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Article: The Challenge Of Covid19 In The Management Of Vascular Access For Hemodialysis In An Universitary Hospital.

Afonso, Beatriz / Nóbrega, Leandro / Castro-Ferreira, Ricardo

Portuguese journal of cardiac thoracic and vascular surgery

2023 Volume 30, Issue 1, Page(s) 37–42

Abstract: Introduction: Chronic kidney disease prevalence has been increasing worldwide, with an increasing need to deliver an effective treatment. During the first months of the coronavirus disease 2019 (COVID-19) pandemic healthcare systems around the world ... ...

Abstract	Introduction: Chronic kidney disease prevalence has been increasing worldwide, with an increasing need to deliver an effective treatment. During the first months of the coronavirus disease 2019 (COVID-19) pandemic healthcare systems around the world were under stress. Therefore, the aim of this study is to report a single center experience with arteriovenous fistula (AVF) creation while also evaluating the impact of COVID-19. Methods: Procedures for AVF creation in a tertiary hospital between March 2017 and December 2020 were included in this study and their case records were retrospectively analyzed and data retrieved. Results: A total of 582 procedures were performed and a total of 568 accesses were created (506 being made pre-COVID onset and 62 post-COVID onset). The period between the referral to the vascular surgery consultation was significantly longer for the COVID group [18 (23) days vs 28 (44) days; p<0,001] while the period between the consultation to the surgery was significantly shorter [76 (77) days vs 40 (57) days; p<0,001]. This resulted in significantly less time between referral to surgery in the COVID group [103 (77) days vs 88 (55) days; p=0,008]. Conclusion: The ability of hospitals to adapt their resources was paramount to mitigate COVID impact. In the institution where the study took place, the time from referral to consultation was increased significantly during the first months of COVID but the time from consultation to surgery was significantly reduced. Overall, these results show that there was a successful effort to expedite the creation of a vascular access.
MeSH term(s)	Humans ; Retrospective Studies ; Vascular Patency ; COVID-19/epidemiology ; Renal Dialysis/methods ; Hospitals
Language	English
Publishing date	2023-04-04
Publishing country	Portugal
Document type	Journal Article
ISSN	2184-9927
ISSN	2184-9927
DOI	10.48729/pjctvs.260
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Article ; Online: A prospective study on varicose veins surgery impact on systemic endothelial function evaluated by arterial brachial flow mediated dilation.

Nóbrega, Leandro / Cardoso, Rita / Leite-Moreira, Adelino / Castro-Ferreira, Ricardo

Vascular

2023 , Page(s) 17085381231175707

Abstract: Objectives: Chronic venous disease (CVD) is a prevalent pathology, and endothelial dysfunction is recognized as a core of its physiopathology. Flow-mediated dilation (FMD) is one of the most widely used tests for evaluating endothelial function. The aim ...

Abstract	Objectives: Chronic venous disease (CVD) is a prevalent pathology, and endothelial dysfunction is recognized as a core of its physiopathology. Flow-mediated dilation (FMD) is one of the most widely used tests for evaluating endothelial function. The aim of this study is to evaluate the influence of varicose vein (VV) surgery on FMD. Methods: A prospective study with patients with superficial CVD and saphenous incompetence on Doppler ultrasonography that were proposed for VV surgery. The FMD test was performed before and 6 months after the procedure. The operator performing the post-operative evaluation was blinded to the pre-operative result. Results: A total of 42 patients were included in the analysis. The median pre-operative percent change of FMD was 4.20% (±1.30) and the post-operative was 4.56% (±1.25) ( Conclusions: Our findings do not corroborate the presence of an overall endothelial dysfunction prone to modulation by surgery. Nevertheless, further studies are needed to confirm our findings.
Language	English
Publishing date	2023-05-22
Publishing country	England
Document type	Journal Article
ZDB-ID	2137151-9
ISSN	1708-539X ; 1708-5381
ISSN (online)	1708-539X
ISSN	1708-5381
DOI	10.1177/17085381231175707
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Article: Myocardial stretch-induced compliance is abrogated under ischemic conditions and restored by cGMP/PKG-related pathways.

