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2.
Vasc Endovascular Surg ; 54(2): 195-197, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31597540

RESUMO

BACKGROUND: The carotid sheath contains clinically important and vital anatomical neurogenic, vascular, and lymphatic structures that allow for a great variety of lesions. Vascular anomalies found in the carotid sheath are rarely reported and may be easily misdiagnosed as arterial aneurysms, neurogenic tumors, paragangliomas, or lymphatic masses. METHOD: We present a 60-year-old woman with a vascular malformation arising within the carotid sheath at the right carotid bifurcation, which mimics carotid body tumor. RESULT: The mass was excised successfully with an uneventful postoperative course, and histological analysis suggested a vascular malformation with thin-walled blood vessels, lined by endothelial cells and separated by fibrous tissue. The patient was in good clinical condition without signs of relapse of the mass at 6-month follow-up. CONCLUSION: Vascular malformation is a rare but existing possibility of pathology in the carotid sheath, which can be effectively removed by meticulous surgery.


Assuntos
Tumor do Corpo Carotídeo/diagnóstico por imagem , Malformações Vasculares/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Resultado do Tratamento , Malformações Vasculares/cirurgia
3.
Br J Radiol ; 93(1106): 20190781, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31868522

RESUMO

OBJECTIVE: Sedation for pediatric patients undergoing interventional procedures in radiology is in increasing demand. Once only anesthesiology-performed, there is a demand for sedation services to perform sedations for these procedures. However, the safety of performing long sedations by non-anesthesiologists in interventional radiology has not been reported. This pilot study aimed at describing a single center's experience and outcome with sedation. METHODS: This study reviews the sedations performed at a single center by a pediatric emergency physician who performed the sedation. The results regarding safety and satisfaction were reviewed. RESULTS: A total of 52 sedations were documented. Four cases of significant adverse events and three adverse events occurred. In all cases, the procedures were completed. None of the patients required intubation or admission following the sedation. There was high satisfaction by the interventional radiologists. CONCLUSION: This small pilot study shows that sedations for procedures in interventional radiology can be performed safely and successfully by dedicated non-anesthesiology sedation services. This may be considered as an alternative when anesthesiology service is not available. ADVANCES IN KNOWLEDGE: This small, single center pilot study examines the safety of sedation by a non-anesthesiologist for interventional radiology procedures. This may offer an additional method of performing procedures in the pediatric population while anesthesia is not readily available.


Assuntos
Sedação Consciente/métodos , Medicina de Emergência/estatística & dados numéricos , Malformações Vasculares/cirurgia , Adolescente , Anestesiologistas , Criança , Pré-Escolar , Sedação Consciente/efeitos adversos , Medicina de Emergência/normas , Métodos Epidemiológicos , Feminino , Humanos , Lactente , Masculino , Segurança do Paciente
5.
Tech Vasc Interv Radiol ; 22(4): 100628, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31864528

RESUMO

Ongoing discovery regarding the origin and treatment of vascular anomalies requires standardized nomenclature which itself must undergo iterative updating. This article introduces the 2018 International Society for the Study of Vascular Anomalies (ISSVA) classification, emphasizing the biologic basis of vascular anomalies, summarizing the key features of commonly encountered entities, and serving as a foundation for subsequent articles presented herein. Vascular tumors are discussed to highlight their distinction from vascular malformations which will receive greater attention with respect to management and technical considerations within the issue.


Assuntos
Neoplasias de Tecido Vascular/classificação , Neoplasias de Tecido Vascular/diagnóstico por imagem , Radiologistas , Terminologia como Assunto , Malformações Vasculares/classificação , Malformações Vasculares/diagnóstico por imagem , Humanos , Neoplasias de Tecido Vascular/terapia , Valor Preditivo dos Testes , Prognóstico , Malformações Vasculares/terapia
6.
Tech Vasc Interv Radiol ; 22(4): 100635, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31864534

RESUMO

Vascular malformations are generally congenital benign lesions that have multiple variations in treatment algorithms. Surgery can be used as a single modality or as an adjunct in multimodal therapy to treat these lesions. Here we discuss surgical treatment of the major vascular malformations, including lymphatic, venous, and arteriovenous malformations. We explain some of the basic principles to resection of simple and complex lesions and adjunctive therapies. These adjunct therapies include chemotherapeutic injections, embolization, and laser therapy. Surgical resection of complex lesions should only be performed by an experienced vascular anomalies surgeon. A team approach is generally necessary to provide safe and effective treatment. While surgery for these complex lesions is an option, the most important principle to adhere to when treating any of these lesions is that the treatment should be no worse than the disease.


