Graduated Compression Stockings Does Not Decrease Walking Capacity and Muscle Oxygen Saturation during 6-Minute Walk Test in Intermittent Claudication Patients.

BACKGROUND: We analyze the effects of graduated compression stoking (GCS) on walking capacity and oxygen saturation in intermittent claudication (IC) patients. METHODS: Eighteen patients with IC performed the 6-minute walking test in 2 conditions in random order: GCS or placebo sock. Onset claudication distance and total walking distance were obtained. The calf muscle oxygen saturation was continuously monitored before, during, and after 6-minute walk test. Comparisons of the walking capacity and StO2 parameters between GCS and placebo conditions were analyzed by Wilcoxon rank-sum test. RESULTS: The onset claudication distance (GCS: 120 ± 99 meters vs. placebo: 150 ± 126 meters; P = 0.798) and total walking distance (GCS: 330 ± 108 meters vs. placebo: 324 ± 60 meters; P = 0.130) were similar between conditions. There were no differences in StO2 parameters between conditions (P > 0.05). CONCLUSIONS: GCS does not decrease walking performance and calf muscle oxygenation saturation during 6-minute walk test in patients with IC.

Uso combinado de endoprótese GORE TAG® e Gore Exculder® para tratamento de aneurisma de aorta abdominal com angulação extrema / Combined use of GORE TAG® and Gore Exculder® endografts for treatment of abdominal aortic aneurysm with severe angulation

O avanço tecnológico da cirurgia endovascular no tratamento de aneurismas de aorta vem permitindo que uma maior quantidade de pacientes, antes considerados inaptos para essa abordagem, beneficie-se dessa modalidade terapêutica. Apesar da atual disponibilidade de endopróteses com alta conformabilidade, casos com anatomia desfavorável permanecem um desafio para os cirurgiões. Descrevemos um caso anatomicamente desfavorável, resolvido com sucesso pela técnica endovascular, utilizando-se uma manobra não convencional.

The advances in endovascular surgery for treatment of aortic aneurysms have allowed a greater number of patients, who were previously considered unsuitable for the approach, to benefit from this therapeutic modality. Despite the current availability of highly comfortable endografts, cases with unfavorable anatomy remain a challenge for surgeons. We report a case with difficult anatomy that was successfully managed using an unconventional endovascular technique.

Combined use of GORE TAG® and Gore Exculder® endografts for treatment of abdominal aortic aneurysm with severe angulation.

The advances in endovascular surgery for treatment of aortic aneurysms have allowed a greater number of patients, who were previously considered unsuitable for the approach, to benefit from this therapeutic modality. Despite the current availability of highly comfortable endografts, cases with unfavorable anatomy remain a challenge for surgeons. We report a case with difficult anatomy that was successfully managed using an unconventional endovascular technique.

Vein imaging: a new method of near infrared imaging, where a processed image is projected onto the skin for the enhancement of vein treatment.

BACKGROUND: A new noninvasive vein imaging device initially developed for phlebotomy has been tested for the first time for vein treatment. This unique device captures a near infrared vein image, processes it, and projects it onto the skin using green light. OBJECTIVE: To perform the first clinical tests of the device in phlebology. MATERIALS AND METHODS: A pilot study on 23 subjects with varicose veins and telangiectasias was performed. The VeinViewer prototype (V-V-P; Luminetx Corp., Memphis, TN) was tested in five situations: diagnosing feeder veins with the V-V-P, comparison between the V-V-P and ultrasound, marking varicose veins with or without the device, phlebectomy using the V-V-P, and the use of laser and sclerotherapy guided by the V-V-P. RESULTS: One hundred percent of subjects had feeder veins identified by the V-V-P. The ultrasound machine detected fewer feeder veins than the V-V-P, and the device identified more veins than the naked eye in all subjects. The V-V-P could help in finding feeder veins during phlebectomy and in guiding laser and sclerotherapy treatments. CONCLUSION: The device could identify veins that were invisible to the naked eye and too shallow for ultrasound detection. The V-V-P may help find feeder veins and may also help various types of vein treatments.

Peroneal artery approach for angioplasty of the superficial femoral artery: a case report.

The authors report the implantation of a Palmaz stent in the superficial femoral artery using an approach not previously described, the peroneal artery. A 64-year-old man was admitted with extensive necrosis of the right foot. Physical examination showed a normal right femoral pulse but absence of popliteal and tibial pulses. Arteriography showed a superficial femoral artery with critical stenoses but a normal profunda artery. A classic below-knee amputation was performed. During the procedure, the muscular blood flow was considered insufficient, by clinical experience, to achieve limb healing at this level, and so the surgeon chose to perform an angioplasty of the superficial femoral artery lesion, utilizing an access through the leg arteries. After introducing the guidewire through the peroneal artery, the surgeon successfully dilated the lesion and implanted a Palmaz stent. Afterward, the popliteal pulse became palpable in physical examination and improved the skin and muscular aspect in this level. The surgery was finished with a closed stump. The surgery healed satisfactorily, without any complications, and the patient had a satisfactory follow-up, with ambulatory rehabilitation, and recovery of walking capacity with a leg prosthesis. The peroneal approach gave satisfactory results and should be considered in clinical situations like this.