RESUMO
BACKGROUND: Resistance and elasticity of normal and aneurysmal aorta walls are directly associated with this vessel's growth and rupture. This study aims to experimentally analyze the biomechanical behavior of aneurysmal specimens found at autopsy, comparing them with normal diameter aortas removed from age-matched donors. METHODS: Thirty-eight human aortas (30 normal aortas; 8 infrarenal abdominal aortic aneurysms) were harvested during autopsy. An apparatus was built with a digital gauge, plastic tray, connections, and hoses that conducted fluid (air) from a pump through the system. Specimens were dissected, and a flexible balloon was introduced in each of them to avoid leakage. The specimens were fastened on the test tray, and activation of the air pump enhanced system pressure up to their rupture. RESULTS: All 8 aneurysms and all 30 normal aortas specimens evolved to rupture under inflation pressures above 590 mm Hg (mean ± standard deviation = 1,035 ± 375 mm Hg) and 840 mm Hg (mean ± SD = 1,405 ± 342 mm Hg), respectively. In the aneurysm group, 25% of specimens did not rupture in their most dilated region. Percentage of increment in diameter was higher in normal aortas (mean ± SD = 0.2106 ± 0.144) than in aneurysms (mean ± SD = 0.093 ± 0.070). CONCLUSIONS: In the present experiment, unruptured infrarenal abdominal aortic aneurysms could support high pressures nearly as much as nonaneurysmal abdominal aortas. In some specimens, the most dilated part of the aneurysm was not the most vulnerable under pressure. Normal aortas presented higher elasticity than aneurysms.
Assuntos
Aorta Abdominal/patologia , Aneurisma da Aorta Abdominal/patologia , Ruptura Aórtica/patologia , Pressão Arterial , Adulto , Idoso , Idoso de 80 Anos ou mais , Aorta Abdominal/fisiopatologia , Aneurisma da Aorta Abdominal/complicações , Aneurisma da Aorta Abdominal/fisiopatologia , Ruptura Aórtica/etiologia , Ruptura Aórtica/fisiopatologia , Autopsia , Estudos de Casos e Controles , Dilatação Patológica , Elasticidade , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To measure the pulsatility of human aneurysms before and after complete exclusion with an endograft. METHOD: Five aortic aneurysms obtained during necropsy were submitted to pulsatile perfusion before and after implantation of a bifurcated endograft. The specimens were contained in a closed chamber filled with saline solution. A vertical tube attached to the chamber was used to measure volume dislocation in each systole. Mural thrombus was kept intact, and the space around the device was filled with human blood. After each experiment, the aneurysm was opened to check for the correct positioning and attachment of the device. RESULTS: The level of the saline column oscillated during pulsation in each case, with respective amplitudes of 17, 16, 13, 7, and 25 cm before the endograft insertion. After the insertion, the amplitudes dropped to 13, 12, 9, 3.5, and 23 cm, respectively. The differences were not significant. During the post-experimental examination, all devices were found to be in position and well attached to the neck and iliacs. No endoleak was detected during perfusion or by visual inspection. CONCLUSION: Pulsation of an endograft is transmitted to the aneurysm wall even in the absence of endoleak, and should not be interpreted as procedural failure.
Assuntos
Aneurisma da Aorta Abdominal/fisiopatologia , Implante de Prótese Vascular , Fluxo Pulsátil/fisiologia , Aneurisma da Aorta Abdominal/cirurgia , Cadáver , HumanosRESUMO
CONTEXT: Upper limb ischemia is not as common as lower limb ischemia but may cause severe impairment or disability if it is misdiagnosed. CASE REPORT: A case of a woman with cleidocranial dysostosis resulting in upper right limb ischemia is presented. This uncommon condition is an exceedingly rare cause of vascular compression that gives rise to thrombosis of the axillary-subclavian arteries. Only two cases have previously been reported.