Assuntos
Anormalidades Linfáticas/cirurgia , Malformações Vasculares/cirurgia , Procedimentos Cirúrgicos Vasculares , Tomada de Decisão Clínica , Humanos , Anormalidades Linfáticas/diagnóstico por imagem , Anormalidades Linfáticas/fisiopatologia , Seleção de Pacientes , Fatores de Risco , Resultado do Tratamento , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/fisiopatologia , Procedimentos Cirúrgicos Vasculares/efeitos adversos
7.
Tech Vasc Interv Radiol ; 22(4): 100630, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31864535

RESUMO

Venous malformations are very commonly encountered in interventional radiologic practice. Indications for therapy are clearly defined based on the lesion's impact on patient's quality of life. Screening laboratory coagulation studies in patients with historical or lesion morphologic risk factors often reveal abnormal coagulation parameters consistent with localized intravascular coagulation or more severe coagulopathic states. These may require chronic or periprocedural medical management to avoid potentially life-threatening disseminated intravascular coagulation or other thromboembolic phenomena. Once a multidisciplinary decision to treat a venous malformation is made, one must decide between percutaneous and/or surgical techniques. Sclerotherapy with adjunctive stasis of efflux (STASE) techniques have become the mainstay of therapy for most venous malformations as they are well-tolerated and effective. STASE techniques work primarily by (i) the administration of sclerosant(s) exerting an inhibitory and/or endotheliocidal effect on venous malformation endothelium leading to thrombosis, involution, and fibrosis, and secondarily via adjunctive outflow occlusion using any combination of local compression, balloons, gelatin, coils, laser, radiofrequency, or adhesives to improve sclerosant penetration and dwell-time in the lesion. Adhesives alone can fill the lesion to facilitate surgical resection in some cases. Common sclerosants in modern practice include sodium tetradecyl sulfate, bleomycin, polidocanol, ethanol, and hypertonic saline. Most agents can be given directly in unmodified or "neat" form or can be mixed with a gas to form a sclerofoam or embolic such as gelatin to form a sclerogel. Choice and method of sclerosant delivery in each patient is based on the intraluminal lesion volume, architecture, vital structure proximity, agent toxicity, viscosity, and level of experience of the interventional radiologist with that particular agent. Multi-session STASE therapy usually reduces symptoms of chronic pain or mass with low risk of known complications of skin or nerve impairment, compartment syndrome, hemoglobinuria, deep venous thrombosis, or pulmonary phenomena.


Assuntos
Procedimentos Endovasculares , Soluções Esclerosantes/administração & dosagem , Escleroterapia , Malformações Vasculares/terapia , Veias/anormalidades , Tomada de Decisão Clínica , Terapia Combinada , Procedimentos Endovasculares/efeitos adversos , Humanos , Seleção de Pacientes , Fatores de Risco , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Resultado do Tratamento , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/fisiopatologia , Veias/diagnóstico por imagem , Veias/fisiopatologia
8.
Tech Vasc Interv Radiol ; 22(4): 100629, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31864536

RESUMO

Vascular anomalies are classified as either tumors or malformations based on clinical findings rendered through radiologic evaluation, physical exam, and histologic interpretation. These findings comprise the phenotype of the disorder. Recently, advances in the molecular genetics of vascular anomalies have shed light on the genotype of these disorders. These phenotype/genotype characterizations will provide a more precise classification of vascular anomalies and identify potential therapeutic targets for expanded treatment options in the future. In this chapter, we will review the phenotype/genotype characterizations and the possible therapeutic pathways for targeted pharmacologic therapy.


Assuntos
Técnicas de Diagnóstico Molecular , Neoplasias de Tecido Vascular/genética , Malformações Vasculares/genética , Antineoplásicos/uso terapêutico , Predisposição Genética para Doença , Humanos , Terapia de Alvo Molecular , Neoplasias de Tecido Vascular/diagnóstico por imagem , Neoplasias de Tecido Vascular/tratamento farmacológico , Fenótipo , Medicina de Precisão , Valor Preditivo dos Testes , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/tratamento farmacológico
9.
An Bras Dermatol ; 94(5): 521-526, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31777351