Leite-Moreira, André M / Almeida-Coelho, João / Neves, João S / Castro-Ferreira, Ricardo / Ladeiras-Lopes, Ricardo / Leite-Moreira, Adelino F / Lourenço, André P

Frontiers in physiology

2023 Volume 14, Page(s) 1271698

Abstract: Introduction: ...

Abstract	Introduction:
Language	English
Publishing date	2023-10-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2023.1271698
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Article ; Online: The Role of Endothelial Dysfunction and Inflammation in Chronic Venous Disease.

Castro-Ferreira, Ricardo / Cardoso, Rita / Leite-Moreira, Adelino / Mansilha, Armando

Annals of vascular surgery

2018 Volume 46, Page(s) 380–393

Abstract: Chronic venous disease is a potentially prevalent and debilitating condition affecting millions of individuals, mostly in Western world. Predisposing genetic and environmental factors contribute to its development. However, the main etiology remains to ... ...

Abstract	Chronic venous disease is a potentially prevalent and debilitating condition affecting millions of individuals, mostly in Western world. Predisposing genetic and environmental factors contribute to its development. However, the main etiology remains to be elucidated. An extensive literature search was conducted in Medline using the following key words algorithm: ("Chronic venous disease" OR "Chronic venous insufficiency" OR "varicose veins") AND ("endothelial dysfunction" OR "inflammation"). Besides being a multifactorial disease, it is now recognized that the hallmark of chronic venous disease pathophysiology likely remains in inflammation, possibly triggered by sustained venous hypertension and valvular incompetence. Shear stress changes are directly sensed by endothelial cells, leading to its activation and subsequent recruitment of leukocytes and release of proinflammatory agents. Dysfunctional endothelium has a pivotal role perpetuating the inflammatory cascade, with consequent pathological venous changes and chronic venous disease worsening. Endothelial dysfunction may be the central player in the link between varicose veins and deep vein thrombosis. In this article, we aim to analyze the crucial role of endothelial activation in the persistent inflammatory cycle that characterizes chronic venous disease.
MeSH term(s)	Animals ; Chronic Disease ; Endothelium, Vascular/immunology ; Endothelium, Vascular/metabolism ; Endothelium, Vascular/physiopathology ; Glycocalyx/immunology ; Glycocalyx/metabolism ; Hemodynamics ; Humans ; Inflammation/immunology ; Inflammation/metabolism ; Inflammation/physiopathology ; Inflammation Mediators/immunology ; Inflammation Mediators/metabolism ; Leukocyte Rolling ; Leukocytes/immunology ; Leukocytes/metabolism ; Risk Factors ; Varicose Veins/immunology ; Varicose Veins/metabolism ; Varicose Veins/physiopathology ; Vascular Remodeling ; Venous Insufficiency/immunology ; Venous Insufficiency/metabolism ; Venous Insufficiency/physiopathology
Chemical Substances	Inflammation Mediators
Language	English
Publishing date	2018-01
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2017.06.131
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Article ; Online: Incidental abdominal aortic aneurysms are largely undocumented and unmonitored.

Castro-Ferreira, Ricardo / Vidoedo, José / Peixoto, João / Canedo, Alexandra / Teixeira, José / Leite-Moreira, Adelino / Sampaio, Sérgio

Annals of vascular surgery

2021 Volume 77, Page(s) 182–186

Abstract: Background: In countries without organized population screening, incidental detection remains the major form of abdominal aortic aneurysm (AAA) diagnosis. Despite the presumed homogeneity in AAA prevalence, its rate of repair is highly variable, with ... ...