Assuntos
Braço/irrigação sanguínea , Displasia Cleidocraniana/complicações , Isquemia/etiologia , Idoso , Veia Axilar/diagnóstico por imagem , Displasia Cleidocraniana/genética , Feminino , Humanos , Radiografia , Artéria Subclávia/diagnóstico por imagemRESUMO
OBJECTIVE: The purpose of this study was to evaluate the effectiveness of contrast-enhanced ultrasound with a second-generation contrast agent in distinguishing between occlusion and pseudo-occlusion of the cervical internal carotid artery, comparing it with that of conventional Doppler ultrasound and the gold standard, computed tomography angiography. METHOD: Between June 2006 and June 2012, we screened 72 symptomatic vascular surgery outpatients at a public hospital. Among those patients, 78 cervical internal carotid arteries were previously classified as occluded by Doppler ultrasound (without contrast). The patients were examined again with Doppler ultrasound, as well as with contrast-enhanced ultrasound and computed tomography angiography. The diagnosis was based on the presence or absence of flow. RESULTS: Among the 78 cervical internal carotid arteries identified as occluded by Doppler ultrasound, occlusion was confirmed by computed tomography angiography in only 57 (73.1%), compared with 59 (77.5%) for which occlusion was confirmed by contrast-enhanced ultrasound (p>0.5 vs. computed tomography angiography). Comparing contrast-enhanced ultrasound with Doppler ultrasound, we found that the proportion of cervical internal carotid arteries classified as occluded was 24.4% higher when the latter was used (p<0.001). CONCLUSIONS: We conclude that, in making the differential diagnosis between occlusion and pseudo-occlusion of the cervical internal carotid artery, contrast-enhanced ultrasound with a second-generation contrast agent is significantly more effective than conventional Doppler ultrasound and is equally as effective as the gold standard (computed tomography angiography). Our findings suggest that contrast-enhanced ultrasound could replace computed tomography angiography in this regard.
Assuntos
Artéria Carótida Interna/diagnóstico por imagem , Estenose das Carótidas/diagnóstico por imagem , Meios de Contraste , Ultrassonografia Doppler em Cores/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia/métodos , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X/métodosRESUMO
This systematic review focuses on the 30-day mortality associated with open surgery and fenestrated endografts for short-necked (<15 mm) juxtarenal abdominal aortic aneurysms. A search for studies published in English and indexed in the PubMed and Medline electronic databases from 2002 to 2012 was performed, using "juxtarenal abdominal aortic aneurysm" and "treatment" as the main keywords. Among the 110 potentially relevant studies that were initially identified, eight were in accordance with the inclusion criteria in the analysis. Similar outcomes for open and endovascular repair were observed for 30-day mortality. No differences were observed regarding the secondary outcomes (duration of surgery, hospital stay, postoperative renal dysfunction and late mortality), except that the late mortality rate was significantly higher for the patients treated with open repair after a median follow-up of 24 months. Fenestrated endografting is a viable alternative to conventional surgery in juxtarenal abdominal aortic aneurysms with a proximal neck <15 mm.
Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular/métodos , Procedimentos Endovasculares/métodos , Prótese Vascular , Feminino , Humanos , Masculino , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
We compared the prevalence of risk factors between young and old individuals with significant carotid atherosclerosis. We retrospectively reviewed the records of patients aged 39 to 55 years (group I) and aged ≥ 60 years (group II) with significant atherosclerotic stenosis at the carotid bifurcation. Group I patients had significantly higher values for the following factors: weight, height, body mass index, diastolic pressure, prevalence of current smoking, total and low-density lipoprotein cholesterol and significant lower values for systolic pressure, creatinine, and prevalence of coronary artery disease. Group I patients were more symptomatic and showed higher rates of carotid occlusion and near occlusion. Atherosclerosis of the carotid bifurcation was more aggressive in the younger group, with a higher rate of occlusion and near occlusion. Obesity and smoking were significant risk factors for young patients in this sample.