RESUMO

BACKGROUND: The use of monoethanolamine oleate 5% is effective for the treatment of vascular malformations with low blood flow. OBJECTIVES: To report a case series of vascular malformations in the mouth and oral cavity treated with monoethanolamine oleate 5%. METHODS: A retrospective descriptive study was performed in electronic patient charts covering seven years. Patient demographics, diagnostic resources, lesion site, size, and number of applications of monoethanolamine oleate 5% were collected. RESULTS: A total of 21 vascular malformations were recorded, located mostly on the lower lip (52.3%) and resolved in a single application in 14 patients. The authors found 19 patients treated with sclerotherapy. Thirteen were women and six were men, with a mean age of 61 years. STUDY LIMITATION: Small sample size. CONCLUSIONS: Sclerotherapy is an effective treatment for vascular malformations of the lips and oral cavity, with resolution after only one or two applications (n=16).


Assuntos
Doenças da Boca/terapia , Ácidos Oleicos/administração & dosagem , Soluções Esclerosantes/administração & dosagem , Escleroterapia/métodos , Malformações Vasculares/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estética , Feminino , Humanos , Injeções Intralesionais , Lábio/irrigação sanguínea , Lábio/patologia , Masculino , Pessoa de Meia-Idade , Doenças da Boca/patologia , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Malformações Vasculares/patologia , Adulto Jovem
10.
Medicine (Baltimore) ; 98(44): e17779, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689844

RESUMO

RATIONALE: Absence or hypoplasia of the internal carotid artery (ICA) are rare developmental anomalies. Usually, patients with ICA agenesis are asymptomatic due to collateral circulation, but they may present with seizures, headache, or transient ischemic attack. We report a patient with right ICA absence in whom "paroxysmal right eye amaurosis" was the main symptom. PATIENT CONCERNS: A 76-year-old male patient suffered from "paroxysmal right eye amaurosis for 3 years". Three years prior, the patient had suffered sudden one-minute right eye amaurosis without any obvious cause. The attack reoccurred 1-2 times/year until one week before admission when he experienced two sudden right eye amaurosis. DIAGNOSIS: Congenital absence of the right ICA was diagnosed. In this patient with congenital absence of the right ICA, the ipsilateral anterior cerebral artery (ACA) was compensated by the anterior communicating artery (ACOM), and the ipsilateral middle cerebral artery (MCA) emerged from the carotid siphon of the contralateral ICA. INTERVENTIONS: The patient was given antiplatelet treatment consisting of aspirin and atorvastatin after admission and instructed to maintain the treatment after discharge. OUTCOMES: No symptom onset was observed during follow-up. LESSONS: Here, we report the patient's clinical manifestations and imaging findings and analyze the cause of the condition to provide a clinical reference for the study of congenital absence of the ICA.


Assuntos
Cegueira/congênito , Artéria Carótida Interna/anormalidades , Malformações Vasculares/complicações , Idoso , Humanos , Masculino
11.
Medicine (Baltimore) ; 98(44): e17798, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689858

RESUMO

RATIONALE: Dieulafoy disease of the bronchus is a rare vascular deformity. To the best of our knowledge, reports of these involving both lung vascular are hitherto absent. PATIENT CONCERNS: A 67-year-old male was admitted to our department due to agnogenic hemoptysis. DIAGNOSES: Bronchoscopy was performed and some smooth, pulsatile nodular lesions were found in the middle and lower lobes, Computed tomography angiography of the bronchial artery confirmed a left bronchial artery arising from the aortic arch at T4 level, and both bronchial arteries were dilated and tortuous. INTERVENTIONS: Bronchial artery embolization was performed successfully. OUTCOMES: The patient was discharged with no hemoptysis. In addition, patient is under follow-up until today without any further incidents. LESSONS: This case reminds us that Dieulafoy disease of the bronchus could be a potential etiology for unexplained hemoptysis. The clinician should be aware of this disease when bronchoscopy revealed multiple some smooth, pulsatile nodular lesions, thereafter, bronchoscope biopsy should be avoided, as it could lead to fatal hemoptysis.


