Ohashi / Lourenço de Andrade, Rebeca Cristina / Apoloni, Rafael / Simão da Silva, Erasmo / Puech-Leão, Pedro / De Luccia, Nelson

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

    2023  Volume 66, Issue 6, Page(s) 840–847

    Abstract: Objective: To evaluate the in hospital and long term outcomes after open or endovascular repair of subclavian and axillary artery injuries.: Methods: This was a retrospective, single centre study. Data were reviewed from patients with subclavian and ... ...

    Abstract Objective: To evaluate the in hospital and long term outcomes after open or endovascular repair of subclavian and axillary artery injuries.
    Methods: This was a retrospective, single centre study. Data were reviewed from patients with subclavian and or axillary injuries who presented to the authors' centre between January 2009 and December 2022. Outcome data included complications, death, amputations, and re-interventions. A p value < .050 was considered to be statistically significant.
    Results: Over the study period, 62 patients with subclavian or axillary trauma were admitted to the study hospital. Patients were young (median age 32.5 years, range 12 - 53) and most were men (85%); 32 patients experienced blunt trauma, and 30 penetrating trauma. The median injury severity score was 18 (interquartile range [IQR] 9, 34), and 47% of patients had a brachial plexus injury. The arterial injury was occlusion in 62% of patients, and the median ischaemia time was 12.5 hours (IQR 7.13, 24). All patients with subclavian injuries (n = 37) and 13 of 25 patients with an axillary injury underwent endovascular repair (stent graft placement). Open repair was performed in 12 patients with axillary injury (axillobrachial bypass in seven patients). At hospital discharge, the amputation free survival rate was 82% vs. 92% (p = .67), the mortality rate was 10% vs. 8% (p = 1.0), and the amputation rate was 10% vs. 0 (p = .57) for endovascular and open repair, respectively. The mean follow up time was 4.1 ± 3.5 years. After the seven year follow up, the stent primary patency was 42%. No re-interventions or amputations were performed after hospital discharge. Disability was related to fractures and soft tissue and brachial plexus injuries.
    Conclusion: Endovascular treatment was preferred for patients with subclavian artery injuries. Open repair was preferred for patients with penetrating axillary injuries. In hospital and long term complications were related to fractures and soft tissue and brachial plexus injuries, rather than the treatment of arterial injuries. Measures are needed to reduce ischaemia time and improve brachial plexus injury repair.
    Language English
    Publishing date 2023-08-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 1225869-6
    ISSN 1532-2165 ; 1078-5884
    ISSN (online) 1532-2165
    ISSN 1078-5884
    DOI 10.1016/j.ejvs.2023.08.008
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2283: Show issues Location:
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    Zs.MO 381: Show issues

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  6. Article ; Online: COVID-19, Vascular Diseases, and Vascular Services.

    Puech-Leão, Pedro / César, Luiz Antonio Machado / De Luccia, Nelson

    Clinics (Sao Paulo, Brazil)

    2020  Volume 75, Page(s) e1979

    MeSH term(s) Betacoronavirus ; COVID-19 ; Cardiology Service, Hospital/organization & administration ; Coronavirus Infections/complications ; Humans ; Pandemics ; Pneumonia, Viral/complications ; SARS-CoV-2 ; Vascular Diseases/therapy ; Vascular Diseases/virology
    Keywords covid19
    Language English
    Publishing date 2020-05-29
    Publishing country United States
    Document type Editorial
    ZDB-ID 2182801-5
    ISSN 1980-5322 ; 1807-5932
    ISSN (online) 1980-5322
    ISSN 1807-5932
    DOI 10.6061/clinics/2020/e1979
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  7. Article ; Online: Removal of Intravascular Foreign Bodies With a Simple Low-Cost Method: A Report of 5 Cases.

    Ribeiro, Felipe Soares / Kumakura, Harue / da Silva, Erasmo Simão / Puech-Leão, Pedro / De Luccia, Nelson

    Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists

    2021  Volume 28, Issue 3, Page(s) 474–480

    Abstract: Purpose: Intravascular embolization of hemodialysis and central venous catheters is a rare but potentially serious complication. With the increasing use of catheters in medical practice, we are often faced with this type of complication. Novel, simple, ... ...

    Abstract Purpose: Intravascular embolization of hemodialysis and central venous catheters is a rare but potentially serious complication. With the increasing use of catheters in medical practice, we are often faced with this type of complication. Novel, simple, and low-cost techniques are needed for foreign body extraction in order to reduce cardiovascular risks.
    Case report: We describe the approach of 5 foreign body embolization cases. Case 1: a 57-year-old woman with end-stage renal failure with a complete fracture and migration of the distal extremity of a hemodialysis catheter. Case 2: a 55-year-old man with an accidental embolization of the distal portion of a hemodialysis catheter. Case 3: a 76-year-old woman with stage IV breast cancer and an accidental embolization of a central venous catheter guidewire. Cases 4 and 5: a 71-year-old woman and a 2-year-old boy with a port-a-cath embolization. All the patients underwent successful minimally invasive removal of the foreign bodies from the thoracic site using 5Fr pigtail catheters. Additional surgery was not required. No further complications, such as damage to the vascular wall, were noted.
    Conclusion: Our experience with the interlacing and traction pigtail show that it is a simple, practical, and low-cost technical alternative and its benefits should be widespread.
    MeSH term(s) Aged ; Catheters, Indwelling ; Child, Preschool ; Device Removal ; Equipment Failure ; Female ; Foreign Bodies/diagnostic imaging ; Foreign Bodies/therapy ; Foreign-Body Migration/diagnostic imaging ; Foreign-Body Migration/etiology ; Foreign-Body Migration/therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome
    Language English
    Publishing date 2021-04-15
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2006618-1
    ISSN 1545-1550 ; 1526-6028
    ISSN (online) 1545-1550
    ISSN 1526-6028
    DOI 10.1177/15266028211007470
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    Zs.A 4547: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  9. Article ; Online: Combined Angioplasty Technique of the Carotid Territory and Supra-Aortic Trunk by Double Access (Cervical and Limbs) for Tandem Lesions.