Assuntos
Doenças das Artérias Carótidas/etiologia , Obesidade/complicações , Adulto , Fatores Etários , Índice de Massa Corporal , Artéria Carótida Interna/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fumar/efeitos adversosRESUMO
OBJECTIVE: The objective of this retrospective study is to analyze and compare the results of conventional surgical repair and endovascular treatment of blunt aortic injury over the past 8 years. METHODS: Twenty-eight patients (25 male; mean age, 35 years) were treated for blunt aortic injury between April 2001 and March 2009 in a university hospital in Brazil. Twenty-six patients were included in the study: five were treated with operative repair (OR) and 21 with endovascular treatment (TEVAR). Two patients were excluded from analysis: one was managed conservatively, and one was treated with endovascular treatment for chronic dissection related to aortic trauma. RESULTS: Mean age was lower in the OR group than in the endovascular treatment group (17.8 vs. 38 years, P = .003). There was one death in the OR group and four deaths in the endovascular treatment group. Mean follow-up for the overall group was 33.6 months, with 48.7 months (range 8-83 months) for the OR group, and 29.8 months (range 2-91 months) for the TEVAR group. Mean time elapsed from injury to repair was 23.4 hours (range 8-48 h, median 20 h) for the OR group and 30.3 hours (range 2-240 h, median 18 h) for the TEVAR group (P = .374). The duration of surgery was shorter in the endovascular treatment group (142 versus 237 minutes; P = .005). There were no significant differences with respect to the number of postoperative days requiring mechanical ventilation, duration of ICU stay or duration of hospital stay. CONCLUSION: In this retrospective analysis, endovascular treatment was a safe method for repair of blunt aortic trauma, with immediate and midterm results that were comparable to those results obtained with operative repair. No complications from the stent graft were identified during follow-up. Nevertheless, long-term follow-up is necessary to confirm the effectiveness of this treatment.
Assuntos
Aorta Torácica/lesões , Aorta Torácica/cirurgia , Implante de Prótese Vascular/métodos , Procedimentos Endovasculares/métodos , Ferimentos não Penetrantes/cirurgia , Adolescente , Adulto , Idoso , Brasil , Criança , Procedimentos Endovasculares/efeitos adversos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Ferimentos não Penetrantes/mortalidade , Adulto JovemRESUMO
OBJECTIVE: The purpose of this study was to evaluate the effectiveness of contrast-enhanced ultrasound with a second-generation contrast agent in distinguishing between occlusion and pseudo-occlusion of the cervical internal carotid artery, comparing it with that of conventional Doppler ultrasound and the gold standard, computed tomography angiography. METHOD: Between June 2006 and June 2012, we screened 72 symptomatic vascular surgery outpatients at a public hospital. Among those patients, 78 cervical internal carotid arteries were previously classified as occluded by Doppler ultrasound (without contrast). The patients were examined again with Doppler ultrasound, as well as with contrast-enhanced ultrasound and computed tomography angiography. The diagnosis was based on the presence or absence of flow. RESULTS: Among the 78 cervical internal carotid arteries identified as occluded by Doppler ultrasound, occlusion was confirmed by computed tomography angiography in only 57 (73.1%), compared with 59 (77.5%) for which occlusion was confirmed by contrast-enhanced ultrasound (p>0.5 vs. computed tomography angiography). Comparing contrast-enhanced ultrasound with Doppler ultrasound, we found that the proportion of cervical internal carotid arteries classified as occluded was 24.4% higher when the latter was used (p<0.001). CONCLUSIONS: We conclude that, in making the differential diagnosis between occlusion and pseudo-occlusion of the cervical internal carotid artery, contrast-enhanced ultrasound with a second-generation contrast agent is significantly more effective than conventional Doppler ultrasound and is equally as effective as the gold standard (computed tomography angiography). Our findings suggest that contrast-enhanced ultrasound could replace computed tomography angiography in this regard. .
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Meios de Contraste , Artéria Carótida Interna , Artéria Carótida Interna , Estenose das Carótidas , Estenose das Carótidas , Ultrassonografia Doppler em Cores/métodos , Angiografia/métodos , Diagnóstico Diferencial , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X/métodosAssuntos
Traumatismos Abdominais/complicações , Falso Aneurisma/diagnóstico por imagem , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Ferimentos por Arma de Fogo/complicações , Aorta Abdominal/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Tomógrafos ComputadorizadosRESUMO
São apresentadas, nessa separata, as principais orientações sobre a atenção às complicações do pé diabético. A neuropatia, com suas diversas apresentações que acometem os membros inferiores dos diabéticos, as lesões da doença arterial obstrutiva periférica (DAOP), as múltiplas apresentações da infecção do pé diabético, e, principalmente, os cuidados preventivos que possam impedir o estabelecimento ou a evolução dessas complicações são tratados de forma sistemática e simplificada, visando a atenção integral desses doentes. Especial cuidado é dado às orientações diferenciadas para os diversos níveis de atenção nos serviços públicos de saúde, porta de entrada virtual de 80% dos infelizes portadores dessa complicação. São aqui apresentados modelos de atenção e sugeridos protocolos que podem contribuir para a efetiva redução do número de amputações, internações e óbitos de diabéticos com complicações nos membros inferiores.