Assuntos
Artérias Brônquicas/anormalidades , Broncopatias/complicações , Hemoptise/etiologia , Malformações Vasculares/complicações , Idoso , Artérias Brônquicas/cirurgia , Broncopatias/patologia , Broncopatias/cirurgia , Broncoscopia/métodos , Angiografia por Tomografia Computadorizada , Hemoptise/cirurgia , Humanos , Pulmão/patologia , Masculino , Malformações Vasculares/patologia , Malformações Vasculares/cirurgia
12.
Medicine (Baltimore) ; 98(38): e16988, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567935

RESUMO

RATIONALE: Peripherally inserted central catheters (PICC), normally located at the lower 1/3rd of the superior vena cava (SVC) and cavo-atrial junction, are commonly used in cancer patients. Persistent left superior vena cava (PLSVC) is a vascular anomaly, in patients with which seldom research was reported about PICC implanted. After obtaining written informed consent, we present a case where two successful insertions of PICC were performed in a 50-year-old female patient with PLSVC and right SVC. PATIENTS CONCERNS: The patient had ovarian cancer and was admitted for chemotherapy using PICC. DIAGNOSES: Ovarian cancer and PLSVC. INTERVENTIONS AND OUTCOMES: Following insertion of PICC in PLSVC, thrombosis developed. PICC was removed after routine anticoagulation therapy. Owing to tumor recurrence, a second PICC was inserted in the right SVC without any complications. LESSONS: PICC insertion in PLSVC for chemotherapy may be associated with an increased risk of deep venous thrombosis of the upper extremity. A right catheter insertion in patient with PLSVC was preferred.


Assuntos
Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Malformações Vasculares/complicações , Veia Cava Superior/anormalidades , Trombose Venosa/diagnóstico , Antineoplásicos/administração & dosagem , Antineoplásicos/uso terapêutico , Braço , Cateterismo Periférico/efeitos adversos , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/complicações , Neoplasias Ovarianas/complicações , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/etiologia
13.
Stomatologiia (Mosk) ; 98(4): 60-64, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31513152

RESUMO

The aim of the study was to assess the effectiveness of ultrasound-guided use of the foam form of ethoxysclerol for the treatment of venous malformations of the maxillofacial area. The study involved clinical and ultrasound examination data of 60 patient allowing to determine treatment tactics and optimal volume of injected foam sclerosant as well as the role of ultrasound for monitoring of the treatment. The results proved the efficacy of 3% foam ethoxysclerol for less invasive treatment of venous maxillofacial malformations.


Assuntos
Escleroterapia , Malformações Vasculares , Face/patologia , Humanos , Polidocanol , Soluções Esclerosantes , Resultado do Tratamento , Malformações Vasculares/terapia
14.
World Neurosurg ; 132: 58-62, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31479791

RESUMO

BACKGROUND: Oblique lumbar interbody fusion takes advantage of the wide interval between the aorta and left-sided psoas muscle to access the lumbar spine, allowing a minimally invasive approach for interbody fusion with lower associated morbidity. As this approach is gaining popularity among spine surgeons, it is important to understand the potential pitfalls that may arise in patients with congenital anomalies of the vascular anatomy. CASE DESCRIPTION: We present a case of a persistent left-sided inferior vena cava (IVC) affecting the side of approach in a patient undergoing lumbar interbody fusion through an oblique prepsoas retroperitoneal approach. Preoperative imaging of our patient revealed a persistent left-sided inferior vena cava with a wide interval between the aorta and the right-sided psoas, allowing us a right-sided oblique approach. CONCLUSIONS: Thorough preoperative imaging evaluation is essential to identify vascular anomalies that may hinder oblique prepsoas retroperitoneal approach to the lumbar spine. Although rare, double IVC or isolated left IVC may complicate the oblique approach.


Assuntos
Degeneração do Disco Intervertebral/cirurgia , Vértebras Lombares/cirurgia , Fusão Vertebral/métodos , Estenose Espinal/cirurgia , Malformações Vasculares/diagnóstico por imagem , Veia Cava Inferior/anormalidades , Idoso , Humanos , Degeneração do Disco Intervertebral/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Estenose Espinal/diagnóstico por imagem , Malformações Vasculares/complicações , Veia Cava Inferior/diagnóstico por imagem
15.
Rev Port Cir Cardiotorac Vasc ; 26(2): 139-141, 2019.
Artigo em Português | MEDLINE | ID: mdl-31476815

RESUMO

Persistant left superior vena cava is a rare systemic venous anomaly that can be associated with agenesis of the right superior vena cava. It is usually assymptomatic and discovered incidentally during surgery or other procedures. The authors present the case of a 72-year-old male submitted to an aortic valve replacement surgery. After sternotomy, persistant left superior vena cava and absence of the right superior vena cava were identified. The patient developed complete atrioventricular block after surgery, requiring the implantation of a definitive cardiac pacemaker through the brachiocephalic vein and coronary sinus. This case highlights and ilustrates the clinical implications of the described systemic venous anomalies, discussing the necessary management both in the perioperative and intraoperative periods.