Abstract	Background: In countries without organized population screening, incidental detection remains the major form of abdominal aortic aneurysm (AAA) diagnosis. Despite the presumed homogeneity in AAA prevalence, its rate of repair is highly variable, with Portugal treating 2 to 6 times fewer AAA per habitant than other western countries. Objectives: To evaluate the detection rate and monitoring of incidental AAA in a multicentre cohort from Portuguese hospitals. Methods: All abdominal CT scans performed in men ≥ 65 years old in three major Portuguese hospitals between January and June 2018 were selected for review. CT scans prescribed by the Vascular Surgery or Emergency Departments were excluded. Patients with previously known AAA were also excluded. Subjects with newly detected aneurysms were assessed for the two primary outcomes: the description of the finding by the radiologist in the written report; the effective follow-up recommendations by the prescriber of the CT or by the general practitioner (GP). Patients with newly found AAA that met criteria for monitoring or treatment and failed to be given guidance were contacted and included in surveillance programs. Results: Overall, 3292 abdominal CT scans were selected for review. A total of 133 newly found aneurysms were detected (4.2% prevalence in the cohort). Of those, 48 cases (36%) were not described by the radiologist in the written report. Further 42 patients (32%) were not successfully oriented by the ordering physician or GP, despite having had their AAA mentioned. Overall, only 32% (n = 42) of the newly diagnosed AAA were correctly identified and referred to monitoring. Conclusions: Incidental AAA is a common occurrence in in-hospital abdominal CTs. A significant number is not documented by the radiologist and the vast majority is not referred to monitoring. This could be a major reason for the low elective treatment rate of AAA in Portugal.
MeSH term(s)	Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/epidemiology ; Aortic Aneurysm, Abdominal/therapy ; Aortography ; Computed Tomography Angiography ; Humans ; Incidental Findings ; Male ; Portugal/epidemiology ; Predictive Value of Tests ; Prevalence ; Prognosis ; Referral and Consultation
Language	English
Publishing date	2021-08-17
Publishing country	Netherlands
Document type	Journal Article ; Multicenter Study
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2021.05.027
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Article ; Online: Parallel Graft Technique in a Complex Aortic Aneurysm: The Value of Intra-operative Flexibility from The Original Operative Plan.

Castro-Ferreira, Ricardo / Dias, Paulo G / Sampaio, Sérgio M / Teixeira, José F / Lobato, Armando C

EJVES short reports

2019 Volume 43, Page(s) 37–40

Abstract: Introduction: The parallel grafting technique (PGT) is a valuable alternative to prefabricated branched or fenestrated endovascular aortic repair. An often overlooked advantage of PGT is its unique adaptability to different anatomical challenges that ... ...

Abstract	Introduction: The parallel grafting technique (PGT) is a valuable alternative to prefabricated branched or fenestrated endovascular aortic repair. An often overlooked advantage of PGT is its unique adaptability to different anatomical challenges that might appear intra-operatively. Report: A 72 year old male patient presented with a 60 mm thoracic aneurysm, 59 mm juxtarenal abdominal aortic aneurysm, and 32 mm common iliac aneurysm (CIAA). Thoracic endovascular aortic repair plus endovascular aortic repair with bilateral renal artery chimneys and CIAA exclusion applying the sandwich technique was proposed. Because of unfavourable angulation it was not possible to achieve selective left renal catheterisation via axillary access. Changing to a femoral approach allowed successful retrograde catheterisation. The procedure ended with a chimney for the right renal artery and a periscope for the left renal artery. The final angiogram showed no endoleaks and renal and hypogastric patency. The patient was discharged three days after the procedure and remains under ultrasound surveillance after 40 months because of a small type two endoleak. Conclusion: When using a prefabricated branched device, the possibility of selectively catheterising a visceral branch often has no straightforward solution. However, parallel grafting is an extremely flexible technique, which was of paramount importance for the surgical outcome of the present case.
Language	English
Publishing date	2019-04-08
Publishing country	England
Document type	Case Reports
ZDB-ID	2837454-X
ISSN	2405-6553 ; 2405-6553
ISSN (online)	2405-6553
ISSN	2405-6553
DOI	10.1016/j.ejvssr.2019.03.002
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Article ; Online: Novel Biomarkers for Evaluation of Endothelial Dysfunction.