Assuntos
Humanos , Masculino , Idoso , Doenças Vasculares Periféricas/cirurgia , Doenças Vasculares Periféricas , Doenças Vasculares Periféricas/reabilitação , Neuropatias Diabéticas/diagnóstico , Neuropatias Diabéticas/prevenção & controle , Neuropatias Diabéticas/sangue , Pé Diabético/terapia , Úlcera do Pé/patologia , Úlcera do Pé/prevenção & controle , Úlcera do Pé/terapia , Amitriptilina/administração & dosagem , Amputação Cirúrgica/reabilitação , Extremidade Inferior/patologia , Espectroscopia de Ressonância Magnética , Fatores de Risco , Tomografia Computadorizada de Emissão/métodosRESUMO
OBJECTIVE: The objective of this retrospective study is to analyze and compare the results of conventional surgical repair and endovascular treatment of blunt aortic injury over the past 8 years. METHODS: Twenty-eight patients (25 male; mean age, 35 years) were treated for blunt aortic injury between April 2001 and March 2009 in a university hospital in Brazil. Twenty-six patients were included in the study: five were treated with operative repair (OR) and 21 with endovascular treatment (TEVAR). Two patients were excluded from analysis: one was managed conservatively, and one was treated with endovascular treatment for chronic dissection related to aortic trauma. RESULTS: Mean age was lower in the OR group than in the endovascular treatment group (17.8 vs. 38 years, P = .003). There was one death in the OR group and four deaths in the endovascular treatment group. Mean follow-up for the overall group was 33.6 months, with 48.7 months (range 8-83 months) for the OR group, and 29.8 months (range 2-91 months) for the TEVAR group. Mean time elapsed from injury to repair was 23.4 hours (range 8-48 h, median 20 h) for the OR group and 30.3 hours (range 2-240 h, median 18 h) for the TEVAR group (P = .374). The duration of surgery was shorter in the endovascular treatment group (142 versus 237 minutes; P = .005). There were no significant differences with respect to the number of postoperative days requiring mechanical ventilation, duration of ICU stay or duration of hospital stay. CONCLUSION: In this retrospective analysis, endovascular treatment was a safe method for repair of blunt aortic trauma, with immediate and midterm results that were comparable to those results obtained with operative repair. No complications from the stent graft were identified during follow-up. Nevertheless, long-term follow-up is necessary to confirm the effectiveness of this treatment.
Assuntos
Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Aorta Torácica/lesões , Aorta Torácica/cirurgia , Implante de Prótese Vascular/métodos , Procedimentos Endovasculares/métodos , Ferimentos não Penetrantes/cirurgia , Brasil , Procedimentos Endovasculares/efeitos adversos , Seguimentos , Estudos Retrospectivos , Resultado do Tratamento , Ferimentos não Penetrantes/mortalidadeRESUMO
OBJECTIVE: To measure the pulsatility of human aneurysms before and after complete exclusion with an endograft. METHOD: Five aortic aneurysms obtained during necropsy were submitted to pulsatile perfusion before and after implantation of a bifurcated endograft. The specimens were contained in a closed chamber filled with saline solution. A vertical tube attached to the chamber was used to measure volume dislocation in each systole. Mural thrombus was kept intact, and the space around the device was filled with human blood. After each experiment, the aneurysm was opened to check for the correct positioning and attachment of the device. RESULTS: The level of the saline column oscillated during pulsation in each case, with respective amplitudes of 17, 16, 13, 7, and 25 cm before the endograft insertion. After the insertion, the amplitudes dropped to 13, 12, 9, 3.5, and 23 cm, respectively. The differences were not significant. During the post-experimental examination, all devices were found to be in position and well attached to the neck and iliacs. No endoleak was detected during perfusion or by visual inspection. CONCLUSION: Pulsation of an endograft is transmitted to the aneurysm wall even in the absence of endoleak, and should not be interpreted as procedural failure.