    Ribeiro, Felipe S / Casella, Ivan Benaduce / Leiderman, Dafne Braga Diamante / Puech-Leão, Pedro / De Luccia, Nelson

    Annals of vascular surgery

    2020  Volume 68, Page(s) 570.e9–570.e15

    Abstract: Background: The carotid stent angioplasty (CAS) has been the main option for patients with high cardiovascular risk and carotid stenosis. The common femoral artery is still the most used access site; however, the aortic arch manipulation is a critical ... ...

    Abstract Background: The carotid stent angioplasty (CAS) has been the main option for patients with high cardiovascular risk and carotid stenosis. The common femoral artery is still the most used access site; however, the aortic arch manipulation is a critical moment for cerebral embolization. Carotid transcervical access should be considered as a good alternative access route for CAS. Tandem lesions combining supra-aortic trunks and ipsilateral carotid bulb critical stenosis pose a great challenge for the vascular surgeon.
    Methods: This is a retrospective descriptive study based on medical records of our institution. We report 2 cases of complex cerebral vascular insufficiency and discuss therapeutic options and strategies to protect the cerebrovascular territory avoiding microembolization, as well as demonstrate an alternative and safe total endovascular approach for those cases.
    Results: We describe the approach of 2 complex cerebral vascular insufficiency cases: case 1, a 63-year-old male with previous ischemic stroke, right internal carotid artery (ICA) occlusion, left ICA stenosis >70%, and critical stenosis of the origin of common carotid artery (CCA); case 2, a 68-year-old female with previous ischemic stroke, left ICA occlusion, brachiocephalic trunk critical stenosis, hypoplastic right vertebral artery, and aortobi-iliac chronic occlusion. In both cases reported here a challenging solution was chosen, little described in the literature, with cerebral filter protection as the first step. In addition, a literature review was performed to discuss the different approach options for tandem injuries of the supra-aortic trunk and carotid bulb.
    Conclusions: Our initial experience with total endovascular treatment of complex tandem lesions of the carotid territory and supra-aortic trunks show that transcervical access, coupled with distal protection filter device on the first step, is a safe and effective technique for preventing neurological events.
    MeSH term(s) Aged ; Angioplasty, Balloon/instrumentation ; Brain Ischemia/etiology ; Carotid Stenosis/complications ; Carotid Stenosis/diagnostic imaging ; Carotid Stenosis/therapy ; Female ; Humans ; Male ; Middle Aged ; Stents ; Stroke/etiology ; Treatment Outcome
    Language English
    Publishing date 2020-04-25
    Publishing country Netherlands
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2020.04.029
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2882: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  10. Article ; Online: Normal Costoclavicular Distance as a Standard in the Radiological Evaluation of Thoracic Outlet Syndrome in the Costoclavicular Space.

    Duarte, Flávio H / Zerati, Antonio E / Gornati, Vitor C / Nomura, Cesar / Puech-Leão, Pedro

    Annals of vascular surgery

    2020  Volume 72, Page(s) 138–146

    Abstract: Background: The costoclavicular space is a common site of thoracic outlet syndrome. When there is no anatomical alteration, the diagnosis of thoracic outlet syndrome is difficult. Several authors relate costoclavicular distance to symptoms of thoracic ... ...

    Abstract Background: The costoclavicular space is a common site of thoracic outlet syndrome. When there is no anatomical alteration, the diagnosis of thoracic outlet syndrome is difficult. Several authors relate costoclavicular distance to symptoms of thoracic outlet syndrome; however, there is no standardized site for measurement of the costoclavicular distance. This study aimed to determine the standard costoclavicular distance at neurovascular bundle crossing points (near the subclavian vein [Measure V] and the subclavian artery/brachial plexus branches [Measure NA]) using high-resolution chest computed tomography (CT) scans and evaluate its variations with respect to age, sex, height, and body mass index.
    Methods: This prospective cross-sectional observational study analyzed 150 of 156 CT scans from consecutive adult patients (72 females and 78 males). Costoclavicular distance was measured at the subclavian vein and brachial plexus/subclavian artery sites, where narrowing of the costoclavicular distance could lead to symptoms of thoracic outlet syndrome. Costoclavicular distance was analyzed with respect to sex, laterality, age group (<50 and ≥50 years) and body mass index group (body mass index <25 and ≥25 kg/m
    Results: Measures of V and NA were normally distributed. The measured costoclavicular distances were 1.23 cm (±0.40) and 1.24 cm (±0.47), respectively. Age (≥50 years) and body mass index (≥25 kg/m
    Conclusions: Standardization of costoclavicular distance measurements at neurovascular bundle crossing points (subclavian vein and brachial plexus/subclavian artery) is possible. It may aid the diagnosis and help direct the therapeutic indications for symptomatic patients with thoracic outlet syndrome.
    MeSH term(s) Adult ; Age Factors ; Aged ; Anatomic Landmarks ; Body Mass Index ; Brachial Plexus/diagnostic imaging ; Clavicle/diagnostic imaging ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Subclavian Artery/diagnostic imaging ; Subclavian Vein/diagnostic imaging ; Thoracic Outlet Syndrome/diagnostic imaging ; Tomography, X-Ray Computed
    Language English
    Publishing date 2020-11-04
    Publishing country Netherlands
    Document type Journal Article ; Observational Study
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2020.09.060
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