Leite, Ana Rita / Borges-Canha, Marta / Cardoso, Rita / Neves, João Sérgio / Castro-Ferreira, Ricardo / Leite-Moreira, Adelino

Angiology

2020 Volume 71, Issue 5, Page(s) 397–410

Abstract: Endothelial dysfunction is one of the earliest indicators of cardiovascular (CV) dysfunction, and its evaluation would be of considerable importance to stratify CV risk of many diseases and to assess the efficacy of atheroprotective treatments. Flow- ... ...

Abstract	Endothelial dysfunction is one of the earliest indicators of cardiovascular (CV) dysfunction, and its evaluation would be of considerable importance to stratify CV risk of many diseases and to assess the efficacy of atheroprotective treatments. Flow-mediated dilation is the most widely used method to study endothelial function. However, it is operator-dependent and can be influenced by physiological variations. Circulating biomarkers are a promising alternative. Due to the complexity of endothelial function, many of the biomarkers studied do not provide consistent information about the endothelium when measured alone. New circulating markers are being explored and some of them are thought to be suitable for the clinical setting. In this review, we focus on novel biomarkers of endothelial dysfunction, particularly endothelial microparticles, endocan, and endoglin, and discuss whether they fulfill the criteria to be applied in clinical practice.
MeSH term(s)	Biomarkers/blood ; Cardiovascular Diseases/blood ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/physiopathology ; Cell-Derived Microparticles ; Endoglin/blood ; Endothelium, Vascular/physiopathology ; Humans ; Neoplasm Proteins/blood ; Proteoglycans/blood
Chemical Substances	Biomarkers ; ENG protein, human ; ESM1 protein, human ; Endoglin ; Neoplasm Proteins ; Proteoglycans
Language	English
Publishing date	2020-02-20
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80040-5
ISSN	1940-1574 ; 0003-3197
ISSN (online)	1940-1574
ISSN	0003-3197
DOI	10.1177/0003319720903586
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Article ; Online: Nationwide Analysis of Ruptured Abdominal Aortic Aneurysm in Portugal (2000-2015).

Dias-Neto, Marina / Castro-Ferreira, Ricardo / Mani, Kevin / Freitas, Alberto / Leite-Moreira, Adelino / Sampaio, Sérgio Moreira

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

2020 Volume 60, Issue 1, Page(s) 27–35

Abstract: Objective: Ruptured abdominal aortic aneurysm (rAAA) is a lethal condition that requires acute repair to prevent death. This analysis aims to assess the nationwide trends in rAAA admission, repair and mortality in a country, Portugal, without national ... ...