Assuntos
Humanos , Aneurisma da Aorta Abdominal/fisiopatologia , Implante de Prótese Vascular , Fluxo Pulsátil/fisiologia , Aneurisma da Aorta Abdominal/cirurgia , CadáverRESUMO
Os aneurismas da artéria poplítea são freqüentes e estão associados a eventos trombo-embólicos que podem acarretar isquemia grave com risco de perda da extremidade inferior acometida. OBJETIVO: Avaliar a evolução clínica dos pacientes e ultra-sonográfica dos aneurismas de artéria poplítea excluídos pela técnica de Edwards. MÉTODO: Análise retrospectiva dos pacientes com diagnóstico de aneurisma da artéria poplítea operados no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no período compreendido entre os anos de 1996 a 2004. Foram incluídos os pacientes submetidos à exclusão do aneurisma pela técnica de Edwards e que possuíam diâmetro transverso máximo do aneurisma mensurado no período pré e pós-operatório. RESULTADOS: Dezesseis pacientes foram submetidos a correção cirúrgica de 20 aneurismas. O diâmetro do aneurisma no período pré-operatório variou entre 1,3 cm a 6,1 cm (média 3,1cm). O controle ultrasonográfico foi realizado em intervalo de 1 mês a 7 anos do procedimento cirúrgico. Houve diminuição do diâmetro do aneurisma de artéria poplítea em 10/20 extremidades (variação de 0,2 cm a 2,3 cm), aumento em 7/20 (variação de 0,3 cm a 3,3 cm) e estabilidade em 3/20. Observou-se a ocorrência de fluxo no saco aneurismático em 5 dentre os 20 procedimentos. Destes, três apresentaram crescimento do mesmo (60% dos casos com fluxo). CONCLUSÃO: Esta amostra de pacientes, sem rotura ou sinais e sintomas de compressão, associada à análise da literatura, demonstra que o seguimento estreito do aneurisma excluído é necessário.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Aneurisma/cirurgia , Artéria Poplítea/cirurgia , Aneurisma , Artéria Poplítea , Seguimentos , Estudos RetrospectivosRESUMO
CONTEXTO: A isquemia do membro superior não é tão comum quanto a isquemia do membro inferior, mas quando não diagnosticada ou diagnosticada de forma errada determina grave seqüela e até perda da extremidade. RELATO DE CASO: O caso de uma paciente com isquemia do membro superior, devida a disostose cleidocraniana, é apresentado. Esta é uma causa extremamente rara de compressão do segmento arterial subclávio-axilar que evoluiu para trombose arterial. Somente dois casos foram previamente relatados na literatura com esta condição e nesta forma de apresentação.
Assuntos
Humanos , Feminino , Idoso , Braço/irrigação sanguínea , Displasia Cleidocraniana/genética , Isquemia/etiologia , Veia Axilar , Displasia Cleidocraniana/complicações , Artéria SubcláviaRESUMO
OBJETIVO: Avaliar como pacientes com doença arterial obstrutiva periférica têm sido tratados, em nosso meio, com relação aos fatores de risco e comorbidades. MÉTODO: Questionário sobre pesquisa e tratamento da dislipidemia, diabetes, exercício, uso de anti-plaquetários, tabagismo e hipertensão arterial no paciente com doença arterial obstrutiva periférica foi aplicado entre os médicos presentes na reunião mensal de março de 2004 da Sociedade Brasileira de Angiologia e Cirurgia Vascular - Regional São Paulo. RESULTADOS: Dos 102 questionários distribuídos, 75 foram respondidos (taxa de resposta de 73,5 por cento). Entre os consultados, 82 por cento pesquisam rotineiramente perfil lipídico e 20 por cento visam alvo de LDL-colesterol abaixo de 100 mg/dl; 94 por cento realizam pesquisa para diabetes melito; 97 por cento recomendam exercício; 79 por cento prescrevem aspirina; 97 por cento aconselham que os pacientes parem de fumar e 60 por cento se restringem ao aconselhamento isoladamente; 18 por cento não realizam a medida da pressão arterial durante a consulta e 19 por cento visam alvo pressórico de 130 x 80 mmHg. Considerando todas as avaliações em conjunto - intervenção no estilo de vida, no sentido de parar de fumar, orientação de exercícios, uso de anti-plaquetários, realização de pesquisa para diabetes melito, controle rigoroso da pressão arterial e lípides - observou-se que 7 por cento dos entrevistados seguem todas essas recomendações como uma rotina estabelecida. CONCLUSÃO: O presente estudo demonstrou que, em nosso meio, a pesquisa e o tratamento dos fatores de risco e comorbidades nos pacientes com doença arterial obstrutiva periférica estão sendo sub-realizados.