Assuntos
Valva Aórtica/cirurgia , Bloqueio Atrioventricular/terapia , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Doenças das Valvas Cardíacas/cirurgia , Malformações Vasculares/complicações , Veia Cava Superior/anormalidades , Idoso , Bloqueio Atrioventricular/etiologia , Estimulação Cardíaca Artificial , Doenças das Valvas Cardíacas/complicações , Humanos , Masculino
16.
World Neurosurg ; 132: 329-332, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31493612

RESUMO

BACKGROUND: Persistent primitive trigeminal artery (PPTA), which is a fetal carotid-basilar anastomosis, is the most common embryologic vascular remnant persisting in adults. Aneurysms can arise between the internal carotid artery (ICA) and PPTA. Here we present a case of ICA-PPTA aneurysm treated with a flow-diverter stent. CASE DESCRIPTION: A 52-year-old woman had left abducens nerve palsy. Imaging detected a large left ICA-PPTA aneurysm, which we chose to treat with a flow-diverter stent after embolizing the PPTA with a coil. Although the abducens nerve palsy did not change, there were no signs of cerebral infarction, and no new symptoms appeared postoperatively. Blood flow in the aneurysm had disappeared on digital subtraction angiography after 6 months. CONCLUSIONS: This is the first case report of ICA-PPTA aneurysm successfully treated with a flow-diverter stent. We could stop blood flow from the posterior circulation by embolizing the PPTA with a coil, allowing the use of a flow-diverter stent. This report can be used as a reference for the procedure in future work.


Assuntos
Artéria Basilar/anormalidades , Doenças das Artérias Carótidas/terapia , Artéria Carótida Interna/anormalidades , Embolização Terapêutica/métodos , Aneurisma Intracraniano/terapia , Stents , Malformações Vasculares/terapia , Doenças do Nervo Abducente/etiologia , Artéria Basilar/diagnóstico por imagem , Doenças das Artérias Carótidas/complicações , Doenças das Artérias Carótidas/diagnóstico por imagem , Artéria Carótida Interna/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Imagem Tridimensional , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/diagnóstico por imagem , Pessoa de Meia-Idade , Malformações Vasculares/complicações , Malformações Vasculares/diagnóstico por imagem
17.
J Med Vasc ; 44(5): 354-358, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474348

RESUMO

Bilateral absence of the superior vena cava (SVC) is an uncommon congenital vascular anomaly, mainly asymptomatic, usually undetected, and often associated with other cardiac anomalies. Though usually harmless and totally innocent, this vascular anomaly might complicate cardiovascular surgery, the insertion of a central venous catheter and the transvenous placement of a pacemaker. This SVC anomaly is still not well known, underdiagnosed and its incidence is much higher than described. A better understanding of this anomaly and its detection could play a key role in avoiding its potential complications. We are sharing a case of a female adult, with no medical history, who presented herself to the department of visceral surgery with a collateral venous circulation of the upper thorax, that was at first, mistaken for a portal hypertension syndrome, findings were pushed to finally conclude a bilateral absence of the SVC.


Assuntos
Malformações Vasculares , Veia Cava Superior/anormalidades , Adulto , Circulação Colateral , Angiografia por Tomografia Computadorizada , Erros de Diagnóstico , Feminino , Humanos , Flebografia/métodos , Valor Preditivo dos Testes , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/fisiopatologia , Veia Cava Superior/diagnóstico por imagem , Veia Cava Superior/fisiopatologia
18.
Autops. Case Rep ; 9(3): e2019097, July-Sept. 2019. ilus, tab
Artigo em Inglês | LILACS | ID: biblio-1020996

RESUMO

Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare tumor of uncertain tissue origin. Although it has been classified as a benign tumor under the WHO classification, it is locally aggressive, and multiple recurrences have been reported. PHAT commonly involves the lower extremities; however, various unusual sites of origin have been reported. We present the case of a 30-year-old female with dysmenorrhea, who presented a presacral mass on imaging. The core biopsy confirmed the diagnosis of PHAT. She underwent laparotomy and excision. Histopathology confirmed the presence of a tumor comprised of aggregates of ectatic vessels with perivascular hyalinization. An immunohistochemical study showed diffuse CD34 positivity, but S100, MDM2, and smooth muscle actin negativity. After surgical procedures, the patient is disease free as at the 12-month follow-up. Only 120 cases have been published in the English literature to date. Our study is only the third case of PHAT arising from the pelvis to be reported. Though considered to be a rare condition, the diagnosis of PHAT should always be considered in the differential diagnosis of well-defined hypervascular soft tissue mass in the pelvis. The typical histopathological findings along with immunohistochemistry should clinch the diagnosis.