Abstract	Objective: Ruptured abdominal aortic aneurysm (rAAA) is a lethal condition that requires acute repair to prevent death. This analysis aims to assess the nationwide trends in rAAA admission, repair and mortality in a country, Portugal, without national screening for AAA. Methods: rAAA registered in the hospital administrative database of the National Health Service and all nationally registered deaths due to rAAA based on death certificate data were analysed. Three time periods (2000-2004, 2005-2009, and 2010-2015) were compared in patients ≥ 50 years old to assess the variations over time. Results: A total of 2 275 patients ≥50 years old with rAAA were identified in the two databases from 2000 to 2015. The age standardised incidence of rAAA was 2.78 ± 0.24/100 000/year in 2000-2004, 3.17 ± 0.39/100 000/year in 2005-2009 and 3.21 ± 0.28/100 000/year in 2010-2015 (p < .001). When comparing the time periods 2000-2004 to 2005-2009, the age standardised rate of admission (n = 1460) increased from 1.57 ± 0.25/100 000/year to 2.24 ± 0.32/100 000/year (p < .001). The operative mortality rates decreased during this time period (from 55.3 ± 4.7% to 48.8 ± 4.7%, p < .001). In 2010-2015, the age standardised rate of admissions due to rAAA decreased (1.98 ± 0.22/100 000/year). Operative mortality remained stable (48.9 ± 6.2%). The rate of patient deaths outside the hospital decreased from the first to the second period (1.21 ± 0.10/100 000/year and 0.93 ± 0.29/100 000/year, respectively) but later increased (1.14 ± 0.22/100 000/year). This resulted in a higher overall rAAA related mortality in Portugal in the third period (2.20 ± 0.18/100 000/year, 2.21 ± 0.27/100 000/year and 2.26 ± 0.26/100 000/year in 2000-2004, 2005-2009, and 2010-2015, respectively, p < .001). Conclusion: Overall, the incidence of rAAA in Portugal has been stable over the past 10 years. The rates of admission, repair, and death due to rAAA repair seem to have reached an inflection point and are now decreasing. Mortality outside the hospital remains a matter of concern, warranting further planning of streamlined transfer networks and vascular surgical departments.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal/epidemiology ; Aortic Aneurysm, Abdominal/mortality ; Aortic Aneurysm, Abdominal/surgery ; Aortic Rupture/epidemiology ; Aortic Rupture/mortality ; Aortic Rupture/surgery ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Portugal ; Retrospective Studies ; Sex Factors
Language	English
Publishing date	2020-04-16
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.2020.02.024
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Article: Simplified hybrid repair with true lumen recycling for retrograde renovisceral perfusion in a complex chronic aortic dissection.

Castro-Ferreira, Ricardo / Dias, Paulo Gonçalves / Sampaio, Sérgio Moreira / Teixeira, José Fernando / Lachat, Mario

Journal of vascular surgery cases and innovative techniques

2018 Volume 4, Issue 3, Page(s) 226–230

Abstract: A 59-year-old man was referred with complicated chronic type B aortic dissection. Despite the false lumen's being dominant in terms of caliber and limb perfusion, visceral arteries originated in a 9-mm true lumen. A staged approach was performed: open ... ...

Abstract	A 59-year-old man was referred with complicated chronic type B aortic dissection. Despite the false lumen's being dominant in terms of caliber and limb perfusion, visceral arteries originated in a 9-mm true lumen. A staged approach was performed: open aortobi-iliac bypass with preservation of both lumens to the infrarenal aorta, with reinforcement of the aorta and anastomosis with Dacron (wrap technique); exclusion of the dissection by endografting all of the false lumen with three successive thoracic endoprostheses; and maintenance of true lumen perfusion using two periscopes with self-expanding nitinol stents. The patient remains asymptomatic after 1 year of follow-up.
Language	English
Publishing date	2018-08-29
Publishing country	United States
Document type	Journal Article
ISSN	2468-4287
ISSN	2468-4287
DOI	10.1016/j.jvscit.2018.03.006
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Article ; Online: Early results of carotid endarterectomy versus carotid stenting: Outcomes from a Mediterranean country.

Castro-Ferreira, Ricardo / Freitas, Alberto / Sampaio, Sérgio M / Dias, Paulo G / Mansilha, Armando / Teixeira, José F / Leite-Moreira, Adelino

Vascular

2019 Volume 27, Issue 5, Page(s) 468–474

MeSH term(s)	Aged ; Carotid Stenosis/mortality ; Carotid Stenosis/surgery ; Carotid Stenosis/therapy ; Endarterectomy, Carotid/adverse effects ; Endarterectomy, Carotid/mortality ; Endovascular Procedures/adverse effects ; Endovascular Procedures/instrumentation ; Endovascular Procedures/mortality ; Female ; Hospital Mortality ; Humans ; Length of Stay ; Male ; Portugal ; Registries ; Risk Factors ; Stents ; Stroke/mortality ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2019-04-02
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	2137151-9
ISSN	1708-539X ; 1708-5381
ISSN (online)	1708-539X
ISSN	1708-5381
DOI	10.1177/1708538119841451
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