OBJECTIVE: The purpose of this survey was to evaluate how patients with peripheral obstructive arterial disease have been treated, concerning risk factors and comorbidities. METHOD: A questionnaire was applied to all physicians attending the monthly meeting of the Brazilian Society of Angiology and Vascular Surgery - São Paulo Section. Questions were asked about the following major risk factors: treatment of dyslipidemia, diabetes, exercise regimens, antiplatelet therapy, smoking and arterial hypertension. RESULTS: Of the 102 questionnaires, 75 were answered (response rate of 73.5 percent). Of these, 82 percent routinely measure cholesterol levels and 20 percent aim at an LDL cholesterol target below 100 mg/dl; 94 percent perform a screening for diabetes mellitus; 97 percent recommend patients to an exercise program; 79 percent prescribe aspirin; 97 percent recommend patients to quit smoking and 60 percent only do it by counseling; 18 percent do not measure blood pressure and 19 percent have a target pressure of 130 x 80 mmHg. Considering the recommendations as a whole - lifestyle intervention in order to quit smoking, aerobic exercise, prescription of antiplatelet therapy, screening for diabetes mellitus, rigorous control of blood pressure and lipids - it was observed that 7 percent of interviewees follow all of them as an established routine. CONCLUSION: The present study showed that patients with peripheral arterial disease are currently undertreated with regard to the screening and treatment of risk factors and comorbidities.
Assuntos
Humanos , Masculino , Feminino , Arteriosclerose/complicações , Arteriosclerose/diagnóstico , Claudicação Intermitente/complicações , Claudicação Intermitente/terapia , Doenças Vasculares Periféricas/complicações , Exercício Físico/fisiologia , Fatores de Risco , Hipertensão/complicaçõesRESUMO
CONTEXT: Surgical treatment of carotid body paragangliomas is a challenge to the surgeon because of the large vascularization of the tumor, involvement of the carotid vessels and the close anatomical relationship with the cranial nerves. CASE REPORT: A 63-year-old patient was submitted to resection of two carotid body paraganglioma tumors found in the right-side and left-side carotid bodies at the bifurcation of the common carotid arteries. Two surgeries were performed at different times and neither of them presented any morbidity. Arteriography was fundamental for diagnosis of the small, asymptomatic tumor on the right side. DESIGN: Case Report
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Corpo Carotídeo/cirurgia , Tumor do Corpo Carotídeo/cirurgia , Artérias Carótidas , Corpo Carotídeo , Tumor do Corpo Carotídeo/diagnóstico , Complicações IntraoperatóriasRESUMO
Objetivos: Determinar a prevalência das anormalidades do diâmetro da aorta infra-renal encontradas em necropsia e prevalência dos óbitos de origem cardiovascular entre os portadores de anomalias do diâmettro arterial e a população testemunho de amostra.Métodos:Entre os anos de 1992 e 1995, foram dissecadas as aortas abdominais de 645 indivíduos submetidos a necropsia, analisando-se as variações do diâmetro arterial nesse segmento. A fim de não subestimar o diâmetro aórtico, foi criado um dispositivo que distende a parede da aorta com pressão intraluminal controlada. Quanto ao diâmetro, as aortas foram consideradas normais, com aneurisma, ectasia, arteriomegalia ou hipoplasia.Resultados: Foram encontrados 29 (4,5 por cento) aneurismas, sendo 25 íntegros, com diâmetro inferior a 5,0 cm, e quatro rotos, com diâmetro superior a 5,0 cm. Dezenove (2,9 por cento) aortas apresentavam ectasia, 10 (1,6 por cento) arteriomegalia e nenhuma apresentava hipoplasia. Os óbitos por doenças cardiovasculares foram mais freqüentes nos indivíduos portadores de aneurismas da aorta do que no grupo testemunho (p<0,05).Conclusões: A prevalência das anomalias do diâmetro aórtico infrarenal é alta em uma população submetida a necropsia. As dilatações aórticas identificam um grupo de indivíduos com alta probabilidade de óbito por doença cardiovascular...