Assuntos
Humanos , Feminino , Adulto , Neoplasias Pélvicas/patologia , Sarcoma/patologia , Diagnóstico Diferencial , Malformações Vasculares
19.
J Craniofac Surg ; 30(8): e796-e799, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31403517

RESUMO

Vascular malformations (VMs) are benign lesions of blood vessels originated from an error in vascular morphogenesis during the embryologic phase. Generally, when located in the head and neck region VMs occurs in lips, tongue, buccal mucosa, gums, or palate. The VMs are usually asymptomatic, varies in size and may cause facial asymmetries. Different therapeutic modalities are available to treat VMs, which include surgical excision, cautery, cryotherapy, laser therapy, and sclerosing agents. The authors report 2 patients with extensive VM in the tongue treated with intralesional injection of a low-dose solution of monoethanolamine oleate (MO) and lidocaine. The first patient was a 69-year-old male patient and the 2nd a 65-year-old woman. In both patients, it were performed weekly application of 1:1 MO (Ethamolin) with Lidocaine (lidocaine 3% 1:50,000) in the amount of 0.1 mL of the solution per cm3 of lesion, with a total of 12 applications for each patient at the end of the treatment, with good results and without complications. It is important to be alert in which situation sclerotherapy should be used and that small doses of the sclerotherapeutic agent is essential for the prevention of complications after the procedure. Therefore, these patients showed that the sclerotherapy with MO may be an effective and simple treatment for extensive oral benign vascular lesions. In both patients, there was a great improvement in the clinical aspect of the lesions and patient's satisfaction.


Assuntos
Lidocaína/uso terapêutico , Ácidos Oleicos/uso terapêutico , Soluções Esclerosantes/uso terapêutico , Doenças da Língua/tratamento farmacológico , Malformações Vasculares/tratamento farmacológico , Idoso , Feminino , Humanos , Injeções Intralesionais , Terapia a Laser , Lidocaína/administração & dosagem , Masculino , Ácidos Oleicos/administração & dosagem , Escleroterapia , Língua , Resultado do Tratamento
20.
Medicine (Baltimore) ; 98(33): e16802, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415390

RESUMO

Impact of arterial stiffness on aortic morphology has not been well evaluated. We sought to investigate the association of brachial-ankle pulse wave velocity (baPWV) with aortic calcification and tortuosity.A total of 181 patients (65.4 ±â€Š10.4 years, males 59.7%) who underwent computed tomographic angiography and baPWV measurement within 1 month of study entry were retrospectively reviewed. Aortic calcification was quantified by the calcium scoring software system. Aortic tortuosity was defined as the length of the midline in the aorta divided by the length of linear line from the aortic root to the distal end of the thoraco-abdominal aorta. In simple correlation analyses, baPWV was correlated with aortic calcification (r = 0.36, P < .001) and tortuosity (r = 0.16, P = .030). However, these significances disappeared after controlling for confounders in multivariate analyses. Factors showing an independent association with aortic calcification were age (ß = 0.37, P < .001), hypertension (ß = 0.19, P = .003), diabetes mellitus (ß = 0.12, P = .045), smoking (ß = 0.17, P = .016), and estimated glomerular filtration rate (ß = -0.25, P = .002). Factors showing an independent association with aortic tortuosity were age (ß = 0.34, P < .001), body mass index (ß = -0.19, P = .018), and diabetes mellitus (ß = -0.21, P = .003).In conclusion, baPWV reflecting arterial stiffness was not associated with aortic calcification and tortuosity. Traditional cardiovascular risk factors were more influential to aortic geometry. Further studies with a larger sample size are needed to confirm our results.


Assuntos
Aorta/patologia , Artérias/anormalidades , Instabilidade Articular/fisiopatologia , Dermatopatias Genéticas/fisiopatologia , Calcificação Vascular/fisiopatologia , Malformações Vasculares/fisiopatologia , Rigidez Vascular/fisiologia , Idoso , Índice Tornozelo-Braço , Aorta/fisiopatologia , Artérias/patologia , Artérias/fisiopatologia , Índice de Massa Corporal , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Instabilidade Articular/patologia , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Estudos Retrospectivos , Dermatopatias Genéticas/patologia , Calcificação Vascular/patologia , Malformações Vasculares/patologia
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